Articles Posted in Whistleblowers

Patients, politicians, and regulators may find it tough to believe, so they need sharp periodic reminders: While there are many terrific, dedicated doctors working today, there also are some truly terrible ones. And dealing with the harms of medical malpractice by the incompetent and abusive can require courage and vigilance.

  • Perhaps a new, streamed Hollywood serial — starring the likes of Alec Baldwin, Christian Slater, AnnaSophia Robb, and Joshua Jackson — can underscore for the public how grisly the results can be until a rare criminal prosecution derails the likes of Christopher Duntsch, a Dallas surgeon so grim he is nicknamed “Dr. Death?”

cellphonevideonathandumlao-200x300In the running battle between authorities and individuals over excessive use of force, the eyes suddenly now have it: The advance of smart phone technology to ubiquity and with quality video recording is giving claimants powerful new evidence. It is not pretty for law enforcement excesses — and even potentially extra-legal escapades.

Not one, not two, but three news organizations — the Washington Post, the New York Times, and ProPublica — report that they have scoured nationwide to find abundant cell phone videos of official responses to protests over the Minneapolis police killing of George Floyd and other African Americans in custody. Here is a sampling of their disturbing articles:

The Washington Post

drugnovartislogo-300x127Big Pharma focuses relentlessly on always making a buck, no matter the cost to the rest of us, and even a viral pandemic that infects 2.8 million Americans and kills roughly 130,000 of us won’t interrupt the corporate rapaciousness.

That’s the reality that federal prosecutors have reminded the public about with an announced $678 million settlement with Novartis over the drug maker’s doctor prescribing- and kickbacks-scheme.  And it is what Gilead has shown with its planned pricing for remdesivir. It is an anti-viral drug that has shown modest effect in shortening the course of Covid-druggileadlogo-300x11519 infections and was developed with taxpayer funding.

The Novartis case also paints a damning picture of doctors’ complicity in taking bribes to defraud taxpayers (specifically the Medicare, Medicaid, and Veterans Affairs programs) by pushing company products, including the high blood pressure drugs Lotrel, Diovan, Exforge, Tekturna, Valturna and Tekamlo, and the Type 2 diabetes medication Starlix.

bluereport-300x128The University of Michigan is investigating allegations that Robert E. Anderson, former head of the university health service and physician to UM football teams coached by Bo Schembechler and Lloyd Carr, sexually assaulted youthful patients across decades.

Anderson worked for the university for more than 30 years and died in 2008. As the New York Times reported:

“Michigan said its campus police department had opened an inquiry last summer, after Warde Manuel, the athletic director, received a message from a former student who said that Anderson had engaged in abuse during medical exams in the ’70s. During the investigation, Michigan said, other people described ‘sexual misconduct and unnecessary medical exams,’ including at least one allegation that wrongdoing had occurred in the ’90s.”

freedhoff2-150x150Bravo, brevity. Four dozen words is all it takes for a doctor and noted writer on diet and obesity to offer plenty of sound advice on how to get and stay healthy.

Here are the suggestions from Yoni Freedhoff, associate professor of family medicine at the University of Ottawa, founder and medical director of Ottawa’s Bariatric Medical Institute, blogger at Weighty Matters, and author of “The Diet Fix: Why Diets Fail and How to Make Yours Work:”

“Don’t smoke. Get vaccinated. Avoid trans fats. Replace saturated fats with unsaturated if you can. Cook from whole ingredients — and minimize restaurant meals. Minimize ultra-processed foods. Cultivate relationships. Nurture sleep. Drink alcohol at most moderately. Exercise as often as you can enjoy. Drink only the calories you love.”

There seems to be a never-ending outbreak of a certain kind of pathology in the United States. Big Pharma has it and spreads it around, a lot. So, too, do public health figures. Let’s call this scourge what it is — unmitigated gall.

The problem with this nasty condition is that it afflicts the rest of us. Just consider how stomach-churning these shenanigans can be:

Penalties for bogus prescribing of ‘little red pills’ on elderly dementia patients

insurerscam-300x188What happens when a whistle blower provides detailed information about a burly Texan  — with convictions for felony theft and felony injury of a child  — and a burgeoning scam to rip off health insurers for $25 million? Pretty much nothing. For years.

If that sounds outlandish, investigative reporter Marshall Allen has a doozy of a tale to tell about a crook in suburban Fort Worth, Texas named David Williams. His long-running defrauding of some of the nation’s biggest health insurers matters to us all because, as Allen reported for the Pulitzer Prize-winning investigative site ProPublica:

“There are a host of reasons health care costs are out-of-control and routinely top American’s list of financial worries, from unnecessary treatment and high prices to waste and fraud. Most people assume their insurance companies are tightly controlling their health care dollars. Insurers themselves boast of this on their websites. In 2017, private insurance spending hit $1.2 trillion, according to the federal government, yet no one tracks how much is lost to fraud. Some investigators and health care experts estimate that fraud eats up 10% of all health care spending, and they know schemes abound. Williams’ case highlights an unsettling reality about the nation’s health insurance system: It is surprisingly easy for fraudsters to gain entry, and it is shockingly difficult to convince insurance companies to stop them. Williams’ spree also lays bare the financial incentives that drive the system: Rising health care costs boost insurers’ profits. Policing criminals eats away at them. Ultimately, losses are passed on to their clients through higher premiums and out-of-pocket fees or reduced coverage.”

wheelinghospital-300x111As hospitals boost their size and power to push their profits even higher, they’re also raising alarms with federal regulators over their too cozy relationships with doctors who are pulling down big pay from them now as part of their staffs.

Uncle Sam long has sought to ensure that the billions of tax dollars that get spent in the health care system don’t become medical spoils, riches that get passed around a select few through kick-back and self-referral schemes. These are barred by regulation, notably in Medicare- and Medicaid-funded care, and by the “Stark law.”

Jordan Rau of the Kaiser Health News service reported that a hospital in Wheeling, W. Va., has gotten regulators attention by lavishing pay and perks on specialists in its employ, including $1.2 million a year for a pain specialist and $770,000 annually and 12 weeks’ vacation for a cardiothoracic surgeon. The money is far higher than what such experts command in the area and it’s more surprising because the treatment areas these high-paid doctors work in are big financial losers for Wheeling Hospital.

casho-300x168Although lawsuits can result in needed financial support and welcome recognition of harms suffered by patients seeking medical services, the civil justice system has its limits. They showed in cases in the news in which disputing parties agreed to more than $1 billion in resolutions that left issues unanswered.

What to make of the:

khnbills-300x255Doctors and hospitals have become nothing less than unhinged with the numbers they put into their medical bills compared to what rational, reasonable patients expect to pay, new media reports show.

Kaiser Health News Service — and Vox, the online information site — deserve consumers’ thanks for their running exposes of excessive medical bills.

These stories have zeroed in on billing practices that can’t help but provoke an outcry. These include attempts by doctors and hospital to gouge patients for hard to account for and difficult to prevent “out of network” charges, which insurers decline to cover. They also include cases involving steep sums owed due to “balance billing,” in which doctors and hospitals not only take insurers’ “acceptable” reimbursements but then demand yet more payment from patients for the uncovered amounts.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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