In February 2015, a young man showed up in the medical clinic of Richard Gilliam in Monterey complaining of testicular pain. Over the next year and a half Gilliam prescribed hundreds of tablets of controlled substances to the man including hydrocodone, oxycodone, percocet, and morphine sulfate, according to an accusation filed last year by the State Medical Board.
In the initial visit Gilliam never documented the patient’s medical history or a physical exam. He didn’t investigate whether the man was getting prescriptions elsewhere – he was, according to investigators. Also never documented: the patient was autistic and often accompanied by his father, who kept pushing for more treatment.
Not asking questions is counter to what Montage Health’s Prescribe Safe program teaches local doctors.
“We’re encouraging our clinicians to understand there is more data needed to make a good decision,” says Casey Grover, an emergency physician and founding member of the program. “Ten years ago we’d prescribe opioids and call it all good. Now we’re encouraging doctors to ask questions.”
The medical board accused Gilliam of gross negligence in the cases of five patients treated between 2013 and 2018. All five, plus a sixth patient, were included in a second accusation of repeated negligent acts for failing to document treatment or in some cases cutting and pasting earlier entries.
Gilliam signed an agreement on Aug. 27, confirmed on Oct. 25 by the board, that he will accept five years probation instead of losing his license. He will not be able to prescribe specific controlled substances and will have to undergo education and monitoring. Gilliam did not return a call for comment.
UPDATE: Gilliam completed the course "Prescribing Practices," held Oct. 14-16, according to a Medical Board spokesperson. As a result the partial restriction on prescribing controlled substances was lifted. A summary of Gilliam's probation conditions is on the board's website.
Editor's Note: This post was updated with new information from the California State Medical Board.