Guest guest Posted April 28, 2006 Report Share Posted April 28, 2006 From the Old Doc in Drain, Oregon, I'm with Anne on this one. Answer the question you were asked to answer. That is your job. After that it is your private obligation to make any ethical decisions that you have to make. But do remember that what you do will influence many things you don't know about. And you know that you don't know, because all the records are not available to you. In the old days we handled this with professional courtesy; to other physicians problems, or errors, we said nothing because next week we could be in the same place. In 10 years you could be outdated in your documentation habits, someone might say. I hear a lot about how ignoring another physician's poor medical habits releases bad doctors into the pool of physicians. Unfortunately, the ones I commonly see being caught in the system by other MDs are just the irritating ones. One thing you need to decide is if you want to testify before the board on the level of knowledge you have now. Another thing people forget is the legal term "officious mischief" which is a prosecutable offense. How secure are you in your view? Also, just how much time are you willing to put into this one? Interested in having this conversation two years from now? How about 4 years from now..that is how long it took a lady MD I know to finish the task of clearing up her name. The woman who helped report her has moved to another residency, lost one of her children in a custody battle, and is generally in bad taste in the town she was in. I think, with Anne, that the hospital peer review system is the best choice here, if, indeed, you need to report. Make sure you are not doing it because the guy was really rude to you; that makes pretty bad karma. Joanne Yahoo! Messenger with Voice. Make PC-to-Phone Calls to the US (and 30+ countries) for 2¢/min or less. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 28, 2006 Report Share Posted April 28, 2006 In a message dated 4/28/2006 9:47:11 AM Eastern Standard Time, writes: Re: ethical advice I would return disability form as Brent states. One option would be to contact your county medical society. This MD sounds like an "impaired physician". They may already know about this MD and have already tried to "educate him". If they find out he is still not changing his pattern of practice, I assume they will report him for you. But I would strongly recommend letting someone else (ie Med. Soc.) do the dirty work. Mike Safran Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 28, 2006 Report Share Posted April 28, 2006 In a message dated 4/28/2006 9:47:11 AM Eastern Standard Time, writes: Re: ethical advice I would return disability form as Brent states. One option would be to contact your county medical society. This MD sounds like an "impaired physician". They may already know about this MD and have already tried to "educate him". If they find out he is still not changing his pattern of practice, I assume they will report him for you. But I would strongly recommend letting someone else (ie Med. Soc.) do the dirty work. Mike Safran Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 28, 2006 Report Share Posted April 28, 2006 Why could she not make an anonymous report to the medical board? I could be wrong, but I don’t think med boards typically bring the reporting person (doctor or otherwise) into their investigations/hearings to testify. Medical boards are not courts of law. If that were the case, then no one would ever report anything to anybody out of fear of this. Once they receive a complaint it is then up to the board’s own investigation. Still, I suppose going through the hospital review would also work as an alternative. RE: ethical advice From the Old Doc in Drain, Oregon, I'm with Anne on this one. Answer the question you were asked to answer. That is your job. After that it is your private obligation to make any ethical decisions that you have to make. But do remember that what you do will influence many things you don't know about. And you know that you don't know, because all the records are not available to you. In the old days we handled this with professional courtesy; to other physicians problems, or errors, we said nothing because next week we could be in the same place. In 10 years you could be outdated in your documentation habits, someone might say. I hear a lot about how ignoring another physician's poor medical habits releases bad doctors into the pool of physicians. Unfortunately, the ones I commonly see being caught in the system by other MDs are just the irritating ones. One thing you need to decide is if you want to testify before the board on the level of knowledge you have now. Another thing people forget is the legal term " officious mischief " which is a prosecutable offense. How secure are you in your view? Also, just how much time are you willing to put into this one? Interested in having this conversation two years from now? How about 4 years from now..that is how long it took a lady MD I know to finish the task of clearing up her name. The woman who helped report her has moved to another residency, lost one of her children in a custody battle, and is generally in bad taste in the town she was in. I think, with Anne, that the hospital peer review system is the best choice here, if, indeed, you need to report. Make sure you are not doing it because the guy was really rude to you; that makes pretty bad karma. Joanne Yahoo! Messenger with Voice. Make PC-to-Phone Calls to the US (and 30+ countries) for 2¢/min or less. