Am I wrong to turn down the job?


I had an interview with the doctor, all of 5 minutes, and he had me come back for a working interview the next day (when he told his MAs that I'd be back the next day, they gasped and asked "you're making her work on YOUR day?"). I showed up, ready to show my skills, and was so uncomfortable with the whole practice. There's 2 MAs (that particular day the doc had 54 patients on schedule) and they do everything.

Every new patient gets a comprehensive hearing test and tymps (measures air pressure on eardrum, both administered by the MA), spirometry (administered by MA), and nasal endoscope. The MA has the patient sign the consent form for the scope and sprays the numbing spray up the nose. The consent form ISN'T explained at all, patient is just told to "initial here and sign here" and the benefits aren't verified to see if a deductible or coinsurance will apply and to let them know they will be responsible if insurance doesn't pay.

The problem is, not every patient needs the scope or hearing test or spirometry. The MA interviews the patient for basic H&P and asks if the BP runs normal, if the patient says yes, the MA told me "just make something up, like 120/63" and put that for the vital signs. When the MA is picking the codes for the scope and hearing test and spirometry, they pick the diagnosis code that will get it paid by insurance, even if the patient did not indicate the condition at all.

Every patient is also given a diagnosis of allergic rhinitis, seasonal allergy, for future allergy testing. The doctor called the MA and I into a patient exam room to review the pt's previous hearing test and asked why the MA missed the gap between ears and gave the pt's complaint list and asked the MA what the diagnosis should be and what test she didn't order. The MA never guessed right (migraine) and didn't order the CT Angiogram and the doc berated her IN FRONT OF THE PATIENT about it. The doc kept stressing the importance of the MA/LPN diagnosing the patient and scheduling the right tests.

1) Nurses don't diagnose--we asses. 2) doctors decide what tests are needed and ORDER them, nurses schedule or perform the tests. 3) WHO MAKES UP VITALS SIGNS ON NEW PATIENTS??? 4) Every new patient does NOT need the full services, especially the high-dollar ones that aren't routinely covered by insurance or applied to the deductible 5) Don't use a pre-selected diagnosis code to get a procedure covered (literally, every patient had the diagnosis of x, and you have to select diagnosis y to correspond with it).

There were so many things wrong in that office that I would not want to sign my name to any of it. I was offered the job and the MD said I didn't sound excited enough and there were 3000 people that applied for it. He told me the starting pay and that it was $6000 a year more than what he wanted to pay (we figured up he wanted to pay $11/hour). I turned down the job. Was I blowing everything out of proportion? That's not the standard office procedure, is it? I've worked in offices for 5 years and NEVER did what I had to do in my two-hour interview.


12 Posts

Wow that sounds pretty bad! No, you're definitely right to stay far away from that job. It sounds like the things that doctor is doing and having his staff do is clearly in violation of a lot of laws and you don't want to be an employee when it catches up to him. You're right, nurses don't diagnose, we assess, and in some states MA's can't even assess patients beyond vitals let alone diagnose and order treatments/tests. I just started working in an office with MAs and they aren't allowed to give allergy shots or tests because they don't have the critical thinking training to help a patient who has a bad reaction. So I think you made the right decision in turning down the job.


623 Posts

Specializes in Clinical Documentation Specialist, LTC.

You did the right thing. Too many unethical practices going on there and $11 and hour is not worth risking your license for. Good for you for turning it down.

jadelpn, LPN, EMT-B

51 Articles; 4,800 Posts

I agree with the pp. Sometimes a doctor's office is a different world, with assistants who are trained as MA's and work under the doctor's license. Sounds as if he wanted a few of them to be directed by you, therefore, your license at stake as well. What they are doing is fraudulent. And to be subject to being berated for $11.00 an hour? No thank you--find another nurse among the 3000 that applied for the job. Someone is going to end up getting hurt.


199 Posts

"Am I wrong to turn down the job?"

Sounds like you already know the answer, why ask the question? I would've run, not walked away from this job!


1,007 Posts

Has 6 years experience.

Thanks. I was very uneasy when the doctor called and offered the position and he made the comment that I should be happier to be offered the job. I'm wondering if I need to report them to somebody but not sure to whom.