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Posts Tagged "physician"

29Jan

Overbilling Vancouver physician faces discipline hearing

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The medical office of Dr. Viem Chung Nguyen at 1209 Kingsway in Vancouver.


PNG

A Vancouver doctor who was ordered to repay $2 million related to medical service over-billings now faces a disciplinary hearing for refusing to answer questions from the College of Physicians and Surgeons of B.C.

Nguyen has been summoned to the college discipline committee meeting Feb. 12. The purpose of the hearing is to inquire into his “conduct or fitness to practise medicine in B.C.”

He is charged with failing to respond to multiple communications and correspondence from the college. But when there are serious findings by the Medical Services Commission about irregular, or even fraudulent, billing by doctors, as there was in 2017, the case often ends up back at the college for an investigation into the doctor’s ethical and professional conduct.

Nguyen graduated from the University of Montreal medical school in 2002. He specializes in physical and rehabilitation medicine, otherwise known as physiatry. Such doctors — there are three dozen in B.C. — have a broad range of knowledge about the musculoskeletal, neurological, rheumatological and cardiovascular systems.

Outpatient physiatrists (those working in communities as opposed to in hospitals) would see patients with orthopedic injuries, spine-related pain and dysfunction, occupational injuries and overuse syndromes, and chronic pain, for example.

Kristy Anderson, a spokeswoman for the Ministry of Health said Nguyen can’t bill the Medical Services Plan until he is eligible to re-enroll after May 31 of this year. Strangely, Nguyen’s medical receptionist told a reporter over the phone that an appointment could be booked after a doctor’s referral and that he doesn’t charge patients directly; a B.C. Services Card (formerly known as the CareCard) can be used, she said.

Although the government insists that doctors should never bill patients directly for medically necessary services, Nguyen can do so during the temporary de-enrolment.

“During this time, Dr. Nguyen can practise medicine; it is only the college of physicians and surgeons that can remove that right. But he cannot bill to the Medical Services Plan,” Anderson said.

Susan Prins, spokeswoman for the college, said that as a specialist in physical medicine and rehabilitation, “it is reasonable that a major part of his work might be privately funded, independent medical exams, but I can’t confirm that’s the case.”

Neither of the officials could answer why the receptionist told a reporter posing as a prospective patient that a visit would be publicly funded.

It’s unclear if Nguyen has paid back the $2 million he agreed to repay after an audit found a large number of billing irregularities. The government refuses to divulge such information. 

“Due to privacy restrictions under the Freedom of Information and Protection of Privacy Act, the ministry is unable to release any third-party financial information or personal details,” said Anderson. 

“If an individual fails to pay an amount assessed by the audit, they are referred to the Ministry of Finance to pursue collection action as outlined in the Financial Administration Act or the governing statutes,” she added. 

Last year, the commission issued a report that said an onsite audit found poor documentation of Nguyen’s patient records and “for several patients, there was no evidence that Dr. Nguyen ever provided any care to that patient.” 

According to the latest commission report, the government body was able to recover about $8 million in 2017-18 from 18 audited doctors who were deemed to have over-billed in recent years.

There are about 11,000 doctors in B.C.

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Appeal court rejects bid by first doctor ever thrown out of B.C. Medical Services Plan

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23Jan

Fake ‘Dr. Lip Job’ gets suspended sentence for posing as a physician

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Justice Nitya Iyer.


Vancouver Sun

A woman who forged a medical licence so she could buy pharmaceuticals like Botox to then inject into duped customers has been given a 30-day suspended sentence and two years’ probation in B.C. Supreme Court.

Rajdeep Kaur Khakh’s digressions included contempt of court and passing herself off as a doctor so she could inject Botox into facial wrinkles and filler material into lips or other facial areas. Only licensed and trained doctors, dentists, registered nurses (or nurse practitioners) under the supervision of doctors, and naturopaths are allowed to perform such procedures under Health Professions Act regulations and Ministry of Health scopes of practice.

Khakh, who couldn’t be reached for comment, was cited for contempt in March 2018; she signed a consent order at the time prohibiting her from “practising medicine.” But last July, the College of Physicians and Surgeons of B.C. learned Khakh was up to her old tricks administering dermal fillers “numerous times at a location in Vancouver.”