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 28, 2006 Report Share Posted April 28, 2006 Many hospitalist migrate to this form of medicine due to it fitting their personality and practice patterns. Primary care is work and it is quite different from a hospital setting. Documentation in a hospital setting is now forced upon him. Sounds like a good thing. He is correct that in years past , records were quite simple. I too inherited many of these. It does not make them wrong, just not complete for billing purposes and documentation guidelines. Every complaint involving a hospital physician is investigated. Send it there. Leave it at that an sleep better at night. Let those who know and deal w physician make the judgments. Brent > > thanks to all of you so far > > I am still pondering > > The easy part is doing my job I can do that part > > The hard part is the ethical part The doc was not rude to me at all he > just stated that he had taken over apractice once from an old guy who kept > only 3 x5 cards on pepole stating one word like " tonsillits " so this guy > truly thinks that kind of system is ok It just is not int his day and age > .The standard of care is not met and may shortchange a patietn who IS > disbaled or may hurt a patietn who needs a drug problem addressed- i cannot > know . To work as a hospitalist and see patietns onthe side for free > ,dispensing controlled substances is just not up to standards > I willprobably report to the hospital but maybe gently tothe state board > still thinking. > > The reason to report is that patients shoudl be expected to have better > care > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 28, 2006 Report Share Posted April 28, 2006 Many hospitalist migrate to this form of medicine due to it fitting their personality and practice patterns. Primary care is work and it is quite different from a hospital setting. Documentation in a hospital setting is now forced upon him. Sounds like a good thing. He is correct that in years past , records were quite simple. I too inherited many of these. It does not make them wrong, just not complete for billing purposes and documentation guidelines. Every complaint involving a hospital physician is investigated. Send it there. Leave it at that an sleep better at night. Let those who know and deal w physician make the judgments. Brent > > thanks to all of you so far > > I am still pondering > > The easy part is doing my job I can do that part > > The hard part is the ethical part The doc was not rude to me at all he > just stated that he had taken over apractice once from an old guy who kept > only 3 x5 cards on pepole stating one word like " tonsillits " so this guy > truly thinks that kind of system is ok It just is not int his day and age > .The standard of care is not met and may shortchange a patietn who IS > disbaled or may hurt a patietn who needs a drug problem addressed- i cannot > know . To work as a hospitalist and see patietns onthe side for free > ,dispensing controlled substances is just not up to standards > I willprobably report to the hospital but maybe gently tothe state board > still thinking. > > The reason to report is that patients shoudl be expected to have better > care > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 28, 2006 Report Share Posted April 28, 2006 I reported a lawyer to the Bar a number of months ago. They did an investigation and determined his behavior was not something that justified an investigation. I had gone into it realizing that I am not the right person to make the call, and I'm totally fine with their decision. For this reason, I do think the Medical Board is the right place to start. If they're anything like the CA Bar, you won't need to be involved beyond making the report, and he'll never even know about it unless they agree it's worth looking into. You could call and ask what think anonymously (not even give the guys name). Good luck with this, > > HI > I would like some advice > > I independently review some charts for disability I work for a flat fee for > a compnay that itself contracts with The Hartford Group > I get sent charts with medical records of a aptietn and certain questins > have been pre-outlined for me byt he compnay- like moslty- does the medical > record support Mr so and so's inability to lift 5 lbs several times a day > or does the record support the dx of whatever.. > > > So I get a case this week with scant records.The doc taking care of the > patient/ claimant took care of him since the doc was in a traditional > practice That practice records are " transferred tosomeone else and in an > unknown location " The doc left and took another job where he still saw the > patient but the reocrds ahve been " lost " after being placed in storage by > the insittuion.The doc now is a hospitalist and sees this patient. He