Profiting from Pain: Roland Clinic Draws Scrutiny

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Anny Sivilay/Sequoyah County Times

The Wellness Clinic in Roland, Okla., has come under scrutiny by narcotics and medical board officials.

The Wellness Clinic in Roland, Okla., has come under scrutiny from narcotics and medical-board officials.

Anny Sivilay / Sequoyah County Times

The Wellness Clinic in Roland, Okla., has come under scrutiny from narcotics and medical-board officials.

This story is part of a joint project by Oklahoma Watch and The Oklahoman.

TX - Addicted Oklahoma bug closerIf there were an official business model for a high-volume pain clinic, drug enforcers say, it would probably resemble the Wellness Clinic in Roland.

Located in Sequoyah County a few miles west of Fort Smith, Ark., the clinic was operating with a simple set of ground rules and standard procedures when Oklahoma authorities investigated it during 2013 and early 2014.

According to documents filed in June and August of this year by the Oklahoma Bureau of Narcotics and Dangerous Drugs Control and the Oklahoma Board of Medical Licensure and Supervision:

Monthly “exams” generally lasted no more than five minutes. Sometimes a doctor was there, sometimes a physician assistant, sometimes just the office manager.

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The clinic accepted cash or debit-card payments only, up to $195 for the first visit, $95 for follow-ups.

It accepted no insurance, and asked some patients to sign a form promising they wouldn’t file for Medicare reimbursements.

It required patients to submit one prior X-ray, CT scan or MRI. It didn’t matter how old they were.

The clinic’s central figure is Bernard M. Tougas Jr., a physician assistant who migrated from Arkansas after his supervising doctor there died in 2009. Tougas owns and manages the Wellness Clinic and recruited the doctors who work there, according to the state Narcotics Bureau and medical licensure board.

Until several months ago, the clinic’s medical director was Dr. Ronald V. Myers Sr., who describes himself as a 58-year-old family practice doctor, Baptist minister, civil rights activist and pain patient advocate. In his spare time, Myers plays trumpet and flugelhorn in jazz bands.

Dr. Ronald V. Myers Sr.

Anny Sivilay / Sequoyah County Times

Dr. Ronald V. Myers Sr.

Myers is a salaried employee of Tougas, according to investigative documents. He is also Tougas’ supervising physician. State authorities said it is illegal for a P.A. to employ his supervising doctor.

The Wellness Clinic is still operating. Tougas and Myers are still practicing. The narcotics bureau filed an overprescribing case against Myers in June. A hearing has been scheduled for January 2015. The medical licensure board filed its own case against Myers in August and has scheduled a disciplinary hearing for March 2015.

No enforcement actions have been filed against Tougas.

According to case documents, at least two of Myers’ patients at the Wellness Clinic were killed by overdoses of the narcotics he prescribed them. A third patient who also received narcotic prescriptions from him died for unknownreasons. A fourth patient, who was seen by other clinic personnel, also died of an overdose.

“The business model of the Wellness Clinic was designed to provide massive amounts of high-dose CDS (controlled dangerous substances) to patients under the veil of a legitimate pain management clinic,” the medical licensure board stated in one document.

“The Wellness Clinic did so through the careful screening of new patients and firing of current patients coming under the scrutiny of law enforcement. In time, the Wellness Clinic became so well known as a pill mill that people were traveling to it from as far away as Colorado. Patients came from at least 10 different states, some traveling as far as 1,800 miles” per round trip, the document said.

Tougas did not respond to requests for an interview.

Pain - Roland Locator Map

In a document filed with the medical licensure board, Myers denied many of the allegations made by state authorities and demanded “clear and convincing proof” of their accuracy.

Myers stated that he “at all times used sound clinical judgment in the treatment and diagnoses of patients.” He denied that he “failed to adequately examine or care for any patient” or that he “failed to discharge his professional duties and standard of care with respect to any patient.”

In the document, Myers acknowledged that he was Tougas’ supervising physician. But he denied that Tougas was his employer.

In a brief telephone interview with Oklahoma Watch and The Oklahoman, Myers declined to comment on the specific allegations lodged against him. He noted that the cases are civil enforcement actions, not criminal charges.

