ethical advice

[Guest guest]

He should definitely be reported to the state medical board. If he is truly

prescribing these controlled substances & not keeping any records he will

almost certainly lose his license. I can tell you that he would almost

certainly lose his license permanently if he were doing those things here in

Ohio & the board discovered it. That falls way below the standard of care.

ethical advice

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

[Guest guest]

He should definitely be reported to the state medical board. If he is truly

prescribing these controlled substances & not keeping any records he will

almost certainly lose his license. I can tell you that he would almost

certainly lose his license permanently if he were doing those things here in

Ohio & the board discovered it. That falls way below the standard of care.

ethical advice

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

[Guest guest]

I agree. He should be reported. Part of

why medicine is in the state it is in is because bad docs continue to practice

bad medicine.

ethical advice

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

[Guest guest]

Yes, and I’m certainly not a lawyer

but I wonder whether the doctor is obligated now to report him? They

might be since withholding this known info could be potentially harmful to

patients. I would guess the other doctor would be summarily suspended

without even a hearing as soon as the state med board looks into it, assuming

the story is correct.

ethical advice

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

[Guest guest]

Yes, and I’m certainly not a lawyer

but I wonder whether the doctor is obligated now to report him? They

might be since withholding this known info could be potentially harmful to

patients. I would guess the other doctor would be summarily suspended

without even a hearing as soon as the state med board looks into it, assuming

the story is correct.

ethical advice

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

[Guest guest]

Just comment on the question and nothing more. No the record does

not support the disability and leave it at that.

Brent

>

> 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

>

[Guest guest]

Just comment on the question and nothing more. No the record does

not support the disability and leave it at that.

Brent

>

> 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

>

[Guest guest]

Hmmm, tough situation ... I'm sorry to learn you are faced with these

questions.

I'd actually suggest --

1) answer the question as Brent suggests.

2) ask a lawyer (or legal counsel with hospital, your IPA or the company

you are hired by for this work) to check what your legal obligation is if

you have concerns for the legality of his practice. There may be some

specific laws in place that you need to respect - those laws may vary from

state to state.

3) be cautious approaching the doctor him(her)self as you don't know the

response it would trigger and don't know the legality of such an action.

And, finally, do what you need to do so you sleep well at night.

Good luck. And if you learn things that may help us, please share later.

Tim

> Just comment on the question and nothing more. No the record does not

> support the disability and leave it at that.

> Brent

>

>>

>> 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

>>

>

>

>

>

>

>

>

>

[Guest guest]

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