I-Team In-Depth

Pharma Cash Flows To Doctors For Consultant Work Despite Scrutiny

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With physicians’ compensation from pharmaceutical and medical device companies under increasing scrutiny, payments to doctors in Connecticut for consultant work rose to $8.5 million in 2017, up from $8 million in 2016. Payments for meals, travel and gifts also increased from $3.2 million in 2016 to $3.5 million in 2017, data from the Centers for Medicare & Medicaid Services show. Of the total $27.2 million in payments, $4.37 million – or 16 percent – went to 10 doctors holding licenses in Connecticut. The highest paid doctor was Dr. Paul Sethi, an orthopedic surgeon in Greenwich, who accepted slightly more than $1 million in 2017 in royalty fees, consulting work, and other services from several companies, including Arthrex Inc., and Pacira Pharmaceuticals Inc., maker of Exparel. The drug, Exparel, is marketed as an alternative to opioid painkillers post-surgery.

Fines & Sanctions

Med Board Recommends Reinstating License Of Doctor Who Served Prison Term

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The state Medical Examining Board today recommended reinstating the medical license of a former Yale School of Medicine department head who served nine months in prison for lying about his travel expenses while at Johns Hopkins University. In 2017, Dr. Jean-Francois Geschwind of Westport pleaded guilty to four counts of mail fraud arising from his scheme to unlawfully obtain travel expenses from Johns Hopkins, where he was a radiologist, according to the U.S. attorney in Maryland. Geschwind fraudulently received reimbursement for trips to the United Kingdom, France and Japan when some of the expenses were for family vacations and meals, the U.S. attorney said. He was ordered to pay fine of $75,000 and an assessment of  $400 and restitution of $583,484, Connecticut and Maryland records show. A liver cancer researcher, Geschwind wrote to the Connecticut board that in 2015, he was recruited by Yale to become its new chair of the radiology department.

Fines & Sanctions

State Places Yale Doctor On Probation For Alcohol Abuse

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The state Medical Examining Board Tuesday placed a Yale Cancer Center doctor’s license on probation for five years, saying his excessive abuse of alcohol affects his ability to practice as a physician. The board accepted a consent order that said Dr. Harris E. Foster Jr. abused alcohol to excess at various times between 2012 and May of this year. Last week, the cancer center’s website listed Foster as a professor of urology at the Yale School of Medicine and as the director of female urology and neuro-urology at the center in New Haven. After a reporter inquired about his status, the cancer center’s website on Tuesday only listed him as a urology professor. Mark D’Antonio, a spokesman for Yale New Haven Hospital, said Tuesday that Foster is still affiliated with the cancer center, but he cannot comment further because Yale does not comment on personnel matters.

Disparities

HPV-Related Cancer Rates Outpace Vaccine Rates

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Cancers linked to the human papillomavirus (HPV) rose dramatically in a 15-year period, even as the rates of young people being vaccinated climbed, the Centers for Disease Control and Prevention (CDC) reported. The 43,371 new cases of HPV-associated cancers reported nationwide in 2015 marked a 44 percent jump from the 30,115 cases reported in 1999, according to a CDC analysis. HPV vaccination rates have improved over the years, but not fast enough to stem the rise in cancers, the CDC said. Oropharyngeal (throat) cancer was the most common HPV-associated cancer in 2015; accounting for 15,479 cases among males and 3,438 among females, the CDC data show. HPV infects about 14 million people each year and between 1999 and 2015 rates of oropharyngeal (throat) and vulvar cancer increased, vaginal and cervical cancer rates declined, and penile cancer rates were stable, according to the CDC.

Women's Health/Disparities

Poor And Minority Women Face Widening Barriers To Depression Treatment

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Among women, those who are low-income or minority are less likely to get treatment for depression, according to multiple studies. A report by the Connecticut Behavioral Health Partnership found that women were underrepresented in Medicaid-funded behavioral health services in the state even though research shows that women suffer from the most commonly diagnosed mental health disorders more frequently than men. Racial and ethnic disparities, while still considerable, are decreasing in some physical illnesses. “But in mental health care, in the last 10 years, we see those disparities widening,” said Megan Smith, associate professor in the Departments of Psychiatry and in the Child Study Center in the Yale School of Medicine, who runs the Mental health Outreach for MotherS (MOMS) Partnership®, a program that offers mental health services to “overburdened and under-resourced mothers.”