In a follow-up email, Myers portrayed himself as a nationally recognized advocate of compassionate pain treatment who is being persecuted by overzealous state enforcers.

“I have already experienced too much discrimination and racism by some law enforcement agencies in Oklahoma because I have the God-given moral conviction to treat poor chronic pain patients,” Myers wrote.

“Please portray me truthfully as the historic poor and chronic pain patient advocate that I am,” he said.

One of Myers’ defenders is Robert Wiley of Mountain View, Ark. Wiley, 47, is national facilitator for the National Pain Patients Coalition, which Myers helped establish. He also is a patient of Myers at the Wellness Clinic.

“A lot of chronic pain patients, we’re kind of kicked to the side and treated like drug addicts, and we’re not,” said Wiley, who has had multiple back surgeries and a knee replacement. “I’ve been on this treatment for a long time, and it’s worked. It’s actually given me mobility, and a little bit higher quality of life than I would have without it.”

Wiley characterized Myers as a compassionate family practitioner who provides patients like himself with effective and affordable treatment they could not receive in Arkansas. Wiley said he has reviewed the allegations contained in the Oklahoma actions and regarded them as bogus.

“I know what the state has accused him of, and a lot of it is garbage,” Wiley said.

Other than prescribing, treatment at the Wellness Clinic was minimal, according to case documents filed by state investigators.

At least two patients interviewed by a medical licensure board investigator said they were never seen by a physician. One patient said she was seen by Myers in his office, but he “never looked up from his computer” and never made eye contact.

Another patient, identified only as “TB,” said she was seen by Tougas on Dec. 10, 2013. The session lasted about 40 seconds.

“No exam was performed,” the medical licensure board said. “P.A. Tougas merely took some prescriptions from a file and handed them to TB. Yet, it was the defendant (Myers) that signed the prescriptions.”

The patient walked out with a prescription for 84 60-milligram oxycodone pills, 224 30-milligram oxycodones, 30 20-milligram oxycodones and 112 10-milligram diazepam (Valium) pills.

Regardless of whom they saw, the patients received narcotics prescriptions signed by Myers or one of the other two doctors practicing at the clinic, Dr. George B. Howell, or Dr. John C. Friedl, according to case documents. Patients said the prescriptions appeared to have been prewritten.

One patient told agents the clinic waiting room “was always full, sometimes with standing room only,” one case document stated.

That patient “did not feel comfortable among the type of people in the waiting room,” the document said. “He described them as addicts ‘just wanting their pills.’ He had heard patients speaking of where they could sell their medications.”

On April 24, 2013, a narcotics bureau agent posing as a patient went to the clinic seeking medication, according to another case document. She was seen by Tougas. He prescribed her oxycodone and tramadol, another painkiller.

“It is like shoe shopping. You have to try them on to see what fits,” she said Tougas told her.

According to the narcotics bureau and medical licensure board, Tougas ran the show, and Myers provided the cover.

Bernard M. Tougas Jr., who owns the Wellness Clinic.

Todd Pendleton / The Oklahoman

Bernard M. Tougas Jr., who owns the Wellness Clinic.

“P.A. Tougas, under the defendant’s (Myers’) supervision, sought to continually increase the number of patients seeking addictive pain-killing drugs at the clinic and paid bonuses based on a quota of patients seen,” the licensure board stated. “P.A. Tougas effectively ran the clinic and attended to patients. The clinic sees approximately 120 patients a day and ‘fires’ approximately 30 patients a month. The clinic had a goal of adding 10 patients per week.”

Myers is not the only physician who has worked at Tougas’ clinic and gotten in trouble for alleged overprescribing. In February 2014, Howell was “terminated” by the clinic, according to case documents. Three days later, he surrendered his narcotic prescribing licenses issued by the state Narcotics Bureau and U.S. Drug Enforcement Administration. The medical licensure board has initiated an overprescribing case against Howell.

In July, the Wellness Clinic announced that a new doctor, John M. Wellman, was joining its staff. Myers told Oklahoma Watch and The Oklahoman that Wellman has replaced him as medical director of the clinic, although Myers still practices there.

Drug law enforcers said one of the reasons they want the Oklahoma Legislature to grant them authority over clinics is that some owners consider their salaried doctors to be expendable and simply recruit new ones when current ones get in trouble.