The college has been trying to stop Khakh from posing as a doctor for more than three years but each time the college got promises from her to stop, she would continue to do it. For a time, she marketed her services under the Instagram handle “DrLipJob.” She also marketed herself as Dr. Rajii or Dr. R.K., when she injected customers in their homes, cars and other locations.

Although Khakh avoided jail, college spokeswoman Susan Prins expressed satisfaction with the sentence.

“The college … believes that the judge’s reasons will accomplish the task of getting Ms. Khakh to obey and respect court orders in future, and deter other unlicensed practitioners from engaging in unlawful practice. In her comments, Madame Justice (Nitya) Iyer sent a very serious message to Ms. Khakh about breaching consent orders and emphasized the critical public-protection role that regulators fulfil.”

Last November, the college filed a petition with the court in which it sought to have Khakh fined for contempt and/or jailed. Under the current sentence by Iyer, she will have to serve a 30-day jail term if she breaches any of the terms. Khakh must report to a probation supervisor once a week and must also pay a $5,000 fine. Of that amount, $300 is going to go to a former customer who was a witness for the college.

The college first learned of Khakh in 2015 when pharmaceutical companies informed it that she owed $164,000 for products that were advanced on credit. At the time, Khakh was providing services at a spa in Surrey and using a forged medical licence.

“It is certainly the only instance of forging medical credentials to further one’s unlawful practice that I know of,” said the college’s chief legal counsel, Graeme Keirstead.

According to an affidavit filed in court by the college, the forged licence was found on a photocopier at the Clearbrook public library by an employee who notified the college. The name “Dr. Rajdeep Kaur Khakh” was substituted for the original name on the certificate and the expiry date of the licence had been altered.

“Upon review, the document appeared to be a copy of a genuine, but expired, (licence),” Keirstead said, adding that the identification number on the certificate belonged to a practising physician who was registered with the college.

Khakh had previously told a reporter that she went to medical school at the University of Punjab but failed licensing exams.

The college went to great lengths to investigate Khakh, using a security company multiple times for undercover investigations and also going to the spa with a cease-and-desist letter.

The college pursued another similar case, but in that situation a patient got a serious infection after having surgery with a fake doctor in her home-based clinic. A public health warning was issued.

Patients of Khakh’s have complained about their results, but there don’t appear to be any serious adverse events reported.

The college said this in a statement: “Receiving a medical service such as injections from an unlicensed practitioner is risky and has the potential for complications, including reaction to agents, infections or greater harm due to human error. There is no assurance that the practitioner is competent or qualified to provide treatment or that the material and equipment used are safe.”

Prins said unlicensed individuals aren’t accountable to any regulatory body, “which means the public has nowhere to turn if the service or treatment they receive results in complications. We can’t emphasize enough how important it is for patients to check the credentials of the health practitioner they are planning to see to ensure they are licensed and registered with a health regulatory authority (college), and that they have the necessary credentials to perform the procedure.”

Physician credentials can be verified by looking at the directory on the college’s website at cpsbc.ca.

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4Nov

Pressure on B.C. government to recognize physician assistants

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On the other side of most B.C. borders — four U.S. states plus Alberta — patients can see a physician assistant for many health concerns.

But not in B.C., where the province does not recognize physician assistants as health professionals, even though they’re trained to do some of the same work that family doctors do.

Pressure is mounting, however, now that B.C. Green leader Andrew Weaver has become a vocal champion of physician assistants.

In a speech he gave recently to the annual conference of physician assistants in Victoria, he called them a “largely untapped resource” in B.C.

Weaver told Postmedia News that he’s a supporter because with hundreds of thousands of B.C. residents unable to find a family doctor, physician assistants “are a good way to provide highly skilled services in the medical system.”

Weaver said he’s using the agreement the Green party has with the NDP to press for recognition of physician assistants so they can practice in B.C. and be regulated by the College of Physicians and Surgeons of B.C.

The agreement calls for the expansion “of team-based health care, to ensure that people have better access to the type of care they need, including access to services from physiotherapists, nurse practitioners, midwives, dietitians, pharmacists and other health professionals.”

