Should you always trust an Ivy-Leage doctor? Will they sometimes lie to you for financial gain?

There's more than one way for doctors to make profits by concealing facts from patients.   Not all the products they promote are sold through the media, as seen in the story of Dr. William Taylor at UCSD.

Real-world doctors fact-check Dr. Oz, and the results aren't pretty

By Karen Kaplan 

LA Times
Dec. 19, 2014

Only one-third of claims made on 'The Dr. Oz Show' can be backed by medical evidence, study says

11% of the recommendations made by Dr. Oz or his guests contradict medical facts, researchers say

Viewers of 'The Dr. Oz Show' should be skeptical about advice given on the program, experts conclude

What do real-world doctors have to say about the advice dispensed on “The Dr. Oz Show”? Less than one-third of it can be backed up by even modest medical evidence.
If that sounds alarming, consider this: Nearly 4 in 10 of the assertions made on the hit show appear to be made on the basis of no evidence at all.
The researchers who took it upon themselves to fact-check Dr. Oz and his on-air guests were able to find legitimate studies related to another 11% of the recommendations made on the show. However, in these cases, the recommendations ran counter to the medical literature.

Dr. Oz doubles down on bogus weight loss products at Senate hearing

 

“Consumers should be skeptical about any recommendations provided on television medical talk shows,” the researchers wrote in a study published this week in BMJ. “Viewers need to realize that the recommendations may not be supported by higher evidence or presented with enough balanced information to adequately inform decision making.”

Critics of Dr. Mehmet Oz, an accomplished cardiac surgeon with degrees from two Ivy League universities, complain that his show is little more than an hour-long infomercial for weight-loss fads like green coffee bean extract. (The Federal Trade Commission has sued the company that hawks this dubious product.) A spokesman for the Center for Inquiry accused him of selling “snake oil.” In June, a Senate subcommittee took him to task for telling his viewers (who number 2.9 million on any given day) things like: “I’ve got the No. 1 miracle in a bottle to burn your fat. It’s raspberry ketones.”

“I don’t get why you need to say this stuff because you know it’s not true," Sen. Claire McCaskill (D-Mo.) said during the hearing...

Are California doctors violating their Hippocratic oaths in California Prop 45 fight?

Why Are CA Doctors Breaking Their Hippocratic Oath on Prop 45? 

Paul Y. Song, MD  Physician, Executive Chairman of the Courage Campaign, Healthcare Activist
Huffington Post 

10/08/2014 

 

An Open Letter to my fellow medical professionals about California's Proposition 45 and the primary obligation we have to protect the well being of our patients.

Like generations of doctors before us, when each of us graduated from medical school, we were asked to raise our hand and recite the Hippocratic Oath. This was a defining moment in many of our lives. Reciting the words carried great weight and purpose: "I will apply all measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice."

It is through the prism of these words that I watch you appearing in advertisements against Proposition 45 and react in horror. Dr. Amy Nguyen Howell, Dr. Marshall Morgan, and Dr. John Maa, I believe you are betraying your Hippocratic Oaths, and Registered Nurse Candace Campbell, I believe you are betraying the Nightingale Pledge. In fact, in your roles advocating against Prop 45, you are spreading lies designed to mislead and scare the public -- our patients -- in order to protect the insurance industry. It is unconscionable.
The facts are that since 2002, health insurance premiums have increased 185%, while wages for the bottom 70% of our state have remained stagnant. During this same time, California health insurers have issued over 45.7 million denials of treatment, while making record profits which have translated into record cash reserves in the billions.

So let's take a real look at your arguments:

In advertisements paid for by the health insurance industry, you claim that we should keep the new "independent commission" and that special interests are sponsoring Proposition 45 to give "one politician" new power over our health care -- including what treatment options our health insurance covers.
First off, there is absolutely no conflict between this new "independent commission" -- Covered California -- and Prop 45. The Affordable Care Act (Obamacare) was written to accommodate just this sort of rate regulation, and 35 other states already have some version of it.

Covered California is actually run by purely political appointees, some of who have a long cozy history with the private insurance industry. Unlike the State Insurance Commissioner, who is publicly elected to serve as the ultimate consumer protector, the citizens of California have no say in who is appointed to this "independent commission" whereas the Insurance Commissioner is publicly accountable and can be voted out of office.

As for giving the Insurance Commissioner new power over treatment options, this is false on so many levels. First and foremost, it is the private health insurance industry and their administrators, many of who have never cared for a patient, who are denying care, while telling doctors what treatment and drugs they can provide. Our Insurance Commissioner does not do this now and Prop 45 will not give him the authority to do so in the future.

In fact, Prop 45 would simply apply the same regulatory framework to health insurance which has proven so successful regulating auto, home, and medical malpractice insurance in California. Auto insurance rates have actually decreased in the 26 years since Prop 103, saving Californians billions of dollars in premiums. In 2012, our state Insurance Commissioner actually saved doctors like yourselves over $44 million in excessive malpractice premiums using the very same system proposed in Prop 45.

With regard to special interests funding Prop 45, it is actually Big Insurance -- Kaiser Permanente, Well Point, and Blue Shield -- that is spending $37 million of our patients' premium dollars to try and kill Prop 45.
For every dollar that is spent on this campaign trying to protect patients against excessive, unreasonable health insurance rate increases, Big Insurance is spending almost 40 times as much to protect their lucrative status quo.

So, I urge you to stop spreading these lies. I challenge each of you to publicly debate the facts in person. Our patients are suffering mentally and physically from outrageous rate increases, and as the Hippocratic Oath makes clear, we must "keep them from harm and injustice." I call on you to renounce your opposition to Prop 45 and remember the promise you once made to all of your future patients.

Follow Paul Y. Song, MD on Twitter: www.twitter.com/paulysong

Doctor fires employee when she tells him she has cancer

Even before I read this, I had figured out that empathy and a desire to help others don't seem to be traits that medical schools look for when accepting students. And how did this doctor not know that it is against the law to fire someone for getting sick?

A Woman Told Her Boss About A Devastating Cancer Diagnosis. He Responded By Firing Her.
The Huffington Post
By Mollie Reilly
09/11/2014

A Pennsylvania community is rallying around a woman who was fired from her job at an oral surgeon's office following her diagnosis with cancer.

