Ethical dilemma, what would you do?


Hi everyone sorry for an incoming text wall, but I feel like I'm in a rough spot.

I've been an NP for a little over a year and working for an internal medicine practice that I have generally enjoyed. The pay is solid and my physician boss is great.

Over the last few months, the practice has had turnover issues with our MA's and it's basically because the office manager treats them terribly, is a pathological liar, and I think she's framed some of them for her own mistakes. For the most part, I generally have tried to ignore it since I don't have to deal with the office manager and my boss treats me well. However, it does bother me seeing what is essentially young women (many with kids) making just above minimum wage, being treated so poorly.

My borderline concern recently changed when the officer manager fired my MA (who was an amazing worker) for calling in when her 1 year old son was sick at the hospital (it was her first call in). Then this week I learned that the practice has been forcing all the MA's to edit their time cards to remove any overtime (which is a federal crime). An MA that has been there for a while has told me they always do this.

I'm in a situation where I love my job, but hate the way the other employees are treated, and now I know they're also denying employees on the lowest rung of society fair wages. I want to tell my owner-boss since he is likely oblivious, but his wife is the one in charge of the payroll, and he seems to implicitly also trust his Office Managers decisions. I feel like if I say something, it'll get ignored, and could possibly offend him.

To top it all off, a new opportunity has presented itself, although it would make me feel really guilty for leaving the current practice since he trained me in school and gave me my first job.

So I'm basically trying to figure out what others would do in a similar situation. Right now I'm leaning to taking the new job and offering to stay on part time rounding in some of his facilities since that's where I make a big chunk of coin for the practice anyway. It would work out since the new job would be week on week off scheduling, and I would feel less guilty about leaving if he doesn't like that (and I would also remove myself of the office politics by being strictly inpatient rounding). I would also likely tip off the EEOC anonymously.

Sorry again for the long read. Any thoughts?


395 Posts

Specializes in Peds Urology,primary care, hem/onc.

I would definitely interview and see if you can get the new job. I would not feel guilty at ALL because they are treating the support staff poorly and asking them to do illegal practices. See if you can get some actual documentation/proof of them altering their time cards to prevent OT and I would give it to your boss. That is illegal. When you get the new job and leave, if your new boss asks why, I would tell him directly why you are leaving and how poorly the support staff is treated. They are worth their weight in gold and should not be treated that way. If you cannot get a new job, I would anonymously report the payroll practice to the labor board.


219 Posts

The PP basically said everything I was going to - you have an ethical and maybe even legal obligation to expose what is happening. Obviously, make sure you get your ducks in a row and have documentation of what is happening. Also, I wouldn't feel guilty over the new job - if changes and people (should) understand that.

Trauma Columnist

traumaRUs, MSN, APRN

153 Articles; 21,229 Posts

Specializes in Nephrology, Cardiology, ER, ICU. Has 31 years experience.

Yeah I agree - tell the boss the truth!

As an APRN you bring $$ into the practice and you are a stakeholder as well.

This is just wrong - I would be leaving there as well.

Has 24 years experience.

Take the interview and see what happens. Although you do not deal with the office manager, what is going on will eventually affect you. It would be wise to gather any documentation you can of any unlawful events and by all means save yourself!


11 Posts

Specializes in Critical Care/Case Management. Has 25 years experience.

Tough situation. For me it would come down to my values, and morals. It seems as though it's a close knit group where regardless of your concerns, they would be " swept under the rug" and I would have concerns that if I said anything, I would be "disrupting" their illegal activities and be let "go". I would find another job, and possibly report anonymously to the labor division as well.


99 Posts

I agree with above comments but would add that you should tell your boss of your concerns. Like you said he may be unaware but deserves the opportunity to do the right thing.

Hoosier_RN, MSN

3,794 Posts

Specializes in dialysis. Has 30 years experience.

If his wife does payroll, most likely he knows what's going on, regardless of how oblivious he acts. Take the interview. If they pawn smaller mistakes off on MAs, they would probably not hesitate to throw you under the bus for the bigger issues

Agreed. Nail the interview, leave (and leave completely) on good terms and report to EEOC.


303 Posts

Has 12 years experience.
If his wife does payroll, most likely he knows what's going on, regardless of how oblivious he acts. Take the interview. If they pawn smaller mistakes off on MAs, they would probably not hesitate to throw you under the bus for the bigger issues


The practice is his, ran under his name and license. The profits are his also. I would be very surprised if he really doesn't know what the wife is doing. They likely discussed it and mutually agreed to it to benefit themselves financially. I wouldn't get involved in any drama between him and her at that level. She's his wife, he's going to take her side and the situation would likely end with you getting fired.

But, I digress. Your question was what would others do in your situation, but from your post you already know the answer. Interview and take the other job and leave that place, AND be certain to turn these two in. As long as you don't clue them in they won't know that it was you who reported them, and they will have to pay up all that overtime money that they stole from their employees plus a fine.


1,413 Posts

Specializes in Outpatient Psychiatry.

Make an anonymous complaint to the department of labor and go on enjoying yourself.


261 Posts

Specializes in FNP.

Well, it sounds like the new offer has taken away the only barrier to talking with the doc. And as some have offered, leave the place. But only after championing the weak. I've witnessed the same thing. Since graduating with you :) I've been a float provider at a very large group here is SA. There is one clinic in particular that is struggling to keep great MA's because of office drama. Like you, I'm isolated from that due to my position.

I'm not trying to tell you what to do but I loudly voiced my opinion with key lead physicians and nothing was done. I also refused to go back to that clinic. I had no repercussions for my actions and this practice is physician owned. Ultimately, do what you think is right. Personally, I have to stand up for injustices especially to the vulnerable. Not to mention, you lost a good MA, that would piss me off, lol.