Dr Thomas Weiner: The Cancer Con

0:04During the height of the COVID-19 pandemic, a group of locals in Helena, Montana, Montana, gathered outside their local hospital, St. Peter's. It was a beautiful, sunny June day. The wind was whipping, but the skies were blue. And in the backdrop were rolling hills dotted with tall ponderosa pine trees. This may sound like a familiar story, but these people weren't concerned about COVID restrictions and guidelines. I'm here at the weekly stand-in for supporting Dr. Tom Weiner. Instead, they were there in support of a beloved oncologist. I am a cancer survivor, and without Tom, I probably wouldn't have made it.

0:59We support him. One woman held a neon yellow sign with block letters that said, I stand with Dr. Weiner. At about 100 beds, St. Peter's is pretty small. But it is the primary care facility for most people in the region. But during the pandemic, some big controversy swirled around it after Dr. Weiner lost his job. We sure wish you would help us and support Dr. Tom Weiner in his fight to keep his license, and especially the fight for cancer patients who have been ignored through this whole thing. We love Dr. Weiner. Thank you. Dr. Thomas Weiner was at the center of an embittered feud that seemed to split the city into two sides.

1:58because while some people viewed him as a savior, others thought he was a fraud. This doctor had been fired after one of his patients whom he'd treated with chemotherapy for many, many years passed, and it turns out he never had cancer. The question still lingers, whether Dr. Tom Weiner was actually a murderer.

2:33This is The Opportunist, an original podcast from Podcast One. I'm Sarah James McLaughlin. Today, we'll be talking about Dr. Thomas Weiner, a Montana oncologist who held onto a dark secret for years. Weiner's cancer patients loved him. They believed he worked miracles. But in 2020, someone made a shocking discovery. Weiner was allegedly making up false cancer diagnoses and pocketing all the profits from the treatments he provided. Treatments that cost certain patients their lives. Today we'll dive into the tragic death that brought Weiner's scheme to light. and look at the fallout from the investigation into his possible string of murders.

3:40Before Dr. Thomas Weiner, known to some as Dr. Tom, was accused of medical misconduct, Helena, Montana was a peaceful haven for residents and visitors alike. But during the COVID-19 pandemic, the quiet city had become a battleground. On one side was St. Peter's, the local hospital, and on the other side were the people who used to go there for care. Here's David McSwain, the investigative reporter who looked into Weiner's case for ProPublica. I kind of go where the story goes, but I have tended to focus on health care investigations because it's this really interesting nexus of life and death and greed.

4:30During the pandemic, David traveled to Helena. The population's around 35 ,000. It is the state capital, but it still has the trappings of a small town in a lot of ways. It's like 100 miles from Great Falls or Bozeman. So it is pretty isolated. And during the winter, it's hard to make those trips if you want to go see another doctor or go to another hospital. And it's a very insular community. Everyone seems to know everyone and it has a charm to it. But it also allows a doctor to sort of have an outsized presence where you wouldn't see that in a larger city. A doctor like Tom Weiner was a big deal in this community.

5:16Really, he was a big deal across the state of Montana, which isn't known as a hotbed of medical talent. He was a celebrity. He'd come to Helena in 1996 to be an oncologist full-time, which they'd not really had before. They had to bring people in from Great Falls and Zula and elsewhere. So he had a really big and important job. And as he takes over this cancer center, it grows. They get a lot more money. It becomes bigger and bigger. And with that, his stature and pay and status within the community grew. Dr. Weiner saw about 70 patients a day, including some big names. Early on in his tenure, Liz Claiborne, the fashion designer, was a part-time resident in Helena.

6:08He treated her, her husband later wrote about him in his book, you know, very glowingly. So very well respected. People credited him with saving their lives. But Weiner didn't seem to let fame cramp his everyman status either. He really got to know everybody in town. At one point, he treated three generations of the same family. Family members of deceased patients would say, you're in great hands. And to top it all off, Weiner's colleagues respected him too. He did have a very good reputation among oncologists. There was a little bit of that rock star status. He really was a powerful and ubiquitous figure.

6:55Tom Weiner was the heart of Helena, the city's lifeblood. Here's a video that one of his patients posted, describing how lucky she felt to be treated by him. I was diagnosed in 2004 with a chronic inflammatory disease called sarcoidosis. It's a rare disease. It started out in my lungs. And I was seeing local doctors in Montana who tried different medications, which didn't seem to help. And it culminated in 2007 with the disease attacking my brain. I was hospitalized at St. Peter's, our local hospital, for a few weeks while doctors tried to figure out what was going on. It was awful. I got passed around between hospitalists and was sent home without a clear sense of what was going on and spent the next six to eight months literally bedridden.

