I would like to offer my help to you in defending physicians from unwanted Medical Board of California (MBC) Investigations.  I am a practicing Pain Specialty physician with over 35 years of clinical experience, including founding the Stanford University Pain Service in 1989, where I remain an active part of the Clinical Faculty.

 

My unique background has been essential in helping administrative law judges and juries understand that the prescribing behaviors of physicians need to be viewed in the context of longitudinal relationships with patients, their expectations and demands, the evolving evidence of opioid-related harms, and contemporaneous practice standards.

 

I have defended providers ensnared by the MBC “Death Certificate Project.”  During a recent trial, I created the attached timeline to establish the evolution of the Standard of Care in opioid prescribing over the last 40 years. The presiding judge described this timeline as very helpful in establishing the contemporaneous support for the accused physician’s prescriptions.

 

Additionally, I have provided defense for multiple cases in which the judges have found my expertise to be “persuasive” regarding some of the allegations brought against the physicians resulting in lessened sentencing and sometimes even case dismissal. 

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My opinions in one case were deemed “more persuasive than the opinions of Dr. [David] Copenhaver,” who was the MBC expert regarding certain allegations within the case; stating they were, “…supported by the evidence, including respondent’s credible testimony relating to care and treatment plan.”  In another case, it was stated that, “By her demeanor during the hearing, and based on the comments of Dr. Brose and the two-character witnesses, Respondent is a caring practitioner who wants what is best for her patients.”  My testimony was seen by Judge Timothy J. Aspinwall as, “…persuasive based on his training and experience and his correct understanding and application of the standard of care.”

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One of the cases resulted in a dismissal where Judge Tiffany L. King found, “Dr. Brose’s testimony is found to be more persuasive and credible than Dr. Pe̴ña’s in all respects…Dr. Brose credibly and persuasively testified as to the appropriate standard of care when evaluating respondent…Dr. Brose evaluated respondent’s care and treatment of Patients B through E as ‘whole patients’ over the course of several years, and not just during the time period alleged in the First Amended Accusation.”

  

My academic reputation, expertise operating one of the largest Interdisciplinary Pain Treatment Networks, and experience providing consulting services to the largest multispecialty groups on opioid prescribing policy have given me an intimate professional vantage point to the complexities of primary care and specialist opioid prescribing patterns and patient-related behaviors. 

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The new 2023 MBC Guidelines help underscore the need for individualized treatment and focus the review on the longitudinal care of the patient. Now more than ever, it seems that the evidence to support caring, compassionate and longitudinal treatment can be combined with detailed review to provide a strong defense for controlled substance prescribing.