Have you ever spoken with a friend or neighbour about a bad experience in health care? Have you ever read a story that implicated wrongdoing at your place of employment?
How did you feel?
I worked at a large hospital when suddenly; the local news started reporting on the fraud occurring in the Facilities department.
I realize that I may be a little naïve. Not everyone in our profession or in health care has the best interests of the patients as their core value.
Here are a few stories ripped from the headlines that made me cringe:
- TTC insurance benefits planned bilked of $4M: Orthotics clinic provided receipts to Toronto Transit Commission employees for orthotics, but no products were ever received. The owner of the clinic and two employees were charged with fraud. Some TTC employees have been fired, disciplined or trained regarding use of extended health benefits.
- Physical therapist gets 10 years for Medicare fraud, must pay $10 million: Twenty criminal convictions, jail time and restitution…a case from 2012 south of the border with a PT directly responsible.
- Beauty treatments paid by insurance fraud: Fake receipts signed by a RMT were provided to people who were in fact receiving esthetic treatments.
- Crime costs: A Toronto chiropodist created a scheme to bill for orthotics while sending patients to buy Birkenstock sandals at a sporting goods store.
So what can you do about these issues?
- Know and follow your professional code of ethics and standards of practice (find yours on your provincial Regulator’s website)
- Understand your own extended health benefits plan (if you have one) and ask questions if something seems too good to be true.
- Speak up. If you witness outright fraud, report it to the College, to the insurer, to the clinic owner, to the police, and to the patient.
- Educate patients: Here is a great example of patient education on a clinic website.
Over to you
- Have you faced this before?
- Have you been a whistleblower?
- What advice can you share?
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