7:55I was referred to see Dr. Weiner at the Cancer Treatment Center in late 2008 or 2009. And that changed my life because finally I had someone who was extremely knowledgeable, who was extremely caring, and who was willing to take on a very difficult role. But this patient, and many others, had no idea what Weiner was really up to. He really did run his own little fiefdom here, and he didn't have much oversight. And the hospital has done what it can to protect itself from liability. So we have a narrow window into the really egregious accusations that come later. The earliest red flags that at least I can document are more of a financial nature.

8:50Inside the hospital, there's a lot of questions about his pay, which is linked directly to the number of patients he sees. The accusations and concerns against Dr. Weiner began as whispers, not from his patients, but from his colleagues. You know, he was making a ton of money billing for a lot, and other doctors just had questions about how are you doing this? One doctor had said they're billing four times what I would be able to bill. Eventually, his pacer passes the CEOs and the CEOs are asking questions. So the red flags really begin with how are you billing this much and how are you making this much money as an oncologist in a small town?

9:33For years, no one officially investigated Weiner's unprecedented margins. They didn't see a reason to. On the surface, he made so much money because patients loved him. And they referred more patients to him. Since nothing obvious was amiss, no one caught on to his scheme. Until one patient met an untimely and mysterious end. The patient's name was Scott Warwick. Scott first met Dr. Weiner in 2009 when he was 40 years old. Scott and his wife noticed a lump on his neck, which could be just a swollen lymph node, but it could be something worse. He goes to see an area as the throat doctor. That doctor says, well, this could be cancer.

10:28The ENT sent Scott to see Dr. Weiner. Dr. Weiner says, I looked at it, you have stage 4 cancer. He continued to treat Scott Warwick on a chemotherapy regimen for many years. He threw in some other therapies. Weiner's treatment plan was pretty astounding. As many of us have, someone close to me had had that diagnosis and died very swiftly thereafter. In other words, people with stage 4 lung cancer don't usually have that much time left. But Scott was singularly impressive in terms of his survival of this disease. The family really thought they'd found a miracle in Dr. Weiner. And by year 10, no other doctor had really seen Scott Warwick and gone over his records.

11:20And it wasn't until he was beginning to die that anyone delved deeper into his case.

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13:47In 2009, a man from Helena, Montana named Scott Warwick was diagnosed with stage 4 lung cancer. His oncologist, a beloved and revered local doctor named Tom Weiner, put Scott on a years-long regimen of chemotherapy and other treatments, which was unusual. because that diagnosis usually comes with a pretty short life expectancy thereafter. But for all that time, Weiner told Scott that the treatment was working wonders. Unfortunately, the positive results didn't last. In August of 2020, 51-year-old Scott Warwick began suffering from respiratory distress and was admitted to St. Peter's Hospital in Helena.

14:41He was under the care of a lung specialist named Dr. Randy Sasek, who was a traveling doctor on a short-term contract. By the time he met Scott, Sasek hadn't been in Helena for very long. Unlike the local doctors, Sasek didn't have a personal history with the patients he treated. He had to read through their full medical records to figure out how to treat them. And when he read Scott's records, he was stunned. There was never a biopsy done. There was a test of cells, which is not a complete biopsy. And that was how Dr. Weiner concluded that he had stage 4 lung cancer, which kills most in months.

15:24In other words... He never had cancer. Dr. Weiner treated him with chemotherapy anyway. for all those years. Dr. Sasek was stunned. Giving chemotherapy to someone who doesn't have cancer could kill them. But he wanted to give Weiner the benefit of the doubt. So he read through Weiner's notes on Scott. But they were basically indecipherable and had large gaps of information. Sasek kept reading. And finally, he found records of a biopsy on Scott's lung tissue from just a few months earlier. Which came back negative. Definitive proof that Scott did not have lung cancer. Outraged, Sasek immediately told Scott about the negative biopsy.

16:21But Scott didn't believe him. Here's Dr. Sasek on the podcast, Pretend. it's really unsettling to a patient as you can imagine to go to an expert and have them say that you know their new expert who you barely know says that their previous doctor they knew is is wrong now i knew i was going to have to do this to a man who was dying in an icu with the diagnosis he's lived with for 11 years it had taken his job It had massively affected his family life. And it was all unnecessary. You're living day to day thinking that you've got months at any time it's going to come back. That was all an illusion.

