Hopkins halts "black lung" second opinions

Program suspended after report finds doctors usually side with coal companies

November 01, 2013|By Scott Calvert, The Baltimore Sun

Johns Hopkins Medicine announced Friday that it is temporarily halting its practice of giving second opinions in possible "black lung" cases, after ABC News reported that Hopkins doctors usually side with the coal mining companies paying for the service.

In thousands of cases, X-ray readers at Hopkins have "almost unwaveringly" sided with the companies seeking to defeat the claims of coal miners seeking benefits, according to the Center for Public Integrity, a nonprofit investigative reporting outlet that teamed with ABC on the report.

Black lung, classified as pneumoconiosis, is a lung disease caused by inhaling coal dust over time.

"Following the news report, we are initiating a review of the pneumoconiosis B-reader service," Hopkins spokeswoman Vanessa McMains said Friday. A "B-read" is a term for second opinions. "Until the review is completed, we are suspending the program."

Hopkins earlier posted a statement on its website saying its mission is to provide the "absolute best, most accurate and comprehensive patient care."

"We take very seriously the questions raised in a recent ABC News report about our second opinions for pneumoconiosis including black lung disease, and we are carefully reviewing the news story and our pneumoconiosis service," it said.

Hopkins said its Department of Radiology and Radiological Science has provided the federal National Institute for Occupational Safety and Health, or NIOSH, with second opinions on coal miners and industrial workers for 40 years.

"To our knowledge, no medical or regulatory authority has ever challenged or called into question any of our diagnoses, conclusions or reports resulting from the pneumoconiosis service," the statement said.

The Center for Public Integrity said the second opinions from Hopkins often "negate or outweigh whatever positive interpretations a miner can produce." The films are read by radiologists who are professors at the medical school and doctors at the hospital.

The news report focused on Dr. Paul Wheeler, a Hopkins radiologist. ABC said a review of more than 1,570 cases showed that Wheeler didn't find "a single case of the severe form of black lung that would automatically qualify a miner for benefits."

Wheeler defended his readings in an interview with The Baltimore Sun. Hopkins said Wheeler has consistently retrained, retested and recertified with NIOSH as a B-reader, most recently in April.

“The bottom line is I’m following the standard of medical care,” he said, adding that a biopsy is the best way to make a diagnosis.

The report found that coal companies pay a premium for Hopkins' services, which cost up to 10 times more than miners typically pay their physicians for an X-ray reading.

Hopkins said that "there are no financial incentives associated with this program for our B-readers or the radiology department. There are no bonuses or other salary supplements paid to doctors related to the volume of examinations read, expert testimony, or other aspects" of the program.

The Hopkins radiology department and the pneumoconiosis service have received no donations from any of the 25 law firms or coal companies ABC inquired about in September, the institution said.


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