keeps > no records other than a few words on his palm pilot.The few words he writes > are the names and doses and amount of pills. NOTHING else as we have those > notes. > The doc prescribes oxycontin diazepam buspar alprazolam ambien wellbutrin > > there are no notes of examinations etc > The patietn was refrred for imaging failry casually apparnlety see below. > the patient was refrred to another doc who has returned the record request > saying " not seen since JUne 06 " obvioulsy an error.. but so no records sent. > > I am required to call the primary doc .So when I talked with this now > hospitalist doc today he says he does examine the patietn he sasy the > patient was an administrator of a medicl specialty group and " grabbed Xrays " > at this hospital or maybe that " > The doc says that note s are in his head , he rememebrs fine. That notes > are not possible to keep as a hositlaist " I do nothave nurses and all " and > he says that he does not charge the patient-I inquired how he can bill > without documetnation > > My question- > > It is clear to me that this is inappropriate medical practice. > I can handle my job in reviewing the record and commenting about the state > of the patient as best i know etc and hat we should seek imaging studies and > consults if they were done. > The question is how unethical this doc is-- should he be reported to the > ARkansas Board oflicensure? > He is dispensing controlled substances rather casually The patietn may > beneft from them may use them may be disabled or-- not! But no one could > sanction this is as proper medical care. Oy!! Advuceplease?(No I have no > contracts with the group I work for, nothign that might specify my > obligations or restrtics here)) > thanks > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 28, 2006 Report Share Posted April 28, 2006 I reported a lawyer to the Bar a number of months ago. They did an investigation and determined his behavior was not something that justified an investigation. I had gone into it realizing that I am not the right person to make the call, and I'm totally fine with their decision. For this reason, I do think the Medical Board is the right place to start. If they're anything like the CA Bar, you won't need to be involved beyond making the report, and he'll never even know about it unless they agree it's worth looking into. You could call and ask what think anonymously (not even give the guys name). Good luck with this, > > HI > I would like some advice > > I independently review some charts for disability I work for a flat fee for > a compnay that itself contracts with The Hartford Group > I get sent charts with medical records of a aptietn and certain questins > have been pre-outlined for me byt he compnay- like moslty- does the medical > record support Mr so and so's inability to lift 5 lbs several times a day > or does the record support the dx of whatever.. > > > So I get a case this week with scant records.The doc taking care of the > patient/ claimant took care of him since the doc was in a traditional > practice That practice records are " transferred tosomeone else and in an > unknown location " The doc left and took another job where he still saw the > patient but the reocrds ahve been " lost " after being placed in storage by > the insittuion.The doc now is a hospitalist and sees this patient. He keeps > no records other than a few words on his palm pilot.The few words he writes > are the names and doses and amount of pills. NOTHING else as we have those > notes. > The doc prescribes oxycontin diazepam buspar alprazolam ambien wellbutrin > > there are no notes of examinations etc > The patietn was refrred for imaging failry casually apparnlety see below. > the patient was refrred to another doc who has returned the record request > saying " not seen since JUne 06 " obvioulsy an error.. but so no records sent. > > I am required to call the primary doc .So when I talked with this now > hospitalist doc today he says he does examine the patietn he sasy the > patient was an administrator of a medicl specialty group and " grabbed Xrays " > at this hospital or maybe that " > The doc says that note s are in his head , he rememebrs fine. That notes > are not possible to keep as a hositlaist " I do nothave nurses and all " and > he says that he does not charge the patient-I inquired how he can bill > without documetnation > > My question- > > It is clear to me that this is inappropriate medical practice. > I can handle my job in reviewing the record and commenting about the state > of the patient as best i know etc and hat we should seek imaging studies and > consults if they were done. > The question is how unethical this doc is-- should he be reported to the > ARkansas Board oflicensure? > He is dispensing controlled substances rather casually The patietn may > beneft from them may use them may be disabled or-- not! But no one could > sanction this is as proper medical care. Oy!! Advuceplease?(No I have no > contracts with the group I work for, nothign that might specify my > obligations or restrtics here)) > thanks > Quote Link to comment Share on other sites More sharing options...
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