“They’re out there looking for doctors,” said Lyle Kelsey, executive director of the medical licensure board. Kelsey was not commenting on the Wellness Clinic in particular but on the phenomenon of non-physician ownership in general.

“What they want is somebody that doesn’t ask questions and signs the legal document that has to be signed by physicians,” Kelsey said. “Absolutely, they recruit them.”

  • Tami

    This article is simply a one sided slam of the Dr.’s at this clinic. It is much more controlled and dr.’s can not read minds of fake patients with fake records. I am a patient and without Dr. Meyer’s my life would be of a very depressed person whom could not even enjoy my family. You have neglected to tell the story of patients they have helped. We are strictly monitored. Dr. Meyers was at the clinic, I did not even know Dr. Tougus owned this clinic. I was always under the impression that Dr. Meyer’s was the owner. This article is a one sided glimpse of a few patients , out of many that did not take their medication as prescribed and most likely were also buying other drugs off the street. I as a patient am truly shocked by this portrayal. I am a very avid reader of your publication, but will now know that your articles are not a true indication, one sided look. The way chronic pain patients are treated is a real shameful and articles like yours just make our lives harder. People travel because it is so very hard to find a doctor who is affordable and will take you on without insurance, this clinic was the only Dr. Willing to see me without insurance after a major car accident., most dr.’s will not take you as a patient with such severe injuries and no insurance, thank goodness they did, I have no idea how I would of survived it.

    • Rex Reynolds

      Tami you are absolutely right! I have never visited this clinic but I have severe chronic arthritis, stenosis, degenerative disc disease and I have had major surgery for the stenosis which removed a disc and cut through 3 vertabrae to widen my spinal column and inserted two metal plates and four screws to hold my spinal column open. I have extreme pain everyday. I have two years until retirement and disability income is not an option for me. My pain medication allows me to go to work almost everyday and have a little time with my grandkids but not much. My quality of sucks but I deal with it as best I can. I am treated as a drug addict, discriminated against by pharmacists, and made to jump through hoops just to be able to go to work and spend a little time with a few of my 12 grandkids. If the hassles get any worse it just won’t be worth living. I am tired of being treated this way to avoid be bed ridden. I am not wanting to be on disability income though I do qualify. I want to work for a living and support myself. Articles like this just make it harder for us to have any kind of quality of life and the powers that be will not be happy until we give up and choose to go ahead and die. But I am not to that point yet and as long as I can make it to work within 2 or 3 hours after trying to get out of bed I will continue to fight. I wish these government officials could feel my pain for just one day.

      • may

        Your Both wrong> quality yes,quantity ??????we can figure ways to take our medicine s and also do what exercises we can do use a cold pack or a hot pack get hot baths,go see a back cracker , the thing is to take your medications and not over do it,quality care is not just waiting for 3- to 4 hours to get a prescription I find is sad people think Pills are the only thing, Quality is also you trying to find ways;s to get by with not being in pain,,I know I will not take anything stronger then I have to its called quality for my life and how I want to live it,I see some many drug heads go into this clinic with there very old mother ,or grandparents,and as I go to the pharmacy I would see the younger person taken the pills not the person they where prescribed for. its an on going thing..and these doctors refuse to help you ,then like me I was up a creek with out a paddle. till I found a women doctor who I do not feel afraid of, who is caring ,who does has pride in her job and enjoys her patients this wellness clinic diagnosed me wrong,.now I have to find a way to find another type doctor who will help me to keep on living , so much for this clinic ,I can die anytime soon ,quality vs quantity is more important,people take these pills an stop moving,,why bother , get up an get active,your in a wheel chair find a hobby, the day I stop moving an exercising an being able to love an play with my grand kids is the day I don’t want to be here on this earth.

        • mike

          Every person is different, why should I have to suffer because the DEA wants to pass the buck. I have been hurt all my life and if not for this clinic I would probably do something very drastic. People need to shut the hell up some do their job and please let me try to get as much pain reduced life as I can get without people who don’t have a damn clue as to what I go through every “day” trying to regulate my life because they are too stupid to do anything about the junkies except persecute law abiding citizens who are seeking some kind of relief to live their life out.

