Pubdate: Sat, 02 Apr 2005
Source: San Diego Union Tribune (CA)
Copyright: 2005 Union-Tribune Publishing Co.
Contact:  http://www.uniontrib.com/
Details: http://www.mapinc.org/media/386
Note: Does not print LTEs from outside it's circulation area.
Author: Anne Krueger, Staff Writer
Bookmark: http://www.mapinc.org/mmj.htm (Cannabis - Medicinal)
Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone)

SANTEE'S DR. YANG: SAINT OR SINNER

She Treats the Poor but May Lose License

SANTEE -- Standing in the cramped waiting area of her medical office,
Dr. Therese Yang clasped hands with a patient while Linda Vipond, the
mother of another patient, offered her prayer.

"Lord, thank you so much for the healing hands of Dr. Yang," Vipond
said.

Many of Yang's patients, a lot of them uninsured or underinsured, are
highly devoted to the 44-year-old physician. Some call her the Mother
Teresa of East County for her willingness to treat the chronically ill
and those who can't afford to pay.

The Medical Board of California has another description of
Yang.

In a complaint filed last July, Yang is accused of being incompetent
and grossly negligent in prescribing potentially addictive drugs such
as OxyContin to mentally troubled patients.

A hearing is scheduled for August in which Yang faces the loss of her
medical license.

Yang is vowing to fight the medical board charges, saying she's facing
scrutiny because she cares for patients other doctors don't want to
treat.

"I'm guilty of love," she said.

Yang, who has run her family practice in Santee since 1997, has never
taken a salary. Finding the money to keep the practice going is a
perpetual problem.

Patients pay what they can, depending on their insurance coverage and
financial situation.

She moved from a 5,000-square-foot office on Mission Gorge Road to an
800-square-foot office in the same complex because she couldn't afford
the rent for the larger space.

She relies on grants to help pay expenses, most notably $355,000 she
has received from the Grossmont Healthcare District over the past
seven years. She has just two full-time employees and one part-time
employee to help run her practice.

Yang said it's all worth it to fulfill a mission she has felt since
she read about Florence Nightingale when she was 10 years old.

"In San Diego, there's plenty of doctors to take care of the people
who are insured," she said. "I could help the people who weren't
getting care, so I felt I had to do that."

Yang often spends up to an hour at a time with a patient -- good
medicine, but bad business for a medical practice, she said.

One of her patients is 31-year-old Angel Vipond, who with her mother
makes a two-hour drive each month from her Morena Valley home to see
Yang.

Vipond suffers from Lyme disease, a tick-borne illness that she said
causes her migraines and continual pain.

Linda Vipond said Yang was the only doctor in Southern California
willing to treat her daughter.

"I love her, love her, love her," Linda Vipond said of Yang. "She's
honestly been a lifesaver."

Yang recently met with Angel Vipond in a tiny examining room, then
wrote prescriptions refilling Vipond's OxyContin and other
medications. She and Vipond hugged at the end of the
examination.

Later, Yang confirmed that Angel Vipond was "A.V." -- one of five
patients named only by their initials in the medical board complaint.

The complaint alleges that Yang excessively prescribed controlled
substances to Vipond, described as an "extremely troubled young woman
with a severe psychiatric illness."

The board contended that Yang failed to maintain adequate medical
records and conducted superficial physical exams before writing
prescriptions for drugs that Angel Vipond didn't need.

Angel Vipond staunchly defended Yang, her physician since December
2000.

"She is really getting knocked on," Vipond said. "That is really,
really wrong."

Yang said four other doctors diagnosed Angel Vipond with Lyme disease.
Yang said the medical experts who examined the records of Vipond and
other patients didn't have all the information they need to draw a
proper conclusion.

"I'm not surprised they were looking at our stuff," Yang said of the
medical board investigators. "I am surprised they were unhappy."

Yang said that, unlike a typical family practice, many of her patients
have chronic illnesses and also have psychiatric problems.

She said patients who are prescribed controlled drugs are carefully
monitored and must show that the drug is making an improvement in
their lives.

The Goal

"Our goal wasn't to give them the narcotics," she said. "Our goal was
to make them functional in society."

The medical board allegations say that some patients got worse after
being prescribed drugs by Yang.

The medical board said one patient was prescribed five to 10 times the
typical dose of OxyContin, although he was diagnosed as suffering from
a drug dependency.

Another patient taking OxyContin cut his wrists while he was in Yang's
waiting area. Yang said the suicide attempt was a cry for help, and
the patient has dramatically improved. Again, the medical board
provided only initials in their complaint.

Despite the charges, Yang continues to receive support from community
leaders.

Gloria Chadwick, president of the Grossmont Healthcare District board,
said she was aware that Yang faced allegations but didn't know the
details.

"I truly believe everybody is innocent until proven otherwise,"
Chadwick said. "She's got a very good heart. She's very beloved by the
community that she works with. We've only heard positive things."

Sandy Pugliese, president of the Santee Chamber of Commerce and
community relations manager at Sharp-Grossmont Hospital, said Yang is
a valuable asset for the East County.

"She feels this is a calling," Pugliese said. "She has a heart of
gold."

Yang graduated from the University of Michigan medical school in 1984,
and practiced in Arizona before coming to San Diego County in December
1988 to work at the Mountain Empire Health Center, a clinic that
serves the backcountry.

Own Practice

In 1994, she began working at the newly opened Lakeside Community
Clinic until she started her own practice three years later.

Yang said she can afford to work without a salary because her husband,
Peter Yang, is a radiologist at Sharp-Grossmont Hospital who makes
enough to support her and their four children.

Even though Yang isn't paid, keeping the medical office open costs
about $200 an hour, she said. Yang has been sharing the office with a
semiretired doctor, James Kenaga, to help pay expenses.

The office waiting area contains only a few beat-up chairs crammed
together. Next to the waiting area is one of three examining rooms,
where a sliding partition does little to muffle conversation between
Yang and a patient.

Medical files fill up the shelves lining almost every wall. Yang's
desk is in a room little larger than a closet, where drugs and
supplies are stored.

The office setting is humble, but Yang's patients don't care. Some
have joined together to try to raise money to help Yang run her office
and fight the medical board.

Georgianna Hemington, who travels from her Las Vegas home to be
treated for Lyme disease by Yang, is outraged by the medical board
accusations.

"Her principal concern over what's pending with the medical board is
not what would happen to her," Hemington said. "It's for her patients
and the uninsured. That speaks a lot for her."

Yang said it will cost her as much as $140,000 to fight the medical
board accusations. But she said the battle will be worth it if she can
keep helping those who have no place else to go.

"The biggest difference is we genuinely care," Yang said. "We want to
keep the heart in medicine."
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MAP posted-by: Richard Lake