In the eyes of the federal court, Paul Spencer Ruble is a drug dealer who operated a network in Brunswick, Georgia that sold opioids and other controlled substances to addicts.
To the state medical board, he apparently is still Dr. Paul Ruble, an anesthesiologist whose license is active and record is clean. One week after he was sentenced to prison, no disciplinary action is noted on the board's website; no criminal offenses reported; no malpractice cases settled.
But for the next five years, Ruble will be in federal prison. A judge on April 4 imposed the sentence, after Ruble in a plea deal with federal prosecutors last year admitted to a conspiracy charge.
A September 2015 indictment said that Ruble conspired with owners of Apex Health and Wellness in Brunswick to operate a pill mill. Ruble was the only physician at Apex, which prosecutors said was a medical clinic in name only. Its real purpose, the indictment said, was "to attract to Apex large numbers of persons, including drug addicts interested in obtaining prescriptions for controlled substances..."
It was a lucrative business. Over about 17 months, Ruble and other conspirators deposited about $1.8 million in cash from the operation. Ruble's take: almost half a million dollars. But Ruble wrote so many prescriptions from November 2011 to April 2013 that some local pharmacies in the area refused to honor them. Still, prescriptions for Xanax, hydrocodone, methadone and oxycodone flowed out the clinic.
The operation came to a halt in April 2013, when federal agents raided the clinic and seized records, court records show. The clinic owner, Marc Frazier of Florida, pleaded guilty to conspiracy in July 2015 and was sentenced to 44 months in prison.
So why, four years after the raid and more than two years after his indictment, does Ruble still appear to have a clean record with the Georgia Composite Medical Board?
The AJC contacted the medical board April 5 to ask. By April 11, the medical board still hasn't responded. If the board ever responds, or if it posts orders against Ruble, we'll update the post.
However, one reason may be that Georgia law doesn't require courts to report criminal actions against doctors to the medical board. What's more, doctors aren't required to report possible violations by fellow physicians. And physicians aren't required to report their own arrests - although they are supposed to self-report felony convictions. Ruble (a former U.S. Army doctor) apparently didn't comply: He had pleaded guilty last August, though his profile doesn't reflect that.
It can't be determined from meeting minutes if the medical board discussed his guilty plea in the months since. In any number of cases, when the board is seeking revocation of a doctor's license, the minutes don't identify the doctor. Instead, only a case number is listed. The board also sometimes issues private disciplinary orders.
The medical board meets Thursday and Friday in Savannah and apparently could take action against his license then.