Physician Practice Roundup—Alabama doctor not guilty in overdose death; University investigates allegations of doctor misconduct

Alabama doctor found not guilty in overdose death

An Alabama jury earlier this week acquitted a physician accused of prescribing drugs that killed a patient.

The jury found Richard Snellgrove, M.D., not guilty of unlawful distribution of drugs, including opioids, and healthcare fraud tied to the 2016 death of Matthew Roberts, a former guitarist for the rock band 3 Doors Down, according to the Associated Press.

The doctor’s attorney, Dennis Knizley, told the news service that Roberts obtained and abused illegal drugs in addition to the medications he got from Snellgrove and the doctor could not be blamed for his death. (AP article)

Another university investigates allegations of doctor misconduct

Ohio State University is continuing an investigation into reports of alleged sexual misconduct by a former university doctor.

University President Michael Drake sent an email this week to over 112,000 alumni who attended the university from the mid-1970s to the mid-1990s when the alleged misconduct occurred asking for their help with the investigation, the Associated Press reported. The university has received confidential reports from male athletes in eight sports alleging misconduct by Richard Strauss, a former associate professor of medicine, who died in 2005.

The school has hired Seattle-based law firm Perkins Coie to conduct an independent investigation into allegations against Strauss, who worked with university athletic teams as well as at the university medical center and student health center.

That news comes as another school, the University of Southern California, deals with the fallout over charges it mishandled sexual abuse complaints against a former gynecologist at its student health center.

Two hundred professors wrote a letter demanding the resignation of University President C.L. Max Nikias, saying he no longer has the “moral authority to lead.” In a statement (PDF), the executive committee of the board of trustees, however, expressed “full confidence” in Nikias’ leadership but on Wednesday announced it will form a special committee to hire outside counsel to conduct an independent investigation into the misconduct and reporting failures at the student health center. (AP article)

MGMA polls finds most practice leaders unaware of direct primary care

Here’s a statistic you might find surprising: Most medical practice professionals are not aware of the direct primary care model, a poll by the Medical Group Management Association found.

Nearly three-fourths of the more than 1,400 respondents (74%) said they were not aware of the alternative payment model, which gives patients access to around-the-clock primary care services under a single flat membership fee. Many of the respondents who said they were aware of the model (26%) said that it is convenient, works well, improves cost transparency and they looked forward to the expansion of direct primary care, the MGMA said. With the model, patients pay a monthly, quarterly or annual fee directly to the practice. There are no claims to insurance companies, eliminating contracts, third-party billing, fee-for-service payments and the need for relationships with payers. (MGMA poll)

Doctors experience ‘moral distress’ when care denied to patients

It’s not only patients who suffer when they can’t afford care; doctors and nurses also experience “moral distress” and being driven toward professional burnout.

A study published in the Annals of Internal Medicine looked at the effect on doctors and nurses of payment policies in many U.S. states governing dialysis services for undocumented immigrants. Under those policies, these patients with end-stage kidney disease are only covered for dialysis treatment when they are evaluated in an emergency department and found to have life-threatening renal failure. Many of them are denied routine dialysis to help keep them alive.

The result of this emergency-only hemodialysis is increased mortality and costs, but the policies also place doctors in an ethical quandary and contribute to job dissatisfaction and burnout, the study found. (Annals of Internal Medicine study)

Trend shift: Independent and physician-led group practices rebound

More physician groups are undertaking the transformation to value-based care and are vowing to stay independent, according to a Black Book report.

A survey of nearly 900 physician organizations found a recent shift in the decadelong trend of physician-led practices moving to hospital employment. Black Book’s 2018 study found that while physicians working for a hospital or in a practice with some ownership climbed in 2016 to 32.6%, last year independent and physician-led group practices rallied back up to 72%.

Population health and value-based care models are driving the change, said Doug Brown, founder of Black Book Research. Independent physicians are recognizing there are long-term savings if they assume risk and manage population health in the same way as a hospital in an accountable care organization, he said. Many practices are seeking advice from consultants on financially and clinically transforming their operations to value-based care. (Black Book announcement)