Fraud

[CutsWithFury]

There is nothing more disgusting than breathing in nail dust all day.

I dont do much of it it. It opens up appointments for more interesting pathology. I get a lot of trauma/sprains/bumps/lumps/bunions/etc, etc because they didnt want to wait 6 weeks for the guy up the road to burn thru his booked out schedule of nail fungus. To each their own.

And honestly, I dont mind it for patients who truly need it. But my situation is I get a ton of referrals that simply do not qualify for nail care. I can forge it and "make them eligible" but Im not willing to commit fraud. That's the bottom line, at least in my practice location/situation.

Same boat. I’ve been cutting back on my nail care because to be honest they are the patients that give me the most grief. They think this is a nail salon. High maintenance. It was fine when I wasn’t busy but now I am and to be honest I really don’t care about your fungal nails.

Just recently I just told a patient who didn’t like the way I cut her toenails to go seek care somewhere else because I’m not seeing them again. Greatest moment in my podiatry life.

If people complain about waiting for nail care or upset that I’m running late because I’ve been dealing with more complex MSK pathology and they have the AUDACITY to say something to my face then they get discharged.

I once discharged a diabetic patient because his unemployed daughter, who was in the room, asked me “how many years did you study to cut toenails?”

I laughed and cried inside when she said that. I looked at her and said I make more money than you. Walked out. Sent the patient a discharge notice.



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[DYK343]

I laughed and cried inside when she said that. I looked at her and said I make more money than you. Walked out. Sent the patient a discharge notice.



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Is that legal to do? I recently discharged a patient from my practice for sexual harassment against my MAs. It was very difficult to do and was a long process. May be different from state to state I suppose.

I've been asked that before too so keep your head up. It is insulting haha.

 

[CutsWithFury]

Is that legal to do? I recently discharged a patient from my practice for sexual harassment against my MAs. It was very difficult to do and was a long process. May be different from state to state I suppose.

I've been asked that before too so keep your head up. It is insulting haha.

May or may not be legal but it violates one of my hospital clinic policies which is listed on the discharge paperwork we mail them. Quite frankly if they want to sue me for refusing to cut their toenails then good luck finding a lawyer who would want to take that case.

 

[DYK343]

Google search

What constitutes abandonment of a patient?

Patient abandonment is a form of medical malpractice that occurs when a physician terminates the doctor-patient relationship without reasonable notice or a reasonable excuse, and fails to provide the patient with an opportunity to find a qualified replacement care provider.



Very vague. Where I am at a patient trying to group female employees and make sexual harassing statements took 6+ weeks to discharge. Required a repeal process. Required me to find other providers (being a small profession they were are all my friends so that was not fun/easy to do) in network who can provide alternate care. I think I had to do 4-6 weeks of emergency care or something along those lines. State to state probably different but I would be careful..

 

[CutsWithFury]

Google search

What constitutes abandonment of a patient?

Patient abandonment is a form of medical malpractice that occurs when a physician terminates the doctor-patient relationship without reasonable notice or a reasonable excuse, and fails to provide the patient with an opportunity to find a qualified replacement care provider.



Very vague. Where I am at a patient trying to group female employees and make sexual harassing statements took 6+ weeks to discharge. Required a repeal process. Required me to find other providers (being a small profession they were are all my friends so that was not fun/easy to do) in network who can provide alternate care. I think I had to do 4-6 weeks of emergency care or something along those lines. State to state probably different but I would be careful..

You caught me. Patient abandonment for toenails. I abandoned their toenails. Guilty as charged.

That was the most podiometric Dr. DYK343 DPM, ACFOAM, ASPS, FACFAS, specialist in peripheral nerve surgery, CWS, I’m board certified via the ABPM comment ever




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[DYK343]

You caught me. Patient abandonment for toenails. I abandoned their toenails. Guilty as charged.

That was the most podiometric Dr. DYK343 DPM, ACFOAM, ASPS, FACFAS, specialist in peripheral nerve surgery, CWS, I’m board certified via the ABPM comment ever




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Really?

and for the record I refuse to do nerve surgery. They only get worse.

 

[ExperiencedDPM]

Really?

and for the record I refuse to do nerve surgery. They only get worse.