Carol Jumper, who lives in Hopewell Township, Pennsylvania, was diagnosed with cancer impacting her pancreas, liver and ovaries in August. According to her fiance, Dennis Smerigan, Jumper received a letter from her boss, Dr. George Visnich, in which the oral surgeon said he was laying her off without compensation. Raging Chicken Press published the letter on Sunday.

"The symptoms of the disease, the pain medications you will need and the side effects of the chemotherapy will be significant and distracting,” reads the handwritten note, which bears Visnich's letterhead. "You will not be able to function in my office at the level required while battling for your life. Because of this, I am laying you off without pay as of August 11, 2014."...

Smerigan told the Beaver Countian that his fiancee worked for Visnich for more than 12 years...

Current and recovering cancer patients are protected against job discrimination under the Americans with Disabilities Act so long as the individual is able to perform the job's essential functions.

Don't let this story worry you too much.  These people were unworthy of blue-dot-level medical care.  You're much more worthy of care in the eyes of UCLA.  You'll get at least purple-dot treatment.  Unless, perhaps, your health problem itself is a red-dot problem.  (In case you missed it: irony alert!)

Olive View-UCLA Medical Center settles in patient dumping case

By Susan Abram 

Los Angeles Daily News

  06/19/14

SYLMAR>> Olive View-UCLA Medical Center has agreed to pay $40,750 to settle a patient dumping case involving a man who waited in the hospital’s emergency department for more than six hours and never received care for his pain and acute appendicitis, federal officials announced Thursday.
The settlement was made between Olive View and the Office of Inspector General of the U.S. Department of Health & Human Services based on a case in 2011. Federal officials said the Sylmar facility violated the Emergency Medical Treatment and Labor Act by “failing to provide an individual with an appropriate medical screening examination within the capability of the hospital’s emergency department in order to determine whether he had an emergency medical condition.”
According to the complaint, a man complaining of abdominal pain waited in Olive View’s emergency department for more than six hours where he received no care. He left and received medical treatment at another hospital, where he was diagnosed with acute appendicitis among other medical issues and underwent an immediate laparoscopic appendectomy.
Olive View has since made several corrections, Olive View spokeswoman Azar Kattan said. Those include additional physicians assigned to provide rapid medical screening to patients given a triage score of at least 3. On the 1-5 scale, a triage score of 1 is most urgent, Kattan said.
She also said the computer system was modified to provide real-time alerts to the nursing staff among other actions.
“These corrective actions were accepted by the regulatory agencies involved at the time of the original citation in 2011,” Kattan said in a written statement. “We believe they have corrected the problems identified and ensure the timely assessment and treatment of patients seeking care in our emergency room.”

VA treatment records falsified, probe finds

See all posts re false records.

VA treatment records falsified, probe finds
Gregg Zoroya
USA TODAY
May 4, 2014

A VA investigation of one of its outpatient clinics in Colorado reveals how ingrained delays in medical care may be for an agency struggling to rapidly treat nearly 9 million veterans a year amid allegations that dozens have died because of delays.

Clerks at the Department of Veterans Affairs clinic in Fort Collins were instructed last year how to falsify appointment records so it appeared the small staff of doctors was seeing patients within the agency's goal of 14 days, according to the investigation.

A copy of the findings by the VA's Office of Medical Inspector was provided to USA TODAY.

Many of the 6,300 veterans treated at the outpatient clinic waited months to be seen. If the clerical staff allowed records to reflect that veterans waited longer than 14 days, they were punished by being placed on a "bad boy list," the report shows.

"Employees reported that scheduling was 'fixed,' " the findings say.

After the VA endured a year of criticism that it took too long to deliver earned compensation to disabled veterans, the agency faces a new wave of attacks over slow medical care.

Department officials revealed last month that 23 deaths of veterans were linked to delayed cancer screenings dating back four years. More recently, a retired doctor, Sam Foote, alleged that 40 other veterans died because of treatment delays at a VA hospital in Phoenix. VA officials say there's no evidence so far to support those claims, but the hospital administrator was placed on leave pending an investigation by the agency's inspector general.

Sally Eliano, an Arizona woman, complained that her 71-year-old father-in-law, a Navy veteran, died after delays at the VA hospital in Phoenix in the treatment of bladder cancer.

The Medical Inspector's probe in the Fort Collins case could not confirm that patients had been harmed "due to the lack of specific cases evaluation."

A key allegation by the whistle-blowing retired doctor in Phoenix is that staff members manipulated records to hide delays. The same practice was found by the VA Office of Medical Inspector at the clinic in Fort Collins.

While investigators found that VA policies were violated, local medical leaders concluded that the violations were less intentional than the result of confusion and no disciplinary action was taken, says a VA statement released Saturday. Retraining and weekly audits were implemented, the statement says.

The VA in 2013 revamped some of its tracking procedures to better gauge wait times for nearly 100 million medical appointments each year at 151 hospitals and 820 clinics.

The agency found that only 41% of new VA medical patients were seen within 14 days last year, down from 90% reported in 2012 under an old, now-abandoned measurement method.

The VA found it wasn't doing so well with first-time mental health appointments, either. The agency reported in 2011 that 95% of new mental health patients were seen within 14 days, but the new tracking system found the rate in 2013 was 66%.

Mike Davies, the VA director of access, says the revised system for tracking new-patient appointments has finally provided accurate measurements on wait times. He says the department's commitment to track every single appointment is far more stringent than industry standards.

"I don't think there's any other health-care system that does this," Davies says.

He says the VA now can better determine what additional resources it needs to make sure veterans are treated more rapidly.

As a result of what happened at Fort Collins — the Medical Inspector's investigation was completed in December — the VA has done four site inspections to see whether timely treatment standards are being met, Davies says.

They found "other instances of misunderstanding" wait-time tracking requirements, "but we have not found any widespread patterns of misunderstanding," Davies says.

But federal investigators say that despite these efforts, the VA health-care system remains plagued by delays in treatment and opportunities to cover them up.

"Data has to be reliable to be useful," says Debra Draper, who directs an investigative staff for the Government Accountability Office. "So if you've people going in there and doing all kinds of things (to change the data), it really is not reliable."

Draper has led investigations into VA health care problems for years and says the agency has been struggling to accurately assess wait times for decades.

