DIET & NUTRITION 
PATIENT EDUCATION 
OBESITY/WEIGHT MANAGEMENT 
EXERCISE/TRAINING 
LEGAL MATTERS 
GUIDELINES/RECOMMENDATIONS A St. Louis pediatrician received a 20-year federal sentence for trading controlled substance prescriptions to at least 19 patients with addiction for sex acts, nude photographs, and cash over nearly a decade. Medicare and Medicaid losses totaled $114,480, with full repayment ordered.
Why It Matters
- Spiegel prescribed dangerous drug combinations rather than referring patients with substance use disorder to treatment, per federal prosecutors
- He used a co-conspirator to recruit patients and billed prescriptions under relatives’ insurance names to conceal the scheme
- Perjury during the federal investigation added charges; Spiegel lied under oath about authorizing a search of his own phone
- FBI described his conduct as deliberately keeping vulnerable patients dependent to sustain ongoing exploitation and sexual violence
What to Watch
- Warning signs of colleague misconduct: patients with addiction receiving prescriptions without referral documentation or specialist co-management
- Reporting obligations if misconduct is suspected: state medical board, DEA, and HHS-OIG (800-447-8477)
- Billing patterns used to conceal schemes, including prescriptions billed under third-party insurance names
- Federal prosecution trajectory for controlled substance violations: conspiracy, false statements, and distribution charges often stack
More Professional Misconduct
