By Pat Anson, Editor

A Montana doctor who has been at the forefront of the debate over opioid prescribing is closing his urgent care clinic and will no longer prescribe medication to pain patients. Dr. Mark Ibsen said he didn't do anything wrong, but was tired of facing regulatory scrutiny over his opioid prescribing practices.

“The clinic is closing today. I’m going to disappear for awhile,” said Ibsen, who owns and operates the Urgent Care Plus clinic in Helena.

Ibsen said he would stop practicing medicine “in solidarity” with Dr. Chris Christensen, another Montana doctor who was arrested last week and charged with 400 felony counts, including two negligent homicide charges, in connection with the overprescribing of opioids.

Ibsen himself was the target of a lengthy investigation by the Montana Board of Medical Examiners after he started treating many of Dr. Christensen’s former patients after Christensen’s Ravalli county clinic was shutdown. Many of the patients were in opioid withdrawal and went to Ibsen because he was one of the few doctors in the state still willing to prescribe pain medication.

“I’m the last man standing in Montana, I think. I don’t know if there is anyone else who will do it. I think not. Because they were all coming to me because they were abandoned by their doctors,” said Ibsen.

Although a state hearing examiner ruled this summer the medical board “did not meet its burden of proof” in the overprescribing case against Ibsen, he has not yet been formally cleared of charges.  The examiner recommended that Ibsen be put on probation for 180 days for poor record keeping.

Ibsen told Pain News Network he was under a lot of stress and was deeply in debt from the legal cost of defending himself and treating Medicaid patients at low reimbursement rates.

“This is not a protest. This is me saying I can’t do this. I’m working in a hostile regulatory environment. And I’m stopping,” Ibsen said.

“I’m frightened. They’ve got me scared. The DEA said to me two years ago, ‘Dr. Ibsen you are not only risking your license, you’re risking your freedom by prescribing to patients like these.’ And I said patients like what? And they said patients who might divert their pills. And I said might? And they said yes. I said that’s a law enforcement job. My job is to treat the patient in front of me and do what I think is best for them based on what they tell me and what my testing shows.”

Ibsen said his urgent care clinic treated about 30 to 60 patients a day for a variety of conditions and he regularly prescribed opioids to a “couple hundred” patients. He said he didn’t know where they would get their pain medication now.

“I have also deeply considered whether stopping prescribing opiates sends a message that I'm afraid I've done something wrong. Let me assure you I have done nothing wrong. I have upheld my oath as long as I can. The pressure is just too much and today in particular I cannot concentrate on these complex cases. Therefore my clinic is closed and I'm going home,” he said.

"Dr. Ibsen was unfairly targeted and helped Christensen's patients wean from high doses.  Who is going to wean Ibsen's patients now?" asked Terri Anderson, a chronic pain sufferer and patient advocate who lives in Hamilton, MT.

"Pain patients are ultimately the ones who suffer.  I try to look at it from all sides and if it were my brother who overdosed then I would be upset. However it is easy to judge and my first thought is that pain patients come with risk to the prescriber, because they often suffer many other health issues besides just pain, including anxiety, depression and PTSD (post traumatic stress disorder)."  

In the last month, Ibsen said three staff members had resigned from his clinic, which he likened to a “war zone” because of the stress of treating patients who had nowhere else to go.

“Maybe I will come back. But I’m rattled. I’m too rattled to think of the right blood pressure medication to give to a patient. I can’t concentrate. I don’t want any patient injured today because my concentration is so poor,” Ibsen said. “When I am well enough, and I feel safe to practice in the way I know how, I will return.”