If you are a physician or other healthcare provider working at a hospital, you must be aware that the hospital administration is constantly looking to protect the hospital at the expense of its employees or independent attending physicians. Hospitals are constantly being monitored by the local, state and federal governments. If there is a problem, the hospital will immediately look to blame an individual. When this happens, the result can often ruin the career of the physician involved. Also, when something goes wrong at a hospital, that issue is usually on the front page of the local newspapers for days. Accordingly, the hospital will try to redirect the blame to individuals and by punishing those individuals, the hospital will try to cast itself into the role of the protector of the public.
Also, there are instances when a hospital wants to rid itself of a physician who has been on the staff for many years. The reasons for this situation are too many to count. Often, there has been a change in the leadership and the targeted physician holds a position that those now in charge want to go to another, often younger, physician. Sometimes it is just plain favoritism or it is simply that someone has decided that a doctor has to be gotten out of his or her position for personal reasons.
So, what are the warning signs that something very bad is about to happen, completely devastating your life? Usually, the first sign is when you receive a call from the administration telling you that you must immediately attend a meeting with administration and/or the general counsel for the hospital. When this happens, you must be prepared for the worst. If you can, you might do well to avoid the meeting by saying that you have an emergency situation to deal with, either professionally or at home. You will promise to let the administration know when you are back and able to attend the meeting. This will give you an opportunity to try to determine what is going on. Was there a problem with a patient of yours? Have you had hints that, politically, the winds of favor in the hospital have been changing and your head might be on the chopping block?
If so, this article will give you some ideas of how to deal with this very unpleasant conversation that has often been set up to get you out of your hospital employment.
The first thing to recognize is that you should immediately have a discussion with an experienced lawyer before you face the hospital administration. You should also attempt to have that lawyer with you when you are at the meeting. After all, the hospital has its phalanx of lawyers, so why should you not have one on your side? Now, often the hospital will say that you are not permitted to have anyone with you because this is simply a discussion between an employer and an employee. Be prepared to go it alone if there is no other choice.
At the meeting, with or without a lawyer, try to listen carefully to what is being said. Often, you will be told that you have done something that amounts to fraud or some other type of crime. They want you to become so afraid that you will sign anything to end the matter, often with the stipulation that waives your rights to take legal action against the hospital. Often, they find a billing issue, like thousands of these errors, and present them as fraudulent, claiming that you committed a crime. However, in almost all cases the billing error was simply that, an error, and that is not fraud by anyone’s definition. This is a paralyzing thought and many people will sign anything to put an end to the discussion.
If you have not done anything that resembles fraud, do not sign any documents. Do not say very much. Tell the hospital that you have to discuss this with an attorney and you will get back to them later with your thoughts. The hospital representatives may say that this is your only opportunity to sign their documents now and save yourself. If you have not done anything wrong, do not give into their bluff. There is some other reason they want you to go away. Maybe you are making too much money or you have a position that they want to give to someone else. In any event, you want to leave that meeting without saying much and without signing anything. You should retain an attorney who will be able to reach a very favorable agreement with the hospital in exchange for you leaving. This might amount to tens or hundreds of thousands of dollars and a statement that you are resigning for personal reasons and there were no claims against you that forced your resignation.
If you are fired for cause or if you resign while under investigation, it will be reported to the Department of Health or the Department of Education. You may then face a charge of professional misconduct, putting your license in jeopardy. Your goal should be to have the hospital end its investigation and allow you to resign “for personal reasons” sometime later. There will be no reporting to any agency and you can truthfully say to your next prospective employer that you left on your terms and were not terminated for any reason.
In addition to accusations of fraud, the administration might say that you have endangered the life of a patient, have been prescribing controlled substances in a negligent fashion, have committed a HIPAA violation, have had a sexual relationship with a patient or another employee, etc. I have dealt with all of these situations and, many times, the worst outcome can be avoided if the physician does not lose his or her head during the first encounter with the administration.
In summary, it is very difficult to stand your ground when you are suddenly attacked by a hospital administration determined to force you out of the hospital. But, if you remain calm and take the time to look at all of the circumstances, you might very well end up on the side of a favorable outcome when you exit from the hospital. The hospital may get you off of its staff and/or payroll, but, with the assistance of experienced legal counsel, you might well be able to leave with your reputation intact, your license unthreatened and, perhaps, some money in your pocket.