Would you report a physician who was involved in unethical/illegal activities?

Joan Z · Aug 30, 2008

I am sorry to hear you have seen a LOT of unethical doctors. What do you mean by this? What is your practice situation?

The quick answer is, of course I would... in practice, it would depend on what you mean by unethical. Something that harms a pt? In a heartbeat.

OTOH something like downcoding one time, or feeding answers to a pt so insurance will cover the cost of a procedure.... I would love to say that I would always uphold the law, but in practice I have seen that there is a lot of gray between black and white. I would minimally speak to the physician (I am not known for keeping my mouth shut), make sure he/she knows that what is going on is wrong and see what the response is, and go from there.

ANPFNPGNP · Aug 30, 2008

I am sorry to hear you have seen a LOT of unethical doctors. What do you mean by this? What is your practice situation?
The quick answer is, of course I would... in practice, it would depend on what you mean by unethical. Something that harms a pt? In a heartbeat.
OTOH something like downcoding one time, or feeding answers to a pt so insurance will cover the cost of a procedure.... I would love to say that I would always uphold the law, but in practice I have seen that there is a lot of gray between black and white. I would minimally speak to the physician (I am not known for keeping my mouth shut), make sure he/she knows that what is going on is wrong and see what the response is, and go from there.

How about a pain management doctor who wants to make more $$$ and has his manager call elderly patients at home and tell them the doctor needs to see them ASAP - some hadn't been seen in over 2 years. Then when they show up for their appointment, they are scheduled for a pre-op for a procedure they neither need nor want. Of course, some of them have no idea what's going on, so they end up getting the procedure anyway. T On top of that, there's a NP practicing with him who continues to work there, even though she knows what's going on...would you report her to the BON? That's just one of the examples concerning that PM doctor.

How about docs who are getting kickbacks ($200) for each patient they send to a particular sleep center? These docs are scheduling patients for sleep studies, even though they don't suffer from any type of sleep disorder, fatigue, etc. I could go on and on, but I would be here all day.

CseMgr1, ASN, RN · Aug 30, 2008

In a heartbeat. Why? Because they don't mind reporting us for what they deem as "unprofessional behavior" when all we are trying to do is request they act like doctors.

Just my :twocents:

ANPFNPGNP · Aug 31, 2008

I am sorry to hear you have seen a LOT of unethical doctors. What do you mean by this? What is your practice situation?
The quick answer is, of course I would... in practice, it would depend on what you mean by unethical. Something that harms a pt? In a heartbeat.
OTOH something like downcoding one time, or feeding answers to a pt so insurance will cover the cost of a procedure.... I would love to say that I would always uphold the law, but in practice I have seen that there is a lot of gray between black and white. I would minimally speak to the physician (I am not known for keeping my mouth shut), make sure he/she knows that what is going on is wrong and see what the response is, and go from there.

I've seen doctors pressure patients into getting PT (because they owned the clinic) or sleep studies (once again, they owned the sleep center). They've pressured patients into buying supplements for weight loss, energy, etc b/c they make money off of it. One of the doctors was overheard telling his friend that he could make $3,000 per month if he got 100 pts on his weight supplement, so he was putting everyone on it if they were overweight or if they complained of fatigue. Of course, this stuff is not regulated by the FDA.

These docs are now pushing skin care products and laser resurfacing. Their PA told me that she has overheard the doctor tell patients they have crows feet around their eyes and he has the solution for them...and they were there because of a health concern! These doctors aren't dermatologists or cosmetic surgeons, but plain old family practice docs. Also, those doctors are now including IMT's, carotid dopplers and nerve conduction tests to their extensive list of services. Once again, the PA is being pressured into ordering needless studies for patients, just so the clinic can make money.

I keep telling her that she needs to report them to the Board of Medicine, but she's just going to look for another job instead. I can tell you this, if my doctor started pushing this type of BS on me, I would walk out the door and find another doctor PLUS report him to the BOM for unethical behavior. It's just amazing that physicians would sink so low and their PA/NP's not report them!

Trauma Columnist · Sep 1, 2008

How scary. Personally, I wouldn't continue to work for a practice like that. However, I know in a tight job market, that isn't always easy. We have a derm practice in town that advertises on TV, has a boutique in the mall (!!), and desperately tries to persuade anyone and everyone to have more and more stuff done. They also sell cosmetics, a skin care line, vitamins, etc..

prairienp · Sep 2, 2008

how about a pain management doctor who wants to make more $$$ and has his manager call elderly patients at home and tell them the doctor needs to see them asap - some hadn't been seen in over 2 years. then when they show up for their appointment, they are scheduled for a pre-op for a procedure they neither need nor want. of course, some of them have no idea what's going on, so they end up getting the procedure anyway. t on top of that, there's a np practicing with him who continues to work there, even though she knows what's going on...would you report her to the bon? that's just one of the examples concerning that pm doctor.
how about docs who are getting kickbacks ($200) for each patient they send to a particular sleep center? these docs are scheduling patients for sleep studies, even though they don't suffer from any type of sleep disorder, fatigue, etc. i could go on and on, but i would be here all day.

sounds like you are working in the clinic. i would say if you don't report these concerns you are also guilty and may be held accountable along with the md.

