A little more than one year ago, three local doctors â€” and their lawyers â€” made a settlement with the stateâ€™s medical board:
The doctors would pay $20,000 each, attend more than 40 hours of training programs, and all would receive a â€œpublic reprimandâ€? from the board. In return, the board would drop the almost 80 minutely researched allegations it had filed against each doctor.
The boardâ€™s investigatorsÂ proved that one doctor, Boris Pilch, had recorded in medical records that he'd injected medication into parts of patientsâ€™ bodies that do not exist. The board also alleged that the three doctors had, at their San Luis Obispo pain clinic called Interventional Pain Management, given patients drugs knowing they â€œwould have no therapeutic valueâ€? and had over-prescribed narcotics, tranquilizers, and other highly dangerous drugs.
In their settlement, Drs. Dale Kiker, Russ Levitan, and Pilch admitted that â€œcertain records were inadequately maintainedâ€? and that, if proven, the allegations â€œconstitute a basis for imposing discipline.â€?
Kiker maintains that the training he received as part of his punishment was sufficient in taking care of any problems that existed at Interventional Pain Management.
â€œThe bottom line is that everyone in our practice, including me, tries to practice good, solid medicine and do whatâ€™s right for the patient,â€? he said.
To this day, Kiker is still performing the same procedures at his San Luis Obispo office. In 2004, according to insurance company billing records, he billed patients thousands of dollars for the same injections and treatments that the Medical Board had investigated in the years before.
Which could be why one of Californiaâ€™s largest insurance companies is investigating Kiker and Levitan â€” Pilch, as of last contact, is on medical leave.
The companyâ€™s top investigators, who asked New Times not to use the name of the company because of fears of disrupting their probe, is looking into the doctorsâ€™ pain management practice. If the investigators find that Kiker and Levitan have behaved inappropriately, they will lose their accreditation with that company.
Investigators arenâ€™t the only ones watching Kiker and Levitan: In 2004, Kiker's genital aesthetic surgery center â€” or â€œmale enhancementâ€? clinic, as it's called â€” gained national attention.
The business is called Total Life Enhancement (TLE), a listing you wonâ€™t find it in any local phone book. TLE can be found on the web and in name across from the Galileo Surgery Center at the foot of Santa Rosa in SLO.
Kiker, who is an anesthesiologist, has teamed up with a genital surgeon, Dr. Rheinschild, and by most accounts, the doctors seem to be doing well with their business: last year they were featured on cable televisionâ€™s The Learning Channel; Kiker and Rheinschild also gave lectures at an international plastic surgery conference in Brazil.
â€˜Iâ€™m never going back to these people, even if they put me up in a five-star hotel and promise me a penis the size of Dallas.â€™
â€œCharles,â€? Total Life Enhancement patient
But for those who want to know if Total Life Enhancementâ€™s patients have had problems, thatâ€™s a hard question to answer.
Since the $15,000-to-$20,000-a-pop genital surgeries arenâ€™t covered by most insurance plans, there are no peer-review boards peering over the doctorsâ€™ shoulders. Since the business isnâ€™t monitored by the state, there is no oversight board keeping tabs. And while Californiaâ€™s medical board is obviously aware of the doctors, its spokespeople were unable to comment on whether theyâ€™d received any TLE-specific complaints.
One ex-TLE patient found a way to voice his problems with the doctors: he hired a SLO attorney to fight the company.
â€œCharles,â€? who asked New Times to not use his real name because of potential litigation with TLEâ€™s doctors, is a quiet man with a soft Louisiana drawl who pauses hesitantly as he tells his story. Heâ€™d wanted to have genital enhancement surgery since hearing about it in the early 1990s, and when he discovered TLE in 2002, he did some research on Rheinschild. After discovering there were no nasty malpractice secrets in the doctorâ€™s background, Charles scheduled an appointment with him in August 2003.
Charles put up a $2,000 deposit â€” toward what would eventually be a $16,000-plus bill â€” and TLE put him up at The Cliffs Resort in Shell Beach for an eight-day stay. After his surgery at the Galileo Surgery Center on the second day, Charles woke up, walked to the recovery area with a nurse, and unbandaged himself before getting dressed.
â€œI said, â€˜It looks like a crooked banana,â€™â€? he remembers telling the nurse.
Charles says he was reassured that either Rheinschild or Kiker would see him the next day. But for the remainder of his stay, Charles says he never saw any TLE doctor, despite his persistent complaints â€” and along with the fact that Rheinschild prescribed medications that Charles, according to his medical records, was allergic to.
Charles went home to New York City, and for the next few months he says he spent fruitless hours exchanging dozens of phone messages with Kiker and Rheinschild. The few times he did manage to reach them, he was promised a plane ticket back to San Luis Obispo and corrective surgery. Charles can prove he was promised that because he taped the messages.
â€œWeâ€™ll stand behind [it]; weâ€™ll take care of it; thereâ€™ll be no charge from us,â€? Rheinschild says to Charles on one tape. â€œWe want to correct it for you, okay?â€?
But by then, Charles had come to his own conclusions: â€œIâ€™m never going back to these people even if they put me up in a five-star hotel and promise me a penis the size of Dallas,â€? he said. â€œThere is no way Iâ€™m getting back on the plane.â€?
Charles also had another problem: The doctors had allegedly used the wrong kind of stitches, something Charles didnâ€™t realize until he saw his own doctor in New York City. When Charlesâ€™ SLO lawyer asked for his clientâ€™s medical records, TLE gave them to him. And the lawyer found two interesting facts. The records made specific note of the type of stitches used, which is highly unusual for a surgery report. Also, the records were dated one year after Charles had visited TLE.
Today, Charles describes himself as â€œnot very natural-looking.â€? He says he gained few of the results he was promised and in fact lost some of his natural qualities due to scar tissue.
â€œIâ€™m embarrassed to show myself at the gym. But it is what it is. I took a gamble and lost,â€? he said. â€œThey knew how to dance. They danced quickly and adeptly and I fell for it all.â€?
Kiker was unable to comment on patients heâ€™s seen at TLE. He said that since he hadnâ€™t heard of the insurance company review, he was unable to comment on that as well.
Insurance company investigators are unable to guess when their review of the doctors will be finished or what the results will be.
Staff Writer Abraham Hyatt can be reached at firstname.lastname@example.org.
The bigger story
For New Timesâ€™ full coverage on Drs. Pilch, Kiker, and Levitan, go to www.newtimesslo.com. First visit the Archive section and click on any story from 2003. Then type one of the doctorâ€™s names into the search bar and youâ€™ll find Daniel Blackburnâ€™s two September 2000 stories that chronicle the Medical Boardâ€™s lengthy investigation, along with Pilchâ€™s response.