For all their education and obvious talents, some doctors just can’t resist their worst impulses. You should keep this in mind when you look for a doctor or when receiving advice from a doctor where the doctor stands to benefit, if you follow the advice. As I have said many times, just because a doctor says it does not make it so.
Health care in the United States is a multi-billion dollar industry. Some doctors believe they are entitled to more than just the money they can earn taking care of patients.
Unnecessary Treatments
This is a classic and time-tested form of grift for some doctors. They tell you you need expensive spinal surgery that they will perform on you. Sometimes, they also make money on the spinal hardware they place in your back. If you are lucky, your back will feel better after the surgery but for the surgeon, that was never really the goal of the surgery.
It is not just spinal surgery, of course. One doctor in Michigan told some of his patients that they had cancer and needed expensive chemotherapy treatments. As you may know, chemotherapy uses poisons to kill or control cancer. The goal is to kill the cancer without killing the patient. These poor patients went through hell only to find out later that they never had cancer in the first place. That doctor is in prison now but there are probably many more out there who have not been caught.
Defrauding Medicare
There seem to be no end to the doctors who are willing to lend their names to schemes to defraud Medicare. In some forms of the theft, homeless people are recruited and paid to become patients. Doctors bill Medicare for treatments the homeless people don’t need and often don’t ever receive.
One doctor in New Jersey wrote prescriptions for back braces for “patients” he had never met and who never received any back braces. The scheme involved many people and billed Medicare over a billion dollars before it was discovered. The doctor was sent to jail and had to pay over $7 million back to Medicare as restitution.
Sexually Assaulting Patients
Sadly, this form of unethical behavior is not uncommon. Two gynecologists at top universities in Los Angeles were found to have molested their female patients. Millions were paid in settlements. A doctor for the American national gymnastics team molested young women for years. A doctor at Ohio State molested young athletes in the guise of examining them for injuries that had nothing to do with their genital areas. These are just the high profile doctors who have come under public scrutiny. There are lots more where they came from.
Upcoding
Unethical behavior can be fairly mundane. Medical billing is controlled by coding. Every procedure has a code that represents the service provided by the doctor and the amount that should be paid to the doctor for that service. A dishonest practice involves assigning a code for a patient visit that makes it sound like more was done or that the patient was sicker than the patient really was. This upcoding results in more money being paid to the doctors than they deserve.
Kickbacks
This is another tried-and-true method of cheating. Doctors order tests, perhaps needed or perhaps not, and send the patient to a specific laboratory to do the tests. The laboratory inflates the amount of money it charges for the tests and kicks a portion back to the doctor for the referral. Sometimes the doctor owns a part of the lab, which for obvious reasons is against the law.
Conclusion
Be careful when dealing with medical professionals. You shouldn’t assume that they are dishonest or that they don’t have your best interests at heart, because most of them do. On the other hand, don’t leave your common sense at the door. Don’t hesitate to ask for a second opinion, especially if what is being suggested is a significant surgery. Ask questions, especially if something doesn’t sound right. Watch your medical bills, even if you have insurance, to make sure they are accurate and you and the insurance company are not being overcharged. Remember that medicine is big business and you are the customer.
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