Monday, September 25, 2023
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In 2015, physicians responded selflessly to natural and manmade disasters, made ground-breaking discoveries, and cared for some of the poorest people on earth. Others, unfortunately, brought dishonor on their profession. They falsely diagnosed patients with cancer for their own gain, sexted from the operating room, and provided unnecessary treatment. The physicians came from a wide variety of specialties, including cardiology, anesthesiology, and surgery. The "best" were chosen from the many physicians who reached the highest standards of their calling. The "worst" were selected from the extremely short list of those who have been convicted, jailed, and/or who have forfeited their medical licenses for gross misconduct.
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Oliver Sacks, MD, the neurologist and best-selling author, died in August. Called the poet laureate of medicine, the British-born author of Awakenings and The Man Who Mistook His Wife for a Hat, as well as 12 other books, wrote about the human spirit as much as the human brain. "I had discovered my vocation, and this I pursued doggedly, single-mindedly, with little encouragement from my colleagues," he once wrote. "Almost unconsciously, I became a story teller at a time when the medical narrative was almost extinct."[1]
The son of two physicians, Dr Sacks earned his medical degree at Oxford University. At the time of his death from liver cancer, he was a professor of neurology at New York University School of Medicine.
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Plastic surgeon Abdul Ghafar Ghayur, MD, has been likened to a modern-day medical Robin Hood. He performs life-changing surgery on low-income patients in Afghanistan with the income he earns from the plastic surgery and cosmetic procedures he performs on the wealthy. His patients often turn up unannounced seeking reconstructive surgery to treat disease, congenital disorders, and posttraumatic wounds. "If a patient comes and says 'I can only pay $100,' I can do it for $100. Or $20, or $30," Dr Ghayur said. "Because if we decide to wait until the patient has the money, the patient will have no chance of survival."[2] Dr Ghayur told Medscape recently that he would like to start a burn center in Kabul for victims of war and women who have suffered acid attacks.
Image courtesy of Abdul Ghafar Ghayur, MD
Bennet Omalu, MD, who identified a new neuropathology in the brains of professional NFL players, is the subject of a new film. Concussion stars Will Smith and will be released in December. Dr. Omalu discovered the condition caused by repeated blows to the head, after finding sparse neurofibrillary tangles and tau-positive neuritic threads in the brain of former Pittsburgh Steelers center Mike Webster. After he retired, Webster fell into a depression, struggled with drug abuse, and attempted suicide. Dr. Omalu was also the first to identify the condition, which he called chronic traumatic encephalopathy (CTE), in the brains of returning war veterans.[3]
Image from Eric Charbonneau/Invision for Sony Pictures/AP
Two medical researchers have been jointly awarded the $500,000 Albany Medical Center Prize in Medicine and Biomedical Research for 2015. Karl Deisseroth, MD, PhD, from Stanford University won the award for his pioneering work in the field of optogenetics. It enables scientists to study behavior in freely moving animals by precisely manipulating nerve cell activity. Xiaoliang Sunney Xie, PhD, from Harvard University, won his share of the award for groundbreaking work in the field of single-cell biology, which has provided new understanding about how individual molecules and their actions can affect cellular life and diseases in humans.[4]
Images courtesy of Stanford School of Medicine (L) and Harvard University (R)
David Sackett, MD, who was considered the father of evidence-based medicine (EBM), died in May. EBM combined Dr Sackett's statistic-laden field of epidemiology, which is usually focused on public health, with clinical practice. In his words, it is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients." Dr Sackett and others saw EBM as a corrective to the all-too-common practice of medicine based on personal experience, anecdote, intuition, and casual forays into the medical literature.[5]
Image courtesy of the estate of David Sackett, MD
Dr Levi Watkins, the first physician to successfully implant an automatic defibrillator, died in April. As a teenager, Dr Watkins participated in the 1955-1956 Montgomery bus boycott, and he later volunteered with Martin Luther King Jr. as his part-time driver. After the University of Alabama at Birmingham refused to accept Levi into its whites-only medical school, Dr Watkins attended Vanderbilt Medical School, becoming the first black person to graduate. He later became the first black chief resident in cardiac surgery at Johns Hopkins University Hospital. In 1980, Dr Watkins implanted the world's first automatic defibrillator in a 57-year-old woman. He retired from Johns Hopkins and medicine in 2013.[6]
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James "Red" Duke, the Texas surgeon who helped develop the Life Flight helicopter emergency service, died in April at the age of 86. Dr Duke, known for his Texas twang and thick mustache, was one of the best-known surgeons in the state. The changes that Dr Duke brought to emergency medicine influenced the field globally, said the University of Texas Health Science Center at Houston, where Duke had worked. "Dr. Duke was a true pioneer — a talented and tireless surgeon, a dedicated and inspiring educator, and a friend and mentor to everyone he met," said Giuseppe Colasurdo, president of UTHealth and dean of the UTHealth Medical School.