BinkieRN, BSN, RN · Sep 2, 2008

I have seen what I believe to be unethical behavior. I haven't seen or known about anything illegal but yes I would report it in a heartbeat.

I wouldn't hold a doctor in any different regard than any other criminal :down:

ANPFNPGNP · Sep 2, 2008

sounds like you are working in the clinic. i would say if you don't report these concerns you are also guilty and may be held accountable along with the md.

i was working in the clinic a couple of years ago and walked out b/c of everything i saw going on (several midlevels left b/c of this). i used to discuss the docs practices with his fulltime np and even though she seemed concerned she's still there! i agree, she's just as guilty as he is and his time is almost up. these types of things take a long time for the board of medicine to sort through and this doc is fighting tooth and nail (i highly doubt his np is even aware of what's going on). we'll see what the board of nursing decides to do with that np b/c s--- is getting ready to hit the fan. as far as i'm concerned, she should lose her license right along with him. it will be interesting to see what happens, hopefully in the very near future!

i've been amazed at what midlevels don't report, especially nurse practitioners. we are supposed to be patient advocates, yet i see my peers doing whatever it takes to help their bosses make money. i would rather sell burgers at the local diner than be involved with these types of doctors.

ANPFNPGNP · Sep 2, 2008

How scary. Personally, I wouldn't continue to work for a practice like that. However, I know in a tight job market, that isn't always easy. We have a derm practice in town that advertises on TV, has a boutique in the mall (!!), and desperately tries to persuade anyone and everyone to have more and more stuff done. They also sell cosmetics, a skin care line, vitamins, etc..

At least the derm clinic specializes in skin care! There are quite a few family practice/internal medicine clinics offering all kinds of skin care procedures and products.

What really gets me is when they start trying to sell all these nutritional supplements to their patients. I remember reading about a case like that on the TX BOM website. Apparently, all these other doctors don't realize that they could get into the same kind of trouble. It just amazes me that they would sink so low as to try to sell their patients supplements. I mean, these products aren't even regulated by the FDA!

Get this, a PA told me that her boss had bought a case of Aloe Vera gel at a garage sale for $10. He told several of his patients they had dry skin, but he had the perfect remedy for it. He actually sold those bottles of Aloe Vera for $10 each and made a tidy little profit - I heard he bragged about it for weeks. CAN YOU BELIEVE THIS? I can't believe this guy still has a practice. I would not walk, but RUN out of his clinic so fast if this had happened to me. There is no way the Board of Nursing would let us be involved in this type of BS!

Is this happening in other parts of the country? Are docs really that hard up for money?

nursetim, NP · Oct 4, 2008

I did clinicals at a practice that had a "boutique" in the waiting room selling saris (sp?), junk jewlery, junk electronics. Maybe not the same as the other winners you describe. He had his staff do tympanometry on all patients. Ran a pharmacy (he was a pharm tech as well, I guess this made it kosher.) He prescribed more ativan than I have ever seen a single provider prescribe ever. Steroid shots like lollipops. I got invited to leave after about five days there, it was a nightmare. For my troubles I got clinically suspended. :bluecry1: :down: :devil:

I looked into reporting him to the medical board, but I could prove nothing illegal, so Dr. feelgood rolls on. :banghead:

jeepgirl, LPN, NP · Oct 4, 2008

At least the derm clinic specializes in skin care! There are quite a few family practice/internal medicine clinics offering all kinds of skin care procedures and products.
What really gets me is when they start trying to sell all these nutritional supplements to their patients. I remember reading about a case like that on the TX BOM website. Apparently, all these other doctors don't realize that they could get into the same kind of trouble. It just amazes me that they would sink so low as to try to sell their patients supplements. I mean, these products aren't even regulated by the FDA!
Get this, a PA told me that her boss had bought a case of Aloe Vera gel at a garage sale for $10. He told several of his patients they had dry skin, but he had the perfect remedy for it. He actually sold those bottles of Aloe Vera for $10 each and made a tidy little profit - I heard he bragged about it for weeks. CAN YOU BELIEVE THIS? I can't believe this guy still has a practice. I would not walk, but RUN out of his clinic so fast if this had happened to me. There is no way the Board of Nursing would let us be involved in this type of BS!
Is this happening in other parts of the country? Are docs really that hard up for money?

i had an issue on another board where a member was claiming at an NP was selling a MLM weight loss product (I just called it "snake oil") to peds patients (this person was trying to say that since she knew an NP was giving it to her patients, even peds patients, it had to work - so buy some from her!). I called foul. Of course, some girls and I looked up the specifics on the MLM sceme after I had gotten into it with this person, and of course, 87% of the amount sold of the $180 a month supplement goes back to the seller.

Nothing makes me angrier.