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Physician Could Not Heal Himself Doctor In Fraud Probe A Volatile Mix Of Skill, Anger

Dr. Mark Frazier was a medical maverick, an avid gun collector, a respected doctor who saved lives while his own fell apart.

Doctors and nurses described him as volatile and unpredictable. Nurses liked the way he praised them for a job well done. Some doctors didn’t like the way he always had to be right.

They all agreed he’s brilliant.

“He was different,” said Dr. Thomas Marr, who retired in 1993. “Let me put it this way: A most unusual physician.”

This complex, sometimes difficult kidney specialist is at the center of a Medicare fraud investigation that started almost two years ago.

Frazier was a founding partner in Northwest Nephrology Associates, the firm under scrutiny by federal investigators. He may face civil or criminal penalties in the case.

But the fraud allegations aren’t his only worry.

He’s charged with threatening to kill another doctor and interfering with Sacred Heart Medical Center. He’s lost his privileges to practice medicine at Sacred Heart and at Deaconess Medical Center.

The state has charged him with unprofessional conduct and is moving to punish him and perhaps revoke his medical license.

Frazier, 50, is undergoing treatment at C.F. Menninger Memorial Hospital in Topeka, Kan., a well-known center for substance abuse and mental problems.

His lawyer Charles Rohr says the charge that Frazier threatened another doctor is bogus.

And Rohr and Frazier say his personal problems and clashes with other doctors have made him a scapegoat for the fraud allegations.

Frazier has said Sacred Heart is out to get him, even poring over his hotel bills to dig up incriminating information.

Rohr says Frazier probably will never practice medicine in Spokane again.

“They’ve pretty much run him out of town on a rail,” Rohr said. “Between the publicity and the hysteria around this thing, they’ve destroyed him.”

Frazier couldn’t be reached for comment. Most colleagues and medical workers are reluctant to talk publicly about him.

“He was a well-respected member of this medical community for many years,” said Dr. Steven Brisbois, medical staff president at Sacred Heart. “Something changed.”

The collapse of this once-promising career can be traced through interviews, divorce records, civil lawsuits, court affidavits and documents from the state agency that investigates physician wrongdoing.

They suggest Frazier had alcohol problems as long as a decade ago, and show that his partners worried about his mental condition and performance for years.

An evaluation seven years ago found he had personality disorders and an alcohol abuse problem. At least three years ago, he was referred to a state program that helps impaired doctors.

Still, he continued practicing medicine.

Drastic action was taken in June, when he was kicked out of Sacred Heart after problems with his care were reported.

About the same time, nurses reported that Frazier said he wanted to kill Dr. Curtis Wickre, the director of Sacred Heart’s kidney center.

Frazier was hauled to jail and then admitted to the Menninger clinic for treatment.

It was the public implosion of a well-regarded career.

“It used to be, whatever the doctors did, the doctors got away with,” said one nurse, who didn’t want to be identified. “That was the way the system was. Then people started putting their feet down.”

‘A fine fellow’

Frazier was born in Omaha, Neb., and studied pre-medicine at the University of Nebraska.

He married his college sweetheart in July 1970, and graduated with top honors from the university’s medical school in 1972.

“He was certainly one of the superior medical students in our school,” said Dr. Lawrence Alan Schachner, a former classmate who’s now a professor at the University of Miami School of Medicine. “A fine fellow. I was certain he would be a fine doctor.”

Frazier picked nephrology as his specialty and went to work treating people living on dialysis and waiting for a kidney transplant.

He started his Spokane practice in 1980 with Dr. Richard Steury. Only two other kidney specialists worked in town at the time - Marr and Dr. Loren Gothberg.

Frazier helped with the first kidney transplant in Spokane.

“He was brilliant in his field, and he knew it,” said Gothberg, who performed the first dialysis in Spokane in 1957. “My impression is that he wanted to be right. So I didn’t argue with him very much.”

Wickre came to Spokane in 1982. He joined Marr at the Rockwood Clinic, beginning a group that became Northwest Nephrology’s chief competitor.

A suggestion that Frazier might have problems with alcohol came after a car accident on Jan. 27, 1987, near Sandpoint. He totalled his 1984 BMW when he turned in front of a car driven by Patricia Perlinger, a lawsuit said.

The Perlinger family sued Frazier for more than $600,000 and charged that he was negligent by driving while under the influence of alcohol. Both Perlinger and her son were seriously injured, the lawsuit said.

The suit also claimed Frazier was speeding and had crossed over to the wrong side of the road. The Perlingers refused to talk about Frazier or the lawsuit, which was settled out of court for an undisclosed amount of money.

