I think my friend is being taken advantage of

Nurses General Nursing


Have a friend who is a billing clerk for physician for two years. This doctor I think is taking advantage of her but I am not sure. She is a salaried worker. She has no bedside training what so ever. The doc has decided she must accompany him into exam room with female patients because he fears allegations of abuse. He has a receptionist and a medical assitant but they are not always avaliable. She also stated that sometimes she is busy all day with those kinds of duties and then she has to come in to do her billing on Saturday and Sunday. She said the experience has really helped her with her medical coding and she did not seem upset with the situation. As far as I know she is not doing any proceedures. I viewed the situation with some skeptisim but since I am not well versed in what goes on in offices I thought I would ask some other opinions.:nurse: You know what thought jumped into my mind, "Oh great, first they replace nurses with medical assistance, now they are replacing medical assistance with office clerks." How much you want to bet the patients think she is a nurse and are even calling her nurse.

hoolahan, ASN, RN

1 Article; 1,721 Posts

Specializes in Home Health.

I would NEVER come in n another day to finish my actual job. Surely the MA isn't busy the entire week?? She can only be taken advantage of if she alows it. Since she doesn't seem to mind, it's her business I guess. ??

BadBird, BSN, RN

1,126 Posts

Specializes in Critical Care.

As Ann Landers said "you can only be taken advantage of if you let it happen"

Specializes in PACU, PICU, ICU, Peds, Education.

What about patient confidentiality? I would be quite upset knowing that a billing clerk or receptionist were present at my medical exam. The only time that my physician has anyone else in the room is during a pelvic. And it is a NURSE. Nametag with title and everything. If this guy fears lawsuit, bring up the privacy issue.



20,964 Posts

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

yes, the she is. So are his patients. What a butt. I would not stand for it.


1 Article; 5,758 Posts

I knew some people would say "why do you care when she does not?" That was what raised the question in my mind. She was so OK with this and I had such a strong negative reaction to the whole situation. Why did we feel so differently? Probably because there are a lot of things here that go against my training as a nurse. Could you see someone grabing a medical records clerk out of the office and sending them in to exam with doctors. Just would not happen. On the other hand, as I said I am not that familiar with what goes on in doctors offices. For all I know docs might be going to the insurance agent in the office next store and borrowing a secretary to assist in the exam.


381 Posts

Maybe she doesn't mind putting in the extra hours b/c she's paid better than you. LOL Just kidding, I think.

Ditto, hoolahans response.


1,326 Posts

Hey Oramar,

My step-mother has been a file/billing clerk for doctor's office for about 10 years now and she has never been asked to perform any duty outside of that scope.

One question I have is why does the doc need a person in the room? Is this for every single female patient or perhaps only those that he is giving a pelvic exam to? That sounds odd.

Either way and whether or not it bothers your friend, I can't imagine that it is legal or morally/confidentiality correct for him to bring in the billing clerk for these very private exams.


4,516 Posts

The doc looks at it like this I'd bet: the billing clerk is working under his medical license and is a witness to protect him. Thus it is A OK in his mind.

Gotta feeling he can train her to do anything he wants to train her for, actually. I don't know of any laws except those that come into play if he takes her into hospitals/facilities to assist him...then she must have some kind of credential.

I questioned a FPP once about this and he admitted he just couldn't afford nurses anymore, plus nurses would not do labs, billing, xrays, etc so he just cross trained his own office staff to 'do it all.' He does have one nurse on staff who helps him keep track of his hospitalized patients...and helps see them on rounds. So...we still have some respect...LOL!!

I am seeing ads for experienced billing/insurance clerks willing to crosstrain...and they are paying up to $13-14 hr. Not too bad. Docs value these folks....probably their nurses aren't making much more.


1 Article; 5,758 Posts

I guessed that if one doc was doing it the practice is wide spread. It really is a patient safety issue. I wonder who is pulling these guys around by the nose. Reminding them to do this blood work and that xray like we do in the clinical situtation. Nobody that is who. That is why there are so many mistakes. I should have posted this thread under Nursing Issues and Patient Safety. To Colleen, she specific says he takes somebody in with him to see every female patient. During my nursing career I have watched licensed nurses being pushed out of every non hospital postition. Like I said, they replaced nurses with MAs and now they are replacing MAs with totally untrained clerks. :(

sbic56, BSN, RN

1,437 Posts

Specializes in Obstetrics, M/S, Psych.

I don't see anything wrong with him using her to stand by in this manner. She isn't replacing a nurse if she isn't helping with procedures. It sounds like they have made an arrangement that doesn't compromise the patient care and is cost effective. Some changes such as this one are warranted. As long as she doesn't have a problem with coming in on the weekends to finish up, I don't see any problem; that's what salaried workers often do. Hey, I wouldn't do it either, but seems she feels she is getting some benefit from the practice. As far as confiedentiallity goes, anyone working in healthcare has to abide by the same confidentiuality laws, whether in housekeeping or nursing.

hoolahan, ASN, RN

1 Article; 1,721 Posts

Specializes in Home Health.

I should also clarify, I also don't see any6thing wrong w her being there as a comfort to the female pt. I have requested a female be present during my exam w a doc I didn't know during an employee health physical, and I really didn't care if it was a nurse or a gardner.

If a woman is to be undressed in the doc's office, they are to be offered the presence of another female, I don't thin it has to be a nurse.

What I have a problem with is her going in to spend her off time doing her job b/c she can't finish her actual job d/t wearing so many hats. If she just took comp time off, and then wasn't around, the doc would see the importance of having enough staff.

Honestly, these docs are such tightwads. My doc was sued b/c he wasn't promptly informed by the CMA about a pt havng chest pain. Explain how being sued and losing, for a million dollars isn't worth the cost of a nurse for 45-50K a year???

This is a very common pratice around here. Theonly docs who have nurses are the ortho's and the cardilogists, the rest use CMA's.

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