By MEGAN HART & DAN MARGOLIES

Physicians associated with Kansas and Missouri hospitals received about $46 million in payments from drug and medical device companies in 2014, with about 9 percent going to providers in the Kansas City area.

A database compiled by ProPublica shows the companies paid about $4.1 million to physicians associated with hospitals in greater Kansas City, and $1.7 million to those working with hospitals in the greater Wichita area.

It isn’t illegal for doctors to accept meals, speaking fees and other forms of compensation from drug and medical device companies, as long as they don’t receive kickbacks for prescribing certain medications or devices. Some studies have found, however, that doctors who accept payments tend to prescribe more expensive drugs more frequently than generics, at least in certain cases.

Doctors who received more payments were more likely to prescribe the expensive drugs than those who received smaller amounts, though that doesn’t prove the payments caused the prescribing, or that doctors who received payments intentionally did anything differently.

In addition to being geographically concentrated, most of the money went to relatively few physicians. About $2.7 million, or more than a third of the money the industry spent on doctors in Kansas, went to the top 15 recipients – or 0.5 percent of the roughly 2,800 doctors who received some form of payment. Similarly, nearly $20 million, or about half the money the industry spent on doctors in Missouri, went to the top 15 Missouri recipients — out of a total of more than 7,000 who accepted payments.

The Missouri numbers, to be sure, were skewed by one huge outlier – $9million to Roger Jackson, who specializes in orthopedic surgery and invented a surgical table for which he receives royalties. Jackson was far and away the top recipient of industry money in either Kansas or Missouri.

While sorting doctors by the hospital where they work can be instructive, the hospital may not be directly affected by what doctors choose to accept. For example, Steven M. Simon, a physical medicine and rehabilitation specialist, received nearly $542,000 in industry payments – making him one of top recipients of industry money in the Kansas City area. But most of the money was related to his private practice, Mid-America Physiatrists in Overland Park, and not to his affiliation with Shawnee Mission Medical Center.

In a telephone interview, Simon said half or more of the money he received was reimbursement for expenses like air fare and hotels. He said he frequently lectures on medications to other providers, necessitating frequent travel.

“These are FDA-approved programs sponsored by the pharmaceutical company to familiarize physicians with product,” he said.

Similarly, David Michael Wichman, a Wamego, Kansas, psychiatrist who accepted $137,239 in payments, mostly for speaking, said he speaks at continuing education events on his own time and doesn’t consider it related to his affiliation with Wamego Health Center.

Wichman said most of his presentations are to physicians working in rural areas of Kansas and Nebraska. The presentations cover newer psychiatric medications, including antipsychotics and antidepressants, he said.

“A lot of it is going out and talking to family physicians that are struggling to treat psychiatric patients,” he said.

The Food and Drug Administration regulates what information can be included in presentations and requires the speaker to cover how the medication works, side effects and studies the FDA used when deciding whether to approve the drug, Wichman said. Half of the presentation can’t be about a specific drug, but must include general information like how to manage bipolar disorder, for example, he said.

“You can only give that unbiased, this is what the drug is, this is what it does” information, he said.

Wichman said he had done some teaching since he was chief resident at University of Kansas Medical Center in 2008, and gradually been speaking at continuing education events and events discussing pharmaceuticals. He said he supports publishing information about physicians’ finances and prescribing patterns, but thinks concerns about pharmaceutical payments influencing physician behavior may be overblown.

Doctors who attend a presentation about a new drug typically are interested in what it could do for their patients, Wichman said. If that drug offers an advantage, such as reduced metabolic side effects from new antipsychotic drugs, patients benefit, he said.

Doctors “didn’t go to that many years of schooling to be ‘bought’ for a $20 meal,” he said.

The insurance system also limits doctors’ ability to get too eager about a new drug, Wichman said. Most insurers use a form of step therapy, so doctors have to show that their patients aren’t doing well on a cheaper generic before trying a more expensive brand-name drug, he said.

“A lot of these patients that are on the brand-name medications are patients that have failed on two or three non-branded generic medications,” he said.

Megan Hart is a reporter for KHI News Service in Topeka, a partner in the Heartland Health Monitor team. You can reach her on Twitter @meganhartMC

Dan Margolies, editor of the Heartland Health Monitor team, is based at KCUR. You can reach him on Twitter @DanMargolies.

