Calais physician reprimanded for pain medication prescription practices

Posted April 24, 2012, at 5:27 p.m.

CALAIS, Maine — Dr. John S. Tkach, an internal medicine specialist who was affiliated with the Calais Regional Medical Services’ Rural Health Clinic, has been reprimanded by the Maine Board of Licensure in Medicine and ordered to stop prescribing controlled substances for the treatment of chronic pain.

According to Dee Dee Travis, a spokeswoman for Calais Regional Hospital, Tkach no longer is seeing patients at the facility. He remains employed at the hospital interpreting medical tests, she said.

Tkach concedes in a consent agreement that the board had sufficient evidence to conclude that he failed to meet the standards of care for the diagnosis and treatment of nonmalignant chronic pain. Specific concerns with Tkach’s care, the board said, included failure to document rationale for prescribing controlled medications, failure to document violations, failure to consider alternative treatments, early refills, escalating doses of controlled medications, and lack of urine screens and pill counts.

As a condition of the consent agreement, Tkach is indefinitely prohibited from prescribing controlled substances for chronic pain unless he has a chronic pain patient in skilled nursing facilities or long-term care facilities, in hospice care or who has metastatic cancer.

Tkach also agreed to pay the board $2,705, which was the cost of its investigation.

Tkach has been licensed to practice medicine in Maine since November 1994. The investigation into his prescription practices was prompted by a complaint filed in July 2008 by The St. Croix Regional Family Health Center in Princeton.

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