By early 1989, Frazier had moved out of the home he shared with his wife and three children, and filed for divorce. The divorce was final in 1990.

The same year, his partners noticed his alcohol consumption and “its effect on his demeanor and behavior when working,” according to a statement of charges against him by the state Medical Quality Assurance Commission.

At his partners’ urging, Frazier reported to Anchor Hospital in Georgia for an evaluation.

“The evaluation report generated by Anchor Hospital indicated that (Frazier) had an alcohol abuse problem and personality disorders,” the state medical panel’s charges said.

Frazier “did not inform his partners of the results but indicated only to them that it was noted that he had a personality disorder that showed only his difficulty in complying with rules and authority,” the charges said.

In July 1990, Frazier bought a new home on the South Hill’s High Drive. A girlfriend moved in a short time later.

In August 1991, the woman called police and said her boyfriend had assaulted her. She blamed Frazier for causing a bruise the size of a quarter on her right arm.

She said they both had been drinking, a police report said. “She said this was the first time anything like this had happened and that she was afraid,” the officers wrote.

Police described Frazier as angry. When asked for his version of the incident, “he said there was no incident and nothing to talk about,” the police report said.

No charges were filed.

Almost five months later, on the evening of Jan. 5, 1992, a Washington State Patrol officer stopped Frazier on Interstate 90 about 11 miles east of Ritzville. His blood-alcohol reading was .12 - just above the legal limit.

His ticket says he was pulled over for “driving a motor vehicle while under the influence of intoxicating liquor and or drugs.”

Frazier pleaded guilty to a reduced charge of negligent driving and paid a $3,000 fine, which went to the Adams County Sheriff’s Department’s fund for police dogs.

“The defendant has received an alcohol evaluation from Addiction Recovery Systems, Inc. which finds that the defendant has no significant problem with alcohol at the present time,” the court order said. Addiction Recovery Systems is an outpatient treatment center in Spokane.

The charge was removed from his record after he had no drug or alcohol convictions for a year.

Career about to crumble

In early 1994, someone reported Frazier to the Washington Physicians Health Program, a group that helps doctors overcome substance abuse problems.

Dr. Lynn Hankes, who runs the confidential program, said he couldn’t talk about specific cases. But he said the program only accepts people who meet a certain level of need and haven’t been accused of providing poor care.

It couldn’t be determined if Frazier was accepted.

In June 1994, his girlfriend went to the Deaconess emergency room after being injured in an argument with Frazier, the state medical panel’s charges said.

She graduated from college that month and was looking for work. He told her that they needed to start living separate lives.

The next month, Frazier filed a complaint in Spokane County Superior Court to divide the couple’s property. He said they had a history of domestic violence and asked for a restraining order to get her out of the house immediately.

The court gave the woman two days to leave. She moved out, taking $1,000, her computer, her cats, her jewelry, her clothes and her car, court records said.

One of Frazier’s Northwest Nephrology partners, Dr. Mary Anne McDonald, had dinner with him at the High Drive home about seven months later, in February 1995. Frazier collected guns and often visited the shooting range after work. He sometimes showed weapons to other doctors in the Sacred Heart parking lot, court records said.

On the night of the dinner, a gun was on display in Frazier’s dining room, McDonald said in a court affidavit. She claimed the laser-sight rifle was mounted on a tripod and pointed out the window, and that Frazier talked about training the weapon on joggers as they ran by.

He also appeared intoxicated, McDonald said. She said she never went back to his home because he scared her.

Yet McDonald continued working with Frazier for another nine months and didn’t tell police about his behavior that night until June of this year - more than a year after the encounter.

Frazier’s partners learned in July 1995 that Anchor Hospital found more severe personality disorders and alcohol abuse than he had reported five years earlier, the state medical panel’s charges said.

Anchor Hospital had actually recommended that Frazier enter a structured treatment program.

The panel didn’t say how the partners learned of the earlier recommendation.

Yet the next month, in August, Frazier represented Northwest Nephrology at a key public hearing in Walla Walla. The hearing was on whether a for-profit kidney dialysis center should be opened in the rural community, with the Spokane group providing the doctors.

The state granted the request.

In late 1995, the nephrology group split up, just as the federal government started investigating the its billings.

McDonald and partners Katherine Tuttle and Leo Obermiller kept their practice at the Sacred Heart Doctors Building. Frazier moved to Deaconess.