Dr. Duke also hosted a nationally syndicated TV show called "Texas Health Reports." Most recently, Dr Duke worked with the US military to improve battlefield medical techniques.[7]
Image courtesy of UTHealth
Elijah Saunders, MD, a prominent cardiologist and researcher who broke the color barrier, died in August of cancer at the age of 80.[8] Hailed as a pioneer for cardiovascular care in African Americans by his colleagues, Dr Saunders was one of only four black students in his class at the University of Maryland (UM) School of Medicine, the first black resident in internal medicine at the school, and the first practicing black cardiologist in Maryland in 1965. He later became head of UM's department of medicine's section of hypertension. It was there that he conducted important studies that showed that certain blood pressure medications and regimens are more effective for black patients. "Despite the challenges, Dr Saunders followed his own vision for equality in healthcare and became a compassionate leader for what was, at the time, an often-overlooked patient population," notes a UM statement.
Image courtesy of University of Maryland School of Medicine
A 40-person medical team at Children's Hospital of Philadelphia (CHOP) achieved the world's first pediatric bilateral hand transplant this year. The team operated for 10 hours on Zion Harvey, an 8-year-old-boy whose hands and feet were amputated at age 2 because of a life-threatening infection. Within a month after the surgery, the child was able to pick up a piece of pizza. He hopes to someday swing on monkey bars, throw a football, and pet a dog. The surgical team was led by L. Scott Levin, MD. He is the director of the hand transplantation program at CHOP, a professor of surgery at the Perelman School of Medicine at the University of Pennsylvania, and chair of the orthopaedic surgery department at Penn Medicine. "We have a strong belief that Zion will regain sensation and feeling in his hands," Dr Levin told Medscape Medical News. "He's using his own muscles to power the tendons in his new hand because the amputation level was at his wrist."[9]
Image from Matt Rourke/AP
Sanjay Kishor Saint, MD, MPH, who has dedicated much of his career to finding effective ways to prevent healthcare-associated infections, was honored by the Association for Professionals in Infection Control and Epidemiology. He was presented with the 2015 Distinguished Scientist Award in June.[10] Dr. Saint has been a national leader in efforts to prevent catheter-associated urinary tract infections and currently serves on the leadership team of a program that aims to reduce these infections across the United States. He has authored more than 250 peer-reviewed papers and is lead author of the book Preventing Hospital Infections: Real-World Problems, Realistic Solutions. Dr Saint is a special correspondent to the New England Journal of Medicine, member of the editorial board of the Annals of Internal Medicine, and an elected member of the American Society for Clinical Investigation.
He is a professor of internal medicine at the University of Michigan, Ann Arbor, director of the US Department of Veterans Affairs (VA)/University of Michigan Patient Safety Enhancement Program, and chief of medicine at the VA Ann Arbor Healthcare System.
