If you are a physician or other healthcare provider working at a hospital, hospital administrations protect the hospital at the expense of its employees or independent attending physicians. Local, state and federal governments monitor hospitals and large institutional health care employers.  Any problems and these administrations  immediately blame the healthcare provider, which investigation results can ruin a physician’s career.

There are instances when a hospital wants to rid itself of a physician who has been on the staff for many years.  The reasons for this situation are too many to count.  Leadership changes and personality differences result in targeted physicians getting run out of the hospital or practice.

The first warning sign something very bad is about to happen is a call from the administration telling you that you must immediately attend a meeting with administration and/or the general counsel for the hospital. When this happens, you must be prepared for the worst.  I advise my clients to unconditionally accept the invitation to meet, but reschedule the meeting.  This give us an opportunity to learn what the issues are, prepare for responses, and minimize the stress of the circumstances.  Was there a problem with a patient of yours?  Have you had hints that, politically, the winds of favor in the hospital have been changing and your head might be on the chopping block.

The first thing to recognize is that you should call me immediately before meeting with the hospital administration.  A lawyers presences always retched things up, so I advise my clients to initially say nothing, agree to nothing, and ask questions.  Do not offer any information; do not talk, do not answer any questions, get a good understanding of what is going on, take notes, and then advise the employer they will think about the issue (whatever it is) and call to reschedule for a 2nd meeting.

You should also attempt to have that lawyer if you walk into a hospital meeting and there is a phalanx of lawyers.  Now, often the hospital will say that you are not permitted to have anyone with you because this is simply a discussion between an employer and an employee. Be prepared to go it alone if there is no other choice.  But, again, here, do not answer questions — no matter how tough, obnoxious, demanding the hospital employer is!   They can not force you to talk — so DON’T!.  MAKE NO ADMISSIONS — JUST LISTEN — AND SAY OK  I WILL GET BACK TO YOU.

At the meeting, with or without a lawyer, try to listen carefully to what is being said.  Often, you will be told that you have done something that amounts to fraud or some other type of crime.  They want you to become so afraid that you will sign anything to end the matter, often with the stipulation that waives your rights to take legal action against the hospital.  Often, they find a billing issue, like thousands of these errors, and present them as fraudulent, claiming that you committed a crime. However, in almost all cases the billing error was simply that, an error, and that is not fraud by anyone’s definition. This is a paralyzing thought and many people will sign anything to put an end to the discussion.  They can not force you to talk — SO DON’T!.  MAKE NO ADMISSIONS — JUST LISTEN — AND SAY OK  I WILL GET BACK TO YOU.

Do not sign any documents. Do not say very much. Tell the hospital that you have to discuss this with an attorney and you will get back to them later with your thoughts.  The hospital representatives may say that this is your only opportunity to sign their documents now and save yourself.  If you have not done anything wrong, do not give into their bluff.  There is some other reason they want you to go away.  Maybe you are making too much money or you have a position that they want to give to someone else.  In any event, you want to leave that meeting without saying much and without signing anything. You should retain an attorney who will be able to reach a very favorable agreement with the hospital in exchange for you leaving.  This might amount to tens or hundreds of thousands of dollars and a statement that you are resigning for personal reasons and there were no claims against you that forced your resignation. They can not force you to talk — so DON’T!.  MAKE NO ADMISSIONS — JUST LISTEN — AND SAY OK  I WILL GET BACK TO YOU.

If you are fired for cause or if you resign while under investigation, it will be reported to the the Medical Board. You may then face a charge of professional misconduct, putting your license in jeopardy. Your goal should be to have the hospital end its investigation and allow you to resign “for personal reasons” sometime later.  There will be no reporting to any agency and you can truthfully say to your next prospective employer that you left on your terms and were not terminated for any reason.  They can not force you to talk — so DON’T!  MAKE NO ADMISSIONS — JUST LISTEN — AND SAY OK  I WILL GET BACK TO YOU.

In addition to accusations of fraud, the administration might say that you have endangered the life of a patient, have been prescribing controlled substances in a negligent fashion, have committed a HIPAA violation, have had a sexual relationship with a patient or another employee, etc.  I have dealt with all of these situations and, many times, the worst outcome can be avoided if the physician does not lose his or her head during the first encounter with the administration.  They can not force you to talk — so DON’T!  MAKE NO ADMISSIONS — JUST LISTEN — AND SAY OK  I WILL GET BACK TO YOU.

In summary, it is very difficult to stand your ground when you are suddenly attacked by a hospital administration determined to force you out of the hospital.  But, if you remain calm and take the time to look at all of the circumstances, you might very well end up on the side of a favorable outcome when you exit from the hospital.  The hospital may get you off of its staff and/or payroll, but, with the assistance of experienced legal counsel, you might well be able to leave with your reputation intact, your license unthreatened and, perhaps, some money in your pocket.