Need Help Please Advise

[rookiejay]

I need some advice 

I have been in derm 6 mo, PA 10 yrs Medicine 25 yrs 

I had a contract M-F no weekends no call at one clinic 

they tried to force me to work at 3 clinics and i said no and now its 2 

they are now going to make all of us take call, no additional amounts of money 

they ehr has been down for TWO MONTHS i am at least 600 charts behind

i feel like im having a panic attack daily on the charts, 

i have MA who dont listen and dont finish work 

the clinic doesnt have what it runs adds for ie lasers and botox etc 

I buy my own office supplies gloves, my own woods lamp etc 

then , the owner is prone to calling and screaming at you and its boarding on verbal abuse. 

i feel so trapped, 3 1/2 years left on the contract. 

any advice would be helpful, the ehr is still not fixed. IDK what to do 

J  

[mmiller3]

What happens if you break your contract? Have you consulted an attorney regarding the contract? Does changing your call and practice location violate the contract in any way? What about not providing work materials or EHR? It seems like you have a lot of leverage that you could tap into if you consulted a legal professional.

[CAAdmission]

Sounds like they violated the contract on their end. I would mention that and see what they say. You should be able to walk.

How are they billing if they aren't charting?

[SedRate]

3 hours ago, rookiejay said:

I need some advice 

I have been in derm 6 mo, PA 10 yrs Medicine 25 yrs 

I had a contract M-F no weekends no call at one clinic 

they tried to force me to work at 3 clinics and i said no and now its 2 

they are now going to make all of us take call, no additional amounts of money 

they ehr has been down for TWO MONTHS i am at least 600 charts behind

i feel like im having a panic attack daily on the charts, 

i have MA who dont listen and dont finish work 

the clinic doesnt have what it runs adds for ie lasers and botox etc 

I buy my own office supplies gloves, my own woods lamp etc 

then , the owner is prone to calling and screaming at you and its boarding on verbal abuse. 

i feel so trapped, 3 1/2 years left on the contract. 

any advice would be helpful, the ehr is still not fixed. IDK what to do 

J  

Something is amiss here. Is the business going bankrupt? 

I'm sorry this is happening to you. Falling behind and not having the support you need can be so stressful. This might be a silly question, but have you tried discussing this with your physician or manager? Sounds like your contract hasn't been upheld, which gives you an out of this terrible situation. Have you consulted a lawyer yet?

In the meantime, is there a way you can block a few slots for charting? Not charting becomes more of a medicolegal issue at this point. Can you at least do paper charts in the meantime? Hire a scribe temporarily?

Edited May 10, 2018 by Sed

[camoman1234]

Wow! How are you ever suppose to remember what you did 3 months ago and close those charts? Good lord. I would scream breach of contract and look it over very well. This is why I would NEVER sign a contract for more than 1 year and then we can re-visit it yearly. 

[surgblumm]

Rooky---You are no rooky and the handwriting is on the wall. It's time to leave this pack of wolves as they did not follow their obligations to you and being 600 charts behind without all of your notes and photos places you at a poor advantage and in a place of medical error and possible faulty and criminal adding to your notes which can be construed as fraud. Time to leave buddy.

[sas5814]

This is a disaster...run and quickly. Something is very very wrong at this practice and the malpractice, and possible criminal charges are going to come. Do what you can to protect yourself but find a new home ASAP.

[mgriffiths]

I almost want to say TROLL!!!, but you've posted 93 times, so doesn't seem like it.  If everything is true that you are saying, there is no doubt that they have breached their contract and also put you at risk from a billing/malpractice perspective.  You need to break ties immediately and consider if you need to report illegal activity to protect yourself.

[Reality Check 2]

STOP, CEASE, DESIST

Get on a word processor - WORD or whatever, use some sort of voice recognition and do those 600 charts - NOW. Not later - NOW.

YOU are putting yourself in danger of failure to maintain records and possibly missing a biopsy result or something.

Make your own template - do a SOAP note - whatever.

Just get those charts on paper and in a hard drive NOW.

Then - run like hell.

You are in a mill, not a medical practice.

[surgblumm]

When I was in an UCC my wife called it a toxic environment . Her words did not reflect on my patients but on the employers. I gave NO notice, let them know I fidn’t Need their referral and to their dismay and pleading gave immediate notice as in starting today.

