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“Roadmap For New Physicians”: How To Avoid Fraud And Abuse

In October, the Office of Inspector General (OIG) issued a report on Fraud and Abuse Training in Medical Education, finding that 44 percent of medical schools reported giving some instruction in the anti-kickback statute and related laws, even though they weren’t legally required to do so. (As an aside, do we really live in such a nanny state? Over half of all medical schools don’t teach their students anything about this issue — because nobody’s making them — even though it is an issue that looms large in the practice of medicine.)

On a more positive note, about two-thirds of institutions with residency programs instruct participants on the law, and 90 percent of all medical schools and training programs expressed an interest in having dsome instructional materials on the subject of the anti-kickback statute, physician self-referrals (Stark) rules and the False Claims Act.

So in November, the OIG released a Roadmap for New Physicians – A Guide to Avoiding Fraud and Abuse, available on line and as a PDF. It’s a good 30-page primer on the subject. While some of the examples given are specific to newly-minted physicians, anyone in the health care industry would benefit by reading it. The document offers a window into the thinking of the OIG, its perspective on the wide range of issues summarized within, and is a good touchstone for any individual or organization seeking to structure a relationship that needs to stay within the bounds of these laws. Read more »

*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*

U.S. Medical Residencies Via Alleged Hospital Bribe

In another one of the things I had no idea about, there’s a market to assist FMGs [foreign medical graduates] in getting U.S. residencies, which makes sense. Allegedly, this guy was willing to go the extra mile for his clients.

Full marks for creativity, but…

Mr. Everest allegedly provided an employee at the hospital with forged letters from a California hospital to show that the applicants had been accepted into a second-year program. And he gave her a check for $4,000, followed by another check for $2,000. She reported him to hospital officials, and later told him she knew the letters were forged. He then allegedly gave her $6,000 for time to get a letter from a different hospital—which was also forged—and gave her $3,000 more before he was arrested.

Geez.

– Via Hospital Bribe Alleged – WSJ.com

*This blog post was originally published at GruntDoc*

Doctors Meet A Decade Later

I just had my ten-year medical school reunion. It’s hard for me to imagine it’s been ten years since my last medical school class. It’s been fourteen years since that first week of gross anatomy. That class was so hard, I almost dropped out of medical school after one week.

A bunch of us local docs from my medical school class of 2000 rode to academic mecca in a stretch limo. What did I learn from my experience at my ten-year medical school reunion? Other than forgetting a few names:

  • When I was in medical school, lots of medical students, on occasion, would  drink heavily. I learned ten years later some doctors, on occasion, still drink heavily and get drunk.
  • When I was in medical school, lots of medical students smoked cigarettes. I learned ten years later some doctors, on occasion, still smoke (but only when they’re drinking). Apparently.
  • When I was in medical school, some students were really funny. I learned ten years later some doctors, on occasion, are still really funny, even when they aren’t drunk.
  • When I was in medical school, some students were really smart. I learned ten years later some doctors, on occasion, are still really smart. Most of us others have been dumbed down with years of practice.

It was fun to learn about what my colleagues have been doing. Ten years later the cellphones are a bit fancier, everyone’s talking about their Facebook page, and I’m completely content sitting  on the couch with Mrs. Happy watching everyone else get drunk like it was yesterday.

*This blog post was originally published at The Happy Hospitalist*

Young Doctors Who Lie

This is something: A study published in the July 20, 2010 Annals of Internal Medicine finds that 5 percent of residency applications contain plagiarized content. The study from Boston’s Brigham & Woman’s Hospital is based on the personal statements of nearly 5,000 residency applicants that were matched against a database of published content.

The authors comment that the study is limited, among other things, by the fact that it was done in just one institution. It makes me wonder if the number is artificially high or potentially too low.

So why would medical students lie? Read more »

*This blog post was originally published at 33 Charts*

Medical School And “Hard Science”

One of the recurring themes of this blog, not surprisingly given its name, is the proper role of science in medicine. As Dr. Novella has made clear from the very beginning, we advocate science-based medicine (SBM), which is what evidence-based medicine (EBM) should be. SBM tries to overcome the shortcomings of EBM by taking into account all the evidence, both scientific and clinical, in deciding what therapies work, what therapies don’t work, and why.

To recap, a major part of our thesis is that EBM, although a step forward over prior dogma-based medical models, ultimately falls short of making medicine as effective as it can be. As currently practiced, EBM appears to worship clinical trial evidence above all else and nearly completely ignores basic science considerations, relegating them to the lowest form of evidence, lower than even small case series. This blind spot has directly contributed to the infiltration of quackery into academic medicine and so-called EBM because in the cases of ridiculously improbable modalities like homeopathy and reiki, deficiencies in how clinical trials are conducted and analyzed can make it appear that these modalities might actually have efficacy. Read more »

*This blog post was originally published at Science-Based Medicine*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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