Following up on my earlier post on medical fraud in Madison (and damn I wish I’d have thought of that hed last night).
I was being rather careful to not name the physicians involved; many of the things I’d linked had suggestions that looked pretty strong, but I hate getting something like that wrong.
The story has moved on now. Several people have now been identified and quoted in the press.
Dr Lou Sanner, MD has been quoted by the Associated Press:
Doctors from numerous hospitals set up a station near the Capitol to provide notes covering public employees’ absences. Family physician Lou Sanner, 59, of Madison, said he had given out hundreds of notes. Many of the people he spoke with seemed to be suffering from stress, he said.
“What employers have a right to know is if the patient was assessed by a duly licensed physician about time off of work,” Sanner said. “Employers don’t have a right to know the nature of that conversation or the nature of that illness. So it’s as valid as every other work note that I’ve written for the last 30 years.”
Dr Kathy Oriel, MD, who is not just an Associate Professor but also Residency Program Director, was interviewed on WKOW TV (sorry, I can’t seem to embed that video.) Physician-blogger “Unlikely Hospitalist” has some interesting questions over at Pundit Press.
Right now, it appears likely that these doctors, as well as apparently committing fraud and conspiracy to commit fraud, are also violating medical records laws, confidentiality laws, and may be a little out of the bounds of their malpractice insurance.
Dr Valerie Gilchrist, MD is the chair of the Department of Family Medicine at UW-Madison, and Drs Sanner and Oriel’s supervisor. I’ve written and asked for comment.
Update
Tom Holsinger, in comments, makes the point that Wisconsin has a qui tam law. That raises interesting possibilities.
Second update
The fun has begun. According to AP via WMTV Channel 15:
MADISON, Wis. (AP) — The University of Wisconsin medical school says it’s investigating reports that doctors from the school handed out medical excuse notes to protesters at the state Capitol this weekend.
Doctors from numerous hospitals set up a station near the Capitol on Saturday to provide notes to explain public employees’ absences from work. One of those doctors was Lou Sanner, who practices family medicine at the University of Wisconsin School of Medicine and Public Health. Sanner said he had given out hundreds of notes to protesters and many he spoke with seemed to be suffering from stress.
UW Health said Sunday that any doctors who distributed notes did so on their own behalf. The school didn’t specifically mention Sanner but said it was looking into cases involving any of the school’s doctors.
Walker Pneumonia
—apologies to Huey Piano Smith, Johnny Rivers and “Rockin’ Pneumonia”
Demonstratin’ ‘stead of teachin’ class
Don’t want union restrictions to pass
Covered my ass with a doctor’s note, too
I got the Walker pneumonia and a case of union flu
Legislators hidin’ in motels
Ducking out on their duties as well
Over the border so what can the governor do?
They got the Walker pneumonia and a case of union flu
Obama wants the unions to win
So he’s callin’ organizers in
Sent a couple busloads of SEIU
He’s got the Walker pneumonia and a case of union flu
Brilliant!
Excellent as usual, buzz.
As an RN this story surprised me not in the least.In just short of 20 years in the field I have seen and experienced physicians who routinely do not follow the “rules” as expected. I put rules in quotes because while they are supposed to be hard and fast, those physicians who simply do not bother also have no one or institution who will make them responsible for what they simply do not bother to do.
Not to mention the phone screamers, the ones who refuse to call back, or bother to come see their patients even when you’re begging. The issue of physicians who are disruptive became so much of an issue that Joint Commission a couple years ago demanded that hospitals come up with policy and plan on how to deal with them.
I have no expectation, zero, nada, zilch, that these physicians will be disciplined. Even those who are residents and theoretically can be disciplined much easier by a supervising physician.
Well, in the case of the guy who’s a third-year resident, his supervisor (Oriel) is there as well, so I suspect he’s fairly safe.
False claims by government employees for sick leave are fraud on the government. If the physicians involved do not have adequate records showing that they actually examined the striking teachers they wrote medical excuses for, they might be liable for fraud on the government just as much as the teachers, as well as criminal conspiracy.
