Medical Education May Leave Doctors Vulnerable to Fruadulent Schemes
April 26, 2017
Last week twenty-one physicians, mostly late in their careers, were charged in a massive insurance fraud scheme led by a couple in Beverly Hills. The doctors are being charged with accepting kickbacks and conspiracy to commit insurance fraud. They each face up to 25 years in prison, and their reputations and careers are tarnished regardless of the outcome. While the courts decide the innocence or guilt of these particular individuals, it is worth considering how poorly trained the majority of physicians are in navigating the intricacies of anti-fraud laws.
Physicians train for a long time, but medical schools and postgraduate training rarely provide sufficient education on such fraudulent schemes and how to avoid them. Our doctors are extensively trained on how to provide the best medical care, and told to carry malpractice insurance to cover them when they make a medical error. When they enter practice, there is often unexpected pressure to make ends meet and few are equipped to distinguish between a fraudulent scheme and one that might be a legitimate source of supplemental income.
In 2015 the Office of Inspector General, under acting Attorney General Sally Yates, issued several alerts indicating a new era of individual responsibility for physicians and individuals involved in health care fraud and abuse. Prosecutions, historically aimed at hospitals and medical corporations, are now seen as ineffective at deterring fraud. This new priority shifts the responsibility directly onto the individuals, and in healthcare, physicians often have the most to lose.
Medical schools do not typically educate physicians on how best to handle this personal and professional responsibility. By omitting necessary legal education from medical training, doctors are vulnerable to schemes that can ruin their career and hurt patients. Medical education must work to keep our doctors’ careers in good health while they work to improve our health.
© 2023 Elizabeth Shubov