17:08All of it. First thing he did was call his wife and tell his wife I'm an idiot. Which is the most appropriate response. That's the only sane response that Scott Warwick could have had. Scott and his wife didn't believe Dr. Sasek, and they weren't the only ones. Other doctors at St. Peter's brushed him off too. That's because Dr. Weiner was pretty renowned in the community. He treated tons of patients and was credited with saving many people's lives. So when Sasek raised concerns, people didn't take him too seriously. And soon, that was the least of his problems. Because Scott developed a severe allergic reaction to an antibiotic.

18:00The symptoms resembled an extreme burn, causing his skin to blister and peel. St. Peter's didn't have a burn unit, so Scott was rushed to the University of Utah's Huntsman Hospital in Salt Lake City, about 500 miles from Helena. where he remained in intensive care for a few weeks. Eventually, Scott's symptoms got so bad, he stopped being able to breathe on his own. He had a do-not-resuscitate order, otherwise known as a DNR. So when doctors ran out of ways to help him, it was time for his family to say goodbye. Scott Warwick died on September 16, 2020, 11 years after his initial diagnosis. By now, doctors at Huntsman were skeptical of Scott's history too, but no one wanted to say anything and risk offending Dr.

19:01Weiner. Except, one doctor found a way to get the message across without speaking at all. After Scott passed, this doctor asked Scott's wife, Lisa, if she wanted an autopsy done. As he spoke, he looked Lisa in the eyes and nodded his head up and down, a silent but strong nudge. Lisa picked up on his cue. She said yes to the autopsy. And when the results came back, they confirmed everything Dr. Sasek had said. Scott did not have cancer. It would be a huge scandal for a doctor to give someone chemo if they didn't actually need it. And knowingly giving someone chemo who doesn't actually need it could be considered murder.

20:01Chemotherapy is poison, and the medical examiner said he died from a host of lung issues that are most likely the result of chemotherapy poisoning. Chemotherapy works by attacking rapidly dividing cells in the body, including cancer cells. But it can also attack healthy cells. That's why cancer patients who are undergoing chemo tend to have a lot of severe side effects. And if someone doesn't have cancer to begin with, well, it can kill them. But according to Dr. Weiner, that wasn't what happened to Scott. When confronted with the results of Scott's autopsy, Weiner doubled down. He seemed to have an answer to everything.

20:53For instance, he told me Scott Warwick definitely had cancer. And I said, wouldn't it have been hard to miss in the autopsy then? And he said, I was upset, too. I don't know how they missed it. And he had told me that the cancer at various points had jumped around the lung in different places. Weiner insisted that Scott's cancer didn't show up because it was jumping around. As you might know, that's just not what cancer does. It spreads, and it can attach to other parts of the body than where it originated, but a tumor doesn't disappear and then suddenly show up somewhere else. Any trained oncologist would know this.

21:40It was a ridiculous claim, especially for someone who should know better. And for Dr. Randy Sasek, it was the final straw. Something was off about Dr. Weiner. And Sasek had a feeling the truth was buried within decades of shoddy medical records. And the more he looked, the more he realized just how much scandal had festered over the years. Sasek started by confronting Dr. Robert LeClaire, the chair of the hospital's peer review committee. He wanted to know how Scott's oncologist, Dr. Thomas Weiner, had been able to give him chemotherapy for all those years. Sasek didn't mince words. He asked LeClaire, quote, How the f*** did this go on for so long?

22:35Leclerc admitted that he had gotten caught up in a culture of rock star doctors being subject to little, if any, oversight. But he assured Sassik that he'd snapped out of it a long time ago, because in fact, Leclerc had been building a case against Weiner for months. He'd been doing it quietly. If he didn't have all his ducks in a row, he knew Weiner would sue the hospital. At this point, Sasak was a little confused. This would mean Leclerc was compiling evidence against Weiner long before Scott Warwick's autopsy proved he didn't have stage 4 cancer. That's when Sasak realized Weiner had done this many times before.

23:25Here's David to explain part of how he was able to.

23:32Private insurance devote vast resources to denying care. It's part of the business model, right? You don't want to overtreat and you also want to save money. And many of the people in that community do rely on government insurance programs like Medicare and Medicaid. Those programs also have people looking for fraud, but what they're typically looking for, the stuff we read about in the headlines. A doctor overbuilt crazy amounts, really expensive stuff. Dr. Weiner appears to have flown under the radar because where he made a lot of his money was he billed an insane amount of 15-minute visits, really, really short visits.

