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Allison Lee Isley/Journal 

Winston-Salem Dash designated hitter Andrew Vaughn speaks to fans before a minor league baseball game against the Fayetteville Woodpeckers on Friday, Aug. 9, 2019, at BB&T Ballpark in Winston-Salem, N.C. (Winston-Salem Journal/Allison Lee Isley) 20190812w_spt_dashvaughn

Despite charging thousands less, Winston-Salem surgeon left fighting to overturn health care monopoly

A blazing hot, humid Friday afternoon in August didn’t seem like the ideal time for an open house at a medical office.

But Dr. Gajendra Singh, a surgeon and an enterprising small businessman, is fairly well accustomed to doing things the hard way.

The occasion, on its surface, was to celebrate the second anniversary of his twin practices — Forsyth Imaging and Forsyth Surgical — in the Maplewood Medical Park.

The larger issue was the chance to spread the word, again, about a radical concept Singh keeps pushing: providing quality medical care at flat, transparent prices.

He’s committed to it to the point that he’s suing the state over arcane rules that basically allow it to control the marketplace through a monopoly rather than patients/consumers and old-fashioned competition.

“The funny part is I have tried to talk to insurance companies,” he said. “Pay me $5,000 for the same thing you’re willing to pay $20,000 to the hospital. You save $15,000. They turn me down.

“I don’t know why.”

Attracting attention

In the two years since he first opened his doors, Singh has made enough noise to attract the attention of a couple of national publications.

The Washington Post, through syndicated, conservative columnist George Will, featured Singh earlier this year. And Vox, a digital publication known for explanatory journalism and opinion, put together a story in July 2018.

“This surgeon wants to offer cheap MRIs. A state law is getting in his way,” reads the headline on that story.

No doubt the story is flattering, and it’ll be a long, expensive legal fight. I can’t think of one that’s not; lawyers don’t come cheap. In this case, Singh is being helped by the Institute for Justice, a libertarian public-interest law firm based in northern Virginia.

“I’m just hoping we win,” said Singh who amazingly hadn’t broken a sweat despite the 90-plus temperature.

The issue — fair economic competition — is simple. Explaining it isn’t. But we’ll try.

The state has had a certificate of need law for more than 40 years. It requires medical professionals who want to provide such things as MRIs to demonstrate annually the need in a particular area. The theory being that doing so might more fairly spread out availability and prevent overlap.

In practice, Singh says, the state winds up restricting who can purchase medical equipment and protecting hospitals

by setting up monopolies that essentially eliminate competition.

“The effect of the MRI-CON requirement is to prevent (Singh) from acquiring a fixed MRI scanner to provide safe, quality, affordable MRI scans to patients who need them, solely because incumbent providers got there first,” his lawsuit reads in part. “Therefore, the MRI-CON requirement, both on its face and as applied, grants certain health-care providers a monopoly in violation ... of the North Carolina constitution.”

Since he’s not allowed to purchase an MRI machine himself, Singh rents one a day or two per week. It’s an expensive proposition. “For what I pay in a year to lease it, I could buy one outright,” he said.

For the time being, he’s waiting on the courts. Until then, Singh will stick close to his business model with general and laparoscopic surgery and providing imaging scans as CTs, ultrasounds and X-rays.

Modern marketing

He pulls up on his iPhone video from his YouTube channel — yes, you read that correctly — that shows footage of his staff attempting to get answers about prices from hospitals and billing offices.

He charges $400-$600 for a CT, $199 for an ultrasound. Elsewhere, who knows? Ever read a medical billing statement?

“Our prices are all right there where people can see,” Singh said. “No hidden fees. No facility charges. No second charges.”

The side effect of practicing medicine (and doing business) that way is that Singh winds up seeing mostly patients with no insurance or those with large deductibles. People from neighboring states, he said, have started turning up.

Cost-conscious locals have caught on, too. Pete Jennings, a retiree, reported paying Singh $398 for a renal and scrotal scan last month following a bout with kidney stones.

“In 2018 the same thing cost $1,370 at a hospital,” he said. “Medicare paid it. But the cost difference was amazing.”

Singh says that paying $6,000 for a hernia surgery, even if it’s mostly covered by insurance, doesn’t make sense since he can do the same procedure all-in for a flat $1,700.

“For me, $4,000 is a lot of money,” he said.

Indeed. But a lot about U.S. health care and the byzantine world of insurance doesn’t make sense. Anybody who’s ever paid a deductible knows that.

“It just makes me sometimes mad and sometimes happy,” Singh said. “Mad that people have to drive far for medical care they can afford. And happy because I’m able to help people.”

What a crazy way to practice medicine.

Winston-Salem lawyer convicted of cocaine possession

A Winston-Salem lawyer was convicted of possessing cocaine last week.