In this podcast, sponsored by ConnectiCare, Colleen Shaddox discusses the hurdles to mental health care and the programs breaking barriers to care with Yale’s Megan Smith and UConn Health’s Dr. Sarah Nguyen. Lack of insurance coverage, the cost of treatment, a shortage of qualified clinicians, stigma and even fear of losing custody of their children can keep women from seeking help, Smith said.

Women's Health

Connecticut Fertility Trends: Older Mothers And Fewer Babies

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As fertility rates fall nationwide, Connecticut continues to rank among the lowest in the country—a trend doctors attribute to women here delaying childbearing. In 2016, the most recent year for which state-level data is available, Connecticut had 53.4 births per 1,000 women ages 15 to 44, compared with a national average of 62 per 1,000 women, according to data from the Centers for Disease Control and Prevention (CDC). Just four states had lower rates than Connecticut in 2016, and all are in New England: Vermont at 50.3 births per 1,000 women, New Hampshire at 50.9, Rhode Island at 51.8 and Massachusetts at 51.9. The states with the highest fertility rates in 2016 were South Dakota at 77.7, North Dakota at 77.3, Utah at 76.2 and Alaska at 76.1, the CDC reports.  Unlike birth rates, which take an entire population into account, fertility rates reflect the share of babies born to women of childbearing age. Connecticut typically ranks low on the list, along with other “high achievement, high education states,” said Dr. Harold J. Sauer, chairman of obstetrics and gynecology at Yale New Haven Health’s Bridgeport Hospital.

Women's Health

Depression Affects Women At Twice The Rate As Men

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Depression is the leading cause of disability worldwide, according to the World Health Organization, and affects women at about twice the rate that it does men. In Connecticut, 21.4 percent of women report experiencing depression, compared with 13.4 percent of men, according to 2015 Department of Public Health data. Millennial women in the state experience depression four more days in an average month than their male counterparts, the Status of Women data project reported this year. Women are more likely to use mental health services than men, but studies consistently show that the majority of Americans with depression go untreated. In this podcast, sponsored by ConnectiCare, Colleen Shaddox discusses depression and pathways to better mental health with Yale’s Carolyn Mazure, and NYTimes best-selling author Luanne Rice.

I-Team In-Depth

Connecticut Sees Uptick In Stroke Deaths

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While the prevalence of strokes in Connecticut has essentially remained the same in recent years, progress in slowing the number of deaths from stroke has declined in the state, a development the Centers for Disease Control and Prevention (CDC) calls “disturbing.”

The spike reverses a national decades-long trend that brought stroke death rates down. From 1999 to 2014, deaths from strokes were on the decline in the state and nationally. But a recent CDC report found that Connecticut was among 39 states in which the decline in stroke deaths has slowed or the number of stroke deaths has started to increase. From 2012 to 2015, the number of stroke deaths in Connecticut increased 9.5 percent, from 1,263 to 1,384. Stroke deaths were highest in the northeast and northwest regions of the state, CDC data show.

Study: Integrating Legal Aid With Medical Care Improves Veterans’ Lives

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Veterans’ mental health and housing improved when they accessed free legal services in a Veterans Affairs facility, according to a study of veterans in Connecticut and New York City. The more legal services they had, the better they fared, experiencing reduced symptoms of Post-Traumatic Stress Disorder (PTSD) and psychosis, spending less money on abused substances and having better housing situations, the study found. In addition, the study concluded that mental health was improved even if veterans lost their legal battles. The study analyzed the legal/medical partnerships between the nonprofit Connecticut Veterans Legal Center (CVLC) and VA Connecticut Healthcare and between New York Legal Assistance and two VA hospitals. It looked at free legal help given to 950 veterans from 2014 through 2016 and its effects on the mental health, housing, and income of 148 of those veterans followed closely for a year.