It’s been all over the news this last week: the Michigan oncologist, Dr. Farid Fata, who harmed and perhaps even killed his patients by administering unnecessary or inappropriate chemotherapy was sentenced to forty-five years in prison (effectively a life sentence for the fifty year old physician). The reason that Dr. Fata knowingly and unnecessarily prescribed toxic medications to more than 550 cancer patients (including to some who he intentionally misdiagnosed with cancer)? Simple greed. To make money billing for fraudulent care (as well as directly through fraudulent billing practices). In gaining millions and millions of dollars, this degenerate doctor not only hurt his patients, it appears that he hastened the death of some cancer patients and may even have caused some under his care to die needlessly.
What if you or a loved one had been one of this criminal physician’s patients? Would you have suspected that he wasn’t providing the appropriate treatment, let alone wondered if he was acting unethically or even illegally? It’s hard to say “yes” for a number of reasons. First of all, virtually all of us are all raised to trust physicians as the best of professionals and highly ethical individuals. A 2013 Gallup poll ranked physicians #3 (and nurses #1) in terms of "Honesty and Ethical Standards.” (Of note, Dr. Fata had a nurse working with him in his office whose disclosures to the FBI clearly indicated that this nurse was aware of at least her employer’s fraudulent billing practices.) Trust of physicians was particularly integrated into the upbringing of today’s older Americans, and given that aging is associated with the onset of many significant diseases (including cancer), and that 10,000 Americans enter the Medicare pool each day, this inherent trust of physicians (and other care providers) represents a major obstacle to the prevention of other horrific abusive events like that now finally over in Michigan.
There are, however, four important tips that I can as a surgeon (and one who has had the privilege of partnering in the care of many patients suffering from life-threatening diseases) can provide you which may just help you avoid the victimization that has hurt (and even killed) thousands of patients under the “care” of grossly dishonest (and grossly incompetent) physicians.
#1. Trust Your Gut! Physicians (and nurses and other care providers) are human beings, vulnerable to the same pressures and unethical behaviors and greed and desperation as are many of the rest of us. Yep, clinicians drink and gamble and make horrible investments and have affairs and embezzle and participate in all the same destructive tendencies as do non-clinicians. Thus, as I often have said, when first selecting your physician partners, you should approach the process as if you are interviewing them for the job. You may not completely appreciate a physician’s true level of medical expertise, but your internal “Is This A Good and Trustworthy Person?” radar works as well in evaluating doctors as it does in evaluating auto mechanics and babysitters. If something about a physician (nurse, or other clinician) just doesn’t strike you as “right” (they seem shady, they creep you out, they don’t make eye contact, they’re overly impatient or rude, etc., etc.), then trust your gut and move on to another potential physician partner.
#2. Do Your Homework. There are several reputable physician grading websites (such as HealthGrades® and Vitals®) on which, most importantly, you can read patient reviews of that specific doctor. Now we all know that such reviews are quite subjective (it only takes one disgruntled patient to make a physician’s rating plummet), so take any outliers’ comments with a grain of salt. But just as you use readers’ reviewers when considering a book purchase from Amazon® or viewers’ comments when selecting a movie, patient reviews (particularly if there are a large number of reviews) can enlighten you on how a particular physician interacts and cares for his or her patients.
#3. Ask Questions! The same cultural respect for and implicit trust in physicians that prevents so many people from correctly interviewing and selecting the best physician partners also impedes many folks from asking questions once under the care of a provider. Listen, cancer and heart disease and diabetes and all the other tons of significant medical conditions are complicated and frightening. But you cannot let your sense of being in above your head or your fears prevent you (or your friends and family) from asking questions about your illness and about the recommended care which directly impact your health and your life! (This health ownership philosophy, learned from many of my cancer patients, led me to author Own Your Cancer: A Take-Charge Guide for the Recently Diagnosed & Those Who Love Them). It is clear that many of Dr. Fata’s patient victims grew very ill when receiving his recommended treatments. No doubt these poor, suffering individuals (and their loved ones) were extremely concerned about their rapidly deteriorating health. Perhaps some (even many) did question him. The key is again not to simply trust a physician’s answer to your questions, his or her response to your concerns, simply because “the physician knows best.” Which leads us to the next and final tip…
#4. Know When To Get A Second Opinion! This is an entire expert blog topic in itself…but luckily, one on which I have already opined, so please, read it. Specific to situations like the terrible Michigan oncologist case, remember that even once you have started treatment as recommended by a physician, you are still free to seek a second opinion regarding that care, particularly if you are concerned about the efficacy and/or side-effects of that care. For example, if you are receiving chemotherapy and have had no evidence that your malignancy is responding (per the projected outcomes and timeline), you may wish to seek a second opinion. Or if you are experiencing much more severe side-effects or complications than anticipated, there is little harm in receiving input from another medical expert. However, it is critical that you understand from whom you should seek a second opinion.
From every perspective, what happened in Michigan was a disaster. A physician whose moral compass was destroyed once he “permitted this sin to once enter [him] because of power and greed” will spend the rest of his life behind bars (a tragedy for him and his family). And far, far more horrible is the fate suffered by Dr. Fata’s patients and their loved ones. The overwhelming majority of us who endured the emotional, physical, and financial hurdles of college (four years), medical school (four years), internship and residency (for me, an additional seven years, followed by an eighth year as a Surgical Fellow) did not do so for money. Medicine is a “calling” for most clinicians (including nurses). So don’t enter your physician’s office expecting dishonesty or deceit. However, don’t think it impossible, either.