James Johnston – Telling the other side of Tenet Hospitals

Neurologist and Attorney Dr. James C. Johnston is not surprised that Tenet Hospital was indicted again in 2017 for insurance fraud in an ongoing investigation by the FBI Healthcare Fraud Unit, Department of Justice and Office of the Inspector General. Just a few months ago Tenet plead guilty to insurance fraud, sham contracts, bribes and kickbacks, paying the Department of Justice over $516 million to settle criminal and civil charges. For the past two decades Tenet has repeatedly entered settlements with the government over insurance fraud, illegal kickbacks and related crimes, paying several billion in fines, earning the label as “one of the most despicable healthcare companies in the United States.” A simple google search of ‘Tenet fraud’ leads to thousands of articles on this company’s appalling misbehavior and abuse of patients.

In fact, 26 years ago, in 1991, Dr. Johnston was practicing in Texas at one of the Tenet Hospitals, at that time a chain of 116 hospitals that engaged in insurance fraud, bribes, kickbacks and performed unnecessary surgeries and procedures. Dr. Johnston refused to participate in the fraudulent schemes, referred his patients to other hospitals, and contacted the Department of Justice with a whistle-blower complaint against Tenet hospitals.

A hospital-based group of four physicians, one already repaying the government for Medicare insurance fraud, retaliated with an extortion attempt, bribing several workers’ compensation patients to make false allegations against him. The physician involved in Medicare fraud was married to the district attorney, who filed specious charges against Dr. Johnston that culminated in a lengthy court battle. At the time, terrible things were said about Dr. Johnston. The New York Times printed a biased story before the conclusion of this ordeal.

In the end, Dr. Johnston prevailed – Judge Barbara Marquardt heard all the evidence at trial and dismissed the false allegations against him as “pure fiction,” declaring him innocent of any wrongdoing. The Texas Medical Board also reviewed all the evidence and cleared Dr. Johnston of any misconduct or illegal act, found him innocent, and concluded that he maintained the highest professional standards, exceeding the standard of care. So did every other medical board where Dr. Johnston held a license. The New York Times refused to print a follow up story on Judge Marquardt’s findings or the final medical board decision, leaving their misleading story languishing on the internet for the past quarter of a century.

Dr. Johnston’s complaints, along with those of several other physicians at various Tenet Hospitals between 1991-1994 led the Department of Justice, FBI and Office of the Inspector General to investigate, eventually forcing Tenet to sell off a number of hospitals and pay a $900 million fine for billing fraud and related illegal activities. Several of the doctors making false accusations against Dr. Johnston lost their medical licenses, had to repay the government for fraud, and one ended up in prison. The district attorney and his assistant were investigated by the FBI and resigned from office.

The medical community members that know the whole story hold the highest respect for Dr. Johnston – he made a huge personal sacrifice to do the right thing, and stand up for his patients.  James C. Johnston, MD, JD has practiced neurology for 30 years and his reputation as a physician, attorney and member of the community is absolutely spotless.

World Association for Medical Law

 

World Association for Medical Law pic

World Association for Medical Law
Image: wafml.memberlodge.org

Consultant Neurologist Dr. James C. Johnston is a Barrister of the High Court of New Zealand, a Fellow of both the Australasian and American Colleges of Legal Medicine, and an active member of many other professional organizations including the World Association for Medical Law (WAML).

Organized in Ghent, Belgium, in 1967, the purpose of the World Association for Medical Law is to encourage the study and discussion of health law, legal medicine and ethics, for the benefit of society and advancement of human rights. The aim is to promote the study of jurisprudence, legislation and ethics of developments in medicine, health care and related sciences; to address any matters that involve issues of medical and health law; and to encourage research and development in medical law.

The official publication of the WAML is the journal ‘Medicine and Law,’ which has been published for almost 40 years with authors from over 100 countries. The Kennedy Institute of Ethics labeled this journal as a “priority journal.”

The 50th Anniversary Meeting and 23rd WAML Congress was held on 9-14 July 2017 in Baku, Azerbaijan with major sub-themes including medical law and bioethics. Drs. Mehila Zebenigus, Guta Zenebe and James C. Johnston presented a discussion on improving relations between developed and developing countries through guidelines that focus on advancing collaborative partnerships to improve health care. This topic followed their lecture last year at the Los Angeles, USA meeting discussing the medical, ethical and legal problems that arise when Western countries engage in short term medical missions to resource limited nations.

Drs. Mehila Zebenigus and James C. Johnston also discussed concerns related to neuroimaging for the patient presenting with headache. They recommended deleting the currently used guidelines because those guidelines are outdated, and have been a contributing factor in the misdiagnosis of headache disorders.

