Monday, February 6, 2023
The Year's Best and Worst Physicians
Physicians were in the news this year for research fraud, healthcare fraud, and retaliating against whistleblowers, as well as for humanitarian work and focused response in the face of the Tucson shooting. The following are examples of doctors who held themselves to either the highest or the lowest standards this year. Unfortunately, our "best" represent only a few out of so many physicians who honor their profession with exemplary achievements. But our "worst" were easily picked from a very short list.
Wakefield's MMR-Autism Vaccine Study an "Elaborate Fraud"
In January, the BMJ published a series of 3 articles and editorials charging that the study published in The Lancet in 1998 by Andrew Wakefield (pictured above) and colleagues linking the childhood measles-mumps-rubella (MMR) vaccine to a "new syndrome" of regressive autism and bowel disease was not just bad science but "an elaborate fraud." Wakefield was planning to market a diagnostic testing kit with expected yearly sales of 28 million pounds (US $43 million) as well as immunotherapeutics and a "safer single measles shot," for which he held a patent. The third article in the BMJ series claimed that the medical establishment "closed ranks" to protect Wakefield.
Medicare "Fraudsters"
A federal bust of Medicare fraud in 8 cities in September yielded criminal charges against 91 individuals, including 10 physicians, who allegedly billed Medicare for $295 million in false claims with the help of kickbacks, illegal pain medication prescriptions, imaginary psychotherapy sessions, and other ploys. The US Department of Justice called the bust "the highest amount of false Medicare billings in a single takedown in Strike Force history."
Retaliation Against Nurse Whistleblowers
Rolando Arafiles Jr, MD, in November pled guilty to criminal charges in a state court in Winkler County, Texas, for retaliating against 2 nurses who had anonymously reported him in 2009 to the Texas Medical Board (TMB) over the quality of his patient care. In February this year, the TMB put Dr. Arafiles on probation for 4 years, fined him $5000, and ordered him to enroll in a remedial medical education program.
Bribes for Referrals
Thirteen physicians and a nurse practitioner were arrested on December 13, charged with accepting bribes from Orange Community MRI in exchange for referring patients for a variety of imaging exams. The company's executive director was also arrested. The imaging company began making illegal kickback payments as early as 2010, according to a press release from the Offices of United States Attorneys. At the end of each calendar month, prosecutors allege, individuals at the imaging company printed patient reports detailing how many diagnostic tests were referred by each of the defendants to determine the payments due to each.
Physician to the King of Pop
Michael Jackson's personal physician, Conrad Murray, MD, in November was sentenced to 4 years in jail for his conviction on a charge of involuntary manslaughter in the pop star's death. The testimony of 2 renowned anesthesiologists likely helped determine his fate.
Pain Meds Scams
In August, 14 physicians were indicted as members of "the nation's largest criminal organization" involved in illegally distributing opioid analgesics. One of the 14 physicians, Gerald J. Klein, MD, was charged with first-degree murder in the death of a man who overdosed on a massive drug combination that Dr. Klein had prescribed. In a separate case, Sam Jahani, DO, and Eric Peper, MD, faced federal charges of illegally prescribing opioid analgesics and other controlled substances that led to the overdose deaths of 4 patients. In a third case in August, 4 physicians and 13 other clinicians working with 26 pharmacies were charged with conspiring to commit healthcare fraud by billing for illegally prescribed drugs, mostly various opioids.
Medical "Mayhem"
In January, Kermit Gosnell, MD, was charged by a Pennsylvania grand jury with the murder of 7 newborn infants and a Bhutanese immigrant named Karnamaya Mongar, who died of cardiac arrest in 2009 following a meperidine (Demerol®) overdose dispensed by unlicensed, untrained, and unsupervised clinic employees. Other criminal charges include aborting fetuses past the state's legal limit of 24 weeks, violating the state's controlled substance law, abusing corpses, and corrupting the morals of a minor whom Dr. Gosnell hired at age 15 to work at his Philadelphia clinic. The case prompted Pennsylvania Governor Tom Corbett to issue strict new policies for monitoring licensed abortion clinics, and Philadelphia prosecutors paved the way in court toward seeking the death penalty.
Unnecessary Stenting
The Maryland Medical Board in July decided to revoke the medical license of Mark Midei, MD, calling his violations of the Medical Practice Act "repeated and serious." Midei is alleged to have implanted hundreds of unneeded stents when he worked at St. Joseph Medical Center in Towson, Maryland. A similar case also was decided in July when John R. McLean, MD, was convicted on 6 charges of healthcare fraud relating to insurance claims that he had filed for stents deemed to have been placed unnecessarily, as well as for ordering unnecessary tests and making false entries in patient medical records. In November, Dr. McLean was sentenced to 8 years in jail plus restitution.
