Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.
Sex Assault at Mt. Sinai
the experience of the patient whose accusations of sexual assault landed David Newman, MD, in jail, and raises questions about whether Mount Sinai Hospital fostered a culture that made it possible.
In January 2016, Aja Newman (no relation) had gone to the emergency department for severe shoulder pain. When she resisted the second dose of morphine Newman suggested, he went ahead with it anyway -- and gave her a dose of propofol before groping her and masturbating on her.
Aja had been in and out of consciousness, but remembered parts of the assault. When she realized her complaints to hospital staff would go nowhere, she decided to take the hospital bedsheets with her when she was discharged. Grueling interviews with police and forensics teams eventually led to proof of David Newman's guilt. Although no evidence was found on the bedsheets, Aja pressed investigators to spray on her, and their findings verified her story: "It was all over my face, all over between my breasts like I told her."
New York state found three other women -- like Aja Newman, all young women of color -- who also were sexually assaulted by David Newman in the Mount Sinai ED.
"It feels like a nonrandom choice," Esther Choo, MD, an emergency physician who helps lead #timesuphealthcare, told The Cut. "Could this person have been more vulnerable? ... Right at this moment, we are at a crisis for poor black women in this country. We are systematically not providing good healthcare to African-American women, and this is the woman he chooses to do this to?"
The story also examines the culture of medicine at Mount Sinai that allowed such a thing to happen. When Newman's arrest first made the news, support poured in for the doctor, who'd been a rising star in the field. Medical school dean Dennis Charney, MD, is described as a tough and aggressive leader, and the "hierarchical, macho, fear-based, profit-oriented culture of hospital medicine is especially intense and pervasive there," according to the story.
Mount Sinai has also been in hot water over a complaint filed in federal court this spring charging rampant discrimination against women, centering around the promotion of Prabhjot Singh, MD, who allegedly demoted and humiliated women on his staff and hired a deputy who used demeaning language to describe women. (Singh stepped down from his post in July.)
Pharma's 700 MD Millionaires
More than 700 physicians have made at least $1 million from industry since the government's started publicly tracking those relationships five years ago, .
Over 2,500 physicians received at least $500,000 each from drugmakers and medical device companies during that time.
The ProPublica analysis covered more than 56 million payments made from 2014 to 2018, the first 5 years of Open Payments data.
Some experts have mused that making such data publicly available might cause companies to think twice about the payments they dole out, and make doctors rethink taking that money. But the analysis shows little change, with companies still hiring doctors for dinner talks, sponsored speeches, and consulting. There's been almost no change in how much industry spends, with each of the five years tallying $2.1 to $2.2 billion in payments, and about the same number of doctors (600,000) receiving payments in any given year.
Despite perceptions that drug company payments are benign, many drugmakers have recently paid fines to resolve allegations around their marketing practices, ProPublica noted.
In June, Insys paid a $2-million fine and agreed to forfeit $28 million and pay an additional $195 million to . Prosecutors said the firm paid doctors for educational lunches and dinners that the Department of Justice called "a vehicle to pay bribes and kickbacks to targeted practitioners in exchange for increased Subsys prescriptions to patients and for increased dosage of those prescriptions."
And last month, Avanir Pharmaceuticals agreed to pay $108 million, to doctors and marketed the drug for unapproved uses.
Massive Tomosynthesis Marketing Machine
Women are being upsold on 3D mammography by a massive marketing machine, despite no evidence the scans are better at detecting cancer than conventional mammography, .
Industry has pushed the technology, also known as tomosynthesis, by paying influential doctors and celebrity spokespeople, lobbying state lawmakers, and funding experts and advocates, according to the report.
For instance, manufacturers Hologic, GE Healthcare, Siemens, and Fujifilm paid doctors and teaching hospitals more than $240 million in the past 6 years, including $9.2 million directly related to 3D mammograms, KHN found in an analysis of Open Payments data. They also spent at least $14 million to market 3D screening over the past 4 years, hiring breast cancer survivor Sheryl Crow as a spokesperson.
Manufacturers also flexed their muscle with state lawmakers, so that private insurers in 16 states now cover 3D screenings, as do Medicaid programs in 36 states and the District of Columbia. Also, Medicare began paying for 3D exams in 2015, and by 2017 nearly half of the mammograms it paid for were 3D, the KHN analysis found.
Physicians on the payroll include Linda Greer, MD, a community radiologist in Phoenix who lobbied the state of Connecticut to get 3D scans reimbursed. She told lawmakers in a letter that she was "shocked" by how many more tumors were detected with the technology. Greer got more than $305,000 from manufacturers in a 6-year period, including $222,000 directly related to 3D products.
Stephen Rose, MD, an active advocate for 3D screens, testified on behalf of a bill supporting reimbursement in Texas. He's made $317,000 from manufacturers, including more than $50,000 directly related to their 3D products.
"There's a lot of money to be made," Steven Woloshin, MD, director of the Center for Medicine and Media at Dartmouth, told KHN.
Chart Review Squeezes $12 Million More from Medicare
A whistleblower alleges that the insurer Group Health Cooperative in Seattle committed Medicare fraud, .
Former employee Teresa Ross charged that the nonprofit health insurance plan in 2010 claimed some patients were sicker than they were to get reimbursed at higher rates, or billed for conditions patients didn't have. In doing so, Group Health retroactively collected millions from Medicare.
From 2008 to 2010, Group Health's operating income went from almost $57 million in the black to a $60-million loss. But a consultant hired by the insurer helped that turn around. In November 2011, DxID was contracted to review medical charts, resulting in $12 million in new claims.
Ross's case is one of at least 18 "that accuse Medicare Advantage managed-care plans of ripping off the government" by exaggerating patients' illnesses, KHN said.
Ross filed suit in federal court in Buffalo, New York, in 2012, but it remained under seal until July, and is in the initial stages.