Federal tool details financial links between doctors, medical industry

A new tool can help patients discover how cozy their doctors are with pharmaceutical or medical device companies.

The tool, The Centers for Medicare and Medicaid Services Open Payments report, was created under the Affordable Care Act to detail the financial relationships between health care companies and doctors and hospitals. Nationwide, it reports that doctors and research hospitals collected nearly $6.5 billion in such payments last year.

The report lists 11.4 million payments to 607,000 physicians and 1,100 teaching hospitals from 1,444 companies. Data are available on 5,170 Nevada physicians who received $14.8 million. Doctors are listed if they had at least one payment reported by the industry.

Among Nevada physicians receiving big money for royalties, consulting work or serving as faculty or speakers were:

■ Dr. Michael Reis, a Carson City orthopedic surgeon with the Tahoe Fracture and Orthopedic Medical Clinic, who received more than $2.5 million in general payments in 2014, primarily from the medical device companies Stryker and Smith and Nephew Corps.

■ Dr. Fadi Braiteh, an oncologist with Comprehensive Cancer Centers of Nevada, who received nearly $500,000 in payments for travel, food and beverage, and for services rendered to pharmaceutical and medical device companies. Braiteh directs research programs for Comprehensive Cancer Centers and is certified in palliative medicine.

■ Dr. James Del Rosso, a dermatologist and surgeon with Las Vegas Dermatology, who received $405,000 in 341 general transactions.

■ Drs. Troy Watson and Todd Swanson, orthopedic surgeons with Desert Orthopaedic Center in Las Vegas. Watson took in more than $300,000; Swanson $294,000.

The Open Payments program started two years ago. Concerns about physician practices being driven by payments from health care companies created the push for greater transparency.

Southern Nevada physicians asked about payments received said they appreciate the openness of the program because doctors no longer can cloak their associations with industry. The goal of entering into agreements with companies, the doctors said, is improving patient care and shortening recovery times. Meetings, conferences and seminars are work, not vacations, requiring travel that has to be arranged around their practices.

“These are not like the old days in medicine when you’d be taken to Pebble Beach to play golf,” Watson said. “I know it sounds sexy sometimes when you hear that these guys are getting paid what they’re getting paid, but there’s a lot of sacrifice that goes into it as well.”

The research, data analysis, design work, and trial and error that goes into developing a treatment regimen, surgical device or medication is exhaustive. To represent their products, companies choose the leading medical minds in a particular discipline.

“I work for every dollar I get paid,” Swanson said.

The databases are available at https://openpaymentsdata.cms.gov/ and most physicians in Nevada are listed. Some doctors do not appear under a name search but can be found by selecting other criteria such as ZIP codes, city or specialty.

The American Medical Association this week released a cautionary statement about the databases, calling for information to be depicted correctly and in context.

“Unfortunately, the CMS’ Open Payments program has to date been plagued by significant shortcomings that call into question the accuracy of information published, including an overly complex registration process and inadequate opportunity for physicians to review their individual data,” the statement said.

The Open Payments report also lists the four Southern Nevada teaching hospitals. St. Rose Dominican Hospital, Siena campus, however, reportedly received $572,000, but spokeswoman Kathleen Ryan said that number is inflated because Siena was mixed up with one of the company’s hospitals in California. Sunrise Hospital and Medical Center was paid $92,000, University Medical Center, $47,500, and Valley Hospital Medical Center, $52.15, according to the report.

The report lists payments for royalties worth hundreds of thousands of dollars and the costs for a simple lunch. Dr. Mark Barry, a Las Vegas orthopedic surgeon, has only one payment from Biomet Spine, but the royalty is $398,640. On the low end, the only payment to Dr. Richardo Almaguer of Elko, vice chairman of the Nevada Board of Osteopathic Medicine, was one meal that cost Boehringer Ingelheim Pharmaceuticals $15.79.

Braiteh, the oncologist, specializes in gastrointestinal and thoracic oncology and works to develop anti-cancer agents through research. The Open Payments report also links $650,000 in research payments to Braiteh because he was the principal investigator for some clinical trials.

Other doctors linked to major research funding include Nicholas Vogelzang of Comprehensive Cancer Centers ($600,000) and Charles Bernick of the Cleveland Clinic Lou Ruvo Center for Brain Health ($463,000). Vogelzang’s research includes clinical trials targeting malignancies of the urinary tract and genitalia and mesothelioma, tumors of the tissue that lines the lungs, stomach, heart and other organs. Bernick has been involved in Alzheimer’s disease research and treatment for some 20 years.

Dr. James Sanchez, the practice president at Comprehensive Cancer Centers, said Southern Nevada is lucky to have such an expert as Braiteh as part of its medical establishment.

The clinical trials conducted at Comprehensive Cancer Centers are labor intensive and include diagnostic testing and follow-up examinations, and those costs add up, Sanchez said.

Braiteh said he welcomes the Open Payments report as long as people under­stand the dollar figures quoted don’t translate into direct payments to doctors. Much of the costs involve travel-related expenses.

Braiteh said he doesn’t favor one company over another, but instead focuses on treatments that get results and relieve suffering. For example, he touts both Victibex by Amgen and Erbitux by Bristol-Myers Squibb, medications used in the treatment of colon cancer.

As a key opinion leader in his field, Braiteh often is requested at meetings and seminars. He bills for the time he spends preparing for events, he said, much as a lawyer would bill for trial preparation.

“I’m in high demand, which is good, but it involves a lot of time, usually on weekends,” he said. “I’m not ashamed of being compensated.”

Contact Steven Moore at smoore@reviewjournal.com or 702-380-4563.