(and it undoubtedly does), the risk is higher in more sparsely populated states with few resources. The physicians that end up in those states (and yes, I am particularly pointing to the upper tier of states including Montana, WY, ND, SD, ID) have a higher rate of "problems" elsewhere but that may be overlooked or not even identified because of shortages for many specialties. And, primary care may be there only to pay off medical debts with some questions as to whether or not the medical schools that quite often educate these students and the residency programs completed are quite at the standard of others. Alaska and WY remain the two states without medical schools, but they have benefitted in more recent years by gaining access to the University of Washington School of Medicine through the WWAMI Regional Medical Education Program. Before that, an agreement to provide physician training at another regional medical school was problematic, to say the least. I'll say no more on that score, but there were deficiencies.
I am shocked that DEA went so long before investigating and that this "oncologist" was not questioned. This kind of behavior might well have closed a hospital for investigation, had it been closer to Denver. They don't F..K around in the Denver office.
I have long maintained families need a patient advocate in these incidents. Some hospitals have independent assigned professionals that serve this purpose. Some have family members with sufficient medical background (and time) to serve this function.
To all the lives lost who will never know all the facts behind their loved ones' deaths, I feel tremendous sadness. I think the physician in the article was a greedy SOB, but part of his denial may reflect some sense of "mercy" behind his actions. That he was using those levels of phenobarbital suggests his actions were more closely aligned with intentional euthanasia (as veterinarians could certainly attest) than not.
]Bottom line, if things don't SEEM right, ask questions. It is your right.
This was some incredible reporting, I must add.