A Mount Airy physician with a history of substance-abuse disorder, who admitted to improperly using a drug last year, will be allowed to keep practicing medicine under recent state disciplinary action.
Tom Orli, M.D., a gastroenterologist affiliated with Northern Hospital of Surry County, is subject to providing samples of urine, blood, hair or any other bodily fluid or tissue, according to a consent order issued by the North Carolina Medical Board.
The board regulates the practice of medicine and surgery in the state. It licenses, monitors, disciplines, educates “and when appropriate,” rehabilitates physicians and mid-level practitioners to assure their fitness and competence to provide services, says its mission statement.
In its consent order issued last week, the board stipulated that Dr. Orli’s license to practice medicine be suspended indefinitely due to a relapse that came to light in 2017, involving his use of the drug gabapentin. This occurred after previous disciplinary action for substance abuse several years earlier.
However, the board stayed, or halted, the suspension provided that Orli complies with various conditions to ensure his competency to practice medicine, including submitting to the blood and other analyses.
Late last year after the latest violation, Orli signed a five-year monitoring contract with the North Carolina Physicians Health Program (NCPHP). It is an organization that helps medical providers recover from substance-use disorders and other conditions that can impair their ability to safely supply care and services to patients.
Dr. Orli’s association with Northern Hospital of Surry County is continuing in the wake of the state disciplinary action. After hospital officials were asked to comment on his situation, this statement was released Tuesday afternoon:
“Dr. Orli has been an active member of our medical staff in good standing since 2014,” it reads.
“He disclosed his plans to enter the North Carolina Physicians Health Program to our hospital and medical staff leadership prior to entering the program in November of 2017.”
In further referring to Orli’s case, the official hospital statement cites its commitment to public health.
“The delivery of quality, safe care to all patients is the highest priority of Northern Hospital of Surry County. All physicians within our facilities are expected to meet or exceed the professional medical standards of Northern Hospital as well as the North Carolina Medical Board and each physician’s specialty organization(s).”
Problem dates to 2012
Orli was first issued a medical license in November 2002, according to background information in the consent order, which also states that he practiced internal medicine in Winston-Salem.
In July 2012, the North Carolina Medical Board received information that Orli might have improperly obtained medications for his personal use, and he voluntary surrendered his license soon after.
Orli subsequently met with the North Carolina Physicians Health Program and began inpatient treatment for substance abuse.
On Oct. 17, 2012, the physician entered into an initial consent order with the state regulatory board under which his license to practice medicine was indefinitely suspended and he was prohibited from applying for reinstatement for six months.
The North Carolina Medical Board, in September 2013, issued Dr. Orli a license to practice medicine, subject to certain limitations and conditions. At that point, Orli had completed inpatient substance-abuse treatment, signed a five-year contract with the NCPHP and been interviewed by a panel of the board.
That September 2013 action required, among other things, that Orli refrain from using all mind- or mood-altering substances unless lawfully prescribed to him by someone other than himself.
Relapse in 2017
No other problems surfaced until last Sept. 19, when the North Carolina Medical Board received information that Orli might be improperly obtaining gabapentin for his personal use. Gabapentin is described as a non-opioid medication commonly prescribed for nerve pain and seizures.
Taking the drug in high doses is said to produce hallucinogenic effects.
Gabapentin was listed as an “emerging threat” in a recent national bulletin of the High Intensity Drug Trafficking Areas program, which was distributed to narcotics officers.
In Kentucky, for example, gabapentin was found in the toxicology screens of more than one-third of drug-overdose victims in that state during 2015-2016, according to media reports.
During the course of an investigation by the North Carolina Medical Board, Orli cooperated fully, according to information in the latest consent order. This included readily admitting that he had obtained gabapentin for his personal use, having been prescribed this medicine by his treatment team but taking additional doses from supplies he improperly acquired.
On Oct. 11, Orli was assessed by the North Carolina Physicians Health Program and referred to a facility for relapse treatment.
This was accompanied by Orli signing a medical non-practice agreement in early November.
Later that month, he entered inpatient treatment at Pavillon Drug and Alcohol Treatment Center, from which he was discharged on Dec. 6, and then signed the five-year monitoring contract with the physician health program.
On Dec. 12, Orli’s non-practice agreement was dissolved.
Orli acknowledges that when abusing substances, he is unable to practice medicine with reasonable skill and safety, last week’s consent order states, and failing to comply with his original September 2013 order constituted unprofessional conduct.
The terms and conditions for his present stay of suspension require Orli to maintain his contract with the NCPHP, including any recommendation for relapse-prevention treatment.
Unless lawfully prescribed for him by someone other than himself, Dr. Orli also may not use or possess alcohol and all other mind- or mood-altering substances or any controlled substances such as sedatives, stimulants and pain medication.
Upon request by the medical board, Orli must supply urine, hair or other samples for analysis to determine compliance.
Among additional conditions, he must meet with medical board representatives for an investigative review as requested.
Failure to comply with any of the terms will constitute grounds for the board to “summarily suspend” Orli’s medical license, the consent order states.
Tom Joyce may be reached at 336-415-4693 or on Twitter @Me_Reporter.