SALT LAKE CITY -- Dr. Dewey MacKay took the stand in his own defense to describe a small-town doctor who would loan patients money and even deliver prescriptions to their homes.
MacKay's testimony took up most of Monday's session, opening the fifth week of his federal trial on charges of prescribing narcotic painkillers for no medical purpose.
MacKay said as his health problems began to interfere with his surgical practice in 2005, he began changing to a pain-management practice to treat the patients he'd been seeing since 1981 when he first moved to Brigham City. "It became important to continue to take care of them," he said.
"I wanted to improve their (ability to) function, so they could work. I wanted to improve their quality of life."
MacKay, 64, will retake the stand today when he faces cross-examination by prosecutors who have charged him with 86 counts of drug distribution.
The defense has said it expects to rest its case today with witnesses to include Congressman Rob Bishop as a character witness. After rebuttal witnesses from prosecutors in the U.S. Attorney's Office, deliberations on jury instructions, and closing arguments, the case could go to the jury as soon as Friday.
The 86 felony counts are tied to 12 patients, many of whom MacKay testified Monday he terminated as patients upon discovering them to be addicted "doctor-shoppers" feeding their habits from whatever source.
In 2005 complications following a heart attack affected the nerves in MacKay's hands. He began to reduce his surgeries and start a pain-management practice. For the latter, he began digesting the literature and attending regular seminars on pain management, including conferences that ran several days.
In 2007 MacKay split with his partners at his orthopedic clinic, when he had to stop doing surgeries altogether at a time when his partners wanted to expand that part of the practice.
Pain management became virtually all of his practice, and he brought 1,500 charts with him when he left -- which represented some 500 to 600 active patients a year.
To the claim of prosecutors that he was conducting no exams of patients, simply writing prescriptions, Mac-Kay said but for pre-operative situations, no specialist conducts basic examinations of patients. That, he testified, is for the family doctor to check blood pressure, weight and other vital signs.
MacKay said he did insist on seeing all his pain-management patients in person at his office before filling their prescriptions.
"That is the very most important part of it, to ask how they're feeling, how are they doing, are the getting along OK?
"I would ascertain that every time. Where pain is subjective, their statement is very important.
"And if they are alert, oriented, or having a problem being drugged up, I can tell that in a few seconds ... I turned many away and told them to get their act together, to come back when you're sober."
From 1981 to 1993, he was the only orthopedic surgeon, or "bone doctor," in Brigham City.
"It basically allowed me to help a lot of people, but there was a sacrifice," he said. During those years, he was essentially on call 24 hours a day, seven days a week, to the Brigham City Community Hospital.
The Bountiful native spent 10 years as an Army doctor in Texas before returning to Utah.