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Watch out for fraudulent work comp doctors....! - Printable Version

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Watch out for fraudulent work comp doctors....! - 1171 - 01-19-2018

Do you trust your doctor? Maybe too much...?
Desperate to get well; to get back back to your old life before your injury; to be pain free again...?
You can be an easy mark for an unscrupulous physician.

California's work comp system alone has suspended over 200 health care providers last year.
Not just for bogus billings but also for phoney treatment recommendations including surgery for non-existent conditions.

Every state's work comp system is infected by these con artists. Don't be taken in.

Trust but verify has never been truer then when it comes to your health.

What can an injured worker do to prevent being a victim of a fraudulent physician?

RE: Watch out for fraudulent work comp doctors....! - California_Help - 01-19-2018

Very difficult to answer.

I recommend to always get a few opinions before undergoing any surgery or evasive test or treatment. Keep copies of the actual scans and report of scans in case you need another opinion they can be easily provided.

Research as much as you can on the risks of evasive testing's, treatments and surgeries.

Inquire what products are being used including medical devices, injections etc, the manufacturer and device info. There are ways to find out info on what spinal cord stimulators or hip implant, spinal implants for example are having a lot issues. New medical devices cleared under FDA510(k) (which most are) may have not undergone any testing's and it can take years for the public to know if it is causing a lot of problems. 

Run your physician through propublica dollars for docs to see if he is receiving a lot of money from industry. Google your physician and hospital but many bad physicians have good reviews.

Except for California POD's physician owned distributors of medical devices are allowed in the work comp arena. In the US 20% of implants implanted in patients (him, knee, joint, spine etc) are being implanted by a surgeon who has financial interest i.e. distributing the very implants he is implanting in his patients. Statistically surgeons who belong to a POD do a lot more surgeries than the physicians that do not. 
This video is important to watch if you are recommended to have a hip implant, but I believe it is good for any patient to watch who is having any device, knee, hip, spine, stimulator etc. It shows why it is a good idea to research anything that is going to be permanently placed into your body.

Injections into the spine:

Yes they do provide temporary pain relief for many patients, but it comes with risks.

An infamous spinal surgeon in California was cited by CA State Medical board for injecting 5 times the amount of steroid than recommended.

Be aware that spinal epidurals are a money maker for physicians especially if sedation is being used.

Be aware that having injections into your spine comes with risks and they are not always clearly stated to the patient.  I have come across many patients who have gotten a condition called arachnoditis from their spinal epidural. There was a nurse posting on this forum years ago who was disabled not from her spinal epidural which resulted in arachnoditis. If you come across any forums for patients with this painful debilitating condition you will find most got it after an epidural (spine surgery and invasive testing's  in the spine can also cause this). Also be aware there are different types of steroids that can be used to do an epidural and there is one in particular that is causing a lot of problems in particular called depo Medrol . Ask your doctor what product he is using and research it (if he replies a steroid again ask what is the name of it).Spinal epidurals in the cervical spine are more dangerous as there are blood vessels there. It is very rare but can cause death. Due to these issues some countries have banned them.Be aware spinal epidurals are not FDA approved. 

Find a doctor who is a member of medical groups and societies who are focused on ethics. They are out there.

Anyone can fall victim to medical provider fraud. It often involves (not always) a group of individuals, and patients are duped into testing's, treatments, therapies or surgery not because it is medically necessary but because these criminals want to profit off of their body. The Hippocratic Oath promise “to abstain from doing harm” is a basic tenet for healthcare providers so patients can trust providers with their lives.

I was hesitant to post about this because I am aware MOST physicians do not fall into this category. Most physicians are doing the right thing and most often patients do need the test, treatment or surgery that is being recommended. It is the subgroup of criminals that are not looking out for a patients best interest is what I want to make public just so patients can be aware. Medical provider fraud does not just happen in the work comp system, Medicare private insurance and even the VA has also been affected.

Getting a second and third opinion from a physician is the most important.

RE: Watch out for fraudulent work comp doctors....! - 1171 - 01-19-2018

thankx for sharing.
glad you had an opportunity to share the lessons you've learned and the steps you take to protect yourself.
I'm sure others will have suggestions for avoiding scamers trying to invade their claim.