George F. Indest III

You're concentrating on providing quality care to your patients, so it can be difficult for you to closely monitor what your employees are doing. But numerous ways exist by which employees may steal from you: 

The opportunities for employee theft are many, and few thieves are caught. If you own a small medical practice, diligence should be your watchword. You can take steps to help prevent employee embezzlement, however. (For information on how to detect fraud, see "Warning signs".) 

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Take steps to help prevent employee embezzlement. Find out the warning signs on how to detect fraud.

How to prevent employee embezzlement

The lists cover a wide range of tests, procedures, and treatments, including stress tests, nonsteroidal anti-inflammatory drugs, electrocardiograms, and immunoglobulin G testing. Some of the services routinely are used, whereas others are appropriate only for some patients, such as those with certain cancers. Many of the tests listed by these specialty boards can lead to unneeded invasive procedures, overtreatment, unnecessary radiation exposure, and misdiagnosis.  

The American Academy of Family Physicians and the American College of Physicians were among the medical specialty associations that released lists. Eight more specialty associations also will release lists of tests and procedures later this year. 

The medical specialty groups decided to create these lists as part of the ABIM Foundation's Choosing Wisely campaign, an effort aimed at promoting an educational dialogue between physicians and patients. Patients are being urged by these medical specialty associations to actively question their doctors when any of the listed tests or procedures are recommended. 

In many cases, doctors may be reluctant to tell patients when a test or procedure is unnecessary, due to their fear of malpractice lawsuits. Now that a list of tests that may not be necessary exists, patients will have access to some of the same information as their doctors, and they can ask whether a test or procedure is warranted. This ability allows shared decision-making between patients and physicians and can result in less uncertainty by patients about the medical care they are receiving. 

Another motive behind the creation of the lists is reducing the occurrence of unnecessary healthcare. The Congressional Budget Office estimates that unnecessary medical treatment accounts for one-third of medical spending in the United States. Because approximately $2.6 trillion is spent on healthcare each year, a reduction in unnecessary procedures would help decrease medical spending and medical costs. 

This action taken by the medical specialty groups has brought complaints from some doctors. Because of the recommendations, physicians may find it more difficult to address the needs of individual patients.  

Additionally, when physicians perform fewer diagnostic tests and procedures, their income can be reduced, especially under fee-for-service payment schedules that pay for each patient encounter separately. 

Are you in the habit of running unnecessary tests on patients as protection against malpractice? See why you might have to change your behavior.

Author | George F. Indest III

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How to prevent employee embezzlement

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