Dr. Kobza’s official removal from the list leaves a vacuum, as she was the inaugural, because timely, Sadistic Doctor. Who should you NOW avoid at all costs if you seek relief from chronic migraine pain?
Julian Ungar, M.D., PhD. a/k/a Dr. Julian Ungar-Sargon, M.D., PhD.
That’s him. Calls his practice “Neurology and Pain Management.” Educated at the University of London’s medical school and a former member of the Harvard Medical School faculty, for some reason he now runs a little one man show in the humble town of Renssalaer, Indiana (for potential reasons I’ll explore below). Incidentally, all of his staff are wonderful, friendly, helpful people, though that’s no comfort when the doctor ruins your life.
I did a lot of research when Dr. Kobza left me pain-stranded and in deathly fear of losing my job (which, thanks to Unger-Sargon, I eventually did, just as I had in prior similar circumstances, and just as I explained to the good dr. in person and in print). During my research, Unger-Sargon suckered me in with his web marketing which, cruelly enough, targets chronic pain patients by a web site (www.drungarneurology.com) on which he’s placed, right on that front page, an article he’s written, purporting to explain his philosophy. The following are the highlights of this piece of false advertising:
Perspectives in Intractable Pain Management
An analysis of current diverging viewpoints
Introduction
Across America, two opposing attitudes or paradigms of thinking currently exist in regards to medical management of intractable pain. Empirical, long-range medical research has brought light into the darkness of the Old Paradigm. However, despite the studies that support the New Paradigm, millions of people in our country continue to suffer needlessly because safe, medical treatment is denied to them by regulatory agencies and healthcare professionals. The Old Paradigm ignores three decades of international studies that support pain treatment in cancer pain patients and severe intractable pain patients.
The Old Paradigm believes:
- It is not safe or prudent to prescribe pain medication on a continual basis.
- Opioid pain medicine is addictive and can cause long-term damage to internal organs.
- Pain patients should be tough and learn to live with pain.
- When pain patients continue to ask for increased pain medication, they are exhibiting addictive behavior. ….
The New Paradigm knows (supported by three decades of empirical medical research):
…
- Less than 1% of chronic pain patients become addicted or experience long-term physiological damage as a result of prolonged, controlled opioid pain treatment.
- When pain patients receive adequate pain treatment that relieves their chronic pain and associated depression, patients can lead relatively normal, productive lives. Their friends and families frequently give positive reports of an increased “quality of life,” previously thought impossible.
What is intractable pain?
Intractable pain is a pain state in which the cause of the pain cannot be removed or otherwise treated and which, in the generally accepted course of medical practice, no relief or cure of the cause of the pain is possible, or none has been found after reasonable efforts including, but not limited to, evaluation by the attending physicians and surgeon and one or more physicians and surgeons specializing in the treatment of the area, system, or organ of the body perceived as the source of pain.
What are the ailments often associated with intractable pain?
The following is a list of ailments that may result in intractable pain:
- ….
- Tension and migraine headaches
So, Ungar-Sargon is a champion of this New Paradigm? He’s not like the string of ubiquitous Old Paradigm doctors who have cost me my job and my marriage in the past?
He in fact reeks of Old Paradigm and must know it, as he didn’t include this article or any similar New Paradigm truth (as far as I can tell) on the new, oh so inviting, You Tube-enriched, web site he was developing when I was his patient (www.drungar.com). Must still like our business though (he made thousands out of testing me) as HE HAS NOT REMOVED THE OTHER SITE FROM THE WEB (www.drungarneurology.com).
After all the glowing testimonials he had (now including You Tubers), I was eager at my first visit to talk with a doctor who actually cared. You can sense that with a doctor, even independent of their medical treatment of you. But Ungar-Sargon was staccato and brief, and upon seeing my current and longest-term proven medication regimen of an average 40 mg per day of hydrocodone, he burst out as “fact” his opinion that if a patient requires opioid treatment for 10 years, they’re just a medical junkie, and he wouldn’t contribute to anyone being a “medical junkie”. If you go up and look at his article again, you’ll see that his spoken words to me (repeated at our subsequent visits, which are my fault as I should’ve seen immediately that he was irredeemable)—anyway, that his spoken words to me are in direct contrast to his written words he uses as a web sales pitch for his “services”.
