A surgeon training at University of Maryland Medical Center has been granted a state medical license despite a history of prescription fraud and drug abuse.
The State Board of Physician Quality Assurance voted Oct. 1 to issue a medical license to Dr. John L. Flowers Jr., of Glen Burnie, but imposed a long list of conditions, including twice-weekly urine tests and close supervision of his work during a five-year probation.
Flowers has admitted writing bogus prescriptions for diet pills and painkillers for himself and his wife, and to using marijuana even after he was caught in the prescription fraud.
But officials at the hospital, where Flowers is training, said he is now in recovery and proof that drug rehabilitation can save lives and careers.
Flowers, 32, is now a fellow, or trainee, in the surgical endoscopy program. Surgical endoscopy involves inserting fiber optic devices into the body to allow doctors to see inside and perform surgery through very small incisions.
"I think it was obvious the board felt his career was worth trying to salvage," said J. Michael Compton, acting executive director of the Board for Physician Quality Assurance.
Board members were "confident they have initiated appropriate safeguards to protect the public," he said. "He [Flowers] is under constant supervision; he's not out in the community practicing unsupervised."
He described Flowers as "someone just starting in his career, having a personal problem." His drug use "was not really affecting his patients; he was affecting himself."
Flowers was a resident in general surgery at the hospital in October 1988, when police in Anne Arundel County discovered that he had written at least 129 prescriptions over three years for narcotic diet pills -- "uppers" or "speed" -- and painkillers. Some of the prescriptions were made out to fictitious patients.
He told detectives he obtained the drugs for "recreational use." He also said he was treating his wife for chronic bronchitis, back pain and weight control.
Flowers said last week that he and his wife had been under "a lot of stress" at the time, in part because of his long hours at the hospital.
"I took them [the uppers] so I could see my son at night," he said. "The problem was never here [at the hospital]; it was when I tried to have a life at home."
He was arrested and charged with obtaining controlled dangerous substances by fraud. A week later, he was suspended from the residency program at the hospital.
The Board for Physician Quality Assurance charged him with immoral conduct and practicing medicine outside his residency program. The charges could have cost him his right to practice medicine in Maryland.
In May 1989, however, an Anne Arundel Circuit Court judge gave Flowers probation before judgment. Two months later, the hospital reinstated him.
Flowers said the charges before the Board for Physician Quality Assurance were not pursued, and he received no drug treatment at that time.
"I spent a lot of time and money to convince everyone I didn't have a problem," he said. "The diagnosis was missed."
So, Flowers went back to work. But in February 1990, urine tests found traces of marijuana in his system.
Hospital officials again suspended Flowers from patient care, but did not fire him. He was given a second chance.
Frank A. Appel, the hospital's director of quality management and medical staff affairs, said substance-abuse issues are taken "very seriously," and "people who have a demonstrated a problem really are not given a second chance or allowed to participate in patient care unless they are in a rehabilitation program and are closely monitored."
Hospital spokeswoman Ellen Beth Levitt could not explain why Flowers' prescription drug abuse went untreated, except to say the hospital's Employee Assistance Program was not established until after his case was resolved.
Robert K. White, director of the hospital's Employee Assistance Program, said that, had Flowers received treatment after that first infraction, his later use of marijuana in 1990 would have cost him his job.
This time, at the insistence of the hospital's Physicians Assistance Committee, Flowers sought treatment.
He also signed rehabilitation contracts with both the hospital and the state medical society, agreeing to continue outpatient treatment for two years, attend Alcoholics Anonymous or Narcotics Anonymous meetings regularly, undergo regular urine testing, psychotherapy and close monitoring.
In May, he was reinstated into his surgical residency program.
"I was very surprised when I was offered my job back," Flowers said.
"I feel very confident with [Flowers'] progress so far," White said. "He has a very positive prognosis. He also happens to be a very fine surgeon. . . at the top of his class."
White said Flowers has made a "good recovery and has followed through with treatment."
"If Dr. Flowers were to not comply with his treatment at this point, he doesn't get another chance at practicing medicine. And Dr. Flowers knows that."