Trusting Doctors with Cancer Treatment

Stephen Henderson talks with Christopher Friese, Assistant Professor at the University of Michigan School of Nursing and Department of Systems, and of Populations and Leadership.  Friese also has a background as an oncology nurse.  They talk about the federal case surrounding Dr. Farid Fata, a well-respected cancer specialist who fraudulently diagnosed hundreds of healthy patients with cancer and profited via insurance companies off of their expensive treatments.  Federal Prosecutor Barbara McQuade called this one of the “most egregious” cases of healthcare fraud she has ever seen. 

  • Greed as motivator:  Stephen asks if Fata’s primary motivation to commit fraud was financial or driven by a god complex.  Friese says that he believes that greed is the primary motivation in most cases of medical fraud.
  • Incentive to expensive treatment: Friese says that the cancer treatment system is structured so there is monetary incentive for doctors to prescribe more, and more expensive, treatments.  He says that there is no incentive to prescribe affordable medicine or end-of-life care such as hospice treatment.
  • Bad apple: Friese emphasizes that Fata is a “bad apple” and not representative of the majority of US cancer treatment, and that the majority of patients receive excellent care. 
  • Healthy dialogue:  Stephen asks how much an average person should question or trust their doctor in light of this case. Friese says patients should make sure to build a healthy dialogue and relationship with their doctor.  He says that if you do not understand your doctor’s treatment plan, you should ask questions until you do.  He suggests bringing a family member, keeping track of your own medical records, and even seeking out help from another doctor if you feel doubtful.
  • Red flags:  Friese says that if a doctor objects to a second opinion or does not want their patient to engage in a healthy dialogue, this is a red flag. 
  • Poor regulation and statistics:  Stephen asks how the medical community guards against fraudulent cancer treatment.  Friese says the sad truth is that they have not shored up the cancer safety net.  He says that they do not even know how many clinics in the US administer chemotherapy, and that it is hard to quantify or control due to the fragmented care system and state-by-state regulation. 
  • Repairing damage:  Dr. Fata’s case is currently in federal court in Detroit.  Friese says that Fata having to hear from his victims and the families of people he has hurt is an important first step towards healing.   

Click the audio link above to hear the full conversation.  

Image credit: National Cancer Institute

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