in 
Commentary, Community
Commentary, Community Friday
03Aug
Cancer doc profited from chemo, drugs
Friday, August 3, 2007 at 12:48PM Revealing yet still murky story in today's Hawaii Tribune-Herald about Hilo Medical Center being fined $774,542 for violating the complex federal Stark law governing medical contracts between doctors and medical service providers.
One eyebrow-raising part ties in to the discussion of cancer treatment and prevention that has gone on here lately:
On July 1, 2001, the hospital entered into a contract with Dr. Anthony Lim. The hospital agreed to pay Lim $94,000 annually for serving as the "medical director" for the hospital's oncology unit. The hospital also agreed to pay him 20 percent of what the hospital collected for chemotherapy services, including the ordering and prescribing drugs."
Isn't that a clear financial incentive for Dr. Lim to order and prescribe drugs and chemotherapy for cancer patients? Why would he explore any other treatment options when he gets a piece of the drug and chemotherapy action? How can that be a sensible medical practice? Or is it just another profit-motivated scheme by the hospital?
"There is nothing in our poorly written, poorly followed contract that affected patient care," said hospital CEO Ronald Schurra, but it sounds like a conflict of interest and certainly smacks of the problems with the cancer business that Josephine Keliipio has written about lately. Can anyone explain why otherwise a doctor would be given a financial incentive to prescribe a certain treatment?
Also in the story, I couldn't figure out the discrepancy between signing a contract for Dr. Lim to be the "medical director" and this statement later in the story:
"We never implemented a formal process for him to be the medical director."
Geez, you'd think signing a contract would be part of the formal process of implementation. I guess it all shows how little I know about medicine.
View Printer Friendly Version
Email Article to Friend
Reader Comments (7)
His contract with Hilo hospital sounds hazy, poorly thought out and full of legal holes. Where was the great state AG Bennett and his staff in all this?
Hunter is right that the story is murky. Was there an geniuine attempt to get Dr. Lim's side of all this? Is there any continuing effort?
The "fine" is almost what it cost the community to raise its own funds to enlarge the undersized ER room. What a waste of community (that's Hilo AND Puna for those is Opihikao) resources. Hopefully, active duty reporters will dig a lot deeper.
Except for Helen Alton at the Star-Bulletin, medical reporting throughout the state usually goes wanting.
Further, when did Schurra, the CEO, take charge? Is he responsible for a poor contract? or did he inherit it?
Mr. Schurra seems apologetic with statements like, "There is absolutely no ramification here on patient care. There is nothing in our poorly written, poorly followed contract that affected patient care."
But what kind of administration agrees to a "poorly written" contract, then makes up its own rules on payment, resulting in a huge fine?
Answer - an administration that mistakenly believes Hilo Med provides quality care.
The public needs some serious journalism to look at the quality of care Hilo Med is providing. I have collected a lengthy list of mis-diagnoses by Hilo Med doctors, many of which resulted in death. I believe the problems come from the top...but anecdotes are not enough.
Also in the mix are reporting requirements for "unexpected fatalities," medical errors on the part of doctors and nurses, malpractice findings, and outcome studies of patient recovery for a range of treatments. Many reputable hospitals are already voluntarily publishing these statistics on their websites. Others provide them upon request. A friend in the medical administration business told me that everyone should run as fast as they can from a hospital that refuses to disclose or claims not to track such information.
Like I said, I am not an expert, so anyone with more accurate information on this should add their two cents worth, please.
The HTH report left a lot of unanswered questions, and if their previous record of failing to follow-through when they break a story holds true, we may never know the answers. Ah for the days of really good investigative reporting around here. Nobody seems to have the nerve to take a story through to conclusion any more.