Can Independent Primary Care Doctors Survive Dominance of Hospital Health Systems?

Every day, Dr. Leslie Miller of Fairfield thinks about selling her practice to a hospital health system. “Everybody who is in this environment thinks every day of throwing in the towel and joining a hospital,” said Miller, a sole practitioner in primary care for 20 years. “The business side is the problem,” she said, referring to expensive and time-consuming requirements of medical insurance and government regulations. Dr. Khuram Ghumman took the unusual route of working in a hospital system first, then going into private primary care practice because he objects to the “corporatization” of health care. He said conflicts of interest can arise if an owner and its employed physicians have different objectives.

Medical Practices Become Another Pandemic Casualty

After 35 years as an oral surgeon, Dr. Arthur Wilk closed his practice in Clinton following “daunting challenges” caused by the COVID-19 pandemic. In Darien, Dr. Cecile Windels sold her pediatric practice to a hospital health system after enduring significant income losses. They are among thousands of physicians and other health care professionals across the country who have made coronavirus-prompted career changes such as closing practices, joining larger health systems and retiring early.  The reasons for the moves vary from declines in income due to fewer inpatient visits to increased operational costs for personal protective equipment (PPE) and fears of contracting the coronavirus known as SARS-CoV-2. Health care advocates say the changes will exacerbate physician shortages, further erode the existence of private practices, decrease patient choice of doctors and obstruct continuity of patient care. A January report in Health Affairs, a peer-reviewed journal of health policy research, said: “Consolidation tends to lead to higher prices without strong evidence of quality improvements.”

“The national trends are definitely happening in Connecticut,” said Dr. Gregory Shangold, president of the Connecticut State Medical Society.

Army Must Reconsider Applications For Discharge Upgrades Connected To PTSD

Thousands of Army veterans with mental illnesses will get a second chance for a higher discharge status and veterans’ benefits because of a settlement in a class action suit brought by two Connecticut veterans. The settlement requires the U.S. Army to “automatically reconsider” every rejected application for discharge upgrades connected with Post Traumatic Stress Disorder (PTSD) or related mental health conditions that it rejected over nine years from April 17, 2011 through November 17, 2020. So far, the Army has identified about 3,500 affected veterans of the Army, Army Reserve or Army National Guard. The lawsuit represented veterans who were given less than honorable discharges for behaviors they contend were triggered by PTSD, traumatic brain injury, military sexual trauma or related issues. The suit contended that the Army failed to follow its own rules that require consideration of mental health in discharge upgrade applications.

CT Veterans Suicide Rate Rises; VA Monitoring COVID-19’s Impact

In Connecticut, 47 veterans died by suicide in 2018, an increase of 10 from the previous year, newly released statistics show. The increase reflected a higher suicide rate than in the overall state population. The Connecticut veteran suicide rate was 25.1 per 100,000 compared with 14.6 in the overall state population. The state’s veteran suicide rate was 20.3 in 2017. The 2018 rate rose even though the state veterans population dropped by about 1,000 to 187,000.

VA Connecticut Hiring Practices Under Investigation

The U.S. Office of Special Counsel is investigating allegations of illegal employment practices at VA Connecticut Healthcare System connected to the hiring of seven employees­­—some in top management positions­—who are all former co-workers of the system’s director. A separate complaint filed by a whistleblower to the Office of Inspector General of the U.S. Department of Veterans Affairs alleges “gross misconduct” in the hiring of staff from the Manchester (New Hampshire) VA Medical Center. It says that “all management positions were pre-selected.”

“VA Connecticut is in turmoil,” wrote the whistleblower in an anonymous complaint filed in August and obtained by C-HIT. The complaints have put a spotlight on the management of Alfred A. Montoya Jr., who has been head of the West Haven VA for almost a year. Montoya was brought in from the Manchester (New Hampshire) VA Medical Center after years of upheaval in the delivery of health care at the West Haven VA, where surgeries were outsourced to Yale New Haven Hospital after deficiencies were found in sterile procedures.

As Veteran Suicide Grows, National Guard Highest In Active Military

Sergeant William Davidson had been struggling with mental health problems since his deployment to Afghanistan. When he didn’t attend at least one of his Connecticut National Guard drill weekends, the Guard declared him AWOL (absent without leave) and discharged him with a “bad paper” separation. Four months after his discharge, Davidson, 24, fatally shot himself. Davidson, who had two younger sisters, is one among thousands of veterans who die by suicide each year. Despite national goals to prevent veteran suicides, they occur at disproportionately higher rates than in the general population.

Food Safety Nets Are Straining Under Economic Meltdown

Beyond the gleaming office towers overlooking I-95 in Stamford and the pleasure boats that frequent the city’s marinas, thousands of city residents are struggling with hunger, a situation worsened by the pandemic. Severe food needs in Stamford, which has the most COVID-19 cases in Connecticut, reflect the state and national food emergency wrought by record unemployment. Consistent with the national experience, Latino and black residents, who comprise about 40% of the city’s population, are disproportionately contracting COVID-19 and losing low-wage work. Latinos comprise 26% (33,000) of Stamford’s population, blacks 14% (17,000). The Brookings Institution has reported that more than one in five households nationally were food insecure by the end of April.

Homelessness Can Traumatize A Young Child For Life; Collaborative Seeks To End The Costly Consequences

The repercussions of being homeless as a child younger than 6 can be lifelong, and the strain often shows in their speech, behavior, development and health, according to child-care workers and experts. They may be nonverbal, or act out. They’re often sick, but may not have a pediatrician. They may not even know how to brush their teeth. “The impact on these young children is gigantic,” said Darcy Lowell, chief executive of Child First.

Nasal Spray Offers Hope For Severely Depressed Patients

Some Connecticut hospitals and doctors and a clinic are starting to treat severely depressed patients with a new nasal spray called Spravato, touted as the most significant federally approved depression medication since Prozac was approved in 1987. Spravato, which received Food and Drug Administration (FDA) approval in March, has raised hopes for preventing suicides and relieving depression after other treatments have failed. But there are concerns about possible side effects, including drug abuse, elevated blood pressure and heart rate, sedation, and hypersensitivity to surroundings. The nasal spray is prescribed for treatment-resistant depression after at least two other antidepressants haven’t worked and is given with an oral antidepressant. It is only administered in restrictive clinical settings to reduce potential for abuse and side effects.

After Denials, Army Veteran Exposed To Toxic Burn Pit Smoke Gets His Disability Benefits

After being rejected twice, a Connecticut Army veteran has been awarded federal disability benefits for terminal brain cancer he contends was caused by exposure to open burn pits in Afghanistan. Peter Antioho, 33, of Berlin, had to walk daily through heavy smoke emanating from burn pits as he performed his job as second in command on his base in 2012. A variety of items, including human and animal waste, plastic, ammunition and batteries were burned with diesel fuel 24 hours a day in open pits. He was diagnosed with glioblastoma multiforme brain cancer two years ago. (The Conn.