The Arizona Medical Board's punishment of a Tucson anesthesiologist for the improper diagnosis and treatment of chronic-pain patients will effectively shut down his practice, the doctor says.
After reviewing his treatment of several patients, the medical board has voted to censure anesthesiologist and pain specialist Dr. Mohammad Zafar Qureshi, as well as place him on 10 years' probation and forbid him to give injections.
Among the violations Qureshi committed are a pattern of unsubstantiated diagnoses, injecting pain patients in an "anatomically irrational manner" without therapeutic reason and putting patients at risk for neurotoxic damage by giving so many injections, the board found.
Qureshi already was on a two-year probation for poor treatment of a previous pain patient, and was restricted from injecting certain types of pain drugs.
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In defending his therapies in this latest investigation, Qureshi said board members found no actual harm done to the three patients whose cases the board reviewed. In fact, those patients recovered from disabilities to return to work and "a normal life" after his treatments, he said.
"The manner in which I do these injections effectively eliminates so much of their pain that most patients are able to resume a normal life," he said.
Two of the reviewed patients had been on partial disability and one on full disability before he treated them, he said.
"My goal throughout my practice has been to reduce or, preferably, eliminate dependence on addictive medications," he said.
Because his practice mainly involves nerve blocks and trigger-point injections for pain control, the board's action forbidding all injections "will effectively close my practice" when it goes into effect later this summer, he said.
In one of the cases, Qureshi administered multiple nerve blocks and other injections to more than 30 sites on a patient's body to deal with some 12 different pain diagnoses, the board's investigation found.
In another patient similarly treated, Qureshi billed the patient for at least 60 injections, though no medical records were available to show the injections actually were performed.
Defending his therapies, Qureshi said injections for chronic pain "are not given at any anatomically appropriate place" but instead are given "anywhere along the course of the nerve, where there is local tenderness and radicular pain."
"I examine every complaint thoroughly, locate the pain generators and inject them," he said. "This requires many injections, but the results are profound relief from pain."
As for the billing problems, Qureshi said billing for pain management is complex, that there was no evidence to show any patient was overcharged, and that some errors actually "resulted in undercharging for my treatments."
He said he has not decided if he'll appeal the decision.
"Because I am already close to retirement age, it may not be worth the expense, energy or stress to continue this agony," he said.
Other board action
In another case, the medical board issued a reprimand to Tucson neurologist Dr. Scott Forrer after investigating a patient complaint about his treatment of her abdominal pain.
The board found that Forrer failed to adequately examine the patient, performed unnecessary tests on her and did not deal with her main issue of abdominal pain.
The discipline carries no restrictions on his practice.
Efforts to contact Forrer for comment were unsuccessful.
"Because I am already close to retirement age, it may not be worth the expense, energy or stress to continue this agony."
Dr. Mohammad Zafar Qureshi,
on whether he'll appeal the Arizona Medical Board's censure and 10 years' probation, which he said "will effectively close my practice."
