Cancer Patients Denied Care; DIY Medical Test Boom; Opioid Maker’s Influence on Docs

Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

Cancer Patients Denied Care

When Barbara Quarrell was diagnosed with cancer in 2022, she headed to Memorial Medical Center in Las Cruces, New Mexico, where she had cared for patients for years as a nurse. However, the hospital wouldn’t take her insurance, so she was denied care there, NBC News reported.

The news outlet provided Memorial with the names of 9 patients who said they were turned away or had to pay up front for care. Three more patients who had reported similar experiences asked not to be identified, and another was deceased, the outlet reported.

Memorial was formerly a nonprofit community hospital owned by the city and county, but it’s now a for-profit facility operated by private equity-backed Lifepoint Health, NBC News reported. “Memorial is just one facility, but the changes there underscore a nationwide trend of for-profit entities taking over nonprofit hospitals’ operations,” the article stated.

Neither Memorial nor Lifepoint pointed to specific inaccuracies or discussed the experiences of the 9 patients, NBC News reported. A spokesperson for Apollo Global Management, the private equity firm behind Lifepoint, did not provide comment.

Though Memorial says it does not deny care, 2 officials there called to apologize to 2 patients who had spoken with NBC News, the outlet noted.

Ultimately, Quarrell relocated more than 200 miles away to receive care at another facility that took her insurance.

DIY Medical Test Boom

Do-it-yourself (DIY) medical testing is on the rise across the U.S., the Washington Post reported.

Silicon Valley start-ups are offering tests for a wide range of conditions — from menopause and food sensitivity to thyroid function, testosterone levels, ADHD, and sexually transmitted diseases, according to the Post.

The boom is fueled by a growing network of independent labs, as well as an increase in distrust of ‘Big Medicine’ and rising confidence in home testing thanks to the COVID pandemic.

The home diagnostic market generates $5 billion a year, according to market research, and it’s expected to nearly double by 2032.

While some patients report success, physicians are concerned that the trend can lead to problems like misdiagnosis or delayed medical care, the Post reported.

The FDA has also taken notice, as the agency in April “finalized a contentious rule” to start holding lab-developed tests to the same standards as their conventional counterparts. Yet businesses are pushing ahead, selling their products and having them promoted by social media influencers.

Bob Wachter, MD, of the University of California San Francisco, who is an adviser to health-tech start-ups, told the Post that the rise in self-testing is a promising way to address shortfalls in the medical system, but there’s “a lot of snake oil.”

Opioid Maker Tried to Influence Doctors

After opioid maker Mallinckrodt was “forced by the courts to publish more than 1.3 million internal documents,” researchers sifted through nearly 900 contracts and reported their findings in The BMJ.

“For those of us who study pharma influence, the document trove was an unprecedented window into the inner workings of how a corporation not just directly co-opts physicians to push pills, but also seeks to increase sales by influencing medical science and opinion — an extensive marketing playbook that we call the ghost management of medicine,” Sergio Sismondo, PhD, of Queens University in Ontario, Canada and Radboud University in Nijmegen, Netherlands, and Maud Bernisson, PhD, also of Radboud University, wrote.

“The documents outline a smorgasbord of tactics to achieve greater sales — from shaping the language of medicine through designing continuing medical education (CME) courses and recruiting physicians to serve as influencers, to planting articles in scientific journals,” they added.

There were 876 contracts for the development or circulation of medical information, the researchers reported. In response to an FDA requirement that opioid manufacturers educate physicians about risks and benefits, Mallinckrodt “launched a CME programme named Remedies: Focus on Opioid Tolerance,” the researchers found.

Key opinion leaders were also deployed, the researchers reported. Terms used in physician materials included “pseudoaddiction” — “the idea that a patient’s need for higher doses (traditionally seen as developing tolerance of, or dependence on, a substance) was different from addiction,” as well as “chronification” — or the “market friendly notion that untreated acute pain develops into chronic pain.”

Mallinckrodt did not respond to the researchers request for comment.

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