I don't know how Dr. Fata ran his practice but a patient usually needs a referral from his own physician to make an appointment with an oncologist. The patient may present with certain symptoms or test results and the physician is sending the patient to an oncologist for an official diagnosis.

So, no second opinion? If only to see what other treatment plans are available.

Eld, that’s a question I pondered for a long time too, but in retrospect I can understand why now. In our case, we already had x-rays and blood work done and the primary care doctor has said there was something seriously wrong. She said she wasn’t a specialist and couldn’t confirm a diagnosis but that there was a serious problem and we needed to see a Hemotologist/Oncologist right away. Fata who was right next door at the Cancer Institute just confirmed her concerns and gave it a name; so in our mind, a second opinion wasn’t even a consideration.

Now prior to the consult, we had to fill out a HUGE historical that seemed pretty extreme. The questions made it so that going in, Fata could see what our back ground was and what insurance, income and educational levels we had. He knew from talking with the patient what their medical knowledge was or wasn’t. He was very manipulating and good at picking up on any queues of vulnerability. He relied on the concept that patients wouldn’t know what to ask, wouldn’t understand what was missing or what was extreme in their treatments (or diagnosis) and they would trust him implicidly, which they did. He also had plenty of patients that were, like my DH truly ill and treated correctly but I think it was the patients behavior that partially drove that via questions, participation in care, advocacy and the amount of oversite involved.

There are some other contributing factors like he doctored records and tried to keep the testing in house as much as possible but IMO, biggest contributor to his success was the trust aspect and lack of oversite.

Inconceivable.

I agree.

"In house" is becoming more common in the medical field. Could save money on paperwork and allow price negotiations due to scales, but also I wonder about accountability. A friend of mine, in a completely unrelated situation, kept getting treated for a condition she didn't have until a medical practitioner (physical therapist in this situation) looked at her x-ray and said, "It doesn't look like you have what you have been sent here to get treatment for." In her case, everyone just accepted the incorrect diagnosis of her initial physician. Without much review of the physical evidence for the diagnosis since that happened with the initial doctor. In the system's defense, my friend had a rare condition which is probably what made it go initially undetected, but at least the PT gave the medical check that uncovered the deficiency. My friend had an esophageal problem and they had only been looking at her throat, trachea and lungs, not the esophageal section that was actually closing up due to scar tissue formation. There were actually no abnormalities in the areas surveyed, but since she presented symptoms of similar problems like asthma or vocal chord swelling, that's what she kept getting treated for, no matter what doctors she went to.