Draper says a key problem is a lack of oversight by top VA officials. The Fort Collins problems, for example, came to light only after a whistle-blower stepped forward.

Numbers of outpatient visits are spiraling, in large part because of an aging veteran population and young combat survivors suffering multiple medical and psychological issues.

At Fort Collins and the nearby VA Medical Center in Cheyenne, Wyo. — which oversees seven clinics, including the one in Fort Collins — officials complained they didn't have enough doctors or supporting staff.

The result is jobs are left undone, VA investigators found. Staff required to follow up with veterans to schedule necessary appointments often didn't have time.

Investigators found that nearly half the clinic's 6,000 veteran patients did not have necessary medical appointments scheduled.

"Many of the (clerks) reported significant stress when trying to explain to veterans why they cannot make earlier appointments for them," the report says. "By entering (false data), the wait time for that patient appears to be zero days. ... The wait times were actually much longer."

Finally, a Kaiser doctor, oncologist Jennifer Lycette, speaks out about doctors forced to allow harm to patients to increase profits

"...Lycette’s suit states, however, that she became troubled by new Kaiser policies after [executive Jeffrey] Weisz was brought in.

"Among her other complaints, her suit alleges she expressed concerns about a ban on referring patients to non-Kaiser specialists or clinical trials outside of Kaiser -- even though doing so would be in the best interests of patients.

"She resigned in April 2013, because of her oath to do no harm and her belief that Kaiser policies were "making patients suffer," her suit states.

"According to the website for Oregon Health & Science University, Lycette relocated to Astoria and is now working at OHSU's Cancer Care Center at Columbia Memorial Hospital..."

Former oncologist claims Kaiser Permanente pushed profits over patient care, files $7 million lawsuit
Aimee Green
Oregon Live
April 23, 2014

A former oncologist at Kaiser Permanente is suing the health care company for $7 million, claiming she had no choice but to quit her job after complaining the organization was maximizing profits to the detriment of cancer patients.

Dr. Jennifer Lycette claims quality of care took a nosedive when Northwest Permanente Medical Group hired Jeffrey Weisz as its president and executive medical director in 2011. Weisz had previously worked for Kaiser in Southern California.

"During Dr. Weisz's tenure (in California), he established a reputation as a ruthless administrator who found ways to minimize payrolls by shrinking staff while patient loads skyrocketed, often leaving the remaining staff members trying to cope with impossible patient demands which ultimately harmed Kaiser's patients," reads Lycette's lawsuit, filed Tuesday in Multnomah County Circuit Court.

In an email statement, Kaiser spokesman Michael Foley said, "The care needs of our members, patients, and customers come first. Allegations that claim otherwise are not supported by fact.

"We're reviewing the lawsuit that was filed," he addied, "and will address its inaccurate allegations through the judicial process."

The suit was filed by Lake Oswego attorney Roderick Boutin.

Lycette's suits claims that during a November 2012 meeting, Weisz ordered Kaiser's Portland oncologists to cram an initial consultation and bone-marrow biopsy of patients -- something that should take two to 2.5 hours and be done over two visits -- into one, 60-minute visit. Lycette’s suit states pain medication that must be taken orally takes 30 to 60 minutes to kick in, so a 60-minute visit would leave patients rushed and in pain.

Lycette "openly and respectfully voiced her concerns," and Weisz responded by shouting at Lycette in "a very angry and threatening manner," her suit states.

Lycette's suit also claims she complained in April 2012 to the then-chief of medical oncology, Nagendra Tirumali, about understaffing. She says patients were struggling to schedule appointments and some chemotherapy patients were only seeing their regular oncologist every two or three months.

Tirumali responded that Lycette was being “emotional,” according to a copy of an email attached to the suit. Lycette’s suit characterizes Tirumali's response as a "veiled attack" on her gender. Her suit states she later asked Tirumali whether he would have accused a man of being "emotional" over the issue of understaffing.

Lycette, 40, worked for Kaiser for about seven years -- from 2006 until she resigned in spring 2013 -- at its Interstate medical offices in North Portland and Sunnyside Medical Center in Clackamas, according to her suit. Her suit states she had the highest patient satisfaction rating, 89 percent, in her department.

Lycette’s suit alleges that before taking the job in 2006, she asked several Kaiser doctors if they thought they could care for patients without feeling that financial overhead compromised care. They assured her they could, the suit states.

Lycette’s suit states, however, that she became troubled by new Kaiser policies after Weisz was brought in.

Among her other complaints, her suit alleges she expressed concerns about a ban on referring patients to non-Kaiser specialists or clinical trials outside of Kaiser -- even though doing so would be in the best interests of patients.

She resigned in April 2013, because of her oath to do no harm and her belief that Kaiser policies were "making patients suffer," her suit states.

According to the website for Oregon Health & Science University, Lycette relocated to Astoria and is now working at OHSU's Cancer Care Center at Columbia Memorial Hospital.

Lycette is seeking $2 million in economic damages and $5 million in non-economic damages.

UCLA pays $10 million for retaliation against surgeon who exposed industry payments that may have compromised patient care

This case is just a small part of a larger problem at UCLA. Another small part of the problem, the behavior of Eugene Washington, dean of the David Geffen Medical School at UCLA, is discussed HERE.

UCLA'S $10 MILLION WHISTLE-BLOWER RETALIATION CASE:

"Shortly before Pedowitz joined UCLA in 2009, the university was already facing criticism from Congress over the failure of a top spine surgeon to report nearly $460,000 in payments he received from Medtronic and other medical companies while researching their products' use in patients, government records show.

"Dr. Jeffrey Wang, who left for USC Spine Center last fall, stepped down as head of UCLA's spine program in 2009 after U.S. Sen. Charles Grassley (R-Iowa) publicized his lapse in disclosure as part of a larger investigation into medical conflicts of interest.

"Several patients are now suing Wang and UCLA in state court for negligence, fraud and malpractice in connection with surgeries involving Medtronic's controversial Infuse bone graft."

"...'What good are all the policies if they protect the wrongdoers and fail to protect the actual whistleblower?' Quigley said. 'The university wanted to cover it all up.'"