    • warrenlee

      Well, tami,, I am so glad you got the help you needed. For years, dr tougas helped my wife and me for the pain problems we had and we had faith in him,,, until one day out of nowhere the clinic got an “anonymous” call about mary. You see, the clinic has this policy that was written by a complete idiot, that says,,”if I even hear something bad, that patient will get kicked out”. The person who designed that rule never stopped to consider that gossip has nothing to do with fact. So,, if someone asks you for a few pills, and you refuse to give them,,, and they decide to call the clinic to slander you,,,be prepared! Because betty and Debbie will target you like a cornered animal and attack you with all they got. After all it happened to my wife,, who was declared for 8 years as a great patient by dr tougas,,, and he also said “mary is my favorite patient”. But for him to stand up to his ma ma,,,, oh now that ,,,, he cannot do. He might not get his “red roper” BB gun for Christmas,, after all,, he could shoot his eye out ,,,, kid. Once again,, it takes a complete incompetent idiot to even write a “rule” like this for the clinic to follow, and its unprofessional,,, because this same scenario, could happen to anyone,,, even you! And it will ,,, sooner or later, Whatever integrity you think you have will be taken away from you all at once when this happens,,, you will become the lowest of scum and a junkie,, or addict addicted, piece of crap, and they will do it in front of 30 patients or more to let them all know what happens if anyone gets out of line. If the clinic gets closed down as a result of this incident,, so be it,,, and I am sorry for all the pain patients who will have to do without,, because of it all. They targeted the wrong patient,, and all it would take, is for them to “own up to it”,,, and settle with her for the deframation of character, breaking of doctor patient privilege, medical misconduct, and the sexual assult on her by doctor howell,,, which is the real reason she got kicked out,,,, to cover it all up. By the way,,, “abondenment” is by law, a form of malpractice. So,, little dear, if you want to blame someone for all of this,,, start with tougas and his ma ma,,, who seem to write the policies for this clinic, In closing,,, I have to say this,, if I thought that I was going to lose my business “practice”, or my license and insurance over one incident,,, I would try to resolve it by offering a “sit-down”, and offer to try to come to a solution to resolve it, rather than getting flushed down the toilet by the medical board or the DEA.

    • May

      come one March , 1 ST, then March 12,13th and then back to court again,I wont leave this alone I would rather see you go down before you molest or kill another patient..Tougas, Myers Howell. For all those on pain meds what part of a physical do you get from these doctors or do you just go for the meds ?

  • Tami

    I just do not know what these bureaucrats think is going to happen as they shut legitimate needed health care providers down. Addicts will get they’re drugs, patients will not get there medicine needed to function.

  • joshua

    This is absolutely over exaggerated..i been going to this clinic for many years! Iv been suffering from severe sinusitis from a bike accident that cracked my sinus cavity open and skull in several areas! Which cause major problems to where I had 3 sinus surgerys and so for the only solution is pain meds…without these people I wouldn’t be here! HOW ELSE DO I ESCAPE MY PAIN!? SUICIDE?

    • may

      No not suicide Joshua .I been operated on from head to toe. when I was entering into this stage of my life with oh no the operations did not work I am in more pain then before.I am introduced to these clinics.took my doctor almost one year to figure out what I can take and can not,then we figured out what was need to get me by till i see him next,he would give me a physical.Doctor Breckman was a Good Doctor but he passed away,Tougas and Myers Use to work for Breckman .Patients complained to Breckman how rude Myers was,and uncaring ,finally Breckman had to fire Myers.,then Tougas fallowed, Tougas use to be a good caring person,But he got turned around an I’ ve known Tougas for ever,never did I expect him to put his life on the line like this not that I knew Myers money heard of him Myers prescribed me penicillin I could of died if I didn’t get the phone call from my pharmacy i want quality care not quantity care,

  • Joann

    I agree absolutely agree that this is a very one-sided story. I have watched my mother-in-law over the past 16 years go from a vibrate woman to one barely able to stand and walk without crying. She has multiple health issues, and the medication she receives from Dr. Myers has been a life saver. The only way she can get any relief is with the medication he provides. While it is unfortunate that there are patients that abuse the system and medication meant for those in true need, it is an unavoidable fact. Let’s not persecute those in true need, and the Dr.’s willing to see their need for relief for what it really is. It is just like anything, there are those that abuse, and those that know how to manage like a responsible adult.

