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SP is writing Rx's for a co-worker without documentation


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I found out that one of my urgent care SPs is writing Rx's for Methadone and Norco for the cleaning person at our office, #120 every month for several months, without ever formally seeing him or writing a chart note. The pharmacist called questioning why an urgent care doc is prescribing so many narcs on a regular basis. The staff asked me what to say to the pharmacist and I told them that they needed to take it up with my SP, since I had no knowledge of the situation, other than the fact that I saw no documentation that explained the Rx's, and no documentation that these Rx's were ever written... shortly after that, a staff member shredded the faxes that the pharmacist sent. My question is... what is my responsibility in reporting this activity, and to whom do I report it to? Without evidence (I do not know which pharmacy sent the fax) and without proof, I need advice on my next step. 

 

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Whatever state you are in will likely have a database for controlled substance rx's being issued, even if you don't have access to it. Making an inquiry to the regional DEA office or the state attorney general's office is not a bad place to start- they should be able to access controlled rx databases without requiring you to submit proof. Too bad office staff seems to want to help cover this up.

 

Is this your only SP, or do you have others as you're working in urgent care? The state medical board may also be curious about these activities

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If you know the SP well and/or consider them a friend you might want to let them know about the pharmacy call. If you don't know them well or think your mentioning it could endanger your job situation I would pursue other anonymous avenues for looking into this.

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Are you sure he wrote for the narcs? Cleaning lady didn't just swipe a prescription pad? A PA on my ER rotation had her NPI or whatever number stolen and someone was prescribing narcs for themselves. They only found out because they said someone called in the narcs for a patient "after hours," which obviously doesn't exist in an ER.

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Whatever state you are in will likely have a database for controlled substance rx's being issued, even if you don't have access to it. Making an inquiry to the regional DEA office or the state attorney general's office is not a bad place to start- they should be able to access controlled rx databases without requiring you to submit proof. Too bad office staff seems to want to help cover this up.

 

Is this your only SP, or do you have others as you're working in urgent care? The state medical board may also be curious about these activities

We do have one in California. I have just found out that my SP's license was on probation for 2-3 years for using and being in possession of controlled substances 10 years ago (Google is amazing!) At this time he is my only SP at this clinic, the other one quit 2 months ago.

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If you know the SP well and/or consider them a friend you might want to let them know about the pharmacy call. If you don't know them well or think your mentioning it could endanger your job situation I would pursue other anonymous avenues for looking into this.

I have to do it anonymously, otherwise I'm out of a job...

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Are you sure he wrote for the narcs? Cleaning lady didn't just swipe a prescription pad? A PA on my ER rotation had her NPI or whatever number stolen and someone was prescribing narcs for themselves. They only found out because they said someone called in the narcs for a patient "after hours," which obviously doesn't exist in an ER.

Yes I am sure. I saw the prescirption before it was shredded. And my SP and the cleaning guy are thick as thieves...

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Yes I am sure. I saw the prescirption before it was shredded. And my SP and the cleaning guy are thick as thieves...

maybe the doc is taking them himself....or splitting them 50:50 with the cleaning guy....or selling them.

how do folks think they can get away with this in 2014? before EMRs and pharm databases, sure. But now???

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EMEDPA: That's what I thought, too. My SP is constantly taking naps on the job, has a very labile personality, his eyes are always bloodshot, and at times he is not very coherent. He also asked one of our staff for her Adderall repeatedly, ordered testosterone supplements and fentermine without approval under the auspices of "providing patients with comprehensive care' (and this is in an urgent care). Our cleaning person owns his house outright (in California, no less!), rolls in driving one of three Mercedes Benz's, and brags about how much money he has. Maybe he had money before he took a cleaning job, I don't know. The more I write about this, the fishier it sounds. *sigh*

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EMEDPA: That's what I thought, too. My SP is constantly taking naps on the job, has a very labile personality, his eyes are always bloodshot, and at times he is not very coherent. He also asked one of our staff for her Adderall repeatedly, ordered testosterone supplements and fentermine without approval under the auspices of "providing patients with comprehensive care' (and this is in an urgent care). Our cleaning person owns his house outright (in California, no less!), rolls in driving one of three Mercedes Benz's, and brags about how much money he has. Maybe he had money before he took a cleaning job, I don't know. The more I write about this, the fishier it sounds. *sigh*

chances are cleaning guy is paying doc for scripts and selling them. As a senior em pa I drive a newer entry level honda. our e.d. cleaning folks drive old american beaters.

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This is one of those "run, don't walk" moments....

 

Nothing good can come from you staying there.

 

I used to have a per diem job in a family practice close to home. My spider sense told me something was fishy when I interviewed but I rationalized it - I needed more FP experience, close to home etc. There were definite signs of things wrong - I remember going in to his office to put a chart on his desk and saw his Amazon order for "how to treat your sex addiction" on his computer screen....just left there for anyone to see...

 

Then I showed up one day and 2 investigators from the medical board were there. My immediate concern was for my own licence - but they told me I was not under investigation, just the SP. I immediately gave my notice and got out of there. Turned out he was secretly taking pictures of female patients and a disgruntled former employee reported him. I never witnessed him doing anything inappropriate but I now have great faith in my spider sense and ALWAYS listen to it now.

 

Sadly, this former SP - who wasn't really a bad guy but apparently needed a lot of psychiatric help - he lost his practice and eventually committed suicide I

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RUN forest RUN

 

Seriously - do not report him - only is going to come back on you

 

just resign and find another job

 

so far you only have limited evidence 

 

 

run far run fast unless you have 100k sitting in the bank which you can use for the legal defense of YOUR license when he goes after it - he is your SP!

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To be fair it doesn't really sound like you know anything definitive.  You have a lot of suspicion but no solid facts to back anything up... at least no solid facts that can be supported by any evidence.  This isn't really a solid foundation on which to go to the owners and start leveling accusations at someone.

 

I think your only obligation here is to protect yourself and get the hell out of Dodge as quickly as possible.

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To be fair it doesn't really sound like you know anything definitive.  You have a lot of suspicion but no solid facts to back anything up... at least no solid facts that can be supported by any evidence.  This isn't really a solid foundation on which to go to the owners and start leveling accusations at someone.

 

I think your only obligation here is to protect yourself and get the hell out of Dodge as quickly as possible.

 

yup    run

 

 

GTFO and then call the DEA...let them do the investigative work...they'll get them...

 

 

as a dependent practitioner I would be VERY careful of making reports to any agency if you do not have facts

they can and possibly will make your professional life VERY hard if they decide to grind and axe.....  ?anonymous complaints

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as a dependent practitioner I would be VERY careful of making reports to any agency if you do not have facts

they can and possibly will make your professional life VERY hard if they decide to grind and axe.....  ?anonymous complaints

 

By the sound of it, it shouldn't be very hard to get some shred of evidence...

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