So the Dr. who is on the record as beatifically stating, “No doctor should ever make you feel shame for an illness” (see http://jewishwhistleblower.blogspot.com/2005/07/part-of-rabbi-jeremy-hershy-worchyori.html) calls me a “medical junkie” on my first visit, without even having yet had the benefit of seeing my voluminous record. Presumptive? Sadistic?
I saw him a few times, sending him gobs of research between visits (even of his mantra-like “evidence based, peer reviewed” modality), but he never budged a nanometer.
He never once asked about my pain or how to treat it while his lengthy testing took place—apparently he expected me to take off work for several months while getting my new MRI, a couple of brief massages by his admittedly excellent masseuse, some electro-diagnostic testing (which did go beyond the testing any prior neuro had invested in me), and an experimental nerve block which didn’t work. He didn’t even ask about prescribing my needed triptans, which had fortunately not run out.
This is from my last attempt at reasoning with him, after he’d not merely closed his ears to my personal experience, but closed his eyes to all the stacks of medical research I’d sent him (including his own article). (I’m at attorney and research happens to be my strength.) He had continued to dogmatically claim his blind faith that opiates are not an evidence-based treatment for intractable, debilitating migraine pain. So I sent this:
Enclosed with this letter is what I anticipate to be the last of the evidence-based medical literature I’ll send you. It’s a Practice parameter of the American Academy of Neurology, current as of October 21, 2008, titled “Evidence-based guidelines for migraine headache (an evidence-based review)”.
Table 1, on page 5, “opiate analgesics” are recognized as one of the more effective treatments for migraine headaches.
Specifically, “Butorphanol nasal spray” is recognized to have an effect that is “statistically significant and far exceeds the minimally clinically significant benefit.” Pp. 5, 10.
It is also recognized to be “very effective: most people get clinically significant improvement.” Id.
The quality of evidence supporting this conclusion is “Grade A. Multiple well-designed clinical trials.”
Did it make a dent? Not in his thinking. He’s one of those Old Paradigmers whom science won’t convince until they get their own reckoning with intractable, debilitating pain of some sort.
Therefore, Dr. Julian Ungar a/k/a Dr. Julian Ungar-Sargon is hereby listed as a Sadistic Doctor as defined by this site, in order that this knowledge may help to lessen the string of unsuccessful doctors that potential pain patients must suffer through before finding solace, hope, and strength in a real doctor belonging to what Dr. Ungar-Sargon calls “the New Paradigm” of pain management.
One last thing. Why IS London educated, former-Harvard Medical School faculty Dr. Ungar-Sargon in a little one man shop in Renssalaer, Indiana? Certainty is not ours, but I did find a Boston Globe article from February 28, 1990 which could explain why he’s not still at Harvard at least.
“DOCTOR FINED $390000 FOR ILLEGAL PRESCRIPTIONS”
In what authorities say is the largest civil fine imposed on a doctor for illegal drug distribution, a Brookline neurologist agreed yesterday to pay the federal government $390,000 in penalties.
Dr. Julian Ungar-Sargon, a former member of the Harvard Medical School faculty, has been ordered to pay the penalty to settle a complaint alleging he illegally prescribed Percodan and Percocet from the Manomet Medical Center, which he owned and operated in 1985 and 1986. The complaint alleges he left hundreds of presigned prescriptions for patients to pick up during visits of five minutes or less.
Authorities said the case represents a growing trend in the illegal drug market, as increasing numbers of doctors, pharmacists and other medical professionals with access to drugs are found illegally distributing them for their own profit.
“It’s a serious and growing problem,” said John J. Coleman, the head of the Drug Enforcement Administration in Boston yesterday. “We are alarmed at the number of practitioners who become involved in providing abusers with these drugs.”
Said US Attorney Wayne Budd: “What this says to the medical community is that street dealers are not the sole targets of this office.”
But defense attorney Nancy Gertner yesterday angrily criticized federal authorities’ characterization of this case. “There is no charge of illegal drug distribution at all,” said Gertner, who represents Ungar-Sargon. “There are a host of complicated regulations he did not follow. But what he did was legitimately prescribe drugs as part of a legitimate practice.”
Gertner said Ungar-Sargon, in agreeing to the settlement, admitted only to the fact that he failed to get the appropriate state and federal licenses to prescribe drugs in Massachusetts. He held those licenses in other states.
“We negotiated in good faith and they obviously didn’t,” Gertner said yesterday, alluding to the US attorneys’ office.
Members of the medical profession also disputed assertions by federal authorities that people licensed to prescribe drugs increasingly are involved in illegal drug distribution.
