How Professional Patient Advocates Would Have Stopped Farid Fata

Posted by:

On Friday, Dr. Farid Fata was sentenced to 45 years in prison in the state of Michigan.

If you read or watch the news reports you would think the reason behind his long sentence had something to do with the fact that he had diagnosed 500+ people with cancer they didn’t really have, told them they needed chemo, then treated them for those cancers they didn’t have. As a result many died, some will deal with the aftermaths of unneeded chemo for the rest of their lives, some are ruined financially in medical debt, and worse.

The headlines read things like,

Michigan doctor gets 45 years in prison for hurting patients

Farid Fata, Doctor Who Gave Chemo to Healthy Patients, Sentenced to 45 Years in Prison

Doc Told Hundreds of Healthy People They Had Cancer

He did do those things. Horrible, cruel, heinous crimes against those victims and society that hit way too close to home for me.  He is a despicable human being and deserves many more than 45 years in prison, in my not-so-humble opinion.

But here’s what most of us are missing:

Fata wasn’t found guilty, nor will be be imprisoned, because any of those people suffered. He isn’t paying the price for anything related to the heartbreak, fear, mental or emotional anguish he put those patients and their families through. His legal-guilt has nothing – NOTHING – to do with the physical, mental or emotional horrors of his crime.

No. Instead he is going to prison because he defrauded the government and Blue Cross-Blue Shield out of money. His crimes were money crimes. According to CNN, “He pleaded guilty to 13 counts of Medicare fraud, one count of conspiracy to pay or receive kickbacks and two counts of money laundering.” According to the Detroit News, the amounts total $34 million.

Could Fata have been stopped?  Yes, he most certainly could have.

In fact, I will go out on a limb and say that all 553 patients could have avoided what happened to them. Every one of them could have gotten the care they needed, and avoided the care they did not need … Continue Reading →

7

Do Advocates Have a Duty to Report Dangerous Patients?

Posted by:

Warning! This will be one of those posts you think back to from time to time, because the answers aren’t clear or easy, and the stakes are so high.

danger

A few weeks ago we all watched the news about 150 people who lost their lives as their plane crashed into the French Alps; a tragic loss of life which we learned later was caused by the co-pilot, who had intentionally crashed the plane – suicide by one – mass murder of 149 others.  Horrible, tragic, and just so very, very sad.

It’s easy, of course, to dismiss the young pilot as crazy – depressed, suicidal, truly an example of mental health gone awry.  But if you’re like me, the next thought that pops into your head is a question, “Could it have been prevented?”

Once I learned of the pilot’s mental health issues, and the fact that his doctor had written a note to keep him from working, I wondered how exactly that had taken place. Writing a note isn’t the same as actively reporting to the authorities (whoever those authorities might be) unless a copy of the note was delivered to those authorities… (And as an aside, I wonder if the doctor stopped at handing the patient-pilot a note telling him not to fly, and didn’t report it to the right authorities, and if so, how does he sleep at night?)

But even more importantly, what are the rules or laws in the US? Is there any responsibility to report a patient who is dangerous to himself, or certainly others? Could a provider be held legally responsible if he did – or didn’t – report?  How does HIPAA affect the assignment of responsibility? If there is a duty to report such a patient, where is the line drawn? How does that reporting take place?  And how does one decide whether a patient is truly dangerous to someone else, or just him/herself – or even truly dangerous at all?

…..(sidebar)

I’ve been there. I’ve reported.

When I was a first grade teacher, many (many!) moons ago, teachers were mandated to report suspicion of child abuse among our students. One of my students, David, repeatedly came to school with black and blue marks, or a sore arm…. I would ask him how he got hurt and he had a new story every time — including the day he came to school with a black eye. When I asked him how he had gotten a black eye, he responded, “My mother said I fell down the stairs.”

And then I knew I had no choice but to report David’s situation. I was so upset to be put in that position! I was in my mid-20s at the time; still wet behind the ears. My hesitancy was a fear that when I reported it, David’s life would become even more difficult for him. Would he be taken away from his mother, perhaps thrown into foster care? If so, would that be a good thing in the long run? Or?

But none of those questions were mine to ask or answer. The law was the law. And I reported David’s injuries to state authorities.*

…..(end of sidebar)

Healthcare Professionals and the Duty to Report

So out of curiosity, I went looking for answers to my questions about providers and dangerous patients, and I learned something I had never known before, even after ten years of helping patients become smarter about navigating their care.

Continue Reading →

3

Sorry. That’s Not Good Enough

Posted by:

scoldingwomanOne of the most visible changes in the new health insurance reality are the medical bill surprises people are receiving that they never received before, for services covered previously as a matter of course. You know – whereas their insurance automatically approved a CT scan for purpose X in the past, now patients need pre-approval. Without that pre-approval, payment for that CT scan comes out of their own pockets – totally unexpected and usually very expensive.

Most of us learn the hard way that we need to get permission for many of the services that used to be automatically approved. I know I did. About two years ago I received the full billing ($350) for my annual trip to the dermatologist. I had been referred by my primary, the check-up was a covered benefit, but because I hadn’t gotten it approved ahead of time, I received the bill, and was told I was responsible, for the full ride.

I was stunned! And angry, too…. When I called my insurer, the customer service rep told me that was their new policy, and I was out of luck; there was nothing she could do to help me. When I asked when the rule had changed, she told me she wasn’t really sure. When I asked why I had never been notified, she said she didn’t know… Bottom line, I got NO information from her. I finally asked to speak to a supervisor who was even less helpful – until I told her I would be in touch with the state insurance department. Only then did she say she might be able to help me sort out the billing. Eventually they did cover the cost of my appointment – because they couldn’t prove to me that I had ever been notified of the change in policy.

I’m not going to lament here the fact that it seems like nothing can be done by customer service these days without threatening them first. Instead let’s look at some lessons for advocates; that is, that when we know we need something, or when we are stonewalled, the only real answer is “that’s not good enough.”

I raise it today because it almost happened again last month, as follows:

Continue Reading →

2

The Weakest Link

Posted by:

weakestlinkRemember that TV show from a decade or more ago?  When a contestant failed to answer a quiz question correctly, the host would sternly declare, “YOU ARE the WEAKEST LINK. GOOD-BYE!”  Remaining, of course, were the more knowledgeable contestants, presumably a stronger chain of smarter people who could get the job done.

Oh man, how I wish I had been able to invoke that host’s dismissal powers this past week!  As both my husband and I had to deal with different parts of the healthcare system, we encountered roadblocks – the weakest links – and in each case, we had to go over their heads to get what we needed.  THEY were the weakest links.  The problem is, they are still working there, stymie-ing patients every day.

And over and over again, the words of so many of you echoed in my head, Continue Reading →

0

You’re Not Charging Enough, and It’s Hurting Our Entire Profession

Posted by:

cycloneproject

  • What is it worth to find someone who can save your life?
  • What is it worth to find someone who can provide quality to a life that has little or no quality because of health problems?
  • What is it worth to find someone who can save you tens of thousands of dollars, or to prevent you from going bankrupt?
  • What is it worth to find someone who can alleviate your fear, and provide peace of mind?

……………..

I can tell you what it’s worth based on what I read in the press, in the APHA Forum, in my email and based on feedback from many of you:

On the high end, it’s worth about $350 an hour.

But on the low end, every day, many of you behave as if it’s worth is $0. Nothing. Zero. Nada. Zip. 

And in most cases, you don’t realize that is what you are doing.

Continue Reading →

4
Page 4 of 6 «...23456