Managing Healthcare Professionals:Mini-Case Studies

Sharon B. BuchbinderDale Buchbinder

1. You are a new administrator at Jonestown Medical Center. You receivea telephone call from the nurse manager of the emergency room. Dr.Smith, an emergency room physician who is an employee of your hos-pital, has just reported for duty. The nurse manager suspects that Dr.Smith is intoxicated. What do you do?

2. You are the CEO of Sleepy Hollow Retirement Community andNursing Center. A resident's family has come to you to complain thattheir loved one, who is on pain medication, is in intolerable pain.Her medications appear not to be working anymore. One of thefamily members states, "My 90-year-old mother saw the nurse putthe pain medicine in her pocket." What do you do?

3. You are the practice manager of Docs R Us, Lrd., a large multi-spe-cialty medical practice employing over 100 physicians. You are con-ducting a random review of billing for doctors in the practice andyou discover that one of the internists in your group who treatsmostly Medicare recipients has been checking off the wrong code forher procedures on the billing form. The procedures on the patientrecord do not match the billing form codes. You pull up her files forthe past 3 months and find a pattern of upcoding. When you meetwith her to review this miscoding, she becomes very defensive andangry. What do you do?

389