Fired After 40 Years, Oncologist Whistleblower Pursues Lawsuit

Roxanne Nelson, RN, BSN

August 30, 2021

A lawsuit filed by a Virginia oncologist against a health system that fired him has been allowed to go forward.

Dwight Oldham, MD, an oncologist who was fired after being employed by the same organization for 40 years, alleges that he lost his job when he raised concerns about its breast imaging protocols and about possible fraud with regard to payouts from a federal program.

He had subsequently filed a lawsuit against Centra Health, Inc, of Lynchburg, Virginia, his former employer, in November 2018, as a whistleblower complaint in US District Court.

Oldham also alleged that his firing was a breach of contract and had asked to be reinstated in his job, along with unspecified monetary damages.

In October 2020, Centra had filed a motion to have the lawsuit thrown out, and the court heard arguments on that motion in January 2021.

Now, in a partial victory for both sides, US District Court Judge Norman Moon dismissed part of the complaint — that Oldham cannot sue for breach of contract. But Moon held that Oldham's claims of illegal retaliation had merit, and that the case can go forward.

The Court concluded that Oldham has "alleged facts sufficient to state a claim for retaliation under the False Claims Act and Virginia Fraud Against Taxpayers Act."

Excessive Imaging

In his lawsuit, Oldham reported that there were multiple problems with Centra's breast imaging protocols, including the inappropriate use of breast ultrasound and MRI and a referral process that excluded certain physicians from seeing patients with breast cancer.

He started raising concerns about Centra's breast imaging practices back in August 2016, according to his lawsuit, but meetings that he set up with administrators were cancelled by Centra.

A year later, Centra banished Oldham from all its facilities, citing "threatening behavior" as the reason. This happened 2 days after he was at the oncology office reviewing files with the intent of filing complaints about Centra's practices. While he was there, he discussed the issue with a staff member and revealed that he was preparing the complaints.

A few weeks after Oldham was fired, Centra released a statement saying, "We became aware of a pattern of behavior by Dr Oldham that resulted in a work environment for our team members that was both hostile and unsafe," as reported by local news.

Oldham alleges that the true reason for firing him was his intention to report Centra's allegedly fraudulent activities. About a week after his banishment, Oldham reported his concerns about Centra's allegedly illegal billing activities to the chair of Centra's board of directors.

Centra did not respond to multiple attempts made by Medscape Medical News for comment on the case. Oldham and his attorney John R. Thomas also declined to comment.

Concerns About Practices

Oldham worked at the Lynchburg Hematology Oncology Clinic (LHOC) for several decades before it merged with Centra in 2014. At the time of the merger, he was medical director of LHOC, but in 2017, Centra split the position into two jobs. After the split, Oldham was then responsible for supervising implementation of the oncology care model (OCM).

As time went on, Oldham became increasingly concerned about alleged practices at Centra that he deemed inappropriate and fraudulent:

  • Centra uses nurses as "breast navigators," who are assigned to each patient to assist them through the course of breast cancer treatment. Oldham's complaint alleges that these navigators control referrals of new patients and Centra "used their control of the referral process to exclude certain physicians from seeing breast cancer patients," as well as to intimidate physicians into tolerating overuse of imaging by Centra.

  • There was inappropriate use of breast ultrasounds and MRIs, which led to about 50 to 100 unnecessary breast MRIs per year, according to the lawsuit. While the national average for using a breast MRI following a cancer diagnosis is about 33% of cases, the rate was 74% at Centra, reads the suit.

  • Centra agreed to participate in the OCM in 2015 at Oldham's request. The OCM provides participating organizations with a monthly payment of $160 per patient to invest in quality improvements. In November 2017, Oldham reviewed the preliminary financial data for the OCM and found that Centra was not eligible for any performance-based payment. However, Centra continued to participate in the OCM and collect such payments, while allegedly improperly using imaging and other services.

In the fall of 2016, Oldham addressed the OCM issue with former Centra CEO E.W. Tibbs. According to the lawsuit, Tibbs assured Oldham that there would be "corrective action" to address the lack of progress in meeting financial targets under the model. However, the meeting resulted in a reshuffling of the administrative staff and Oldham being removed as director for medical oncology.

Support From Colleagues

Shortly after he was fired, several physicians at Centra responded to what they called groundless accusations against Oldham, according to an email obtained exclusively by local television station WDBJ. Eight physicians in the hematology/oncology department sent an email to colleagues which stated, in part, that they "firmly deny any physically threatening behavior of any kind...Dr Oldham has been a pillar of our medical community for almost 40 years," according to the news report.

In that same email, Oldham commented that "many of you are wondering what happened, and put simply, my dissenting voice has been silenced. The suggestion that I was physically threatening to anyone is both false and ludicrous. The suggestion that I have ever endangered patient care or safety in any way is also false, and absurd."

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