UCLA surgeon Dr. Robert Pedowitz, who said the medical school allowed doctors to take industry payments that may have compromised patient care

UC OKs paying surgeon $10 million in whistleblower-retaliation case
The settlement ends a case brought by the ex-head of UCLA's orthopedic surgery department
By Chad Terhune
Los Angeles Times
April 22, 2014

University of California regents agreed to pay $10 million to the former chairman of UCLA's orthopedic surgery department, who had alleged that the well-known medical school allowed doctors to take industry payments that may have compromised patient care.

The settlement reached Tuesday in Los Angeles County Superior Court came just before closing arguments were due to begin in a whistleblower-retaliation case brought by Dr. Robert Pedowitz, 54, a surgeon who was recruited to UCLA in 2009 to run the orthopedic surgery department.

In 2012, the surgeon sued UCLA, the UC regents, fellow surgeons and senior university officials, alleging they failed to act on his complaints about widespread conflicts of interest and later retaliated against him for speaking up.

UCLA denied Pedowitz's allegations, and officials said they found no wrongdoing by faculty and no evidence that patient care was jeopardized. But the UC system paid him anyway, saying it wanted to avoid the "substantial expense and inconvenience" of further litigation.

[Maura Larkins: Closing arguments were about to begin in the case. UCLA had already invested "substantial expense and inconvenience", and would have incurred very little expense or inconvenience if it had simply allowed the closing arguments to go forward. The reason it settled was that it realized that the weight of the evidence showed that UCLA did indeed jeopardize patient safety and certainly violated conflict of interest standards and the legal rights of the whistle-blower.]

As department chairman, Pedowitz testified, he became concerned about colleagues who had financial ties to medical-device makers or other companies that could unduly influence their care of patients or taint important medical research.

He also alleged that UCLA looked the other way because the university stood to benefit financially from the success of medical products or drugs developed by its doctors.

One of the orthopedic surgeons that Pedowitz complained about testified at trial about receiving $250,000 in consulting fees in 2008 from device maker Medtronic. In memos to university officials, Pedowitz raised concerns about the financial dealings of other doctors as well.

Inside the courtroom Tuesday, Pedowitz sat in the front row with his wife and daughter as the judge told jurors that a settlement had been reached. He said he felt vindicated by the outcome.

"These are serious issues that patients should be worried about," Pedowitz said in an interview. "These problems exist in the broader medical system and they are not restricted to UCLA."

The seven-week trial in downtown Los Angeles offered a rare glimpse into those potential conflicts at a time when there is growing government scrutiny of industry payments to doctors.

Starting this fall, the federal Physician Payments Sunshine Act, part of President Obama's healthcare law, requires public disclosure of financial relationships between healthcare companies and physicians.

Many doctors and universities defend long-standing industry arrangements as essential for carrying out cutting-edge research and top-flight medical education.

In a statement Tuesday, the UC regents said they "resolved this lawsuit to end a prolonged conflict and permit UCLA Health Sciences to refocus on its primary missions of teaching, research, patient care and community engagement."

The statement added that "multiple investigations by university officials and independent investigators concluded that conduct by faculty members was lawful. Patient care was not compromised."

This latest settlement eclipses a $4.5-million payout the UC regents made last year to resolve a racial discrimination lawsuit filed by another UCLA surgeon.

Pedowitz, as part of his settlement, left the UCLA faculty, effective Tuesday. He had agreed to step down as department chairman in 2010 after initially voicing his concerns to top UCLA officials. He filed a whistleblower retaliation complaint in March 2011.

Experts in medical ethics say the UCLA case shows much more needs to be done within academia and by government regulators to address potential conflicts of interest in medicine.

Susan Chimonas, associate director of research at Columbia University's Center on Medicine as a Profession, said some medical schools are still reluctant to take on specialists who bring in considerable money from patients, medical research and patents on breakthrough products.

"Institutions can be dependent on the money these big-earning specialties like orthopedic surgery bring in," Chimonas said. "They are the cash cows and they can set their terms. This is not the first time I've heard of medical schools having policies that are not well enforced."

In an interview last week, the chief compliance officer at the UCLA Health System flatly rejected the notion that the university didn't enforce its policies or look fully into Pedowitz's allegations. She also said industry ties are unavoidable at a big medical school and rules are in place to prevent conflicts.

"We have processes in place to identify those relationships in a transparent fashion and ensure they don't have any inappropriate influence on the actions of the university," said Marti Arvin, chief compliance officer. "In order to meet our mission, it is important we have both the brilliant minds we have at UCLA and collaboration with industry."

Arvin said the university "thoroughly and objectively investigated those allegations of noncompliance raised by Dr. Pedowitz. We were able to determine the vast majority were unsubstantiated."

She said two doctors fell short of university expectations in their handling of outside income, but there was no violation of law or university policy in either instance.

Arvin cited the case of Dr. Nick Shamie, the orthopedic surgeon who testified at trial about receiving $250,000 from Medtronic for consulting work. She said department policy at the time didn't require Shamie to send that outside income through UCLA's faculty compensation plan.

At trial, Pedowitz said he was deeply troubled by the large amount of money Shamie was paid. He testified that he was particularly concerned that Shamie was trying to enroll patients in a research study involving Medtronic at the time.

"I saw this as an obvious problem," Pedowitz testified.

In court, Shamie said he abided by university policy and didn't pursue the study further because finding patients was too difficult. He couldn't be reached for additional comment.

The other physician cited by Arvin for a potential shortcoming was Dr. David McAllister, vice chairman of clinical operations for the orthopedic surgery department.

He didn't report payments from the Musculoskeletal Transplant Foundation, a nonprofit tissue bank that does business with UCLA, because he didn't think disclosure was required in that instance because it didn't involve a for-profit entity, Arvin said.

McAllister also declined to comment, referring a call to UCLA.

Shortly before Pedowitz joined UCLA in 2009, the university was already facing criticism from Congress over the failure of a top spine surgeon to report nearly $460,000 in payments he received from Medtronic and other medical companies while researching their products' use in patients, government records show.

Dr. Jeffrey Wang, who left for USC Spine Center last fall, stepped down as head of UCLA's spine program in 2009 after U.S. Sen. Charles Grassley (R-Iowa) publicized his lapse in disclosure as part of a larger investigation into medical conflicts of interest.

Several patients are now suing Wang and UCLA in state court for negligence, fraud and malpractice in connection with surgeries involving Medtronic's controversial Infuse bone graft. UCLA said it doesn't comment on pending litigation. Wang couldn't be reached for comment.

