A news release from the U.S. Attorney’s Office in Montana detailing Pickens’ guilty plea was delivered anonymously to the Tribune last week. It states Pickens wrote more than 70 fraudulent prescriptions for oxycodone, OxyContin and hydrocone in six patients’ names with “no legitimate medical need and no legitimate doctor/patient relationship” from October 2007 to November 2009. In a few instances, he forged another physician’s name on the prescriptions. He then filled the prescriptions at pharmacies and used the prescribed pain killers himself to support an opiate addiction, the document states.
Pickens, who was practicing in Billings then, entered a 90-day treatment program at the Betty Ford Center in November 2009. He later enrolled and has continued in good standing with the Montana Professional Assistance Program, where he was monitored and received additional treatment.
Following his treatment at the Betty Ford Center, he resumed his anesthesiology practice in Billings.
On March 2, 2011, Pickens was sentenced in Montana’s federal District Court to three years of probation and fined $2,500 by Chief U.S. District Judge Richard F. Cebull. Pickens has since paid that fine.
Pickens is forthcoming about his history of opiate addiction, which he said began when he and his family were experiencing problems.
“Honesty in recovery is one of the guiding lights, and I think that at the end of the day, even though it can be tough, people usually respect you for it,” he said in an interview with the Tribune last week.
PVHC board, administration informed
Powell Valley Healthcare Chief Executive Officer Paul Cardwell said Pickens disclosed his past substance abuse issues and treatment at the Betty Ford Clinic to the PVHC board and administrators when they were considering him for a position at Powell Valley Hospital.
“He has not had any action taken against him by the Montana Board of Medicine,” Cardwell said in an email on Wednesday — a fact later verified by the Tribune.
Pickens also applied for and received a medical license in Wyoming, with the stipulation that he register and remain in good standing with the Wyoming Professional Assistance Program.
“Our board felt: He disclosed his substance abuse issue and charges up front, went for treatment, willingly submits to multiple weekly tests, has a clean Montana license, obtained a clean Wyoming license, has full privileges from CMS (Center for Medicare and Medicaid Services),” Cardwell said.
Cardwell said he decided not to disclose Pickens’ background when announcing the hire because he wanted to give the community a chance to first meet and get to know the doctor and his family.
“It was really my call,” Cardwell said. “I can understand if you don’t agree. We elected not to be the group (that disclosed the information).”
Although a Billings Gazette article reported that Pickens would be prohibited for five years from working at institutions that accepted Medicaid and Medicare patients, that was not accurate, Pickens said in an interview Thursday.
“There is a review process that goes on in order for that decision to be made,” he said. “They’re in the midst of that now. They make their decision two years to three years down the road.”
Pickens said he’s not concerned about the results of that review.
Cardwell said Pickens’ references “raved about his training and clinical skill set.”
Indeed, court records include character reference letters expressing unwavering support for Pickens. They were written to Judge Cebull in January by family members, an official from the Montana Professional Assistance Program, other doctors and anesthesiologists and an attorney friend of 20 years.
“Cory has done all that has been asked of him by this office with respect to rehabilitation and reintegration,” wrote Michael Ramirez, clinical coordinator for the Montana Professional Assistance Program. “My impression is that he has not tried to diminish his responsibility for the behaviors which led to the current criminal charges ...
“A core principle ... is that physicians with addiction problems who have been adequately treated and properly monitored represent a tremendous asset to the community in which they serve. More often than not, a physician in recovery becomes a more effective healer. They listen more attentively to their patients, are frequently more compassionate about the privilege of serving as a physician, make better colleagues and work diligently to regain the trust of others. They also are better family members.
“My considered opinion,” Ramirez continued, “is that Cory is on the path to becoming such a physician.”
Dr. Charles Aragon wrote of watching Pickens reach his lifetime goal of becoming an anesthesiologist, and later, watching his determination to overcome opiate addiction.
“I am aware of the difficulties that Dr. Pickens is facing,” he wrote. “At no time have I ever heard Cory take anything but full responsibility for his actions ... Dr. Pickens is doing an excellent job, and is an inspiration to me as I’ve watched the humility and courage with which he has faced his problems.”
Other doctors also testify of Pickens’ character, the quality of the medical care he provides and the compassion with which he treats his patients.
The Billings Gazette reported that at Pickens’ sentencing, Judge Cebull said if it were up to him, he would recommend that Pickens’ rehabilitation include him continuing to work as an anesthesiologist.
The path to recovery
Cardwell said he believes Pickens will remain committed to his recovery and be vigilant in complying with his monitoring requirements, which include urine or hair sampling at random times four days per week.
“Once I saw his treatment plan, plus the period of time that he’s already been sober, I felt there was a really good chance he will beat it, and he’s on the right path,” Cardwell said.
“He has worked since his treatment at Betty Ford. I think he is a great candidate that deserves a second chance, and we will be lucky to have him.”
Cardwell said Pickens was selected from among more than 10 candidates who did not have substance abuse history because of his outstanding training and medical skills.
“We found out he is a pretty stellar medical doctor,” Cardwell said. “As a group, we feel strongly that Dr. Cory Pickens will provide outstanding anesthesia services to the citizens of Powell. However, he will continue to be tested four plus times weekly.”
Robin Roling, PVHC vice president for patient care services, said Powell Valley Healthcare has stringent controls in place to prevent the diversion or misuse of medications, with inventories checked at the beginning and end of each shift to verify they match the record of medications given to patients. Practitioners have limited access to medications, and an electronic dispensing system verifies that any medication removed matches the prescription records of the patient for whom it is intended, she said.
Pickens makes no excuses for his addiction, and he accepts responsibility for his actions and the subsequent consequences.
“I have to check in with the Montana and Wyoming programs 365 days a year,” he said. “If you miss so much as a day of checking in, it’s considered a dishonor of your agreement, and you lose your ability to practice.”
Pickens said his case was unusual, because people in similar circumstances who completed treatment generally were not prosecuted in the past, as long as they remained committed to their treatment and recovery. His case appears to signal a change in philosophy, he said.
“They’re not necessarily going to give a physician a chance to participate in that program unilaterally; they will take steps to prosecute,” he said.
But, he added, “The DA was professional, and at some level, I sense some understanding of my circumstances. But at the end of the day, I’m not complaining. I did what I did for self use, and everybody needs to be accountable for their actions.”
Through his experience and treatment, Pickens said he learned that “sometimes people can be very focused on work and put other issues aside, and they inevitably stack up.
“I’ve learned to take time to appropriately address things as they come, and I think it makes me far more tuned into a patient’s needs. It certainly makes me more compassionate toward any individual in helping them deal with any crisis in their lives. Certainly, I’ve experienced one.”
As difficult as this experience has been, he said, the healing process has brought rewards as well.
“The biggest gift out of this is a very united family,” he said. “I’ve always been a very clinically skilled physician, and having a family unity makes me a better physician. Family is very important to me.”