[Cideous]

Places like this usually end up one way.  You show up to work one day and there is a chain across the door and note in the window with an attorneys phone number on it.   Blah.

[rookiejay]

the problem is we have MA scribes who are supposed to do the EHR, the system is off and on, I have paper charts, but I have to tell the MA the basic stuff for HPI, they do about 1/3rd of their work. so I have the paper charts, No way they will give me charting time. I have gone to the admin regarding my contract and everything and they tell me to ask someone else who sends me to someone else. This is like a Chain Derm clinic in 3 states. I plan on going to a lawyer and trying to get out of the contract. Now I have such little time with all the charting I have to drop off laundry and have someone else wash my clothes. That has not happened for almost 40 years. 

So I chart all the time, and now charts in March that are complete and just needed to be signed are now showing up if IU signs them they cant bill. I have a pissed off mom of an 18 yo with shingles, she is now complaining about me because she doesn't understand shingles is NOT an STD. The paper for the visit is blank as MA didn't do the paper or the EHR, its been since April 20th and now the office lost some of the paperwork to scan into the chart. 

Patients are quitting the practice because they don't get their Rx for weeks if ever, as the MA don't add the pharmacy. All the while the owner/ med director is sending emails about how the cosmetic sales have to go up 45%. How can I stand there to sell your personal creme if I'm behind in charts? I'm expected to see 50 a day and I said no more than 30 when we cant chart. 

I talk to my manager and my district manager and the personal assistant to the owner and I only get excuses. I feel like they are obligated to have a working ehr for the clinic, how long is too long for systems down. I've never had more than a day or two at best. 

 

[sas5814]

run, run, run....you aren't practicing medicine. You are in a money mill. Get out yesterday protecting yourself as much as possible.

Another conversation and there will be wildly different opinions but while getting out you may consider reporting them to appropriate agencies. There are so many things wrong here it defies description. In law enforcement we used to have something called queen for a day. The first person to snitch gets a pass as long as they are 100% truthful about everything. It may not work with regulatory agencies but it will probably be better than getting sucked up in an investigation somewhere down the road.

[surgblumm]

72 hours would be the maximum before paperwork becomes so disturbed that import information on excisional biopsies and other lab work is not lost and a potential malignancy is left untreated and metastisizes. You are the treating PA and I am sure will share this liability. My advice is to cancel the contract and hopefully, your malpractice coverage allows you to be covered to represent you. If you have a personal liability insurance it will. It's now more than inconvenient but can make you a liable provider.

[rookiejay]

Today EMA the system we used started signing the charts for 3 of today's patients. I notified the manager and she said it was happening at all the clinics ( we have about 30 of them in 3 states), when I looked one chart was signed at 1022 am while my ma was trying to enter the hpi, and I was in a room doing a bx. 

MY NAME !! just like I signed it. !!  

Ive been told to be patient and calm down,,, enough!

When I tried to talk to the admin the tone and words used you would have thought I was crying over a broken nail! 

We noticed that charts that were pending, that those were also signed, and a new name I have never seen before. 

new line added 

I went into the room did x, y, z, that she Personally was in the room with provider my

name, and treatment is 

MIPS : Null 

when I told the admin they said '' oh she is not even at work today we called Ema but they are not answering'' 

I said putting my name there is fraud, that you cant forge my name.  

They said send us a list of names when I mentioned that the back charts from MARCH are being signed also, they didnt seem to care. They acted like it was no big deal. Then I got a txt that said the charts should be fixed by 2pm tomorrow. 

I cant chart I feel like I am drowning, even if i could walk out tomorrow im still obligated to finish this turd pile, so im trapped. 

 

[rookiejay]

On 5/10/2018 at 7:02 AM, Sed said:

Something is amiss here. Is the business going bankrupt? 

I'm sorry this is happening to you. Falling behind and not having the support you need can be so stressful. This might be a silly question, but have you tried discussing this with your physician or manager? Sounds like your contract hasn't been upheld, which gives you an out of this terrible situation. Have you consulted a lawyer yet?

