Dilemma

[deathmerchant]

Lets say hypothetically there is a neurologist who is ordering unnecessary MRIs and labs and diagnosing every patient with MS (even though they definitely don't have MS by current standards) and starting them on DMDs.(and some other practices). What should be done?

What I mean to ask is- is there is a way to deal with this without getting that person is serious trouble and without getting personally involved? What would be the right thing to do in this situation?

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[Telamir]

Do you think this is coming from a place of greed/malice or is this coming from a place of ignorance/incompetence?

 

[deathmerchant]

Do you think this is coming from a place of greed/malice or is this coming from a place of ignorance/incompetence?

I have no idea honestly. Most likely former with some of latter.

 

[elanmorin]

Is this person a colleague in your practice? If so, I'd bring it up with your program or clinic's leadership. If not, I'd report them to your state's medical board. They would likely get in trouble for that, but your personal involvement in the case would likely be limited. However, it sounds like they are doing harm to the patients so it seems the right thing to do.

 

[Agast]

See Dr. Death, Season 2 where Dr. Fatwa tells all his patients they have cancer and starts them on unnecessary chemotherapy. It’s the intersection of greed and sociopathy.

 

[Thama]

Lets say hypothetically there is a neurologist who is ordering unnecessary MRIs and labs and diagnosing every patient with MS (even though they definitely don't have MS by current standards) and starting them on DMDs.(and some other practices). What should be done?

What I mean to ask is- is there is a way to deal with this without getting that person is serious trouble and without getting personally involved? What would be the right thing to do in this situation?

Is this a situation where the neurologist/practice owns their own MRI and/or infusion center, and thus is profiting directly from misdiagnosis? If so, it's quite likely they are committing Medicare fraud and this should be reported.

 

[deathmerchant]

Is this person a colleague in your practice? If so, I'd bring it up with your program or clinic's leadership. If not, I'd report them to your state's medical board. They would likely get in trouble for that, but your personal involvement in the case would likely be limited. However, it sounds like they are doing harm to the patients so it seems the right thing to do.

See Dr. Death, Season 2 where Dr. Fatwa tells all his patients they have cancer and starts them on unnecessary chemotherapy. It’s the intersection of greed and sociopathy.

Is this a situation where the neurologist/practice owns their own MRI and/or infusion center, and thus is profiting directly from misdiagnosis? If so, it's quite likely they are committing Medicare fraud and this should be reported.

They are not a colleague. They have a private practice in a small town. Over the past few years, I happened to see several patients admitted in a hospital that have been "diagnosed" with MS or someone coming to my office for second opinion on MS.

It's psychopathy honestly.

I do believe they have an MRI and infusion center associated with them. I am not 100% sure though. I checked with my state board- in my state there is no way to anonymously report this. I will have to get involved, esp if it is contested and then I might have to go to court. Also they have been in practice for 20 years so Im sure they have connections at the board.

 

[Thama]

Medicare fraud goes straight to the feds, no state board required.

 

[nikolaite]

No offense intended whatsoever in the following; it’s anonymous internet advice, so take it for what it’s worth. If you have good reason to suspect Medicare fraud (which you can get a good idea of if you’re seeing Medicare patients from his office) you may be set reporting on that. Since that will get the fed’s people in the doc’s record office pulling patient records and billing, it could suffice for your purpose to end the psychopathy if the feds can substantiate Medicare fraud. Some of the federal fines wreck private practices. If the doc is being psycho, he’s likely not being actively crafty to cover his tracks in his records. My axiom on that subject is “evil is stupid.”

If you’re really concerned about the state medical arts board looking into the doc for licensing purposes, consider if you have a good relationship with one or two of the referred patients. If so, maybe inform them tactfully about the situation and briefly instruct them on how to make a concise patient complaint to the board. This is obviously only if you can trust them to keep your name out of it.

Barring that, it seems that you have a responsibility to the medical profession to make the complaint. It hurts the credibility of the medical profession when psychopathic doctors are not ostracized and stopped, especially when their fellow doctors are fully aware of what is going on.

 

[deathmerchant]

No offense intended whatsoever in the following; it’s anonymous internet advice, so take it for what it’s worth. If you have good reason to suspect Medicare fraud (which you can get a good idea of if you’re seeing Medicare patients from his office) you may be set reporting on that. Since that will get the fed’s people in the doc’s record office pulling patient records and billing, it could suffice for your purpose to end the psychopathy if the feds can substantiate Medicare fraud. Some of the federal fines wreck private practices. If the doc is being psycho, he’s likely not being actively crafty to cover his tracks in his records. My axiom on that subject is “evil is stupid.”

If you’re really concerned about the state medical arts board looking into the doc for licensing purposes, consider if you have a good relationship with one or two of the referred patients. If so, maybe inform them tactfully about the situation and briefly instruct them on how to make a concise patient complaint to the board. This is obviously only if you can trust them to keep your name out of it.

Barring that, it seems that you have a responsibility to the medical profession to make the complaint. It hurts the credibility of the medical profession when psychopathic doctors are not ostracized and stopped, especially when their fellow doctors are fully aware of what is going on.

You are right on all accounts.I do believe I have responsibility here. I have never thought about this or been in a situation like this.
First, even the Medicare fraud line is asking for all kind of information which I don't feel comfortable giving. I don't even know if he sees medicare patients or not.

Second, I have seen like handful of these patients myself but I have heard same stories from some other physicians. But I am not 100% sure. Everyone makes mistakes in diagnosis. Is it just that or is it fraud and malpractice?!

I have tried talking to couple of patients indirectly but they were not interested. They in fact didn't like the idea that I was refuting the diagnosis they have had for so many years.

 

[nikolaite]

It’s a hard choice. If you really have a solid complaint, legal advice might be worthwhile. You may be able to find a competent medico-legal rep in the $200-$500 per hour range to advise you; don’t go to a regular financial, business or life-planning attorney. Just know that lawyers don’t really start to listen to what you’re saying until you’re talking to the $1000+ per hour guy. If you have any doubt on who to talk to, call your state bar association for a referral.

I wish you all the best.

 

[nikolaite]

What are these infusion centers and why are they so profitable?

I've seen that mentioned a few times in this forum.

An infusion center is an outpatient facility that takes over the non-oral med admin patients from hospitals; they run cancer, blood disease, lupus, RA, MS and other treatments. This frees up hospital resource and is supposedly more convenient for patients.

I’m not sure that they’re particularly profitable as opposed to hospital infusion, but because infusion centers can be run on a smaller scale, I see a higher likelihood of private practices owning these. The temptation to refer patients to one’s own infusion center would be right there, promising an added source of revenue if one can get over the qualms regarding ethics of conflict of interest and fed restrictions on self-enrichment by referrals.

Maybe someone else can give some more info to fill out the answer to your questions.