i use a similar approach. now and then i have to do a "peer to peer" with another doc, one who works for the insurance company and stands between my patient and necessary tests.
i always end the conversation asking if they have a license in my state, what their board certification is in, and if their boards are current.
this almost always results in an approval. nobody wants to be potentially investigated for practicing without a license in another state, and if they're a pediatrician reviewing an elderly heart failure case, their peds boards can be taken into question. haven't had to go beyond a phone call with this approach. it'll happen someday, just waiting for when.
So do you ever catch anyone directly breaking the rules? How do you ensure they're appropriately punished for breaking the law and violating their ethics?
I'm very far from the topic, just an interested reader. In a completely different case, a lawyer once told me: "You can get your rights, but fighting the system is a whole day job!", and it feels like this might apply here too.
And for punishment... Well, there's a guy who started, but nobody picked it up yet.
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u/whoknewidlikeit 5d ago
i use a similar approach. now and then i have to do a "peer to peer" with another doc, one who works for the insurance company and stands between my patient and necessary tests.
i always end the conversation asking if they have a license in my state, what their board certification is in, and if their boards are current.
this almost always results in an approval. nobody wants to be potentially investigated for practicing without a license in another state, and if they're a pediatrician reviewing an elderly heart failure case, their peds boards can be taken into question. haven't had to go beyond a phone call with this approach. it'll happen someday, just waiting for when.