In the meantime, is there a way you can block a few slots for charting? Not charting becomes more of a medicolegal issue at this point. Can you at least do paper charts in the meantime? Hire a scribe temporarily?

we have scribes they are terrible on top of the ehr failure, and in no way would i get any admin time, i had to work on a no weigh bearing break in my foot, for a month, had to go to the urgent care on the weekend, ive , and i was told i can get my root canal that day,  

on all the issues ive gone to my mgr the regional and the personal assistant to the owner, and no. 

Edited May 17, 2018 by rookiejay
hit enter too soon, added data

[mgriffiths]

18 hours ago, rookiejay said:

when I told the admin they said '' oh she is not even at work today we called Ema but they are not answering'' 

I said putting my name there is fraud, that you cant forge my name.  

They said send us a list of names when I mentioned that the back charts from MARCH are being signed also, they didnt seem to care. They acted like it was no big deal. Then I got a txt that said the charts should be fixed by 2pm tomorrow. 

I cant chart I feel like I am drowning, even if i could walk out tomorrow im still obligated to finish this turd pile, so im trapped. 

You are not trapped.  You need to call as a whistle blower and report the fraud that is ongoing.  There is absolutely no excuse saying someone is not answering.  You need to begin compiling a file to protect yourself and report immediately.  Every day you continue along you continue to put yourself at risk.

[mmiller3]

20 hours ago, rookiejay said:

we have scribes they are terrible on top of the ehr failure, and in no way would i get any admin time, i had to work on a no weigh bearing break in my foot, for a month, had to go to the urgent care on the weekend, ive , and i was told i can get my root canal that day,  

on all the issues ive gone to my mgr the regional and the personal assistant to the owner, and no. 

At this point, you should not be posting anything further, but looking into the advice you have been given. If you choose to continue to work in the environment you are in, then you will have no one to blame but your self if any problems arise down the road (and I suspect they will).

That, or this is just a troll-thread. If so, I bit.

 

[surgblumm]

Why are you waiting? You are being abused, mishandled, terrified, acting as a servant. You have had some really great suggestions but you hesitate to follow them but instead post about the same problem. When I went to jump school in the Army, I stood in the doorway of the aircraft and hesitated a moment when my jumpmaster applied his boot to my butt because I was a Medic and I was needed in the Vietnam war. We are collectively doing the same. You are hesitating and coming short of the boot, you are trapped in fear of some relationship with people who are breaking the law. Quit Today.

[rookiejay]

is  700 charts behind and yes its still messed up and even if i quit today i still am obligated to finish the charts.        I had this once before at a place that a patient punched my nurse in the face and threatened to return with a gun and kill me, and the MD would not fire him as a patient. So I quit, then I had to go back and work for free while i finished the charts, I cant afford to go.   I guess I was hoping someone would tell me , does a legal threshold of days a system can be down before the company is negligent exist?  

[mgriffiths]

1 hour ago, rookiejay said:

So I quit, then I had to go back and work for free while i finished the charts

I am now calling bull.  You don't quit, you refuse to see patients until you are caught up on your charting.  If the MDs threaten to fire you, you threaten to file as a whistleblower and contact medicare, medicaid, and every insurance company that has been billed for the last 10 years.  They pay you until you walk out the door with your work done.

But more importantly, you have allowed this to now happen twice?!?!?!?!?!  I no longer have pity on you, something is wrong.  When I leave work every single one of my charts is completed...EVERY.SINGLE.ONE.  I know this may not be the norm, but to get more than a few days behind is unacceptable.  You are now in a second job where you have ended up being behind on charts.

1 hour ago, rookiejay said:

I had this once before at a place that a patient punched my nurse in the face and threatened to return with a gun and kill me, and the MD would not fire him as a patient.

The MD refuses to fire the patient, you tell the MD you are filing assault charges on behalf of your nurse and filing charges against the patient for criminal threat.

 

Bottom line, this story gets more and more ridiculous the longer you continue to reply to posts.  I stand by my initial post on 5/11.

Edited May 22, 2018 by mgriffiths

[surgblumm]

Rookiejay- You are not obligated to do your charts, you are a free person who fulfilled your part of the bargain and they failed. Don't think you have any obligation to these thieves. Don't worry about recommendations. Don't use them and don't talk about them to your new employer but get out. I am not going to communicate about this thread in the future because you are paralyzed and are not following advice.