    • may

      how can this be a one sided story,when we have patients and more people whove seen this happening,pluse one of their own doctors testified against them it was a PILL MILL

  • may

    Business of wellness clinic has violated the Oklahoma Professional Entity Act, which says unless a person is a licensed medical professional he or she cannot serve as a shareholder, officer, director or manager of a corporation engaged in the practice of medicine.

    • may

      If the Wellness Clinic was so Innocent why change the name? If you call them good doctors then why are they in court getting license taken away whats with all the cover up,? Then you have one doctor that worked there Himself quit!! WOW* Cause of the way Myers and Tougas ran the Wellness clinic. He himself called the Wellness clinic a pill mill.People, I under stand the pain, I also would rather know I am going to see a Doctor who actually cares about me, Myers just lick his food from his fat fingers and play on the websites, Then remember oh yes, Here’s a patient and he forgets your name ,while sitting in front of Myers for a while,Then he has to dig threw mounds of food containers left from last week and this week to find your file stuck to some chicken wing sauce, that was just brought in Just so he can hand you a prescription,Sometimes he don’t know if your in his office cause your a new Patient or their to get a prescription..I asked Myers to look at my ear as I was having ear ache pain, The nurse left my door open,his office was right there,He was not Happy,He didn’t know I was the patient asking for the examination on my I just had neck replacement put in ,Doctor Myers said,and I Quote ” WHAT DO THESE DRUG HEADS THINK? WE ARE REAL DOCTORS “” The Nurse told him to hush ,He looked at her and she pointed to me, Myers said oh darn,well how I’am I going to get over to that room? Took three Nurses to Push him in to see me from his Office desk chair in to the room I was in,.then he said he couldn’t see anything wrong ,no swelling,nothing,,but he prescribed me penicillin, I didn’t notice it till the Pharmacy called me to tell me I couldn’t take that medication penicillin I am allergic to it? Now you tell me ? if I had not paid attention to what my pharmacy informed me.I would more then likely be dead .So this is the type of Doctor s you crave for? Ones that will stick anything in your moth? I am lucky to still be alive..this is a pill mill I even seen patients that was being used by family members to get the pills,your disgusting , Since when is Myers a Catholic ? show me in the bible the ST MADRON..more like Ron is MAD? Devil stuff

  • britt

    My dad went to this clinic,his back had been broken twice and he did need the medicine but every time he went in there I saw at least a dozen people who were high while sitting in the waiting I saw so many who would be limping in the office and as soon as they left they were happy and just fine….I think this is a good place for people who are actually hurting like my father was, but they need a better process for deciding who gets the medicine, because in the 5 years I’ve went in there with my dad it was always going to whoever had the money in hand.

    • may

      I agree,But these doctors at this clinic are here for the money, want a caring doctor got to little rock Doctors building of University

  • Margaret

    I have been a patient at this clinic and never felt like it was a pill mill. Doctor Tougas has done everything to try to help me with the pain i have been living with for years.. i now am able to at least get out of bed in the morning without hitting the floor with my face. I’m 46 and have degenerative disk disease in my neck and scoliosis in my lower spine. which by the way was diagnosed by other doctors who had me in so much pain by the physical therapy and crap they put me through. i literally was crying my eyes out from the pain. the other doctors didn’t give a crap about me or my life. oh well she is young and will survive. well guess what yes I’m surviving because of these doctors!! i have been thru cancer even!!if you are trully in pain and need help they will help you and not make you feel as tho you are a drug addict. they care. and it shows in the way they treat you. If it wasn’t for them i would have given up and done something stupid a long time ago and would not be able to be at home with my son and enjoy being a mother and grandmother. at least i can walk straight most of time because of them

  • I do not know nor do i believe that any patient received all those different oxycodones that’s just stories.Those Doctors over at the Roland clinic do not prescribe that bunch of pills nor do they even come close.I have been a patient there for several years!