I always told the residents that tarsal tunnel patients have 1 of 2 results. 100% improved or 100% worse and if anyone is going to get CRPS, it’s one of the nerve surgery cases. Couldn’t agree with you more.

 

[ExperiencedDPM]

Same boat. I’ve been cutting back on my nail care because to be honest they are the patients that give me the most grief. They think this is a nail salon. High maintenance. It was fine when I wasn’t busy but now I am and to be honest I really don’t care about your fungal nails.

Just recently I just told a patient who didn’t like the way I cut her toenails to go seek care somewhere else because I’m not seeing them again. Greatest moment in my podiatry life.

If people complain about waiting for nail care or upset that I’m running late because I’ve been dealing with more complex MSK pathology and they have the AUDACITY to say something to my face then they get discharged.

I once discharged a diabetic patient because his unemployed daughter, who was in the room, asked me “how many years did you study to cut toenails?”

I laughed and cried inside when she said that. I looked at her and said I make more money than you. Walked out. Sent the patient a discharge notice.



Sent from my iPhone using SDN

The nail thing always ruffled my feathers. The straw that broke the camel’s back was the day I got a hospital consult for a “bad infection”. It was a crazy day at the office with 55 patients and 18 of them were new patients.

I get to the hospital and the “bad infection” was onychomycosis. I walk into the room to cut those bad boys and there is a neurosurgeon doing a consult in the same room, in the adjacent bed. I closed the curtain and I hear him talking about REAL medical issues and I’m behind a curtain making mycotic nails fly across the room.

That was the game changer and the day I retired my chippers, clippers and nippers.

Never wanted to experience coming home for dinner and having my wife tell me there is a friggin’ nail stuck in my hair. Or reaching into my shirt pocket to take out a piece of paper and finding a rogue nail piece in there.

Those all led to my decision to let nail salons cut nails. It didn’t go over well with my partners. But I was the senior partner and didn’t ask for their permission.

Best move I ever made.

 

[DYK343]

The nail thing always ruffled my feathers. The straw that broke the camel’s back was the day I got a hospital consult for a “bad infection”. It was a crazy day at the office with 55 patients and 18 of them were new patients.

I get to the hospital and the “bad infection” was onychomycosis. I walk into the room to cut those bad boys and there is a neurosurgeon doing a consult in the same room, in the adjacent bed. I closed the curtain and I hear him talking about REAL medical issues and I’m behind a curtain making mycotic nails fly across the room.

That was the game changer and the day I retired my chippers, clippers and nippers.

Never wanted to experience coming home for dinner and having my wife tell me there is a friggin’ nail stuck in my hair. Or reaching into my shirt pocket to take out a piece of paper and finding a rogue nail piece in there.

Those all led to my decision to let nail salons cut nails. It didn’t go over well with my partners. But I was the senior partner and didn’t ask for their permission.

Best move I ever made.

I have 2-3 years before I will declare an ultimatum to stop consults for diabetic care completely. I cant wait for that day. That day is the day I am free of my loans and have more freedom to fight the system. And the system being my well paying MSG job. Until then I keep paying these things down. As of now I only fight mildly and they dont seem to notice much. But when they gone.... I go for the jugular on axing diabetic foot care.


...I just got back from the OR. Another late night amp.

 

[CaptainCool]

Don’t worry, they will get some of our esteemed colleagues to jump on board.

One of my buddies went to a seminar outside of Philly. There’s a DPM who lectured on the HyProCure. The guy was stupid enough to brag to the audience that he always bills 28585, ORIF of a talo tarsal dislocation!!! And apparently does a load of these and said he always gets paid. i assure you that if he was audited he’d be writing a big check back.

He practices in New Jersey. If anyone knows anyone there in the insurance industry or the OIG, message me and I’ll give you his name. Maybe you can win a whistle blower case.

That dude is wild, he’ll be giving a presentation with post op xrays from like a bunion surgery or hammertoe surgery that he did and you’ll see that he also threw a hyprocure in because why not. I also can’t believe he hasn’t been

 

[sloh]

I am a PM&R physician and read through this entire thread. Best thread I've read in a while. Informative AND hilarious!