Thread by @davidmcswane

Let me tell you a story – one of the more haunting I’ve seen in 20 years of journalism. It’s about greed, death and denial. It took two years to unravel one doctor’s myth, a hospital’s complicity in creating it, and a documented trail of suspicious deaths… 🧵

2/ While reporting on COVID, I found myself in Helena, Montana, talking to medical staff at St. Peter’s hospital. It’s the only acute care facility in ~ 100-mile radius & was the only option for residents. It was home to a fabled oncologist named Dr. Thomas C. Weiner…

3/ For 24 years, Weiner ran the hospital’s lucrative cancer center. He boasted seeing 60 + patients a day. He was a powerful figure, made $2M a year. His nurses revered him; colleagues feared him. He was credited with driving out 2 CEOs who questioned his pay, his patient load…

4/ Over drinks, those staff said that, in 2009, Weiner diagnosed a patient with stage 4 lung cancer, which kills most in months. He treated that patient with chemo & other therapies for 11 years, they told me. ELEVEN YEARS? How? I suspected something wasn’t right ...

5/ Citing that case, the hospital eventually fired Weiner. It split Helena in two - those who saw a brilliant miracle-worker who'd kept a terminal patient alive for 11 years vs those who had doubts. His supporters organized online, held rallies & raised funds for a billboard …

6/ The staff said he then sued St. Peter’s for wrongful termination & defamation. He actually sued? I asked. This meant exposing himself & the hospital to pre-trial discovery. I planned to go to the court in the morning ...

7/ Why so much intrigue over a doctor? Hoping for answers, I went to the court, found the case & was instantly deflated. All the evidence was under seal. All signs pointed to a settlement, forever concealing what happened in Helena. I was later able to obtain that discovery…

8/ Secret files show how Weiner built a high-volume business that billed as much as possible to medical insurance as he sent numerous patients through a carousel of unnecessary & life-threatening treatments …

9/ Records show the hospital enabled that business, how it had financial incentives to look away. The more treatments Weiner billed to insurance, the more money he and the hospital made. Weiner has a phrase for the pay structure that made him rich:
"Eat What You Kill." ...

10/ Records show St. Peter's ignored warning signs for years, including internal complaints from nurses & doctors. Worried his patient load could draw scrutiny from regulators, the hospital hired a consultant to study his pay. While it could be defended, the consultant warned …

11/ His patient load was “exceedingly high” & his compensation “a significant outlier." The pay and workload of 150,000 doctors were presented as dots in a graphic. That lone dot up in the corner? That’s Weiner...

12/ To my surprise, Weiner agreed to many hours of interviews. He's calm, cool and collected. The bottom line, he said, was that without him, St. Peter’s had no cancer center: “You want me to keep seeing everyone? Then you’re going to pay me more, because I’m doing more work.”...

13/ Weiner said he talked to expose a problem in the American healthcare system: A hospital can arbitrarily ruin a doctor’s career & legacy with unfounded accusations. He was the hero of this story, he said …

14/ The allegations against Weiner include that he misdiagnosed many patients, prescribed dangerous & unneeded levels of narcotics to potentially 100s of patients, hospital and court records show. He denies all of them ...

15/ There were also fatalities directly tied to his care, according to interviews and records I obtained. For instance, medical reviewers found one elderly patient died as a direct result of him doubling her morphine …

16/ Weiner dismissed this particular finding as “ridiculous” and, in our conversations and in court testimony, denied that he caused or hastened death in any of his patients …

17/ 1 case especially haunted St. Peter’s staff - the sudden death of a 16-year-old girl. Read the story to find out how I got to the bottom of that case, among others, and eventually confronted Weiner with this question: “Are you killing your patients?”...propublica.org/article/thomas…

18/ Weiner dismissed this story as “a hit piece.” He maintains his medical license. A spokesperson with the Montana Board of Medical Examiners declined comment but referred me to his license, which shows no disciplinary actions…

ebizws.mt.gov/PUBLICPORTAL/l…

19/ In August, he was hit with a civil lawsuit by the federal government for alleged fraudulent billing of public insurance and over treating patients. He denies the allegations and has filed a motion to dismiss …

storage.courtlistener.com/recap/gov.usco…

20/ The hospital refuted none of what I found and offered a statement that broadly denies comment, citing ongoing litigation: "this situation is isolated to a single, former physician, and we remain confident in the exceptional care provided by St. Peter’s medical staff.” …

21/ ProPublica is a non-partisan investigative nonprofit. I can’t imagine any other news organization devoting the time and resources to report this difficult story. If you’d like to contribute to this sort of reporting, you can donate here: give.propublica.org/give/346423/#!…