In January 1996, Frazier called his ex-wife to warn her he couldn’t make his support payments because of the Medicare investigation, divorce records said. “The gravy train is over,” she said he told her.

During March 1996, nursing staff at the Kidney Center at Sacred Heart noticed that Frazier “manifested bizarre behavior,” the state medical panel charges said.

He had “a noticeable smell of alcohol on his breath and about his person,” the charges said. “He appeared in a grouchy and surly mood. He ordered the nurse to assemble supplies for a procedure which he then inexplicably did not perform.”

A complaint against Frazier was filed with the state Medical Quality Assurance Commission that month.

Frazier believed allegations of professional incompetence were made in retaliation for moving his practice to Deaconess, court records said. He said in court records that his move cost Sacred Heart up to $7 million a year in business.

Frazier sold his High Drive home in September 1996 and moved to a log home south of the city on Regal.

At some point, the Washington Physicians Health Program agreed to determine if Frazier qualified for the program. The Washington Medical Quality Assurance Commission also asked Frazier to undergo an evaluation.

The career that Frazier spent 25 years building was about to crumble.

Nurses report threats

This past spring, Frazier’s life fell apart.

Wickre sent him a letter May 1 with new patient care standards for all kidney doctors. Frazier was asked to sign the letter and return it by the end of June.

His ex-wife’s lawyer filed a motion for contempt against Frazier on May 9, saying he had paid only slightly more than half of the child support owed for 17 months.

In mid-May, nurse Carol Moring said Frazier called her in the dialysis unit in Coeur d’Alene. She said he told her: “I hate Dr. Wickre. I mean hate. I really hate him.” If the two were in the woods, Frazier said, Wickre would disappear.

Also in mid-May, nurse Donna Burke said Frazier told her he was “getting a lot better at target practice because every time I shoot, I see Dr. Wickre’s face on the target. I am going to kill Dr. Wickre.”

He later asked Burke not to tell anyone what he said.

Neither nurse did, for several weeks.

Some health-care workers now dismiss the threats as an example of Frazier’s unusual sense of humor. “He was just trying to have a sense of humor, but people didn’t get his sense of humor,” one nurse said.

On May 19, Frazier told Wickre he hadn’t been consulted about the new patient care standards, and said he planned to check with other doctors to see if they agreed.

Then Frazier started making mistakes, according to the state medical panel.

He sent one patient to Sacred Heart’s emergency room on May 20. The medical panel’s charges said the patient was comatose with high blood sugar, critical lung problems and high blood acidity. But Frazier adamantly refused to let the patient be placed in the intensive care unit.

Instead, he had the patient moved to Deaconess, where he had moved his practice.

Another kidney patient was admitted to Sacred Heart on May 30. Frazier didn’t recognize the patient’s need for immediate intensive care and dialysis, the charges said.

He registered the patient verbally as being “no-code” before talking to the patient - a violation of hospital policy, the charges said. “No code” means extraordinary life-saving measures shouldn’t be taken.

Frazier has denied those charges through Kathryn Barron, one of his lawyers.

On June 3, nurse Moring told a staff meeting about Frazier’s threat a few weeks earlier against Wickre. The next day, Burke told Wickre what Frazier had said to her. Wickre said later he took the threats seriously.

Sacred Heart suspended Frazier’s privileges June 4 after deciding he was acting with impaired judgment.

“I know the hospital has been sort of working with him over a long period of time,” Wickre said in an interview last week. “The hospital’s decision on his privileges was not made on a sudden whim.”

Brisbois, who chairs the Sacred Heart committee that polices doctors’ care, said the hospital was trying to help Frazier for some time.

“There were quite a number of cases over a period of time that culminated in us taking the action we did,” he said.

On Frazier’s last day at Sacred Heart, he performed a biopsy on Rachel Anglin-Arthur’s kidneys.

“He was very good, very calm to me,” said Anglin-Arthur, who was a patient of Frazier’s for almost four years. “He did everything calm. I didn’t know anything was wrong. He was a good doctor. I think he still would be a good doctor.”

That evening, according to court documents, former Northwest Nephrology business manager John Taylor called Frazier about 5:45 p.m. to decide what to do with his patients.

Frazier’s speech was slurred and his sentences disjointed, Taylor said in an affidavit. Frazier referred to himself as the Lexington, a World War II fighting ship that took many direct hits but didn’t sink.

He said, “One of these days, I’m going to go nuclear.”

Five days later, on June 9, Frazier was arrested while getting his tires changed at a Valley Les Schwab store. He was charged with threatening Wickre’s life and taken to jail.

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