Dr. Mark Kris Receives First ASCO Humanitarian Award
Mark G. Kris, MD, Chief of the Thoracic Oncology Service and the William and Joy Ruane Chair in Thoracic Oncology at Memorial Sloan-Kettering Cancer Center, and Professor of Medicine at Weill Medical College of Cornell University in New York City, has built homes for families in Hyde Park, New York, with Habitat for Humanity; gone to Costa Rica to build a basketball court and a church; made several trips to assist with earthquake relief in Haiti; and helped with relief efforts in Biloxi, Mississippi, after Hurricane Katrina. The American Society of Clinical Oncology (ASCO) has given Dr. Kris the inaugural ASCO Humanitarian Award for his dedication and compassion in his professional work and his volunteer efforts.
Psychiatrist Recognized for Efforts in Haiti
In November 2010, Jean Tropnas, MD, received an award from the American Psychiatric Association in honor of his efforts to bring mental health services to the people of Haiti after the devastating earthquake that struck the impoverished island in January 2010. Clinical Assistant Professor of Psychiatry and Behavioral Sciences at SUNY Downstate Medical Center, Brooklyn, New York, Dr. Tropnas met with and counseled physicians and nurses working in makeshift clinics after their hospitals were destroyed. In June 2011, the University of Miami hosted the Haitian Mental Health Summit, which Dr. Tropnas helped organize. A task force emerged with a plan to coordinate with the Haitian government and nongovernment organizations the rebuilding of the mental health infrastructure in Haiti.
Tucson Shootings
In January, many focused on the daily press briefings from Peter Rhee, MD, MPH, and G. Michael Lemole, MD, heads of the University of Arizona Medical Center's Departments of Trauma and Neurosurgery, respectively, as they reported on their care of Rep. Gabrielle Giffords after the tragic shootings in Tucson that left 6 people dead and 13 others wounded.
2011 Nobel Prize in Medicine
The Nobel Prize for medicine was awarded in October to 3 scientists whose discoveries about the immune system are expanding how clinicians prevent and treat infection, inflammatory diseases, and cancer, including a form of cancer that claimed the life of one of the new Nobel laureates. Bruce Beutler, MD, and Jules Hoffmann, PhD, received a half-share in this year's prize for discovering receptor proteins that can spot bacteria and other microorganisms and then activate the body's innate immunity to defend itself. The other half of the $1.5 million prize went to the late Ralph Steinman, MD, who discovered the dendritic cells that turn on the T cells at the heart of active immunity, which creates an immunologic memory against invaders. The Nobel committee selected Dr. Steinman before learning of his death.
Renowned Children's Cancer Expert, Dr. James Nachman, Dies
James B. Nachman, MD, Professor of Pediatrics at the University of Chicago, died on June 10 from a suspected heart attack while rafting on the Colorado River in the Grand Canyon. He was 62 years old. Dr. Nachman was a world-renowned pediatric oncologist and was instrumental in developing the treatment regimen known as "augmented postinduction therapy" for acute lymphoblastic leukemia. He was described by his colleague, John Cunningham, MD, as "an outstanding clinician, teacher, and clinical researcher. He made seminal observations in leukemia and lymphoma that have impacted the lives of many children and adults with these diseases. He was an outstanding doctor, beloved by his patients, their families, and his colleagues."
Research Pioneer Honored for Work in Postpartum Depression
University of Pittsburgh Medical Center psychiatrist Katherine L. Wisner, MD, MS, a pioneer in the study of postpartum depression, is the recipient of the 2011 Women in Science Award from the American Medical Women's Association. She did her initial training in England because Europe was far ahead of the United States in the study of perinatal psychiatric disorders. Dr. Wisner recalled that when she first went into medicine, "we were pondering as a society why all the data were based on men. We didn't want to include women with messy menstrual cycles and pregnancy -- so I was able to carve out women's mental health as an area of research...We must get data on things that aren't being studied, and pregnant women have been neglected for so long."
Dr. Valentin Fuster Honored With Grand Prix Award
The Lefoulon-Delalande Foundation of the Institute of France has awarded Dr. Valentin Fuster the 2011 Grand Prix Scientifique. Dr. Fuster is Director of the Mount Sinai Heart Center in New York City and Past President of the American Heart Association and the World Heart Federation. The recipient of this award, worth €500,000, is honored for a significant scientific contribution to physiology, biology, or cardiovascular medicine. Dr. Fuster is best known for his profound contributions to the understanding and prevention of atherothrombosis and was the first to have highlighted the role of platelets in acute coronary syndromes. He is also renowned for his work on coronary plaque. Dr. Fuster is the only cardiologist to receive the 2 highest gold-medal awards and all 4 major research awards from 4 major cardiovascular organizations.
