Hailed as a savior upon his arrival in Helena, Dr. Thomas C. Weiner became a favorite of patients and his hospital’s highest earner. As the myth surrounding the high-profile oncologist grew, so did the trail of patient harm and suspicious deaths.
Adding to a six-figure base salary, his pay was calculated by the number of relative value units, or RVUs, he billed on behalf of the hospital. The system compensates doctors using weighted values for certain types of visits or treatment. It works like this: A doctor might be paid $100 per RVU. A routine physical might be equal to 1 RVU, or $100; a more complicated and time-consuming procedure like radiation therapy might equal 8 RVUs, or $800. In other words, the more patient visits and treatments a doctor bills to insurance, the more that doctor and the hospital earn. Weiner described this system, which is common in American medicine, as “eat what you kill.”
In 2019, two nurses and a pharmacist questioned a Weiner order to apply a fentanyl patch on a 93-year-old woman who was already on opioids and bobbing in and out of consciousness. A nurse texted Weiner to ask whether he was sure. Weiner responded, “Tell them put it on or I will rip their lips off.” Weiner told me this was “an inside joke.”
What an article.
Federal regulators also failed to address alarming trends. An analysis of Medicare drug data shows that, from 2013 to 2020, Weiner’s volume of opioid prescriptions ranked ninth among all cancer doctors who bill the program. When it came to morphine, Weiner consistently ranked among the top five. In 2017, he prescribed more morphine than any other cancer doctor. The Centers for Medicare and Medicaid Services did not respond to questions.
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If a patient wants CPR or a machine to keep them breathing, they elect to be a “full code.” Weiner, the hospital said, had a pattern of altering, without consent, a patient’s status from full code to a DNR/DNI, do not resuscitate and do not intubate.
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If the residents of Helena had seen those files, they would know how Weiner built a high-volume business that billed as much as possible to public and private insurance, all the while sending numerous patients through a carousel of unnecessary and life-threatening treatments. They would have learned that the hospital had financial incentives to look away.
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When I asked Weiner why the hospital would publicly accuse him of various types of malpractice but withhold its concerns about his end-of-life care, he said it’s because administrators knew what he was doing and even encouraged it.
Jesus Christ.
What an article.
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