Shortly after raising his concerns, Pedowitz said, he was pressured to step down as department chairman in 2010. Pedowitz said he was further retaliated against by being denied patient referrals and prevented from participating in grants and other activities.

Before UCLA, Pedowitz worked at UC San Diego and as chairman of orthopedics and sports medicine at the University of South Florida.

Mark Quigley, an attorney representing Pedowitz, said the case could have been avoided if the UC system enforced the policies it already has in place.

"What good are all the policies if they protect the wrongdoers and fail to protect the actual whistleblower?" Quigley said. "The university wanted to cover it all up."

Utah doctor Martin MacNeill guilty of killing wife, leaving her in tub

How many doctors are secret sociopaths? Is it possible that lack of ethics is an advantage for doctors in administrative positions? How much did Martin MacNeill care about his patients?

Utah doctor Martin MacNeill guilty of killing wife, leaving her in tub
A jury only took hours to convict a Provo, Utah doctor and former Mormon Church official in connection with his wife's 2007 death. NBC's Mike Taibbi reports.
By Paul Foy
The Associated Press
Nov. 8, 2013

PROVO, Utah - A jury convicted a doctor of murder early Saturday in the death of his wife six years ago, bringing an end to a trial that became the nation's latest true-crime cable TV obsession with its tales of jailhouse snitches, forced plastic surgery, philandering and betrayal.

Martin MacNeill was accused of knocking out Michele MacNeill with drugs after cosmetic surgery, then leaving her to die in a tub like one that was displayed during the trial.

...MacNeill was medical director of the Utah State Development Center, a residential center for people with cognitive disorders, who moonlighted in other medical jobs, once consulting for a laser hair removal clinic. He had a law degree but wasn't known to practice law and has since surrendered his law and medical licenses.

The highlight of the three-week trial was a mistress who MacNeill introduced as a nanny within weeks of his wife's death. His older daughters quickly recognized Gypsy Willis as his secret lover and said her mother had been arguing with her husband over the affair.

The daughters went to work uncovering what they call their father's secret life. They abandoned him while dogging authorities to open a murder investigation. It wasn't until MacNeill's release in July 2012 from a federal prison in Texas on charges of fraud that Utah prosecutors moved to file charges of murder and obstruction of justice.

Willis also served a federal sentence for using the identity of one of MacNeill's adopted daughters to escape a debt-heavy history. That daughter had been sent back to Ukraine, supposedly only for a summer.

For a time, MacNeill's only family defender was his only son. Damian, a 24-year-old law student, committed suicide in January 2010, according to his sisters, who have said he was haunted by their mother's death.

Prosecutors said MacNeill might have gotten away with a perfect murder, but his erratic behavior the day of his wife's death and shortly afterward was "dripping with motive."

They reminded jurors about testimony that MacNeill stood in the bathroom yelling what prosecutors called phony grief, "Why did you do this? All because of a stupid surgery," as paramedics tried to revive his wife.

Family testimony suggested it was MacNeill who insisted his 50-year-old wife, a former local beauty queen in her California hometown, get the surgery. Prosecutors said he used it as an excuse to mix painkillers, Valium and sleeping pills for her supposed recovery.

"Make no mistake, the defendant's fingerprints, if you will, are all over Michele's death," Grunander said.

Prosecutors say MacNeill contrived a medical condition in the weeks leading up to his wife's death, telling many around him he was dying of cancer or multiple sclerosis to absolve him of any motive in the death. He also made use of a cane and could be seen limping at times.

Investigators who subpoenaed MacNeill's own medical records found he was in good health. And they discovered something else: MacNeill had been collecting veteran benefits for decades, saying in an application he had bipolar or anti-social disorders.

MacNeill's arrest warrant contains a former girlfriend's explosive allegation — not used at the trial — that MacNeill killed a brother and tried to kill his mother long ago.

Utah investigators confirmed the brother, Rufus Roy MacNeill, was found dead in a bathtub in New Jersey. They determined MacNeill was never charged and found no indication he was ever under investigation for it.

Cheryl Clark seems to be working for a magazine, Health Leaders, that is genuinely interested in improving the practice of medicine

Cheryl Clark seems to be working for a magazine, Health Leaders, that is genuinely interested in improving the practice of medicine.

Cheryl Clark
Health Leaders
Nov. 2, 2013

Are you a journalist interested in how doctors practice medicine?

A position is opening up at the company I work for that I would seriously consider applying for. You'd write for hospital providers and physicians about issues in service lines, ethics, physician culture and behavior, relationships with hospital administrators, care appropriateness, medical training and certification, fraud, regulatory changes that are pivoting doctor pay toward outcomes measurement for the whole patient and away from the "pay per visit" and lots of other stuff.

You'd write 50 weekly columns a year and 1,700 (or so) -word articles for our monthly print magazine, HealthLeaders.

Doctor falsely diagnoses patients with cancer so he can give treatment, collect Medicare

Michigan doctor arrested for purposely misdiagnosing cancer
by Jen Hayden
Daily Kos
Aug 07, 2013

Greed knows no bounds. It pushes people to do unspeakable things. For Dr. Farid Fata, a Michigan oncologist, there were no limits:

Dr. Farid Fata, 48, of Oakland Township was arrested Tuesday and charged for allegedly submitting false claims to Medicare for services that were medically unnecessary, including chemotherapy treatments, Positron Emission Tomograph (PET) scans and a variety of cancer and hematology treatments for patients who did not need them. Dr. Fata owns and operates Michigan Hematology Oncology Centers (MHO) which has offices in Clarkston, Bloomfield Hills, Lapeer, Sterling Heights, Troy and Oak Park.

Dr. Fata was scamming Medicare to the tune of $35 million.

In the course of the scheme, prosecutors say Dr. Fata falsified and directed others to falsify documents. MHO billed Medicare for approximately $35 million dollars over a two-year period, approximately $25 of which is attributable to Dr. Fata, federal officials said.

