Wichita ? Ruling them a flight risk, a federal magistrate ordered Friday that a Kansas doctor and his nurse wife remain in jail pending trial on a 34-count indictment charging them with operating a “pill mill” in a scheme that allegedly caused the overdose deaths of at least four patients.

U.S. Magistrate Judge Donald Bostwick also ruled that Dr. Stephen J. Schneider posed a danger to the community, because even if Schneider was ordered to not practice medicine there was no way the court could police that stipulation.

“I do not see conditions I can impose that would adequately protect the community,” Bostwick said.

Schneider and his wife, Linda Schneider, who is also known as Linda Atterbury, pleaded not guilty in U.S. District Court in Wichita on Friday on counts including conspiracy, unlawful distribution of a controlled substance, health care fraud, illegal monetary transactions and money laundering.

At this point in federal proceedings, a magistrate judge can only accept a not guilty plea. But Schneider made it a point of forcefully telling the judge: “I am not guilty.” His teary-eyed wife quietly entered her plea.

His court-appointed attorney, Jay Greeno, declined to comment to reporters after the hearing. Greeno told the judge his client “still has patients out there that still need him.” Greeno said the doctor did not want to surrender his license as prosecutors had requested as a condition of release because he has patients with “real health issues” that need his care.

Assistant U.S. Attorney Tanya Threadway told the judge that prosecutors know of at least 56 of his patients who have died, and have 35 more deaths to investigate.

“Not only is he a danger physically, but he is a danger economically to this community,” Threadway said.

Attorney John Rapp, the court-appointed attorney for Schneider’s wife, said at her later hearing that with her husband in jail, Linda Schneider could not prescribe medication and posed no danger.

Prosecutors allege the Schneiders continued to practice medicine and prescribe drugs and their fraud continued unabated despite their knowledge the government was investigating them. The Schneiders’ clinic had been under investigation for years and was raided by federal authorities in September 2005.

The couple were arrested Wednesday after they engaged in an almost six-hour “cat-and-mouse game” to elude surveillance teams, Threadway argued in a detention hearing.