help, torn about staying in current job

[simplyFNP]

I am currently working in a family practice with one physician. This physician, my boss, initially requested that I chart under his name/credentials. After I refused he is now requesting to sign off on all of my charts, meaning he does not want me to lock the charts even though I'm charting under my individual username and password. I am unsure if he is wanting to do this because he wants to bill incident to, by pretending as if he actually took part in the plan of care. He is not actually on site so I don't know how he will be able to prove that he was in two separate locations in different area codes. I really like this job but feel as though there is too much unnecessary requests being made on the MD's part. I do not want to be involved in anything fraudulent. Please advise....

[babyNP., APRN]

I'm not sure what you're torn about. Run!

[traumaRUs, MSN, APRN]

Agree. Run!

[simplyFNP]

I have started looking for another job. I guess I just wanted to be sure that this was not something that anyone else has experienced.

Perhaps deep down inside I wanted to convince myself that this was normal.

Thanks

[WKShadowNP, DNP, APRN]

My docs write a separate note attesting and agreeing they discussed poc with me.

Seems curious.

Good luck on your job hunt.

[No Stars In My Eyes]

I knew a doc long ago who used to stop by the OR suites when his colleagues were doing operations, 'just to see how things were going.' As he was leaving, he'd look at the patient's chart, noting name, dx, etc. He would then send the patient a bill for 'consultation'. I know this because it happened to me; I was one of those patients in the OR, having my impacted wisdom teeth removed. I also worked 3-11 at that hospital.

I took the bill to his office and standing in the waiting room full of patients, I told the nurse at the desk, not loudly, but not whispering discretely, either..."I don't see how I could be receiving a bill from Dr. So+So; he may have come by the OR and my doctor may have said "Look at this"...and on the way out he picked up my name off the chart...but THAT'S not a consultation."

At that moment, that doctor came out from around the wall that backed the receptionist's area, where I am quite sure he heard everything I said. He looked at me, looked at the bill, picked it up, and looking me straight in the eyes, he tore the bill in half. I just said thank-you as I nodded my head once, turned, and left.

To ME the look he communicated to me was sort of, "How could you possibly have known that? You were under anesthesia!"

It never occurred to me that he should be reported; I was young and was simply happy with not having to pay that bill.

So, all that to say, yeah, there are doctors everyday who try to get away with padding their income. Not all, but you do hear or read about medical practices getting caught trying to defraud Medicare/Medicaid.

I also know of a big, booming nursing-temp business that had a Financial Officer doing the same thing. It nearly tanked the business, but now it is a small business with barely any redeeming qualities. How the mighty have fallen. How people think they can get away with it is beyond me.

If I was employed where you are, it would also make me suspicious of the way the doc seems to conduct business. If he got caught doing what you think he's doing, there would be an investigation; how would you explain your 'part' in it, as in: if you knew, why didn't you report him...or were you two in collusion? THAT possibility right there would give me pause and not just nudge me, but PUSH me to find another job, pronto!

[simplyFNP]

thank you so much for your post. you are absolutely correct.

[DizzyJ DHSc PA-C]

I would agree, if you think he is doing something wrong, they you don't want to work there. However, if you have no proof or direct knowledge of the fraud, then you aren't committing any fraud. You may suspect something, but that doesn't make you accountable for anything. You aren't doing anything wrong, based on your post. I worked in a practice where I new they were committing fraud and even with reporting them I couldn't get anyone to care.

[simplyFNP]

I would agree, if you think he is doing something wrong, they you don't want to work there. However, if you have no proof or direct knowledge of the fraud, then you aren't committing any fraud. You may suspect something, but that doesn't make you accountable for anything. You aren't doing anything wrong, based on your post. I worked in a practice where I new they were committing fraud and even with reporting them I couldn't get anyone to care.

Did you end up leaving that job after that?

[RosePMHNP]

Hi simplyFNP,

I agree with the other responses that it seems like a major risk to stay at this job. To chart under his name/credentials brings up an ethical AND legal issue in my eyes. Can you trust this MD enough to continue working with him?

I understand that it's hard to leave a job you like, but the stress that this conflict/concern with the physician might cause you in the long run seems like a strong reason to consider a different position. I wish you the best in your decision!

[DizzyJ DHSc PA-C]

Did you end up leaving that job after that?

Yes, I left. The whole practice was a mess. It was a husband physician and wife office manager situation and NEVER EVER AGAIN.

[No Stars In My Eyes]

Yes, I left. The whole practice was a mess. It was a husband physician and wife office manager situation and NEVER EVER AGAIN.

Whew! Good for you!

I worked in a husband and wife office once and BOTH were docs.

They thought their quick-fire bickering-bickering-bickering was amusing, I guess in a 1930's madcap-movies kind of way. It wasn't; it set my teeth on edge.

It's a thousand wonders I didn't just scream at them to SHUT-UP!

The wifey doc took few patients, and was mostly busy on her computer trying to figure out a way to get out of paying her student loans.

I second your vote of NEVER EVER AGAIN!