The complaint further alleges that Dr. Fata directed the administration of unnecessary chemotherapy to patients in remission; deliberate misdiagnosis of patients as having cancer to justify unnecessary cancer treatment; administration of chemotherapy to end-of-life patients who will not benefit from the treatment; deliberate misdiagnosis of patients without cancer to justify expensive testing; fabrication of other diagnoses such as anemia and fatigue to justify unnecessary hematology treatments, and distribution of controlled substances to patients without medical necessity or are administered at dangerous levels.

Dr. Fata was prescribing painful and unnecessary treatments to patients:

The feds say he also deliberately misdiagnosed patients “as having cancer to justify unnecessary cancer treatment,” WXYZ reported.

Federal agents say Fata directed the “administration of chemotherapy to end-of-life patients who [would] not benefit from the treatment,” and deliberately misdiagnosed “patients without cancer to justify expensive testing.”

Thankfully, Dr. Fata isn't likely to get out of jail any time soon:

Dr. Fata faced a federal magistrate Tuesday afternoon. Assistant U. S. Attorneys assigned to the case argued Fata is a flight risk because he has access to about $14 million in liquid assets and a home in Lebanon. The magistrate is temporarily detaining Fata until another hearing can be held on Thursday. He faces up to 20 years behind bars if he’s convicted.

Twenty years? Not long enough. Not nearly long enough.

Samuel Shem: What I've learned from speaking out against the brutality of medical training

Samuel Shem, 34 Years After 'The House of God'
What I've learned from speaking out against the brutality of medical training, in advocacy of quality connection -- and four additional "laws" for good doctors
By Samuel Shem
The Atlantic
Nov 28 2012

For better or worse, except in real danger, I don't seem to run on fear. Guilt, yes; fear, no.

It's a good thing, because my book The House of God enraged many among the older generation of doctors. I was maligned and disliked. The book was censored by medical school deans, who often kept me from speaking at their schools. None of it really bothered me, though. I was secure in the understanding that all I had done was tell the truth about medical training.

I took this pseudonym because I was just starting my psychiatric practice and wanted to protect my patients from knowing that their therapist had written such an irreverent novel. (They all found out, and didn't care -- but "Shem" had arrived, and refused to depart.) I also felt that real writers had no place in going out and publicizing their novels. I refused all invitations. And then one day I got a letter forwarded from my publisher, which included the line:

"I'm on call in a V.A. Hospital in Tulsa, and if weren't for your book I'd kill myself."

I realized that I could be helpful to doctors who were going through the brutality of training. And so I began what has turned out to be a 35-year odyssey of speaking out, around the world, about resisting the inhumanity of medical training. The title of my talk is almost always the same: "Staying Human in Health Care."

The theme of my speaking out is simple: the danger of isolation, the healing power of good connection. And any good connection is mutual.

I base a lot of my talks on what I've learned from The House of God. About how I've come to see it, and all my novels, as a "fiction of resistance," a way of resisting the injustices of a system.

It wasn't until years into my journey that I realized the importance of the fact that I and my fellow interns were products of the 1960s. We grew up in that unique lost period of American history -- beginning with FDR and ending with Reagan -- when we learned that if we saw an injustice, and got together and took action, we could bring about change. During my college years, we helped put the Civil Rights laws on the books and ended the Vietnam War. When we entered our internships we were a generation idealistic young docs. We soon were caught in the clash between the received wisdom of the medical system, and the call of the human heart. Our patients, and we, were being treated inhumanely. As Chuck the intern put it:

"How can we care for our patients, man, if nobody cares for us?"

If we decide to walk through suffering alone -- "stand tall, draw a line in the sand, tough it out" -- we will suffer more, and spread more suffering around.

And so we took action. The novel can be read as a model of nonviolent resistance. Big hospitals, like all large hierarchies, are "power-over" systems. The pressure comes down on the ones at the bottom, and they become isolated. Not only do they get isolated from each other, but each gets isolated from his or her authentic experience of the system itself. You start to think "I'm crazy," instead of "This is crazy." In The House one of the interns does go crazy, and another commits suicide.

The crucial question is how to find mutuality -- or "power-with" -- in a "power-over" system. Historically, the only threat to the dominant group -- whether of race, gender, class, sexual preference, ethnicity -- is the quality of the connection among the subordinate group.

***

In The House of God there were 13 "Laws." I would now add these four:

Law 14 : Connection comes first. This applies not only in medicine, but in any of your significant relationships. If you are connected, you can talk about anything, and deal with anything; if you're not connected, you can't talk about anything, or deal with anything. Isolation is deadly, connection heals.

One of the worries in how the new generation of doctors practice medicine is their use of computers. If you have a laptop or smart phone between you and your patient, you are much less likely to create a good, mutual connection. You will miss the subtle signs of the history, of the person. With a screen between you, there is no chance for mutuality, and the connection has qualities of distance, coolness, rank, authority, and even disinterest. The "smart" digital appendages can make you, in human-connection terms, a "dumb" doctor.

This, as more and more studies suggest, can lead -- hand in hand with the tyranny of algorithms and other "quality/efficiency/cost-containers" -- to more tests, more errors and medical mistakes, lower quality care, and higher costs to all.

Law 15 : Learn empathy. Put yourself in the other person's shoes, feelingly. When you find someone who shows empathy, follow, watch, and learn.

Law 16 : Speak up. If you see a wrong in the medical system, speak out and up. It is not only important to call attention the wrongs in the system, it is essential for your survival as a human being.

Law 17 : Learn your trade, in the world. Your patient is never only the patient, but the family, friends, community, history, the climate, where the water comes from and where the garbage goes. Your patient is the world.

Some have said that The House of God is cynical. And yet in rereading, it has a constant message that I was dimly conscious of in writing: being with the patient. In the words of the hero of the novel, the Fat Man, "I make them feel that they're still part of life, part of some grand nutty scheme, instead of alone with their diseases. With me, they still feel part of the human race." And as the narrator Roy Basch realized, "What these patients wanted was what anyone wanted: the hand in their hand, the sense that their doctor could care."

And so in 1974 I came away from The House of God aware of at least one thing: The essence of medical care, and life, is connection.

***

Fast forward 30 years.

I have published two more novels -- Fine and Mount Misery. Also, with my wife, co-wrote the play Bill W and Dr. Bob about the founding of Alcoholics Anonymous, and a nonfiction book We Have to Talk: Healing Dialogues Between Women and Men.

Love and death. How lucky we are.

