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

Hospital Administrators Knew Their Star Surgeon Was Dangerous

In the first installment of a two-part investigative series, the Boston Globe Spotlight Team reported on the amassed by New Hampshire cardiac surgeon Yvon Baribeau, MD.

For three decades, Canadian-born Baribeau was a star at Catholic Medical Center in Manchester, where he earned more than $1 million each year prior to his abrupt retirement at the age of 63 in 2019, the Globe reported. And, after his departure, hospital officials have continued to speak of him in "glowing terms."

However, a Spotlight Team investigation found that reality "could not have been further from the carefully crafted public image" of the high-profile surgeon, and that "executives who treated him as a star, and promoted him to the public, knew the truth and its consequences."

"The facts are blunt and chilling: Baribeau has one of the worst surgical malpractice records among all physicians in the United States," the Globe wrote.

Baribeau has settled 21 medical malpractice claims related to his work at Catholic Medical Center, the Globe reported. And in 14 of those cases, he is accused of contributing to a patient's death.

Ultimately, there has been no U.S. physician with more settlements involving surgical deaths over the last two decades, the Globe reported, citing an analysis of a national physicians' database. And there has been no physician in New Hampshire with more settlements of any kind, the Globe added.

Though the public remained largely in the dark when it came to Baribeau's troubles, his institution long knew of them, the Globe reported.

"Hospital executives were well aware for years how dangerous he had become," the Globe wrote. "They knew because they had been repeatedly warned by surgeons and other medical professionals at Catholic Medical Center that Baribeau's errors were harming, even killing, patients."

"And yet for years hospital management resisted reining in one of their leading rainmakers," the Globe added.

Surgeon's Colleagues Sounded Alarms Before 'Summer of Death'

The second installment of the into Yvon Baribeau, MD, detailed how the cardiac surgeon's colleagues tried to get him barred from operating on patients, to no avail.

These doctors "knew they might be risking their careers by seeking to oust one of the top revenue-generating surgeons at the hospital, but they believed Baribeau was making more and more deadly mistakes," the Globe wrote.

One patient of Baribeau's who was a retired Army officer lost so much blood after the surgeon allegedly lacerated a major blood vessel that she had to have her entire blood supply replenished nearly five times, the Globe reported, citing a hospital colleague who had reviewed transfusion records. Sadly, the patient died the following day.

"But as tragic outcomes were happening more frequently, hospital leaders appeared to be shielding Baribeau from consequences," the Globe wrote, citing numerous current and former medical staff who spoke to the outlet. Some doctors who spoke out against Baribeau even faced administrative actions against them.

In the summer of 2018, Baribeau returned to the operating room after beginning treatment for cancer, the Globe reported. What followed was what numerous current and former Catholic Medical Center doctors refer to as "the summer of death," the Globe added. In just five weeks, three of Baribeau's patients died, and two were severely injured during surgeries.

Ultimately, in the wake of a whistleblower lawsuit and concern from nurses, Baribeau was finally removed from the operating schedule toward the end of that summer, and again when his name resurfaced on the schedule later in the year, the Globe reported. He has since retired.

Baribeau's attorney Beth Catenza told the Globe that her client is the victim of "a group of physicians with a long history of personal bias against him," and that he has always made patient safety a top priority. Top hospital officials adamantly denied that they ever placed profits ahead of patients, or that they retaliated against any colleagues for speaking out against Baribeau, the Globe reported.

Hospitals Divert Unprofitable Services to Health Center 'Look-Alikes'

Increasingly, hospitals are outsourcing what are deemed unprofitable outpatient services to independent, nonprofit organizations they set up to provide primary care, .

"Medicare and Medicaid pay these clinics, known as federally qualified health center [FQHC] look-alikes, significantly more than they would if the sites were owned by hospitals," KHN wrote.

Look-alikes -- similar to FQHCs -- are eligible for federal programs that help reduce costs and recruit providers, KHN reported. They're able to secure prescription drugs at discounted prices and attract doctors who are then eligible for a government program that helps them pay off their student debt.

At the same time, look-alikes do not get an annual federal grant for operational costs, KHN reported. And the federal government does not cover their malpractice risks.

Of converting clinics to look-alikes, Jeffrey Allen, a partner with the consulting firm Forvis, told KHN that it is often a strategy for hospitals that have a high proportion of Medicaid patients.

Hospitals believe they'll fare better by spinning off a money-losing service and providing grant funding to a look-alike in order to keep it solvent, Allen told KHN.

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