Who’s responsible when a physician harms patients—and no one intervenes?
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The higher the practitioner’s position in the medical hierarchy, the more the reluctance to accuse.
—Peter Kowey, MD
An oncologist with a long track record of harming patients finally had his medical license revoked in December of 2025. []
The case, which was profiled in ProPublica, reveals how difficult it is to penalize powerful physicians who may mistreat or neglect patients. Not only did the Montana oncologist, Thomas C. Weiner, deny the claims against him, but many of his peers feared the consequences of speaking up. []
Related: Suspicious patient deaths, a powerful oncologist, and the doctors who paid a price for speaking upWhy colleagues may stay silent
Peter Kowey, MD, a professor of medicine and clinical pharmacology at Thomas Jefferson University and author of Failure to Treat, says this kind of behavior is not uncommon. “The higher the practitioner’s position in the medical hierarchy, the more the reluctance to accuse,” he said.
There are many reasons for this. “Colleagues may be fearful of retaliation, or such conduct may not be noticed or uncovered due to failure of patients to complain, the rotation of staff members to other employment, nepotism, favoritism, political alliances, or the common organizational politics which transpire in every occupational environment,” says Alex J. Keoskey, a partner at Frier Levitt who specialties in healthcare litigation and licensing board hearings.
In some cases, it boils down to revenue. Dr. Kowey says that any number of senior doctors have falsely inflated case complexity to increase reimbursement for both the physician and the hospital. That can go on for years until someone finally blows the whistle, he adds.
“Ghost surgery, whereby senior physicians allow their juniors to operate alone while billing for the procedures themselves, is an excellent example of behavior that should warrant license suspension but rarely does,” says Dr. Kowey.
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Every institution and practice group is responsible for ensuring their patients receive safe, reliable care. Keoskey says compliance officers—who are designated to receive reports of malpractice, mistreatment, or incompetence—should be separate from medical staff members. That’s so that “there are no conflicts or favoritism, which may discourage reporting, due to fear of retaliation,” says Keoskey.
Ultimately, the responsibility falls on the chief medical officer (CMO), says Dr. Kowey, “but most CMOs do not conduct regular surveillance of physician behavior but only react to repeated allegations.” Another consideration is that reporting a physician to a licensing bureau attracts negative publicity, which hospitals, in general, work hard to avoid, he adds.
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