During this time, as they say, life happened. There were many life struggles, and walks through the suffering. Luckily, at the right times, I was accompanied by others.

From Mount Misery, and also from conducting gender dialogues all over the world while writing We Have to Talk, I learned the importance of shifting focus from a center on "I" or "You", to "We." As in, for physicians, "We've got all the information; let's talk about what we can." The patient will say, "I think maybe we should .. " Suddenly there is a concreteness in your approach to treatment, that you are in this together.

From Bill W. and Dr. Bob, I learned that, in Bill's words: "The only thing that can keep a drunk sober is telling his story to another drunk." Alone, an alcoholic cannot resist alcohol. The self alone -- self-will or self-discipline -- will not work. What works is asking for help from a non-self-centered perspective. AA is an astonishing mutual-help organization, because alcohol and drugs are diseases of isolation.

***

My latest novel, The Spirit of the Place, took me in a new direction. I had always wanted to go back to my small town on the Hudson River and join my old mentor, a family doctor, in practice. Life had taken me elsewhere, but the beauty of fiction is that you can do in a novel what you haven't in the world.

At a point toward the end of the novel, the fraught protagonist has to make a choice. He struggles with it until he hears a kind of voice in his head:

"Don't spread more suffering around. Whatever you do, don't spread more suffering around." ...

--Samuel Shem, MD, PhD, is a doctor, novelist, and playwright. He is the author of books including The House of God and The Spirit of the Place.

How UCLA's Millionaire Doctor/public employee David Feinberg got $1.3 million amid tuition hikes, budget cuts and a recession

Dr. David Feinberg

[Maura Larkins comment: Both Dr. Feinberg and Chancellor Gene Block are psychiatry professors. A lawsuit has been filed against yet another professor of psychiatry at UCLA. Dr. Alexander Bystritsky is accused of causing the wrongful death of a woman by giving her dangerous medications in order to make her feel happy and to believe she was cured of her illness, causing her to give a large donation to UCLA.

What kind of ethics does Dr. David Feinberg have? What's he going to do with all this money? I'm guessing it's not all going to scholarships for students who can't pay tuition at UCLA.]


UCLA's Millionaire Doctor David Feinberg
How Feinberg got $1.3 million amid tuition hikes, budget cuts and a recession
By Beth Barrett
LA Weekly
Mar 31 2011

Last year, when Stanford Hospital & Clinics was considering poaching Dr. David Feinberg from UCLA, where he is the associate vice chancellor and CEO of its public hospital system, the university brass and the powerful UC Board of Regents decided to do whatever was required to keep their golden administrator.

Things were bad at UCLA when the feverish bid to retain Feinberg broke out. It had just been slammed with $60 million in academic program cuts by the deficit-riddled state of California, and faces another $96 million bite on July 1. In a series of recent hikes, the university raised average student tuition 40 percent from about $7,000 to more than $11,000.

More tuition hikes were coming, and the university owed its employees $21.5 billion in future pension payments that it had no clear-cut way to pay.

But the vast Ronald Reagan UCLA Medical Center, a public nonprofit, had experienced a financially robust previous year under Feinberg, and the facility in 2009 enjoyed high patient-satisfaction rankings as usual. Despite California's stubborn recession, UCLA Chancellor Gene Block — like Feinberg, a psychiatry professor at the School of Medicine — decided to make his colleague a staggering offer: He would nearly double Feinberg's $739,695 base salary to $1.33 million.

That included a 22 percent pay raise of $160,300 and an annual "retention bonus" of $250,000 paid every year that Feinberg does not leave for another job. Block also decided to continue Feinberg's "incentive bonus," which had hit $210,739 in the previous fiscal year.

There was nothing else quite like Block's offer elsewhere in California's university medical schools. The next highest paid is UC San Francisco's CEO Mark Laret. San Francisco, like UCLA, is a top facility, ranked seventh in the nation by U.S. News & World Report, close behind No. 5 UCLA.

In 2010, Laret's $739,700 pay was reduced as a result of the systemwide pay cuts. But with an "incentive" bonus of $176,912 and a car allowance of $8,916, he earned $876,215. Now, suddenly Feinberg was in line to earn nearly half a million dollars more than Laret.

On June 30, Feinberg will begin getting his annual quarter-million-dollar bonus simply for not leaving for another job.

Feinberg's juicy pay package led to uncomfortable headlines for UCLA on Sept. 17, the day after the Board of Regents approved it.

Then, in late December, Feinberg earned UCLA another round of unwanted media attention. The San Francisco Chronicle obtained a private Dec. 9 letter in which Feinberg and 35 other executives in the UC system lashed out at the Board of Regents. The highly compensated group weren't demanding help for academic programs and students. They were threatening to sue the struggling California universities if the regents didn't boost the executives' long-standing $245,000 salary caps used to calculate their pensions.

The change would create a sizable pension boost, costing the universities $5.1 million per year — for just 36 government employees. In addition, the 36 executives insisted the new pension deal be retroactive to 2007, taking from the universities an additional bite of $51 million.

In the letter, Feinberg and the others wrote that it was "the University's legal, moral and ethical obligation" to hand over the pension boosts. They also threatened, "Failure to do so will likely result in a costly and unsuccessful legal confrontation," and emphasized that they were writing "URGENTLY."

The letter, which proved to be deeply embarrassing to UC officials and the regents, was widely assumed to have been leaked by a UC university system insider disgusted by the demands.

The demands from the 36 were a direct political challenge to UC President Mark Yudof, who had publicly opposed bigger pensions for university executives. The University of California system owes $21.6 billion in future pension payments to all its retirees — but it hasn't got the money, and doesn't know where it's going to get it. Yudof is pursuing fiscal reforms to raise the missing billions, including upping the retirement age for future employees from age 60 to 65 for maximum pension benefits — and, once again, raising student tuition and fees.

The leaked letter enraged students, critics of cushy government pensions and salaries and incoming Gov. Jerry Brown, who is a nonvoting member of the Board of Regents.

Brown opined in the Chronicle in December: "These executives seem very out of touch at a time when the state is contemplating billions of dollars in reductions that will affect people who are far less advantaged."

In early January, under a media spotlight, Block opposed the pension boosts, and the demand was not approved by the regents.