Physician assistants could be part of that team-based care, he said.

With family doctors in short supply in B.C., the College of Physicians and Surgeons of B.C. has said it is ready to regulate physician assistants as soon as the provincial government gives its OK.

Often called physician extenders because physicians delegate work to them, thus improving physician productivity, physician assistants have two years of training after undergraduate degrees. The program is offered in Canada by various institutions like the Universities of Toronto, McMaster University and the University of Manitoba.

Just over 600 physician assistants are working in clinics, communities and hospitals in a handful of provinces and territories, qualified to do physical examinations, take medical histories, order tests, prescribe certain medications, and assist surgeons before, during and after surgeries. Their taxpayer-funded salaries range from about $75,000 to $150,000, comparable to what nurse practitioners earn.

Physician assistants have been used extensively in the Canadian military for five decades, on military bases and missions abroad. Some companies, such as those in the energy and mining fields, employ them for occupational health, advanced first aid and other employee health care needs.

But because B.C. has not amended the Health Professions Act to recognize and regulate them, the Canadian-trained assistants can neither be used by companies here nor be hired by doctors here. (Some large medical practices use internationally trained doctors in a similar assistant role but they are not physician assistants who’ve passed the Canadian exams).

Eric Demers is one such physician assistant. He recently retired from the Canadian military after a 23-year career, the last seven as a physician assistant taking care of navy and army personnel.

He said that since he is too young to retire entirely at age 44, he wants to get back to work diagnosing, prescribing and treating under the supervision of physicians.

“I’ve had five deployments abroad to places like the Balkans, Afghanistan and Libya and I’ve served on various submarines. It’s disheartening to know that I can’t employ my skills and knowledge as a civilian.”

Demers said there are companies in B.C. that are interested in hiring physician assistants at no cost to taxpayers, so “designating or recognizing us doesn’t mean that there would be an expense to the government.”

In the military, Demers worked in hospitals in Vancouver and Nanaimo after agreements were struck between Canadian Forces and health authorities. And, when the military was called in to assist while B.C. forests were burning, “we weren’t limited to who we provided treatment to.

“So I don’t know why we are facing this challenge getting recognized by the B.C. government.


Physician assistant Kashif Mushtaq, left, speaks with patient Kyle Fiorini, at Hotel-Dieu Grace Hospital emergency department in Windsor, Ont. physician Assistant is a recognized profession in Ontario.

Janisse, Dan /

City

The Canadian Medical Association and Doctors of B.C. have been in favour of the physician assistants for years. At the recent annual conference of Stone’s group in Victoria, Dr. Kathleen Ross, president-elect of Doctors of B.C., said physician assistants would be “an important support for doctors and patients.”

Yet the B.C. Ministry of Health has for years put its focus on nurse practitioners as part of its team-based primary care strategy despite studies showing that a broader scope of health professionals are needed to improve access for patients.

Last year, a report from the Conference Board of Canada said physician assistants are “a largely untapped resource that can help governments continue to provide high levels of service while reducing overall system costs.”

Health minister Adrian Dix was not available for an interview. But Laura Heinze, a spokeswoman for the minister, said while the government will continue to review how physician assistants might be integrated into the health care system, “our current focus is to maximize the effectiveness of the (already regulated) professions that we have right now in B.C.”

In the legislative assembly recently, Dix repeated that nurse practitioners were the first priority but the government plans to revisit the use of the physician assistants at some point.

Trevor Stone, president of the Canadian Association of Physician Assistants, said it’s a disgrace that military veterans who served as physician assistants abroad and at Canadian Forces bases in B.C. cannot continue their careers when they return to civilian life.

“Putting physician assistants to work in British Columbia has been stalled for far too long,” he said. “We have members across the country who would come back to B.C. to work in a heartbeat. With better and faster access to care, it’s patients who would be the big winners.

“It’s time for British Columbia to catch up with Ontario, Alberta, Manitoba, New Brunswick and many other parts of the world,” said Stone, adding that using physician assistants, especially in rural communities, “is an obvious way to save money and improve the health of British Columbians, yet the government refuses to act.”

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