“Almost all physicians are honest and try to use these drugs safely and appropriately,” said Dr. Errol Green, a spokesman for the Massachusetts Medical Society, which represents about 14,000 physicians. He added of Ungar-Sargon: “If he was doing it, we are glad he was caught. But he is the exception.”
Authorities said yesterday that Ungar-Sargon, of Heath Hill in Brookline, committed more than 200 violations of the federal Controlled Substances Act during the two-year period. A provision of that act governs how doctors can prescribe drugs.
Hundreds of illegal prescriptions were authorized by Ungar-Sargon, officials said. He either illegally authorized persons not licensed to prescribe drugs to give out the prescriptions, authorities said, or issued prescriptions himself, although authorities allege he was never licensed to prescribe controlled substances in the state by the DEA.
He also violated the law by signing and filling out prescription forms in advance of the day they were issued, authorities said.
But Gertner said only qualified medical personnel issued prescriptions and that Ungar-Sargon simply failed to get the correct authorization in Massachusetts to prescribe drugs. “He just didn’t dot his i’s and t’s. This is a bona fide practice by a highly qualified neurologist.”
Federal authorities said many of the prescriptions were for drugs such as Percodan, a painkiller that makes its users feel “euphoric.” The street value for the drug obtained illegally is about $8 per tablet, compared to the price of less than a dollar paid for a tablet with a legal prescription. “There is a vast illegal market for these controlled substances,” said Jeffrey S. Robbins, the assistant US attorney who handled the case.
Yesterday’s civil penalty, approved by US District Judge Andrew Caffrey, settled a civil case brought by the US attorneys’ office under the federal Controlled Substances Act against Ungar-Sargon. Until yesterday, the highest fine paid to the US government in such a case was $350,000, paid by a Baltimore drug company in 1989.
“A penalty of $390,000 sends the signal that this is serious business,” Budd said in an interview yesterday.
Criminal charges also were brought against Ungar-Sargon by the Plymouth County District Attorneys’ office. But in 1989, a jury acquitted him of violating state drug laws.
Initially charged in the state case with Ungar-Sargon was Melvyn Smullen, an employee of the Manomet Medical Center, and Ann Durkee, the center’s manager. Smullen has pleaded guilty to charges of practicing medicine without a license and Durkee pleaded guilty to two counts of unlawful possession of a controlled substance.
Asked why they chose to levy a civil penalty against Ungar-Sargon yesterday, officials at the US attorneys [sic] office emphasized that they were pursuing civil charges because state authorities had been pursuing criminal charges.
Nationwide, 133 federal indictments were brought in fiscal 1989 for violations of the drug diversion provision of the Controlled Substances Act, which governs those licensed to prescribe drugs, according to the DEA. That is more than double the number of indictments brought in fiscal 1987, according to George Festa, an assistant special agent in charge of the DEA in Boston.
Festa said that civil fines collected for the violations were also on the rise, soaring from $565,167 in fiscal 1987 to $1,708,994 in fiscal 1989.
According to sources and court records, Ungar-Sargon was a well-respected doctor with excellent credentials. He was educated at the University of London’s medical school. A spokesman for Harvard Medical School confirmed that Unger[sic]-Sargon was on the university faculty while lecturing at Children’s Hospital from 1984 to 1986.
He was also on the staff of Brigham and Women’s Hospital at the time he was operating the Manomet Medical Center, according to court records. Ungar-Sargon is currently a neurological consultant in Pennsylvania and New Jersey. His license to practice in Massachusetts is under review.
Hmm. Personally, I think the jack-booted DEA thugs have no business practicing pain medicine without a license themselves. So I sympathize with Dr. Ungar-Sargon on this front. But even if this explains his pathological reluctance to prescribe narcotics, it does NOT explain his fraudulent marketing that misrepresents him as a doctor who knows (from three decades of scientific research, remember?) that even long-term opiate treatment is safe in chronic pain patients—when, of course, he his in fact resolutely hostile to long-term opiate treatment of anyone, and to any opiate treatment of migraneurs (in spite of that category’s inclusion on his list of intractable pain causes that may require said narcotic treatment). Plus, he cost me my job, knowingly. I reiterate: he knew my job was at risk.
I did check out his Indiana medical license and he was prohibited from prescribing narcotics for several years after getting his Indiana license, but since then has been approved to prescribe the feared “medical junkie”-creating substances.
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