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

Hopkins Pathologist Placed on Leave

Jonathan I. Epstein, MD, an "internationally regarded pathologist" at Johns Hopkins Hospital, has been placed on administrative leave following accusations of questionable choices that may have harmed patients and fellow doctors, according to .

Epstein allegedly gave second opinions or pressured other doctors to give second opinions that validated diagnoses determined by his wife, a fellow pathologist, the Post reported. In one such alleged example, Epstein validated a diagnosis made by his wife, Hillary Epstein, MD, which led to a patient having their bladder removed. However, post-surgical tests revealed that the initial diagnosis was incorrect and the surgery was unnecessary.

This instance came to light because of a report and interviews conducted by the Joint Commission, according to the Post. The report, which is not yet public, revealed "a culture of bullying and intimidation in the surgical pathology department." The report didn't name Epstein specifically, but rather described a pathology department leader, the Post reported.

Epstein wrote comments to the Post and cited patient privacy as to why he couldn't speak to the bladder removal case. He did speak to the allegations of bullying colleagues, writing that he thought the interactions were "collegial, professional, and undertaken in the interest of patient care."

Ob/Gyn Sued for Sexual Assault

A total of 94 women have brought a case against their former doctor, David Broadbent, MD, for alleged sexual abuse during medical appointments, according to a ProPublica with The Salt Lake Tribune.

The women alleged Broadbent touched their genitals and breasts, sometimes without gloves or a speculum, without warning or reason -- and that they often experienced pain and bleeding.

One of these women was Carmela, who chose Broadbent because he spoke Spanish. She had moved to Utah from Mexico and doesn't speak English. She saw him for years while reportedly experiencing abuse she didn't realize at the time was not how medical care was delivered.

Broadbent delivered all of her kids, according to the report. When her daughter grew up and needed to see an ob/gyn for the first time, she was horrified by what Carmela described. After looking into it, she told her mom that "something's not right." Carmela joined the lawsuit after seeing similar allegations against Broadbent, and her daughter is the translator for the ongoing lawsuit.

A previous judge ruled the case had to follow medical malpractice rules, not sexual assault, but the case has finally made it to the Utah Supreme Court. There's not a national standard for sexual abuse in medical settings, according to the report.

"State laws are generally silent on whether sexual assault lawsuits involving health care workers should be covered by malpractice laws, leaving courts to grapple with that question and leading to different conclusions across the country," the article stated. Utah has a new law that deems sexual assault in healthcare settings is not considered healthcare. However, it doesn't apply retroactively, leaving this case to previous laws, the report found.

Rural Hospitals Struggle With Medicare Advantage

Battle Mountain General Hospital in rural Nevada is holding out against Medicare Advantage plans because of notorious low rates and late payments. But Jason Bleak, who runs Battle Mountain, isn't sure how long his hospital can hold out, according to and NPR.

Medicare Advantage plans are privately operated and contract with the federal government to provide healthcare for older Americans. They're also often cheaper for patients. The plans don't pay hospitals as well as Medicare -- especially not in rural areas, where Medicare offers higher prices to make up for lower patient volumes, the article stated. With Medicare Advantage plans booming, rural areas get hit differently than more urban areas.

Carrie Cochran-McClain, chief policy officer of the National Rural Health Association, said that "Depending on the level of Medicare Advantage penetration in individual communities, some facilities are seeing a significant portion of their traditional Medicare patient or beneficiaries move into Medicare Advantage."

Seven hours away from Battle Mountain in a different rural area of Nevada, Mesa View Regional Hospital already has contracts with 21 Medicare Advantage plans. But those plans owe the hospital $800,000 for already delivered care, the article stated. Despite this, with 40% of the surrounding area on these plans, there's no choice but to accept them.

Bleak thinks that eventually Battle Mountain will also have to cave and accept Medicare Advantage plans when enough patients sign up.

"The question is," Bleak said, "how can we match the reimbursement so that we can sustain and keep our hospitals in these rural areas viable and strong?"

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