A trial underway in West Palm Beach will have serious impact on hormone replacement therapy (HRT) businesses around the state. HRT businesses are exploding around the state and country. The underbelly of the business exists where business owners do not approach it as a medical service deserving of the same seriousness (clinically and legally) as any other healthcare service. Four of the doctors involved have already pled guilty to conspiracy charges and were placed on five years probation. One of the doctors relinquished his license.
The allegations involved in the case shed light on some of the more nefarious aspects of HRT business, which in this instance include—
●Anabolic steroids were prescribed for athletic enhancement
●Thousands of prescriptions for high doses anabolic steroids were written by the physicians involved
●Human growth hormone (HGH) was prescribed (though the FDA strictly limits the use of HGH)
●Glaringly, one of the physicians involved also prescribed oxycodone, Xanax and Soma
●The diagnoses of hygonadism were too uniform
●Patients residing in California and New York had never been examined by doctors who practice in Palm Beach County (where the scripts were written), [though Florida law clearly prohibits such activity]
●Controlled substance prescription blanks were pre-signed by at least one of the doctors
The case targets not only behavior which careful and ethical practitioners should know are violations, it also underscores the need for greater regulatory clarity. Telemedicine laws in Florida, for instance, need a lot of work. This is particularly true for HRT businesses, where face to face medical evaluations are required initially and where prescription refills are routine and may be tricky when patients do not reside locally.
The case bears some striking similarities to a 2006-07 case, also arising West Palm Beach, where one local owner escaped jail time for his role in a “steroid ring” (where HGH was also sold) by pleading guilty to conspiracy and paying $200,000 in restitution. That case also involved a sweep that targeted a compounding pharmacy in Central Florida, Texas and New York criminal prosecutions, as well as enforcement targeted at HRT clinics in Deerfield Beach and Delray Beach.