Kevin Cartledge, 47, pleaded guilty Wednesday in Forsyth Superior Court to felony possession of cocaine, Assistant District Attorney Penn Broyhill said.

Judge David Hall delayed entering judgment under a state law known as 90-96. Under this state law, Cartledge is placed on probation for a year.

Cartledge has to follow all the recommendations of his probation officer and he has to attend meetings of his treatment group. He is also subjected to random drug screenings. And he cannot possess any firearms.

If he successfully completes probation, he can have the charge dismissed. He comes back to court in August 2020.

The charge stems from Winston-Salem police officers coming to Cartledge’s house on Cambridge Road on Aug. 25, 2018, where officers were doing a welfare check on another person at the house. Officers noticed a baggy with a white substance inside on top of Cartledge’s wallet.

Cartledge told the officers that the wallet and the baggy belonged to him, Broyhill said. The officers field-tested the substance and confirmed that it was cocaine. Broyhill said it was a small user amount of cocaine.

According to his Linkedin page, Cartledge graduated from Wake Forest University School of Law in 1997. He practiced law most recently for Spilman Thomas & Battle PLLC. According to a news release on the law firm’s website, Cartledge had nearly 20 years of experience in law and would be focusing on complex commercial and employment litigation. He had been recognized, the news release said, in the practice of law by Martindale-Hubbell, the Best Lawyers in America, North Carolina Super Lawyers magazine and Business Leader magazine.

He has since left the law firm and opened up his own practice, according to his directory listing on the N.C. State Bar.

Wilkesboro Walmart evacuated; man faces multiple charges after police say he went into store with pellet gun

Wilkesboro Police arrested a man following an incident Saturday night at the Walmart at 1801 W. U.S. 421 in Wilkesboro when he was found armed with what resembled a real gun but turned out to be a pellet pistol.

Jimmy Roger Minton, 29, of Wilkesboro has been charged with multiple offenses including assault, larceny, possession of stolen goods, and communicating threats, the Wilkesboro Police Department said in a press release.

Minton could face additional charges at the end of the investigation, police said.

Wilkesboro Police received a call about 7:26 p.m. Saturday about a disturbance between two people in the parking lot of the Walmart.

Police officers were told that the man caused a disturbance and might have a knife and that he may have gone inside Dunham’s Sports.

At Dunham’s Sports, an employee at the store told an officer that a man was inside the store with a handgun.

Wilkesboro police said that the man pointed a weapon at the officer, who found him in the back of the store. The officer took cover and ordered the man to drop his weapon.

Although the man got out through the back of Dunham’s Sports, officers received a report that he had gone inside Walmart.

After being directed to the rear of the store by Walmart employees who were evacuating, the officers found the man in a bathroom, police said.

Police said Minton dropped his weapon and was taken into custody without incident.

Once the weapon was recovered it was determined to be a pellet gun.

The store was searched for other possible suspects or threats but was cleared by officers on the scene.

Report finds older drivers may be more distracted by vehicle technology

Older motorists are more likely to be distracted by technology in vehicles than younger drivers, according to an AAA Carolinas Foundation for Traffic Safety report released recently.

The report defined older drivers as those ages 55 to 75, and younger drivers as those 21 to 36.

The foundation said the technology “has the potential to increase comfort and extend mobility for older drivers, but first it has to stop distracting them.”

For example, the report found that older drivers removed their eyes and attention from the road for an average of 8.6 seconds, compared with 4.7 seconds for younger drivers, when performing tasks, such as programming the navigation system or tuning the radio.

Some vehicle infotainment systems included multiple menus and cumbersome functions “that significantly reduced older drivers’ ability to easily complete seemingly simple tasks.”

The report was conducted in collaboration with researchers from the University of Utah.

“Taking your eyes off the road for just two seconds doubles a driver’s risk of a crash,” the foundation said.

“Voice-command functions found in new in-vehicle technology are intended to help drivers by keeping their eyes and attention on the road,” said Tiffany Wright, the foundation’s president. “Unfortunately, the complexity and poor design of some of these systems could cause more harm for older drivers, in particular, instead of helping them.”

By 2030, more than 1 in 5 drivers on the road will be 65 or older.

In 2018, there were 46,524 reported wrecks involving a driver 65 or older, resulting in the deaths of 305 older drivers, according to the state N.C. Department of Transportation.

Recommendations from the report include: improving voice-command technology; simplifying software menus; removing complex center-console controls; and positioning system controls to allow drivers to keep their eyes on the road.

“Those changes would better meet the needs of older adults and make the systems safer for all drivers,” according to researchers.

AAA Carolinas offered other suggestions that include: avoiding interacting with in-vehicle infotainment technology while driving except for legitimate emergencies; and practicing using the voice command and touch screen functions when not driving to build comfort in case emergency use is required.