[rookiejay]

I quit on the 31st of last month and by June 6th they were threatening to suspend or fire me. I dont get it, then they also want me to change my mind and stay. I have a lawyer looking at the 180 day outclause. 

on that other job I went to the WA DOH, and they did nothing, 2 yrs later im told im in an investigation for over Rx at that clinic, and I had to send my saved emails to them and say yes I told you about this 2 yrs ago. My pill bottle was years old and had been scooped up along with others. As far as I know that place is still open. You would be shocked when you do go through the right path. 

Im not asking for pitty, I just wanted a place where the people I spoke with understood the situation and might have been through something similar.  I was behind on charts at the pain clinic bc the syncromed II pump was under recall and it involved doing those, and I had charts left to do the day that patient punched my nurse. ( fyi that place kept my last paycheck )

The woman who ran our med school and helped write the book '' PA a guide to clinical practice'' I called her and she said " get the F out now and call 911 if they try to stop you'', This was years ago, now I find myself in a bad spot. She has retired and does more travel work, and I just didn't have anyone who would understand. The way other providers might. 

 

 

[sas5814]

You are in a poisoned environment. Figure out 1) everything you can do to protect yourself. Document everything. Save everything. 2) Figure out how to be gone as quickly as possible.

That is all.....

[rookiejay]

things got bad, or from bad to worse. they would never let me have time off for my own md apt, finally, i get in at the end of the day. my normal 90/60 was 178/90!!! I said no way that machine is broken, get another, still high 160's/90's. Doc offers me Xanax does some labs said ' quit your job', so I tell my boss via txt that im getting high bp when im stressing out. The next day Im triple booked after I told mgr im going to need to slow down a little. I had chest pain and shortness of breath through the am, but tried to power through. The regional manager rolled her eyes at me and said '' its always something with you'' and demanded a Dr note so I would be allowed to slow down for chest pain. I had 15 min of a 1-hour lunch left. I tried to get the note but my Doc said No come in now, why are you even there? I said they won't even let me slow down. So when I went inside the Mgr and Regional went to lunch, ( the owner is Txting me while on phone w/ my MD about im trying to destroy him and he is going to the board and his lawyers) its now 1pm and the first patient is screaming because her chart notes are gone - yes 90 days and counting of unreliable messed up ehr- and I cant breathe, the chest pain is getting worse and I am worried about my bp. I ask the girls to take it. WE DONT HAVE A BP CUFF IN THE OFFICE !!!! I cant tell is this anxiety or is this AMI? Im almost 50 it could be the real thing. I call my Mgr on the phone and ask can I please go see my MD he is telling me to come now, I cant breathe my chest hurts. ... She says yes yes , go go , I ask for an email or txt that said this is ok. 

She went silent for 5 min, then I get a message I have to call the owner/ boss and his assistant first to get permission to go... ARE YOU KIDDING ME!!! 

I could see the fear in the eyes of my MA so I called 911 for myself and spend 6 hours in the ER, I got a Dr note that says I am allowed to see the DR. 

I had a follow up with my own MD, my TSH >150, my Thyroid Antibodies >1000, Iron 15L, 

He made me take a week off work got my thyroid going again, gave me WAY more Ativan than I needed. I slept this last week, now its Friday. 

The Company Lawyer is telling me that my contract is 4 years. I have had 2 MA quit without notice one when system 1st went down and another last Monday when they were '' collecting statements'' about me, and a front desk girl who just returned after 3 weeks leave related to stress. So it is not just me. 

I have like 3k to my name, I put a lot into coming here. I don't really have money for a lawyer. I'm scared. Im being bulled for sure. I think he thinks I want money from him, I don't I just want to get as far away from him and his shitty clinics ASAP. 

So I told that to his lawyer this afternoon and I am waiting to hear back if I am fired, or taken to court or turned into the board. I said I did not want to fight, but if he puts it in that direction, I will fight back. I saved tons of stuff on my phone the treats and months of systems down ehr problems. 

I can't believe this is really happening. Honestly, If I heard this story I would think, it cant be true. But it is, Some shady cheap clinics to do just enough to get by and hope nothing goes wrong or they get caught. I have a friends friend who is a lawyer from another state look at the contract, but that is as good as it gets for me.