  • warrenlee

    my email is probably out of date,,, I don’t get on the computer very much. however, mr. Robert wiley,, I wanted to clear something up with you, it seems that you have a one sided view of this whole thing,,, but you know very little about this whole investigation with the dea, the medical board,,and the hearings that are at hand. if you knew the whole truth about everything that has transpired ,, you would feel like a complete fool. I met with dr myers on the 16th of December and talked this whole thing out,, he agreed with me on many points. I gave him a letter for all the staff to read that could exonerate the clinic from much of the scrutiny that is happening right now with the hearings in Tulsa,, but somehow they did not take heed, and I know, that the one thing that the medical board wants to hear from all of them is the one thing that eludes them. this is probably too deep for you,, but, its always easier to be narrowminded,,, after all, that is the path of least restistance,,, now if this all sounds “inflammatory”,, sorry,,, but your upside remarks, without knowing the whole story, reminds me of an “ostrich, sticking its head in the sand” as if it is really hiding!!!

  • May

    Tougas and Howell your next,

  • Bevie luningham

    This story is full of cliches. You could honestly substitute a different clinic in a different state and its the same old tired story. Do people never tire of being “busy bodies”? Oh, they come from ‘ far and wide’.

  • paul

    This story is bull I’ll tell you what I went to the Roland clinic for years and stopped going cause I moved and not one time did I ever walk out from seeing Dr Howell with a prescription I’m my hand you have to go wait back in the lobbie for your name to be called and the prescription was never hand written only signed by the doctor. Easier for the Dr to review it and sign it then it is to write the whole prescription out. Another thing no Dr from this clinic ever prescribed 30, 20mg OC this clinic prescribes on a 28 day cycle 30 is not a option. There’s a lot of crap in this article like that I could go on and on if you ask me whoever wrote this wanted the clinic shut down for personal reasons

  • Mitzi

    Did any patient sitting in the waiting area on a regular monthly basis ever observe a fairly nicely dressed older gentlemen that never seemed to actually have an appointment but knew most or all of the staff and even engaged in conversations with some of the patients. Well that was an Oklahoma Bureau of Narcotics agent assigned to the Wellness Clinic. He was friendly, never had a comment or criticism of the protocol, never suggested adding particular policies or putting any restrictions in place, never appeared worried or concerned about the unruly affairs of the parking lot, just sat as a friendly observer with his badge hidden in his pocket taking mental notes on how to use all of his observations to take the clinic down when the time came.
    Encouraging a partnership between a regulating agency and a clinic under scrutiny, enforcing action against rowdy patients in the parking lot that were suspected of selling or trading drugs, meeting with the doctors in the clinic to implement a plan to put a stop to this sort of activity would have apparently taken way more effort than spending a few years sitting in a chair jawing with the locals and collecting his paycheck.



  • Witness

    I have spoken to many recovering addicts who used to receive prescriptions from this facility. I was told that they simply had to bring, not even show, just bring some kind of radiology folder from a medical facility, give a list of ailments, without the “doctor” actually looking at the records, and they would receive a stack of prescriptions that astonishes me. From different strengths of hydrocodone and oxycodone to methadone for pain, to Valium and high doses of Xanax and Soma, and all of them in staggering amounts. I expressed my disbelief that any medical professional would risk his or her medical license that way and was assured that this was absolutely common practice. While there may have been actual patients going to this clinic with real medical issues who were truly seeking pain control and treating their medications responsibly, there were just as many, if not more who were there to get whatever they could either for their own addiction or for whatever they could sell on the street. I have heard that from the mouths of MANY people who have admitted it. As a person with a chronic pain condition myself, it makes me angry because a clinic like this and the people who flock to it cause the honest people who simply try to live with their conditions, to be painted with the same brush as the druggies and pushers. It really sucks because these honest people use minimal medications for their best quality of life and do their best to avoid drug tolerance, dependence and addiction.

  • david

    I know there are people who look for the high but it’s people like you who stop people who really need the pain medicine to function from getting the help they need. I have scoliosis n my spine looks like a spiral staircase with toys laying on it. Doctors are so scared of these investigators, they will barely give me enough medicine to set up in bed. I live in constant agony n can’t even get up n get around without suffering for days for it. People who work part time can’t afford insurance n they can’t work full time cause they aren’t able. You should be ashamed of yourself for what your doing to people who need help. The doctors can’t afford to have mercy anymore cause of federal n state control. I hope you have to go threw it someday with nobody to give any mercy to you. It will be different then. I live a miserable life because of merciless people who won’t mind their own business.