COMMENTARY

Physicians Are Talking About: Phony Physicians On Call

Mindy Hung

Disclosures

June 23, 2010

Medical imposters -- con artists who fool physicians and patients alike with rudimentary know-how and stolen or faked medical certifications -- are the subject of recent postings on Medscape Physician Connect, an all-physician discussion group.

Dr. S. Brown encountered a medical imposter under glamorous circumstances more than 30 years ago. "When I met him," Brown recalls, "he was flying up to our rural hospital on a fixed-wing aircraft, part of a team bringing sick newborns back to the university's neonatal ICU [intensive care unit]."

The man had used a cousin's medical degree and identity to obtain a pediatric internship, residency, and fellowship in a university hospital. But Brown notes, "The thing about it was that he was good. He saved lives."

A neurologist who worked with the same imposter recalls, "He was an excellent technician, far more adept than I was at getting lines into infants. He went on to do peds then neonatology at what was generally accepted as the best program on the West Coast, and [he] was only found out much later when he was being made chief of neonatal transport."

A cardiologist tells a similar story about a fellow student in medical school: "He told everyone he was from Australia and had a ranch there. Took a month off from school to be a medic for the Eco-Challenge [a multiday adventure race]."

Things soon took a turn for the worse. "He was found out after trying to obtain a passport in 2 different names. [He] had forged documents and handguns in his apartment."

The cardiologist adds, "The interesting part was that he had been doing really well in med school."

Other imposters are not such quick studies, although they get away with the ruse for a time. A pain specialist tells of a jazz saxophonist who forged a diploma from a Mexican medical school. The masquerader mastered minor surgical repairs and sent complicated cases to his colleagues. "Although we all had stories of some bizarre episodes involving his medical care," the pain physician reports, "he was never sued for malpractice."

An emergency medicine physician working overseas declined to hire an American who claimed to have a PhD in psychiatry. Undaunted, the fake psychiatrist set up his own practice but drew complaints from female patients for his use of sensual massage as therapy. Finally, the emergency physician comments that a patient googled him and could find no medical license issued to the so-called psychiatrist from any state. "But she did find an old Web page of his. It was his acting portfolio, with pictures of him posing in 'Star Trek' uniforms, in the hopes he'd get picked up by an agent."

An internist reports on a member of the housekeeping staff at a busy university hospital who donned scrubs and gave women pelvic examinations. A pediatrician comments on an impostor who pretended to be a nurse-midwife. "Apparently, he delivered at least several dozen babies, did exams, etc., using only a hospital ID (probably stolen) that had the photo and name changed," the pediatrician notes. "He supervised some student deliveries, too!"

For some physicians, the imposters get a little too close for comfort. A neurologist reports that his identity was stolen by a physician impersonator who used the neurologist's name to order tests on the fraud's mother. "He rang up a huge Medicare bill at 2 hospitals in town before the x-ray techs finally turned him in," says the neurologist. "They googled [my name] and found out that I practiced in another city. Eventually, they set a trap and caught him the next time he brought his mom in for a test."

More orthodox forms of medical fraud, such as medical identity theft of patients and false billing, account for a large percentage of the approximately $68 billion worth of healthcare scams committed each year.[1] But fake physicians take their toll on the community in other ways.

An internist writes that she had worked for a company that did corporate physical examinations for executives and for the Federal Bureau of Investigation (FBI). The physician-impersonator was a pharmacist who knew most of the medical lingo. "People actually gave him high ratings for his recommendations," the internist notes.

The imposter told prospective employers that his wife was divorcing him and that she had burned all of his documents to get back at him. The company hired him on the basis of copies of an orthopaedic surgeon's diploma and medical license that he provided and letters of recommendation he obtained or forged. When the FBI discovered the fraud, the internist says, "The medical director of the company (not the owner) had to go to Los Angeles to review all the FBI charts and make sure no malpractice was done in light of legal threats. Either while he was there or just after he returned to New York, the medical director committed suicide over the fiasco."

A question that plagues many physicians who encounter medical imposters is why they don't get caught sooner. The pain specialist whose colleagues were hoodwinked by a jazz saxophonist writes, "When I look back, I still wonder how he could have gotten by. Why were we so willing to accept him as merely a marginal practitioner, rather than a fraud?"

As the pain specialist notes, medicine is an apprenticeship and students learn by doing. "Although they do not guarantee excellence," the specialist notes, "we must rely on credentialing, licensing, and verifiable educational background to make the distinction."

A public health physician who works as a medicolegal evaluator offers the following tips for recognizing the work of a potential medical imposter:

  • Excessive hyperbole, especially with underlining and exclamation points: "VERY SEVERE pain!!!" Why is the "doctor" yelling? Would the diagnosis be less credible if written in a normal way?

  • Overly detailed notes with acronyms and descriptions using anatomic rather than medical terminology. Medical doctors typically use both standard and nonstandard abbreviations, sacrificing detail for clarity and simplicity.

  • Perpetual use of copied and pasted medical notes. The problem with identifying a new thread in an old, resubmitted electronic medical chart note is that, unlike a handwritten note, the basic thrust of the latest encounter may be buried in a mountain of established information.

"Several red flags pop up when reviewing a whole chart," the public health physician adds, "and some of them should make you believe something is wrong."

The full discussion of this topic is available at: http://boards.medscape.com/forums/.29fc432a

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.

processing....