Patient modified lab orders!

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[Raryn]

I recently had a patient modify my lab orders and add a test. She had a standing order and claims she spoke with me in authorizing an additional test and adding it to the order, I do not recall the conversation. I advised that I was pressing criminal charges, however this was not a Rx order, and the previous order was standing. What are the thoughts here as the police only seem to be concerned about an Rx forgery.

If it's a standing order, I presume the patient added a blood test. Outside of there being some kind of wacky result that you are now required to follow up on and address, there's no harm to you. The patient/their insurance are the ones stuck paying for it and there's no malpractice or licensing board consequences to over-ordering blood tests.

I mean, it's technically fraudulent... but I would almost certainly let it slide and just tell the patient not to do it again. If you're really worried, I'd also contact the lab and inform them that any orders that patients told them you added on need to be confirmed with you prior to being run. I wouldn't press it more than that.

 

[smq123]

I think that telling the patient that you are pressing criminal charges is excessive. There is no harm to your license, and it is certainly different from writing a fraudulent medication prescription.

Do you use an electronic health system to order your tests? Some EHRs automatically transmit your lab orders to Quest/LabCorp, and might prevent patients from adding on their own labs in the future. A frank but gentle discussion with the patient to figure out why he/she ordered this test may also help clear the air. But I don't think a punitive approach is warranted.

 

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[Crayola227]

hhm, as far as punitive, honestly, this might be a patient I would fire

the doctor/patient trust goes both ways, and sure, we don't fire them for lying to us (we'd have noooo patients left) this sort of forgery could get you into all KINDS of trouble depending on what it was
ascribing medical decisions to you that are not yours? um, no. these are the sorta lies I can see turning into something nasty in front of a medical board or jury

I would document this heavily and cut them loose

the reason being, is if they do something like this again and it's worse, the patient could always claim you were in on the deception, and point to you continuing to be their doctor after this little incident as proof of how you two make "joint" decisions like orders you never authorized

I'm just thinking too how an attorney out for your blood could spin things in the future when this patient forges a narcotic prescription and dies from OD

this just makes me feel like the sorta patient I need to move the keyboard just to type my EHR password

I'd be pissed like you but I don't know that I would go for legal action

as they say in the USMLE, you should refer this patient to a colleague cuz even the abusive patients always deserve a 2nd chance at care
I would also warn the colleague
maybe having to switch doctors will teach this a patient they need to learn
the party line isn't about respecting physicians anymore, but yeah, this one needs to learn some respect

 

[gutonc]

ngủ ngon nhé các bác ...

Totes.