Ethical Dilemma

[Throw Away2]

deleted

---

Members don't see this ad.

 

[erg923]

I am a doctoral student at an APA accred. university. For practicum I do neuro evaluations and report writing for a psychologist in the community. Since working for them I have noted many things which concern me and I'm not sure what to do about it. The psychologist works 15 or so hours a week and expects to maintain the same income they did when they worked full time 20+ years ago.

1. The psychologist pays a psychometrist to do testing, but also requires them to write reports. They do a terrible job with reports, but its not really their fault. The psychologist removes their name from the final report and the patient and insurance is non the wiser. The psychologist does the same with my reports. The psychologist then bills it as if they did all the work themselves.

2. The psychologist continually requires me to work beyond my hours limit each week. I cannot go into too much detail so I can stay anonymous. I have tried to set boundaries with the psychologist by explaining my cap on hours, but they ignore it or become angry with me. I have spoken with my program faculty about this. They said they are aware and have spoken with them before about requiring students to make up hours even if the psychologist did not have people to test.

3. The psychologist sends home testing protocols with patients so they do not have to stay in the office while the patient completes forms (e.g. MMPIs and PAIs). Many times we are doing assessments for court cases and disability. I suspect that sometimes the patient looks up response patterns to manipulate their results.

4. The psychologist's standard battery is upwards of 12+ assessments, some of which are extensive. They become angry with me when I take 3-4 hours to administer the complete battery, but also angry with me if I use the abbreviated assessments.

5. The psychologist is not current with the research in neuro. They prefer to use a canned diagnosis for everything because they are afraid they will be called into court to testify if wrong. I will often put what is likely the correct diagnosis, but they make me change it to the standard diagnosis. Sometimes the patient does not have any diagnosable disorder, but psychologist requires me to put one because they cannot bill otherwise. In these cases I will put a v-code or something mundane.

My main worry is that this is my assistantship and I originally committed for 2 years. I would like to speak with the psychologist about this, but the power-differential keeps me from doing so. I have made suggestions that would help her operate without ethical bounds (e.g. have psychmetrist conduct all assessment and I would write all reports). What do I do? I would like to report them to the board, but I cannot do that anonymously. I also feel guilt about committing to something then abandoning it - I know I shouldn't though. What would yall do?

1. Document specific incidents of each. Report back to your DCT. If true, there is more than enough to warrant a board complaint from your DCT. If #1 is true, its insurance fraud and should also be reported.

Also, what is a "canned diagnosis."

 

[WisNeuro]

Well, if he is billing the testing and report writing as if he had done them himself, that is fraud if he is billing insurance. You'd have to look into it, but if you know about this and continue to help with such an enterprise, you could be culpable in some way as well. If this is the case, I would not feel bad about abandoning the placement as I would eventually like to practice in the field in your case, and a criminal case with my name in it would be no bueno.

 

[WisNeuro]

Also, what is a "canned diagnosis."

My assumption is just someone who copies and pastes something like the computerized interpretive report of the PAI or similar.

 

[BuckeyeLove]

I've seen this in practice in my state where clinician's utilize "psych assistants" and claim that, although they essentially did the entire interview, testing, and report, they were still in charge of the entire evaluation process. It's shady as f. Somehow they have never been taken to task for it.

 

[WisNeuro]

I've seen this in practice in my state where clinician's utilize "psych assistants" and claim that, although they essentially did the entire interview, testing, and report, they were still in charge of the entire evaluation process. It's shady as f. Somehow they have never been taken to task for it.

It's not just shady as f, very clearly, especially with the new codes, it is clearly illegal when billing insurance or medicare. 96132 and 96136 clearly spell out qualified individuals for billing that code, and I'm pretty sure medicare does not allow prac students as qualified users. Furthermore, if he's billing medicare, unless they are in Texas, this person can't bill for anything that the prac student does.

 

[Justanothergrad]

Yeh, sadly there is a lot of this in the PP world of assessment. I'd document it as you see it and consult with your DCT immediately about your concerns. It's not just bad training, there are some legal implications.

 

[PsyDr]

Standard advice: talk to you DCT, document everything, keep quiet otherwise. File a board complaint after you are out of there.

Aggressive advice: Want to become a millionaire? Document each case. Wait until you graduate. Find a qui tam law firm, explain, file a suit against him for any case involving medicare or the courts. You get 3x damages, less 40% of the firm's take.

 

[Throw Away2]

Update: I spoke with faculty and they were very concerned - particularly about the fraud aspect. We are meeting and they will be investigating. Thanks everyone for the advice.