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During week 9 of my FW IIA, I'm picking up patients for my CI and…
During week 9 of my FW IIA, I'm picking up patients for my CI and discover there is no evaluation in the chart and no notes completed for 2 months. My CI has asked me to "fill in documentation" so they can bill for the 2 months of treatments. I don't even know if the treatments were done..
Ethical Dilemmas
Veracity: To provide accurate, objective and comprehensive information that is grounded in honesty and truth.
Giving what this code of ethic stands for, this case is in direct violation. The CI is asking me (the student) to make up false information for treatments that may or may not have been done. This puts me in a dilemma of integrity.
Veracity is the main code in question, however, justice is also a dilemma. To not document on evaluations and sessions, how does the therapist, student, or insurance know that the patient needs services and is benefits/ making progress?
Another dilemma for the student is what to do about the CI. This is obviously a violation and not ethical on the CI's part; at the same time this the person who has authority of the student at this point and their job and license could be in jeopardy so should the next step be to go to CI or go above to their superior?
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Action steps
- Decide not to complete this request from the CI and talk to them directly about the ethical violation they are committing along with the deceit to insurance companies and the patients. As well as the difficult spot they are putting on me, the student.
Professional/Liability issue: This could create a strain on the relationship between the CI and student.
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This volition hurts the integrity of occupational therapy as a profession and interrupts the oath we all took when entering clinical practice. It does not put the client first and instead just puts billing first.
- Go to my school resources including mentor and fieldwork educators. It would be important to keep them in the loop of the dilemma and receive advice of continued action steps.
Professional/Liability issues: I don't think that this would cause a big issue. Getting advice from fieldwork educators is what they are there for. It would be opening up the violation for more people to be aware of; if the CI was trying to keep it a secret then it could cause an issue.
- Go to the rehab director/ CI supervisor. This would be my last step after talking to my CI and school and would be dependent on the advice received and if my CI recognizes the violation and is taking steps to accurately and honestly fix/ change the situation. If they do not take accurate steps then I would absolutely talk to the rehab director. This violation is not accurate and does not give patients the accurate opportunity for services and benefits.
Going over the head of your immediate supervisor could always cause issues in the work place. However, if this violation continues, there is no other choice. This is correct thing to do for integrity sake and the patient.
This could also force the director/ supervisor to take action steps that could affect insurance/ reimbursement.
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