A finding that a physician wrote a knowingly false official medical absence excuse for a government employee has major consequences which very possibly include decertification for MedicAid claims, as that is a state-operated program. This could financially cripple a physician, particularly if there are federal Medicare and private insurance rules allowing, or requiring, decertification of physicians who are decertified from MedicAid for fraud.
If Wisconsin allows taxpayer suits concerning fraud on the state government, we might see an exciting race to Wisconsin courthouses next week by attorneys filing class actions against these physicians.
Tom, if I’m not mistaken, they’re violating a number of Federal laws and regulations as well. Not that I expect Holder to prosecute.
Back in the day (I’m seasoned, but not tottering), these actions would have been “firable” offenses. Is that not the case today?
I look forward to seeing a flood of citizen-taxpayer suits. Misfeasance, malfeasance, nonfeasance … take your pick. Lying to a publicly funded employer to obtain pay under false pretenses is theft of taxpayer dollars. Each and every perpetrator should be prosecuted to the full extent of the law.
In this instance, the protestors’ right to free speech must be literally free – on their own time, on their own dime.
Mr. Martin,
Look up “qui tam” here:
http://en.wikipedia.org/wiki/Qui_tam
Someone in Wisconsin has confirmed, on another board, that Wisconsin has a qui tam statute. Those excuse-happy physicians have just offered all their money to Wisconsin trial attorneys.
I like it.
If I had a serious stress related problem and could get one of these handouts, I would own the doctor for failing to follow up or offer meaningful advise. Malpractice is clear. You can probably get an good Democrat attorney to do it on a contingent basis.
Mr. Martin,
Check out the comments by physicians and attorneys in this thread:
http://punditpress.blogspot.com/2011/02/university-of-wisconsin-department-of.html
Thanks, Tom. I linked that back in the original post, but I should have linked it here as well.
There is very little difference between a doctor who knowingly helps an employee commit financial fraud by claiming sick leave to which he is not entitled and a doctor who knowingly helps someone fake an injury for an insurance claim or worker’s compensation claim.
I wonder if Wisconsin has a state equivalent of the Federal False Claims Act that provides for treble damages for this type of fraud?
Under res ipsa loquitur, the University of Wisconsin School of Medicine could, itself, be responsible for the misconduct of these doctors. Were they not in the pay of the university at the time they were in the streets signing fraudulent doctor’s notes? Let the master (U of Wis.) answer.
In any state, it is a violation for a physician to prepare an untrue diagnosis or issue a prescription or medical note without conducting an examination and creating a genuine medical record. Failure on any of these measures is a frequent cause of sanctions against physicians. In this case, the notes were knowingly prepared to further a financial fraud, potentially moving their acts from the category of simple administrative misconduct to the arena of actual crimes.
I imagine that by now someone has told them how stupid they have been and I would be surprised if they do this stunt again.
Even if you do not want to file a formal complaint with the Department of Regulation and Licensing you can send an informal letter of complaint to the secretary in charge of the department [email address on their website] or to the governor’s office.
Let them know.
Rachelle, follow Tom’s Pundit Press link; there’s extensive discussion and some good documentation on that. Short answer, they do have a state false claims act, and they are a qui tam state apparently.
Thanks for the reference. I have added his site to my bookmarks.
Rachelle, I believe you mean “Respondeat superior” where the employer is responsible for the actions of an employee. see here http://en.wikipedia.org/wiki/Respondeat_superior
http://en.wikipedia.org/wiki/Res_ipsa_loquitur
Res ipsa loquitur, literally “the thing speaks for itself” is about:
“…the common law of negligence, the doctrine of res ipsa loquitur (Latin for “the thing speaks for itself”) states that the elements of duty of care and breach can be sometimes inferred from the very nature of the accident, even without direct evidence of how any defendant behaved.”
of course if you are a NYPD Blue fan you will remember this (from wikipedia):
“The famous opening scene between Sipowicz and ADA Costas includes her saying the line “I would say ‘Res ipsa loquitur’ if I thought you knew what it meant,” to which Sipowicz replied, “Hey, ipsa this you pissy little bitch.” The phrase Costas is referring to is latin meaning ‘the thing speaks for itself’. ”
and he grabs is crotch while saying it.
