Thursday, June 14, 2012

What Happened in My Office Parking Lot Last Month

     A patient came to my office, Colasante Clinic, to address several medical problems, and as an afterthought mentioned that he had been intercepted on the way to his car after his last office visit about a month ago
     The incident was disturbing enough for him to bring it up today.
     Here's what he told me.
     "I was leaving your office with my wife.  Someone came up to me and said he was doing 'independent study' and wanted to ask me a few questions."
     It is natural to comply with a simple request made by a clean-cut man in broad daylight, especially when he acts important.
     It was a dark-haired fellow, he said, who was well-built.  He took the patient, accompanied by his wife, off to the side away from the front door, and began to query him.
     "First he asked me if I had a lot of tests done at my office visit.
     "'Only the tests I asked for,'" I said.
     "Then he asked me if I had any unnecessary tests."
     The patient hesitated.  What is an unnecessary test?  If he had had the tests he requested, would it be logical now to label them unnecessary?  Why would he keep coming back to the office if he thought he was having unnecessary tests, or if the medical providers were in any way causing doubts in his mind about their integrity or ability to treat him?  It seemed like a trick question. 
     His wife decided how to respond.  She pulled him by the arm.  "Let's get out of here," she insisted, casting the "independent study agent" a dirty look.  "Smart Ass," she added.

     What happened?  The "clean-cut well-built man" sounded to me very much like the FBI agent who led the raid on my office a year ago.  Now what is he up to?
     I am getting an education in the methods used by government agents to build a case against a doctor.  They call the doctor's patients.  They appear outside the doctor's private office and ask patients questions when they leave.  They show up at patients' houses first thing in the morning, flashing their FBI badges, and frighten ordinary people into giving up their right to remain silent.  They call out to patients over the locked gates and fences of their yards way out in the country and ask the patients to say things that will incriminate their doctor. They cause patients and employees to be confused enough by disorienting questions to say things that might be construed as negative, about their doctor. They collect as many little pieces of "evidence" as possible so that they can present them in a twisted way to a judge;  then the judge will allow the FBI agents to storm the doctor's office, terrify patients and staff, and take everything into custody.  They may even pretend to be patients, inventing symptoms to test the doctor, and then decide for themselves, without any medical knowledge or training, whether the diagnostic tests the doctor ordered and the procedures performed were justified or not..
     Suppose an FBI agent had crushing chest pain and a doctor appeared to help him.  Would the FBI agent be ticking off in his mind the tests and treatments he considered "unnecessary," so that once the FBI agent recovered he could have the doctor investigated for fraud?
     Right now FBI agents are looking everywhere for cause, legitimate or not, to indict me, a typical family doctor, for fraud.  They are calling my staff.  They are frightening loyal staff into quitting.  They are accosting my patients in my parking lot.  They are suggesting the answers patients and employees should give in order to build a case against the doctor.  They wear badges and carry guns when it suits their purposes because they know this kind of intimidation is more likely to get the people whose privacy they intrude upon to say what they want to hear.
    "Why are they doing this?"  I ask my lawyer.  (I now require many lawyers.)  "Isn't there real fraud going on somewhere in this country?"
    "You are low-hanging fruit," he answers. "It's too hard for them to catch the big guys. Unlike the criminals who are really committing fraud, you have bricks and mortar, you go to an office every day, and you're not flying the coop.  If they can make a case against you by twisting and turning anything they hear from patients or staff, they will."
    The impact of this kind of intrusion on a medical practice is huge.  Splinters of doubt are wedged into the patients' psyches, disrupting mechanisms by which healing is effected.   Staff members worry about their jobs and are distracted during work hours, or they get on Craig's List to put together an employment back-up plan.  Patients feel they have to spend valuable office visits reassuring the doctor that despite the nasty questioning by the FBI they still think the doctor is good.  FBI agents hovering around a doctor's office, attacking, pillaging, insinuating and otherwise misusing authority make everyone wonder whether they are protecting The American People from criminals or enacting a travesty of the legal system. 
     The impact on me as a doctor is that I want to quit the practice of medicine.  But just in case that's exactly what the FBI would like me to do, I'll plug on for awhile longer. I like my patients. They need me.  Besides, I want to see how the story ends.  

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