Image courtesy of Sanjay Saint, MD
In July, Farid Fata, MD, was sentenced to 45 years in prison in Detroit for administering excessive or unnecessary chemotherapy to 543 patients. Some of them he deliberately misdiagnosed with cancer. In addition to enduring needless chemotherapy, the patients suffered anguish at the possibility of death. The massive criminal scheme netted at least $17 million from Medicare and private insurers. One witness said the oncologist overtreated her father to the point of killing him. The US Department of Justice had asked for a 175-year sentence, citing many aggravating factors, including the loss of faith in the medical profession that his actions produced.[11]
Ophthalmologist David Ming Pon, MD, was found guilty in October of cheating Medicare by pretending to perform procedures on patients who did not need them. A federal jury convicted Dr. Pon on 20 counts of healthcare fraud. He faces a maximum of 10 years in prison for each count. Federal prosecutors said that Dr. Pon, of Leesburg, Florida, falsely told more than 500 Medicare patients that they had macular degeneration. He would aim a laser at the patients' eyes, but set the energy at such a low level that the lasers were not effective. The scam netted Dr Pon more than $7 million, according to the Department of Justice.[12]
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Joseph Mogan III, MD, was sentenced to about 8 years in prison in March for operating two "pill mills" in suburban New Orleans, Louisiana. He gave out illegal prescriptions for narcotics and other controlled substances on a cash-and-carry basis. Dr. Mogan might have received a longer sentence had he not previously testified against a former New Orleans police officer who gave advice on how to operate under the radar of law enforcement. Prosecutors said the officer helped Dr Mogan and his co-operator Tiffany Miller because Miller provided sexual favors and thousands of dollars in cash.[13]
Image from iStock
Dr Aria Sabit pleaded guilty in a federal district court in Detroit, Michigan, in May to conspiring to receive kickbacks from a medical technology company. In 2010, Apex Medical Technologies, which distributes spinal surgery instruments, told the surgeon that if he invested $5000 in the company and used its hardware, he would share in the revenue. Ultimately, he received $439,000 from his investment. Dr Sabit also pleaded guilty to stealing $11 million in insurance proceeds after billing Medicare, Medicaid, and private insurers for spinal fusion surgeries that omitted the documented hardware and also to illegally prescribing a painkiller. Dr Sabit faces a prison term of 9 to 11 years.[14]
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A Virginia jury awarded a patient $500,000 in June after an anesthesiologist made mocking and derogatory comments, which the patient accidentally recorded on a cellphone while he was sedated. The case inflamed the public after The Washington Post first reported the story. The recording captured anesthesiologist Tiffany Ingham, MD, commenting on the patient's penis and making fun of him. The surgical team also entered a fake diagnosis of hemorrhoids into his medical record. Professional societies had sharp words about the Dr Ingham's ethical breach. "There's really no excuse" for Dr Ingham's behavior, said J. P. Abenstein, MD, president of the American Society of Anesthesiologists.[15] On June 24, Dr Ingham resigned her privileges at Florida Hospital Waterman, in Tavares, according to the Orlando Sentinel.
Image courtesy of Kentucky Air National-Guard
A former researcher at Iowa State University was sentenced to 57 months in prison in July for systematically falsifying data to make an experimental HIV vaccine look effective. The researcher, Dong Pyou Han, PhD, was supposed to inject rabbits with a vaccine and test their sera for HIV antibodies. Dr Han not only gave the head of the lab false test results about the vaccine, but he also injected the rabbits with human antibodies. The research, presented at three academic conferences, stirred hope in the HIV/AIDS scientific community that a vaccine was at hand. And on the strength of the results, the lab director received $13 million from the National Institutes of Health (NIH). In February, Dr Han pleaded guilty in a federal district court to making false statements to the NIH.[16]
Image from Charlie Neibergall/AP
The Washington Medical Quality Assurance Commissions suspended the license of Arthur Zilberstein, MD, in June for sexting from the operating room. The commission said Dr Zilberstein "compromised patient safety due to his preoccupation with sexual matters" during surgery. He was charged with exchanging sexually explicit texts during surgeries when he was the responsible anesthesiologist, improperly accessing medical-record imaging for sexual gratification, and having sexual encounters in his office. The commission also said that Dr Zilberstein issued at least 29 unauthorized prescriptions for controlled substances and legend drugs and had sexual relations with one patient for whom he was prescribing drugs. It was also found that Dr Zilberstein made disparaging and racist remarks about a patient.[17]
Image courtesy of Arthur Zilberstein, MD/Twitter
An Ohio cardiologist was convicted in September of billing Medicare and other insurers for $7.2 million in unnecessary tests and procedures. Dr Harold Persaud put lives at risk by performing stent insertions, catheterizations, imaging tests, and referrals for coronary artery bypass graft surgery that were not medically warranted, according to prosecutors. "This doctor violated the sacred trust between doctor and patient by ordering unnecessary tests, procedures and surgeries to line his pockets," said Stephen D. Anthony, Special Agent in Charge of the FBI's Cleveland Office. The Westlake cardiologist was found guilty of one count of healthcare fraud, 13 counts of making false statements, and one count of engaging in monetary transactions in property derived from criminal activity.[18] He was first indicted in August 2014.[19]
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