But three weeks later, without a formal vote, the regents — who include such notables as investment banker Richard C. Blum, husband of Sen. Dianne Feinstein, and Sherry L. Lansing, former chair/CEO of Paramount Pictures — found a way to give Feinberg and other UC system medical center executives statewide a different costly reward: "incentive" bonuses totaling $2.6 million that had been deferred from 2009.

Feinberg topped the bonus recipient list, raking in $218,728.

The popular doctor now has critics aplenty. Students, facing further tuition hikes as Gov. Brown struggles with a massive deficit, are flabbergasted at the Wall Street–like disparity between how the UC system treats its highfliers versus its students.

Student Matt Margolis, president of the Bruin Democrats, says thousands of UC, California State University and community college students "have to take quarters off, drop classes, get kicked out of their housing." For UC leaders "to respond to the need to scale back by cutting the budget and raising tuition — I don't see how that sits well with the CEO of the medical center having his salary doubled...

Dr. Drew Pinsky responds to allegations he received GlaxoSmithKline payments

Dr. Drew Pinsky responds to allegations he received GlaxoSmithKline payments
By Michelle Castillo
July 4, 2012
(CBS News)

After being accused of taking payments from GlaxoSmithKline to promote the antidepressant Wellbutrin, Dr. Drew Pinksy told CBS News everything he said was in accordance with the law and accurate according to his medical experience.

"In the late 90s I was hired to participate in a 2-year initiative discussing intimacy and depression which was funded by an educational grant by Glaxo Wellcome," Pinksy told HealthPop in a statement. "Services for the non-branded campaign included town hall meetings, writings and multimedia activities in conjunction with the patient advocacy group the National Depresive and Manic Depressive Association (NDMDA). My comments were consistent with my clinical experience."

Pinsky - a board-certified internist, addiction medicine specialist, and radio and television personality - was mentioned in a complaint filed by the U.S. government against the pharmaceutical company, according to the Forbes.

The document states that Pinksy allegedly received two payments in March 2009 and April 2009 from GlaxoSmithKline totaling $275,000 to promote Wellbutrin SR. The Wall Street Journal reported in June 1999, he made statements on "Loveline," a television and radio show he co-hosted, saying that he prescribed Wellbutrin to depressed patients because it "may enhance or at least not suppress sexual arousal" as much as other antidepressants are known to do. Pinsky was also reported to have made comments on other media, including another national radio program called "David Essel - Alive!," Forbes added. In both instances, he did not disclose that he was paid by the company to do so, and he promote uses of Wellbutrin that had not been approved by the Food and Drug Administration.

GlaxoSmithKline recently plead guilty and had to pay $3 billion in the largest settlement of health care fraud in U.S. history, HealthPop reported. The company was charged with unlawful promotion of certain prescription drugs.

Many "mistakes" found in newbie-doctors' resumes

Many "mistakes" found in newbie-doctors' resumes
By Kerry Grens
Feb 21, 2012
(Reuters Health)

Honesty and attention to detail are qualities expected of physicians, yet two studies looking at applications to training programs in obstetrics show that up to 30 out of every 100 applicants took credit for research publications that could not be found.

"Our hope is that these are honest mistakes and not willful attempts to mislead," said Dr. Michael Frumovitz, a professor at the University of Texas MD Anderson Cancer Center in Houston, and lead author of one of the studies.

In a field where precision is important, "even if it's an honest mistake it's very troubling," he said.

Earlier studies have found that other specialties within medicine suffer from the same problem.

Anywhere from one to 30 percent of applications to training programs in radiology, emergency medicine, orthopedics and others include references to published research that can't be located by reviewers.

Frumovitz and his colleagues and a separate group at the University of Washington, who published their reports in Obstetrics & Gynecology, wanted to find out if the same was true in their fields.

The team led by Frumovitz collected all 258 applications to a fellowship program at MD Anderson in gynecologic oncology from 2004 to 2008.

The applicants were doctors who had completed their medical school and residency training.

Of the 148 doctors who listed that they had published research findings, 44 included a reference to a publication that Frumovitz's group could not track down.

"We all believe that applicants have the best intention and are representing themselves truthfully. But (this result) falls right in line with others who have done similar work," said Frumovitz.

The University of Washington team, led by Dr. Anne-Marie Amies Oelschlager, looked through two years' worth of applications to a residency program in obstetrics and gynecology.

Residents are doctors who have finished medical school, and are continuing their required clinical training in a particular field.

Among the 937 applicants, 357 put down that they had at least one research study that was published or about to be published in a peer-reviewed outlet.

When Amies Oelschlager's group went to find those publications, 156 of the 1,000 publications listed turned up missing.

They looked online, in publication databases and even contacted the journal for verification.

Of the other publications that were confirmed, the researchers found inaccuracies there as well.

The biggest error was that 62 applicants had listed a publication as "peer-reviewed" when it wasn't.

Peer review involves submitting a study for scrutiny by other researchers before it gets published, and therefore implies a high degree of rigor.

Amies Oelschlager said her study could not tell whether these were honest mistakes or intentional misrepresentations.

"The best you can assume is that these applicants didn't look up what peer review meant or they don't understand it," she told Reuters Health. "None of that is flattering and you worry whether they really understand the tenets of authorship, research, what is peer review and what is not."

Residencies and fellowships are competitive, and research experience is looked upon favorably when applicants are being reviewed.

"Applicants might be deliberately padding their resumes to try and get a spot, and it's concerning. The whole thing about being a physician is that you are expected to be honest," Amies Oelschlager said.

Dr. Lee Learman, a professor of obstetrics and gynecology at Indiana University School of Medicine, said that it's not clear whether errors on applications relate to errors in medical practice, but it is of concern.

He said that medical students and residents should be aware that misrepresenting their work could have negative consequences on their careers.

"Even though we don't know how this predicts future infractions, most directors of residencies and fellowships don't want to take the risk," Learman told Reuters Health. "They might say, this person might misrepresent data about a patient or misrepresent a step they took during surgery."

Learman encouraged directors of residency and fellowship programs to check the accuracy of applications, and if they can't find the publications listed, to ask the person to produce a copy.

Frumovitz said one way to make sure publication lists are accurate is to require that applicants include a copy of the paper or an identification number that will make it easier to look up.

Amies Oelschlager and her colleagues suggested that medical schools should include training in authorship and peer review.