The future of our health care system, lies with you, dear medical students and residents. While medical school and residency training does a pretty good job giving you didactic and clinical training, they might do a better job teaching you how to avoid the potential mess you will encounter once you complete your training. Perhaps the most shocking thing I encountered after completing residency training was how non-clinical administrators placed so much emphasis on “revenue generation” and not quality care of patients. Unfortunately years later, she encountered medical directors who held those same warped values.
As hospitals continue to buy physician practices, more of you will become employees rather than independent practitioners which might present a conflict with respect to the quality of care for your patients. By allowing a hospital to buy a practice, the physician gives up his or her right to admit to other hospitals that might provide better services. Your practice will become a business although you have received ostensibly very little business training in medical school.
In the name of revenue generation, you might be asked to see more patients than you were trained to see, inflate services on your claims bill or be tempted to earn money in an ethically-challenged way.
A cautionary tale
A physician had a booming obgyn practice in a remote town. She allowed her accountant and office manager access to her unique identifiers such as her DEA number, business checking account number, Medicaid number, etc. She never got involved in the business of her practice because she was too busy taking care of her patients.
One day U.S. marshals armed with guns knocked on her door and carted her off to jail. She had been accused of defrauding the U.S. government out of over a million dollars unbeknownst to her. She wore an orange jumpsuit for a week behind bars until her parents posted bail. She was a divorced mother with an adolescent child and a son who was a decorated war hero in the military. She had graduated from an Ivy League school at the age of 19. She was now a convicted felon who lost her medical license, her freedom and her medical career.
When she was released from jail, she was informed by her attorney that her accountant had died. She didn’t. She was later informed by her probation officer that the accountant had entered a witness protection program. The moral of the story is that you, as a physician, must protect your medical license, your career and the safety of your patients. Sometimes it’s easier said than done.