I wonder if the Wisconsin Board of Medical Examiners will consider the implications for its independence if it fails to act concerning issuance of knowingly false medical absence excuses by these guys.
Your list is missing many known names. It’s on their labcoats.
Your list isn’t even half-full of the known names. Their labcoats were helpful.
Drs. Anne Eglash, Hannah Keevil, James Shropshire and Patrick McKenna should be added to the list, and subtracted from Wis.edu.
You have inaccurately identified Dr. Anne Eglash as having taken part in the ‘doctors’ booth’ Saturday at the state Capitol. Dr. Eglash was not present at the rally and was in fact out of town at the time, You have posted false and defamatory information. Please retract this false information immediately.
Wisconsin Medical Examining Board
Department of Regulation and Licensing
Tom H. Ryan, MPA, JD, Bureau Director
1400 E. Washington Ave.
Madison, WI 53703
(608) 266-2112 / Fax:(608) 261-7083
Complaints Toll Free: (877) 617-1565
http://www.drl.state.wi.us
Patrick McKenna is identified on the UW DFM staff and directory page as a PGY 3. This is a resident in his 3 and final year of post graduate training and as such cannot operate independently as the Department of Medical Education is responsible for his actions. Furthermore, the ACGME is the governing body that credentials hospitals and medical centers to provide post grad training and would likely take a very jaundiced view of this. You may be unaware, but over the past several years there has been a significant increase in the regulations and requirements required of the Med Ed department. Specifically as it relates to work hours. How this extracurricular activity will impact that is unclear, but these are questions his employers will soon be asking. For what it’s worth, the ACGME has withdrawn the accreditation of programs that fail to meet these requirements. John’s Hopkins comes to mind.
http://punditpress.blogspot.com/2011/02/university-of-wisconsin-department-of.html
Bernard F. Micke, MD
This shows what lengths the left will go through to steal.
Frankly, I don’t think the rest of America is up to fighting the left.
I also note that two of the three doctors listed are females. Female entitlement run rampant is the core theme behind this whole issue (whether female doctors, female teachers, etc.).
This should be the equivalent of career self-immolation — without any moral ambiguity as to whether it’s in the service of good or evil. (It’s an enterprise devoted to lying and fraud, figure that part out for yourself.)
The ‘medical’ complexities are largely irrelevant. Basically, these ‘Doctors’ are committing the tort of fraud: they are defrauding the taxpayers. A deposition under the direction of the courts will reveal any material facts in the case, regardless of any supposed confidentiality. For the ‘Doctor’ to claim privilege for his records would be like Al Capone claiming that his accountant’s records were confidential when a crime had been committed.
If by “medical complexities” you mean inadequate medical evaluation, inadequate documentation, and lack of confidentiality during the videotaped “evaluations”, then I do think they are relevant. While these docs’ actions seem to constitute fraud in a legal sense, prosecuting them in the politically heated atmosphere of Madison might be problematic. On the other hand, I don’t see how the Wisconsin Board of Medicine can condone their unprofessional behavior. As an MD, what you see on the videos violates fairly basic ethical restrictions on physician practice. That these docs did this openly on camera implies they don’t understand this. I’d be surprised if they aren’t disciplined by their Board.
I’m sure that every insurance company these doctors have ever done business with is salivating at refusing / re-litigating any of their claims because the doctors have proven “histories and patterns of fraud.”
Doctors are notorious for covering for other doctors. I don’t think anything will happen to Madison’s medical fraudsters at all.
Alas, Wisconsin’s qui tam statute is limited to health care, and wouldn’t cover this situation. Wis. Stat. Sec. 20.931.
I would love to see these doctors (and teachers) get what they deserve. for what is obviously fraud. And no, the end does not justify the means. Our society is built on trust. What good is “social justice” when this supposedly just society is built on cheating?
