Would you have concerns in this situation?

[GetMeOuttaThisMess]

Looked up a potential SP at a new clinic who I've been told by the practice principals (other physicians) would serve as my SP.  On the state board website several prior actions are mentioned, including having surrendered their medical licenses in other states for unknown reasons with the exception that in one state this individual was restricted to treating patients above their mid-teens.  In-state issue was failure to properly maintain a medical record and not notifying current state of prior out-of-state issues.  License is currently in good standing.  Would you align yourself with this individual or walk away, even on a part-time basis during which time you would primarily be working solo?  I don't know if there is an option for one of the other principals to serve as an SP.

[gbrothers98]

I worked with 4 SPs that had checkered BOMP histories in different settings, ED and general medicine.

2 at a part time gig, two at a full time.

I knew about all 4 histories at the BOMP plus I had heard scuttlebutt in the community when I asked around.

I spent some time with all of them prior and came to the conclusion that in both positions I would be like you, solo most of the time.

So I was pretty clear with myself that overall I was capable of doing the right thing and they weren't going to be around to steer me wrong anyways.

Plus for the part time gig, I really needed the cash.

The compromises you make in the real world.

Good luck.

George Brothers PA-C

[Febrifuge]

Have you met this person who would be your SP? Is it at all clear why they would be your SP, and not someone else (or a group of someone elses, potentially including this person)?

 

I would give them -- meaning the people offering the job -- an opportunity to explain the situation. This is public records stuff, and you should feel zero embarrassment or hesitation about bringing it up. If they get defensive or pissy, that would be a red flag and I would walk away.

 

If they minimize it, say it's "ancient history," not relevant, or generally don't give you a simple and clear answer, that's a red flag and I would walk away (and tell them why).

 

If they give a satisfactory reason and you're comfortable with the SP, it could be just fine.

 

The questions center around what happened, how long ago, and what has been done since to get the license back to good standing with no restrictions. Simple misunderstandings can lead to Board scrutiny, but rarely are licenses restricted without there being some fairly damning evidence, or at the very least some belligerent and self-sabotaging behavior on the part of the clinican.

 

The worst-case scenario would be this doc is someone who can't be productive because of restrictions or history, and the practice's workaround is to hire a PA, but this person in charge, and either commit billing fraud or otherwise use you in a way that they aren't being up-front about. Will you patient census be reflected as the SP's, for example? How will billing be done?

 

I get a weird feeling about this, for sure.

[GetMeOuttaThisMess]

Don't know the individual from Adam.  Apparently a semi-retired individual assisting in the opening of an UC center (with their hopes of more to come while cashing in on ACA).  Activity dates back to the '90's.  Nothing mentioned with regard to malpractice and none self-reported.  Other principals are in active specialty practices outside UC/EM.  What will make this interesting is that this position may be a temp pitstop while I await more offers from established institutions (med school/hospital), and at the same time allow me to get my stinkin' DEA authorization.  What makes this attractive potentially is being in on the ground floor so not having to play catch up to others who are more familiar with the system, and the fact that it is only two miles from my house.  The hourly rate doesn't hurt either, especially if only covering 24-30 hours/week.

[GetMeOuttaThisMess]

It would be interesting to put the onus on the medical board to either approve or disapprove the supervisory capacity by requesting supervisory status from this individual.

[ventana]

I would not align with them, ever......  my license as a "dependent" provider is not something I want to mess with

 

If they truly have had numerous license issues they are not following the rules.....

 

why chance it?

[GetMeOuttaThisMess]

The specifics with regard to billing have not been addressed as of yet with myself since the group of physicians are still working to have the facility operational early next month.  With regard to the "why chance it?", it is a valid question and the answer is that I've got to "get back into the game" sooner rather than later due to state licensing requirements in the state requiring my having to have been employed at least equal to part-time during one of the two prior licensing cycles.  With the family situation this past year that was a wash.  As noted in other threads, in my neck of the woods many hospital networks are requiring MS PA's and/or DEA numbers in place without exception, which I am not nor have I had (didn't have a use for the DEA), thus limiting the pool of positions.

 

I have made no formal commitment such as signing anything, and won't, until all questions have been satisfactorily answered in my mind.  I was curious to find out from others their experiences in such a situation.  The contact physician was made aware during communication today that I am aware of the SP notations at the medical board website.

 

Feb, you bring up an interesting point with regard to how the billing is handled.  I wonder how many folks in the ED/UC, walk-in clinics, etc. have any idea as to how the billing is handled since it is "out of sight, out of mind"?

 

Edit:  One other area of concern.  If I'm working solo in an UC setting and someone has a narcotic need (MS injury for example) and I don't have the DEA in place yet, I've wondered how they intend to address that issue?  This is certainly an area in which I would not be comfortable with license or the feds without an adequate explanation.  That does not include calling it in under the physician's DEA.  Still a lot of questions to be answered obviously.

[EMEDPA]

Sounds like the guy has had some personal issues which would only affect you directly if he loses his license due to a recurrence of those issues, leaving you without an sp and the ability to practice. in your situation I would require an alternate SP (s) on the books just in case. that is a fairly standard arrangement at many places anyway. everywhere I work I have a primary sp and all the other docs in the group are listed by name as alternates.

[Febrifuge]

Yeah, if you have a list of three or four SPs, then having old Dr. Cashcow among them may not be a big deal. Having this guy, who never shows his face in the clinic and who you don't know, as your one and only SP would be weird, in my opinion.

 

It's entirely possible that as EMED says, he has whatever quirks or issues that are not all that relevant... for now. But it sounds like this guy needs you a lot more than you need him, really. If they straight-out refuse to let you have someone else as your SP, that strikes me as the "tell" that something weird is happening. I totally understand wanting to get in on the ground floor, but don't get wrapped up in anything sketchy. Even well-run, properly managed, ethically spotless new clinics don't always succeed.

 

EDIT: like EMED, I too have an SP of record (the department head), plus a list of 4 or 5 other Urgent Care docs as alternates, on my state Notice of Intent to Practice document.

[GetMeOuttaThisMess]

Yep, that has always been the case for me as well back when I was in the ED or a multi-provider specialty setting (one primary, the rest were alternates).  It is amazing how this entire process has played out over the past year.  I would have thought that other, non-provider opportunities were going to come to fruition (teaching), and then when that fell through a couple of other opportunities were presented but for whatever reason other choices were made.  As my wife has pointed out, this entire process has been a lesson for me to learn from but in the end the right place, at the right time, will present itself.  As much of a roller coaster ride that this has been I have to agree.  Thanks to all for their input.

[CAAdmission]

Meh... sounds like a bad situation. Unless pressed for cash I would steer clear. If pressed for cash, I would work only until something better presents itself.

[liza21]

What is SP.

[KMD16]

^^ supervising physician (SP).

[GetMeOuttaThisMess]

A final follow-up to this thread. After going back-and-forth on this opportunity I finally made the decision today to take a pass. The work schedule was released and I was scheduled for later this week even though the state medical board had not provided authorization for supervision by the person that would be my supervising physician. My concern finally became that this was more of a moneymaking venture then it was an actual medical practice. The electronic medical software is not in place and plans were made to use paper charting in the interim. Scope of practice interestingly varied from physician to physician that I'd spoken with. The written scope of practice and prescriptive authority agreements also have not been put into place.

[ventana]

Wise choice......