Testimony begins in doctors' trial

The doctors were seeing 60 to 100 patients a day.
By LAURE CIOFFI
VINDICATOR PENNSYLVANIA BUREAU
NEW CASTLE, Pa. -- A trial in Lawrence County Common Pleas Court is either about a case of two greedy doctors or a bureaucracy gone bad.
Those were the two pictures painted Tuesday for jurors hearing testimony in the combined trial of physician Dr. Philip Wagman and chiropractor Dr. Thomas Wilkins.
The men are accused of numerous charges of Medicaid fraud and drug violations, including writing prescriptions for massive quantities of OxyContin and other prescription drugs.
A third physician, Dr. William Mangino II, had his case separated from the other two, and he is expected to go to trial next month in common pleas court. The men all were charged in September 2004.
Jury selection for Wagman and Wilkins' trial took five days, and testimony is expected to last until the end of this month.
Opening statement
"This is a case about greed. This is a case about making money," Jeffrey Baxter, a senior deputy attorney general, said in his opening statement. "This is not a case about doctors making mistakes. This is a case about doctors trying to knowingly make as much money as they can."
Baxter said Wilkins' chiropractic practice on State Street in Union Township was failing until he brought in Wagman, a pain specialist, in mid-2003. "The practice began to grow in leaps and bounds. It didn't grow based on referrals from primary-care physicians," Baxter said.
The growth was based on word of mouth by patients who were promised discounts on visits for referrals, he said. And bonuses were given to employees for scheduling as many patients as they could in a week, he said. The medical practice was soon seeing 60 to 100 patients a day.
The Pennsylvania Attorney General's office has said that patients were required to see the chiropractor first for a $25 fee and then onto Wagman for $40 per visit. Baxter said that Wilkins took medical insurance as payment, but Wagman took only cash.
"You will hear how he didn't take medical histories. You will hear how he didn't conduct periodic reviews of his patients," Baxter said. "What you will hear is that patients were required to fill out a form, and if they indicated they had pain, the evidence will show, they left with a narcotic prescription."
Baxter added that the state will provide evidence that Wagman was overheard talking on his cellular telephone in a Medina, Ohio, restaurant trying to arrange for a one-way ticket out of the country.
Defense
Wagman's attorney, Alexander Lindsay, contends his client tried to work with law enforcement officials to weed out "evil people" who infiltrated his practice to obtain prescription drugs without really having pain.
"The problem with pain is you can't see it on an X-ray," Lindsay said.
Lindsay contends that Wagman made patients take periodic drug tests, undergo psychological counseling and criminal background checks with the New Castle agency People in Need, and he teamed up with Wilkins so they could provide physical therapy. Patients were required to sign an agreement saying they would not abuse the drugs.
Wagman contacted law enforcement, pharmacies and then the county district attorney to turn in abusers, but nothing was done with that information, Lindsay said. "This case is about a bureaucracy behind the curtain that's lost its way," Lindsay added.
Wilkins' lawyer, Carmen Lamancusa, deferred his opening statement until he begins his defense.
cioffi@vindy.com