Drs. Thomas P. Sartwelle, James C. Johnston, Berna Arda and Mehila Zebenigus presented a poster highlighting the concerns related to using electronic fetal monitoring in sub-Saharan Africa, how that procedure causes more harm than good, and wastes scarce resources that would be better used helping children with cerebral palsy.

GlobalNeuroCare.org

 

Global Neurology pic

Global Neurology
Image: globalneurocare.org

A practicing neurologist for almost 30 years, Dr. James C. Johnston is also a Partner with Global Neurology Consultants, a unique group of neurologists, neurosurgeons and neuroethicists focusing on advancing sustainable evidence-based neurological care through collaborative international partnerships.

Dr. James C. Johnston is also the founder of GlobalNeuroCare.org, a non-profit organization dedicated to advancing neurological services in the world’s most impoverished regions. Global NeuroCare holds Special Consultative Status with the United Nations ECOSOC, is accredited by the World Health Organization and affiliated with the Office of the Special Adviser on Africa.

Dr. Johnston established a strict approach to improving neurological services in resource limited regions that follows five key principles: establish long term partnerships with local organizations, focus on improving neurological care in the area, ensure a sustainable approach, foster independence, and perform ongoing evaluation to ensure the likelihood of long term success.

Ethiopia is one region meeting Global NeuroCare’s strict criteria for support. Dr. Johnston has served with the Addis Ababa University Department of Neurology since inception of the residency training program in 2006, and is able to collaborate with the local neurologists who are significantly improving neurological care in a sustainable manner with a positive impact on the health of the nation.

GlobalNeuroCare.org is a tax exempt 501(c)(3) organization that operates entirely on donations and adopts innovative techniques and approaches in providing help to patients in need.

Legal and Forensic Medicine

Legal and Forensic Medicine pic

Legal and Forensic Medicine
Image: journals.elsevier.com

Dr. James C Johnston is a board certified neurologist and barrister with three decades of experience. In addition to his consulting practice and charitable work through Global NeuroCare, he is a prolific author who has published peer-reviewed articles for a number of medical and law journals. Dr. James C Johnston has also contributed to over a dozen books including a chapter for the seminal authoritative text in legal medicine entitled Legal and Forensic Medicine, edited by Roy Beran and published by Springer Publishing (ISBN 978-3-642-32339-3).

A comprehensive multi-volume reference book, Legal and Forensic Medicine examines various aspects of legal medicine and ethics that define the fields of the 21st century. Topics addressed in this publication cover the full breadth and depth of legal and forensic medicine around the world, with practical applications in various international and intercultural frameworks. The text analyzes what the fields of legal and forensic medicine share and how they differ in terms of necessary qualifications and professional applications.

Contributing authors to Legal and Forensic Medicine hail from a number of countries and cultural backgrounds. There is a growing interest in the development of health law and legal medicine institutes around the world, and Legal and Forensic Medicine comes in on the ground floor of this burgeoning discipline to provide the foundation textbook for many courses, both undergraduate and postgraduate. It defines the place of legal medicine as a specialized discipline.​

“The Ethics of Teaching Physicians Electronic Fetal Monitoring”

 

Global NeuroCare pic

Global NeuroCare
Image: globalneurocare.org

A Neurologist, Partner with Global Neurology Consultants, and Founding Director of the nonprofit organization Global NeuroCare, Dr. James C. Johnston is a Diplomate of the American Board of Psychiatry and Neurology, and a Fellow of both the American College of Legal Medicine and the Australasian College of Legal Medicine. Dr. James C. Johnston is a widely published author with recent articles appearing in the Neurologic Clinics; Medical Law International; Neurology; Surgery Journal; and several other peer-reviewed medical journals.

The Surgery Journal published two articles from Dr. Johnston and his colleagues, the most recent entitled “The Ethics of Teaching Physicians Electronic Fetal Monitoring – And Now for the Rest of the Story.” Dr. Johnston and his colleagues Professor Berna Arda and Thomas P. Sartwelle, composed an articulate critique of electronic fetal monitoring (EFM) as a method of predicting and preventing cerebral palsy (CP). The article draws upon Mr. Sartwelle’s decades of experience as a top medical malpractice defense attorney, Dr. Johnston’s considerable medical and legal expertise, and Professor Arda’s unique views of medical ethics gained by her years of teaching at Ankara University where she holds the Chair of Medical Ethics.

“The Ethics of Teaching Physicians Electronic Fetal Monitoring” reviews the history of EFM with a specific focus on CP. Citing the available literature, the article concluded that, not only has EFM proven ineffectual in the diagnosis and prevention of CP, it increases the rate of cesarean sections with concomitant harms to mothers and babies alike. Further, Dr. Johnston and his colleagues stated that EFM, as it is used in defensive medical practice, is a violation of patient autonomy and raises serious ethical concerns. The article may be accessed through the link below:

https://www.thieme-connect.com/products/ejournals/pdf/10.1055/s-0037-1599229.pdf