What a sleazy doctor!

[traumahawk99]

had a patient that became a cmo and a dnr, and her husband was taking her home to die in the morning, if she made it through the night. she as npo, and ready to die at any moment.

so i'm taking care of my patients, trying to keep her comfortable, etc... and the nephrologist comes along... i told him she was npo, and going home tommorrow with hospice.

what does this guy do? he said.. that's not my concern. and he proceeded to prescribe her an inconsequential p.o. med he new she could never take. in other words, he was just billing for a consult while she was still breathing! as long as we have jerks like this using the flesh of dying patients to rip off the system (our health insurance and tax dollars)... there really isn't much hope for the healthcare system.

do i think this clown has any real compassion for patients? it was all i could do not to call him as ass.

[YellowFinchFan]

Wow...

Maybe the difference was that he still thought he would "treat" her since DNR doesn't mean "do not treat"....and maybe if she was made COMFORT CARE only he would've backed off? Just a question...

Recently I had a patient who was being treated by an army of specialists (horrendous complications from a broken hip) Basically she had every virulent hospital bug you could get plus other horros...she was made "comfort care" finally...and when one specialist donned his lunar suit to go in to see her - I told him she's comfort care now ...and he was quite relieved and didn't even write in her chart....

[traumahawk99]

she was both a dnr and a cmo and yes, i made sure he knew it. his demeaner gave his intentions away. he was just billing for a consult.

[graceomalleyRN, RN]

Isn't what he did criminal? I think you should report him to the medical board, for your patient's sake and the sake of taxpayers and everyone paying exorbitant healthcare prices thanks to frauds like him.

[YellowFinchFan]

she was both a dnr and a cmo and yes, i made sure he knew it. his demeaner gave his intentions away. he was just billing for a consult.

that's just unbelievable - I've never had that happen - I think I would be speechless and let him know you would not be able to give the med - and probably take it up with your manager - if anything it could be an incident report for starters..........

[Blee O'Myacin, BSN, RN]

Just because he bills, doesn't mean that medicare (or whatever other insurance will pay) - so the hospital will wind up eating the expense. However, an anonymous tip to the ethics committee might not be a bad idea. But regardless of prescribing the med, the consult is still his time and that deserves to be compensated. My gut reaction is that the med is something that a drug company compensates him by the number of prescriptions written.

Blee

[traumahawk99]

the reality is i can't do anything. if i did say something, the hospital would fire me in less time that it took him for his "consult". i can't do a damn thing, and he knew it.

the other nurse working with me was equally disgusted.

[RN1989]

I've come across this before. I also have documented my refusal to follow the orders and why. It can cure docs like this of that trick.

[ceecel.dee, MSN, RN]

I've come across this before. I also have documented my refusal to follow the orders and why. It can cure docs like this of that trick.

No orders to follow here if he just wrote a Rx for her to go home with. His progress note will be written with his action taken and then he bills. Your refusal to do something does not stop illegitimate billing.

[bollweevil]

the reality is i can't do anything. if i did say something, the hospital would fire me in less time that it took him for his "consult". i can't do a damn thing, and he knew it.

the other nurse working with me was equally disgusted.

You can't fight every battle. You made him aware, I assume you charted med not given and why or otherwise dealt legallly with this order, and what else can you do? The woman will die soon and not suffer because of him.

I do think maybe you should speak with him to understand his true reasons for writing such an order. He could have had something else in mind than what you are thinking. Just a thought.

If this really bothers you, I guess you will have to report him. As you know, though, be prepared for firing, blacklisting, etc. Can you deal with all of that? Let it go and help the living. If the doctor was being unethical, he will answer eventually for his misdeed, perhaps to the highest authority of all. Furthermore, he did actually do the consult and deserves to be paid for it. It's not his fault she's dying, CMO, DNR.

[traumahawk99]

the order he wrote, by the time it was profiled and set up by pharmacy, would have never been given anyway before she was discharged. so there was no order to follow or not follow.

i can't see this as anything other than sucking money from the system. and heck no, i can't question his ethics. i don't really think management would even care.

and i don't think this is really all that rare, in our system. it was just the circumstances that made it apparent.

and this guy is a total pompous ass, with a "get out of my way attitude". in fact, a few weeks earlier he was openly stating his low opinion of nurses in general to another doctor who happened to be on the floor.

[ebear, BSN, RN]

You can call the insurance provider (or Medicare/Medicaid, if applicable) annoymously. Just report the circumstances and what he told you word for word. They WILL investigate this. It's called "fraud".