Lotsa luck getting anything from the Dane County (Madison) DA:
“[Ismael] Ozanne, 39, was tapped by [former Governor] Doyle to replace DA Brian Blanchard, elected to a state appellate court. He won’t face voters until the fall of 2012.”
http://www.thedailypage.com/isthmus/article.php?article=29911
All 3 of these physicians are employed with the University of Wisconsin.
All are government employees.
All may be affected by the rule changes.
I am a physician. My malpractice insurer clearly instructs me not to prescribe treatment nor diagnostic testing for anyone with whom I do not have a doctor patient relationship. Even for family members- an exam and the keeping of medical records is recommended. Failure to do this has resulted in discipline by state medical licensing boards in many states.
Charles Durand raises an interesting point about the insurance carriers these doctors have.
It is likely that they are included on the policy purchased by the residency program.
In any event, they have created a policy defense if any of their ‘patients’ decides to complain of a ‘failure to diagnose’ some obvious problem that should have been detected during their ‘examinations’. A ‘policy defense’ means that their insurer will be justified in not paying any judgment against them.
I should add that now that they have been taped committing what appears to be fraud I would expect that if any of them is sued for malpractice in the future an able attorney is going to produce one of these tapes for impeachment purposes–in other words, they have documented that they will lie even when they are under a professional obligation to be honest.
Very foolish! I bet none of them came back to the street to give second helpings of ‘sick notes’ today.
23 Charles Durand (above) is absolutely right. State licensing boards go after doctors for this sort of thing all the time. It is a serious violation to write a note or a prescription for anyone you haven’t examined and for whom you have no records.
Many state medical boards publish a quarterly magazine that includes, among things, a list of doctors who have been disciplined. A failure to maintain adequate records is commonly included with other charges. By the standards common in most states, these doctors have set themselves up for discipline by the Wisconsin Department of Regulation and Licensing.
Unless the university is completely corrupt, it will want to discipline them as well, if for no other reason than to be able to document that they have taken ‘corrective action’.
The fact that these doctors would openly and proudly write bogus ‘sick notes’ points to ‘moral turpitude’ of the type that can call into question their right to have a license.
Incidentally, teachers are also licensed. It is hard to fire one [thanks to the unions] but I wonder how hard it is to go after the license of a teacher who lies that he was sick [and collects unmerited sick pay] to go to a demonstration. Perhaps it is time to start looking at teachers’ licenses and the standards that must be met for them to continue to hold a license.
Thanks for the correction above.
I did indeed mean respondeat superior [let the master answer] rather than res ipsa loquitur [the thing speaks for itself].
Too involved with my comment to place close attention to my Latin. Embarrassing***
I suspect that in the back of my mind their blatantly wrong and public acts did indeed speak for themselves, to some degree, but I did really mean to say that as employee physicians of the University of Wisconsin, the university is exposed to vicarious liability under the doctrine of respondeat superior.
Thanks again.
Charlie, I have to ask, where did you get Valerie Gilchrist’s name? Haven’t seen it other places, but likely missed some. Sort of puts to rest the argument that this Fam Med department is really good and these doctors only represent a small minority. If the department chair and the residency program director orchestrated this, well, sh@t travels downhill.
NEW
The University profiles for Dr. Sanner and Dr. Oriel are now essentially blank pages.
On the other hand, Dr. Gilchrist’s profile is still in place–but then she didn’t commit fraud in the streets.
Try the links to Sanner, Oriel, and Gilchrist in the article above. Funny. I guess the first two are hoping for a little anonymity, but it’s too late for that now.
I suspect these pathetic excuses for physicians will not be in the street again any time soon passing out fraudulent sick notes to union cheats and thugs. Maybe not in the clinic either. Who can trust them?
Welcome to the world of infamy ‘doctors’.
Hi there, You have performed an excellent job. I?ll certainly digg it and for my part recommend to my friends. I’m confident they will be benefited from this site.
I believe that is among the such a lot important information for me. And i am happy studying your article. However should commentary on few general issues, The website style is ideal, the articles is in reality excellent : D. Excellent job, cheers