Caring for Patients: Betraying the Hippocratic Oath

The Hippocratic Oath is the read to all medical Students in a White Coat Ceremony in the first few days of Medical School. It is also recited at graduation.  I have had the privilege of having worked with some really great physicians who are honest and ethical. They are talented not just in their chosen specialties but are accomplished athletes, musicians, writers, poets, and singers. They all have in common the ability to make patients feel safe. I have had a rare one or two that I chose not to refer patients to because I was not comfortable with a treatment plan but that did not include any of the talented well-rounded ones.

If they slipped up, most of their failings were personal and did not involve patient care.  I have known the specialist who was punched by his wife for having an affair with a nurse. He straightened up and returned to his wife and children. His practice of medicine was never compromised. He did have to wear sunglasses for a few days and made up a strange accident story. Unfortunately, in small towns, gossip is a pastime. One of the surgeons showed up intoxicated and was on his way to the OR but luckily a nurse who really respected his surgical skills intervened. He was never known to intentionally harm any patient. She prevented that from happening. One of our colleagues was caught with drugs and had his licensed suspended while he was in Rehab. These actions resulted in pain and suffering that was experienced by each family and doctor. As colleagues, we were anguished because we truly liked and respected them as people and clinicians.

My heart was overcome with sadness when I learned of Dr. Fata, a Hematologist-Oncologist, who intentionally lied to his patients and colleagues to make money. He had a large practice with thousands of patients and that was not enough. He told disease free patients they had cancer and administered chemotherapy by dangerous methods and doses. He treated patients that did not need it because their prognosis was poor and they should have been in Hospice Care. He did not commit the sin of giving false hope; he committed the sin of doing that and intentionally profiting. He has left hundreds of patients suffering from the effects of chemotherapy agents that have deadly side effects. He also stole millions from insurance companies and Medicare.

I spent six years in private practice and then 14 years working for two medical schools and two hospital systems. Getting reimbursed for services from insurance companies, Medicaid and Medicare is not easy. My greatest fear was a Medicaid or Medicare audit that would find coding errors and require me to pay a fine and pay back the reimbursement from those claims. I was sad when  giving my patients any diagnosis of cancer. I often championed the patient rights when I felt chemotherapy was causing more suffering. Many patients were relieved and just wanted their final days to be peaceful. I had great respect for an Oncologist I worked with. He was always honest with patients and never gave false hope and refused to provide treatments that were of no benefit. His patients often sought a second opinion but in the end returned to his care because they trusted him.

Dr. Fata seemed to be fearless and bold to the point of falsifying patient records and even clinical trial data in order to provide unneeded care and make millions. He has received 45 years in prison. He asked for forgiveness. I knew several physicians who went from being addicted to pain killers to being Addiction Medicine specialist along with practicing their specialty. It was their way of giving back.

One brave doctor alerted the office manager and then the authorities were notified. I do feel for his colleagues who trusted him but can only fear that because he was making so much money, some did not come forward. I would hate for this to be true. Medicare loses billions to fraud. I remember having to send copies of my records when I started billing for endometrial biopsies and colposcopies because Family doctors did not routinely perform these procedures. My malpractice also was higher. I was always careful with documentation.

When physicians make unintentional mistakes, we have the stress of a malpractice case. Those court proceeding leave you exposed but you get through it because you know you did not intentionally harm a patient. Dr. Fata does not have that satisfaction. His patients do have the satisfaction that he is in prison and will never hurt another person. The Hippocratic Oath we all recite was replaced by the greed. 

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