WICHITA, Kan. (AP) — A Wichita woman says she and her dog were out for a morning run when a coyote grabbed the dog and carried it away in its jaws.

Shelley Duncan told The Wichita Eagle she was running near a country club last week with her dog Gwenny, an Italian greyhound, a few feet behind her when the coyote attacked the dog.

The coyote ran off into a brushy area with the dog in its mouth before Duncan could do anything. Duncan says two men helped her look for the dog but couldn’t find it.

Charlie Cope, with the Kansas Department of Wildlife, Parks and Tourism, says he gets up to 15 reports a year of coyotes in Wichita, but this was the first he’d heard of one attacking a dog.

EMPORIA, Kan. (AP) — A 2-mile stretch of the Kansas Turnpike where seven people have died in flooding will soon offer better protection for drivers.

Workers are about halfway through a project to improve drainage on a stretch about 10 miles south of Emporia. Six people, including five members of a Missouri family, died there in 2003. A Texas man drowned last year. All of the deaths were caused by vehicles getting caught in floodwaters.

The Wichita Eagle reports that the $2.7 million project between mile markers 116 and 118 will install massive box culverts that run beneath the highway. The goal is to keep rising water from flash flooding off the turnpike. Turnpike officials said Wednesday that beginning in November, the design should keep water off the road in a 100-year storm.

LAWRENCE, Kan. (AP) — A 31-year-old New Zealand woman has been pursuing charges in Kansas against a teenager she believes harassed her online.

Rachel Gronback lives in Auckland, New Zealand, where she blogs about “fashion, online shopping and body positivity.” Gronback said that when she started receiving inappropriate online sexual messages in November, she was able to identify the suspect as a man who was then a Lawrence high school student.

The Lawrence Journal-World reports she notified Lawrence police. Douglas County prosecutors told her they’re prepared to file a harassment charge, but before a charge can be filed, Gronback would have to be willing to appear in court if it goes to trial.  Her effort to stop online harassment can be found here.

A Lawrence man, Ron Wilson, has offered to help pay for the trip, but she’s still shy some funds.

SIKESTON, Mo. (AP) — Southeast Missouri authorities say they have found the body of a missing 66-year-old Kansas man, whose death appears suspicious.

Larry Weaver of Pittsburg, Kansas, was reported missing earlier this week after he failed to check out of a Sikeston motel. Authorities discovered his motorcycle was also missing, but his wallet and other belongings were left in his motel room.

The New Madrid County Sheriff’s Department told the Sikeston Standard-Democrat  Weaver’s body was found Saturday in a cotton field.

The department says two people were taken into custody Friday and are being held on charges of tampering with a stolen vehicle and receiving stolen property. Capt. Jim McMillen says another suspect is being sought.

McMillen says Weaver’s death appears suspicious and an autopsy is scheduled to determine how he died.

KANSAS CITY, Kan. (AP) — Two Kansas teens have new jobs after their firing from a pizza restaurant touched off a heated discussion about persistent pay inequality in the American workplace.

The Kansas City Star reports that issues arose earlier this month within hours of Jensen Walcott and Jake Reed finding summer jobs at a Pizza Studio restaurant in Kansas City, Kansas. When Jensen asked why she was going to earn $8 an hour while Reed was set to earn $8.25, a female manager fired both 17-year-olds. The friends from suburban Bonner Springs were told it was against company policy to discuss wages.

The California-based pizza chain has since said the manager has been let go and was wrong about the policy. The National Labor Relations Act allows employees to discuss compensation.

ROXANA HEGEMAN, Associated Press

WICHITA, Kan. (AP) — Documents show Kansas Secretary of State Kris Kobach frequently flies in the state-owned executive aircraft to promote voter ID efforts outside of Kansas and to speak at Republican political events across the state. All of that is at state expense.

The Associated Press used open record requests to document thousands of dollars Kobach spent to fly more than 4,350 miles during a 15-month period.

Several flights appeared to either offer no benefit to Kansas or have little connection to Kobach’s official duties. On some trips, the state business coincided with Republican Party functions where he spoke, and his family often flew with him.

Kobach says he visited county election officials and his public appearances did not cost extra.

Kansas has no written guidelines for state agencies traveling on the state plane.