It's easy to make this a story about top surgeon with a God complex, but the bigger story is the regulatory environment that allows this to happen.

A doctor was billing Medicare for seeing up to 70 patients a day - more 15-minute visits than any other doctor in the entire United States. No regulator noticed this or acted?

Multiple insurance companies paid for 11 years of Stage 4 lung cancer treatment without ever requiring proof the cancer existed. Not one claims adjuster or medical reviewer caught this.

Hospital administrators let him make himself both oncologist AND primary care physician for his patients, creating a closed system with no oversight. They let him take over end-of-life care despite concerns about suspicious deaths.

When hospital CEOs tried to question his practices, he organized campaigns to force them out. Hospital administrators chose protecting revenue over protecting patients.

The medical board failed. The DEA investigated but only pursued civil penalties. Law enforcement seems uninterested in investigating multiple suspicious deaths.

What's most disturbing - after all this came to light, his medical license was renewed in 2023. He can still practice medicine and prescribe drugs today.

The whole thing exposes how profit incentives in healthcare can override patient safety at every level and the regulatory framework that we pay to protect us is part of the problem.

How do we fix a regulatory system that fails at every level to protect patients?

One of the scariest part of it all, is the mass support from the people of the town. How popular charismatic personalities can completely blind people from common sense and their ability to demand truth, and in turn, how that can hurt those wronged, and keep the truth hidden away.

This is one of the most horrifying articles I've read, and I somewhat wish I didn't read it.

I understand why it was posted here, and deserves upvotes.

There are bits I wanted to quote for comments but I genuinely believe it's better to read the article and let those parts meet you in the place and how the journalist wrote them.

Imagine being the reporter for this and reading all this, talking to everyone, and then talking to the man himself, and then have to write "no criminal charges pressed"

> 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.”

This is often what people are scared about with US doctors, that the financial incentive will have them over-prescribe and tell you that treatments are needed that aren't.

Crazy Story!

Edit: I think one conclusion to take away, always get a second opinion, don't rely on just a single doctor/hospital's diagnosis.

Perverse incentives need to be stopped. Providers should be firewalled from finances, not in on the action. If one were to dig deeper into more doctors I have no doubt the same kinds of behavior would be discovered along with that form of compensation.

(1) Among other things, this is an awful example of why documentation matters. So many people were taking this man on his word, and I'm sure if there'd been proper paper trails he would've been caught in even more lies, and hopefully much sooner.

(2) Given how high his diagnosis rates were, I wonder if any population-level studies have been inadvertently thrown off by the "high" cancer rates in Montana, or otherwise tried to explain them. From the outside it might've looked like there was some kind of cancer cluster when in reality this guy was just a liar.

(3) I recently heard a similar story, albeit on a much smaller scale, of a woman who was wrongfully diagnosed with HIV and got so sick from the side effects of anti-HIV medication (this was in the late 80s/early 90s when treatment was nearly as bad as the disease) that she was on the verge of dying. Thankfully she sought last-ditch treatment with a doctor who ran some bloodwork and discovered that she was HIV negative.

In that case, the false positive came from a health department employee who'd deliberately lied to her about the results. The employee lied because they wanted the woman to come to their church, where she'd miraculously be "cured" of HIV (and of being gay). But the woman only realized this in hindsight.

https://www.thisamericanlife.org/123/high-cost-of-living/act...

Here's the Facebook group of his supporters [1]. Looks like this article isn't changing their minds.

[1] https://www.facebook.com/groups/736339123587229/

There's so much here that it's hard to comment.

Ultimately it seems like a story of a doctor's cult of personality, greed and buying loyalty, reckless malpractice, and a failure of multiple institutions to detect it or care about stopping it.

Hard to know what to say to such an insane story. Just read it.

We need more people like Dr. Randy Sasich for having the fortitude to resist this story getting swept away

Wow convincing someone for a decade that they have lung cancer! How can one continue so long?

I wonder how many other places this is happening? None of the scenarios here seem all that unique.

medicine is still run on a first name, word of mouth basis, the paper is fluff , the vast majority of which is never looked at. the article mentions a behavior of many many short visits bieng billed, this is called "churning" and churners, the doctors who provide this nessesary service are well known.Churners provide hand pats and prescriptions to patients who are generaly, non compliant to the best medical advice, and are only looking for some afermation, and is in reality, a cross between pschotherapy and a social club, much lke a bartender or other underrated member of the work force. And ALL of the churners are bieng sued, ALL of the time, thats there other function, taking the blame. I know of churner doctors, who have been sued, and have lost there licence, but are still employed by the medical board, hated, victimised,blamed, but still needed, and now ireplacable.And yes they see hundreds of patients a week, who would get, nothing, otherwise. Having been born into a medical family, medical/military, I have heard a great deal of what actualy goes on, and all of the regulation only makes it worse. Go into a real medical environment now, and the offices are lined in computers and lap tops, that are then burried in paper. Both of my parents, who worked in the system, are now patients themselves, and its an ugly ugly mess. More regulation will break the system,is breaking it

An absolutely terrifying read.