24:11And he was compensated per visit. He didn't necessarily make more money by prescribing more chemo. He made more money by the visits. And I don't know if anyone at the Centers for Medicare and Medicaid Services was looking for that. At the same time, there are only so many people in Helena. And that's why Dr. Weiner found ways to keep patients coming back. He would allow people who were sick to get sicker. He would tell people who weren't sick they were sick, those misdiagnoses, and treat them, and sometimes to really devastating effect. There were questions about his end-of-life care, people who did not seem like they were at death's door, suddenly being given end-of-life care and would die.

25:00It wasn't just cancer treatments he was doling out. Weiner overprescribed extremely dangerous drugs as well. There's really hard documented evidence that he overprescribed opioids, opioids, both in federal data and in documents I was able to obtain. In terms of the narcotics, he was certainly a very high prescriber. The first really big questionable thing was in 2015, there was a death of a pediatric patient. She had just turned 16. And there were pretty serious questions about whether or not she was terminal and the amount of drugs that were used towards the end of her life, and nurses had raised red flags internally.

25:44That's really when it started to amplify, and people within the hospital, according to my sources, really started to question the quality of his care rather than just his pay. But yet, it still took years for the peer review committee, the group of doctors inside the hospital who look at these concerns and allegations, really ramped up its look into his care. Finally, in early 2020, Dr. LeClaire began a covert operation, asking doctors and nurses to send him records of Weiner's suspicious patient care. But a lot of what they had was handwritten, as opposed to electronic documentation, and Weiner's notes were notoriously hard to understand.

26:30Folks within the hospital who were very close to the internal investigation, They believe it was intentional, that his record-keeping was so sparse that other doctors couldn't really see what he was doing. So even when people were willing to hand over evidence, it rarely proved anything. That is, until Scott Warwick died. And Dr. Sasik found proof that Weiner had been poisoning him for years. After that, the hospital's review committee had a clearer idea of how Weiner was actually treating his patients. Pretty soon, they realized just how many deaths he might be responsible for.

27:22In 2020, medical staff at St. Peter's Hospital began piecing together how Dr. Tom Weiner intentionally misdiagnosed, and potentially killed, his patients. They went back through old documentation and uncovered numerous suspicious deaths. Here's reporter David McSwain. They sent out 80 random cases for external review. A bunch of those came back with problems. I think it was 13 cases where they had reason to believe something had gone wrong, and they were just egregious. These cases ran the gamut, beginning with a woman who had breast cancer at one point and underwent a mastectomy. After that, she had routine checkups with Dr.

28:11Weiner. who was known not to actually do breast exams, despite being an oncologist. So when she suspected her cancer had returned, Weiner basically ignored it. This woman found a lump, went to Dr. Weiner, isn't treated, and later at another hospital, they found an advanced breast cancer, and she had to get that breast removal again. And there were a slew of other suspicious cases as well. They found a guy named Anthony who had been diagnosed with a sort of pre-leukemia and been given chemotherapy for about the same time period as Scott Warwick. And three separate biopsies showed that he never had it.

28:57Sharon Bilble was an elderly woman who had a host of medical issues and had seen Dr. Weiner for quite some time, though she didn't have cancer at the time. She, as many of his patients, continued to see him because he would make him their primary care physician. Patients would continue to see Dr. Weiner even if they were in remission or no longer had a cancer diagnosis, which again increased his billing. She came to him for what the family thought was a routine visit. She was on a decent amount of morphine just to handle her chronic pain, which there's supposed to be a pain specialist that handles that sort of thing, but he was her prescribing doctor.

29:41And records show that in that visit, he doubled her morphine. and a few days later her daughter found her blue and limp and she eventually died at the hospital. A medical review concluded that she died as a result of Dr. Weiner doubling her morphine, which was very concerning for the family considering all the other allegations around his opiate prescribing. Just case after case after case. There was only one case where he admitted he got it wrong. It was the case of Anthony Olson, who had been diagnosed with a sort of pre-leukemia, and three biopsies showed he never had it. But that person was still treated for nine plus years, and it had a remarkable, devastating effect on his life.

30:29The hospital had settled with Anthony, who continues to deal with the ramifications. But that's the only time Dr. Wine admitted he might have made a mistake.

30:41It just seemed like there were too many allegations for it to be completely accidental. Now, looking back, other staff members have to wonder about the role they played in Weiner getting away with all of this for so long. It does seem that he was revered as sort of like a House MD figure. He kind of had the answer right away where others might not have had it. And he was viewed as having this really sharp mind. Since no one questioned Weiner, he seized an opportunity. It did seem that at times he would go for the most expedient answer or treatment, and that probably contributed to his incredible amount of medical billing and his personal wealth.