In response to recent articles on productivity pressures/ethics issues regarding clinical judgment, I would like to encourage my colleagues to report fraud concerns to higher entities. If rehab supervisors ignore your concerns—please report any fraudulent practices to the Medicare Hotline and/or the Office of Inspector General. You can do so anonymously. Report if you were fired or let go for not giving in to pressures to commit potentially fraudulent activities.

I was pressured to perform under fraudulent clinical expectations (which I refused to do), and I reported it to my immediate director, as well as my regional company supervisor. The clinician and rehab director were investigated by the rehab company and fired. I asked that my identity be protected and it was.

Even though I liked both people who were fired, I had to bring my concerns to those asking me to perform unethically. When their practices continued, I reported the problem to upper management.

This outcome was a best-case scenario, and I realize not all clinicians have such an ideal support system. I have worked for less-supportive companies that made me feel in the wrong for wanting to practice ethically. As a result, I sought alternate employment. I also anonymously reported another company pressuring therapists to treat inappropriately and excessively to the Medicare fraud hotline, which launched an investigation. My heart goes out to those who have lost jobs or left the field to pursue other careers when they only wanted to find an ethical practice setting.

Name withheld by request