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She said that Stapleton had told her to do so. She at least called but this reflects Stapleton’s lack of attention to proper patient history and appropriate use of modalities. It also reflects the poor training provided to the CAs in the Hollern system. Each time a therapy is billed with a carrier for a minimum of 8 minutes when only 5 minutes were performed the patient is shorted and the claim is fraudulent. I pointed this out to Marilyn Sexton the insurance person for Uncle Paul but she referred me back to the Hollern business system. There is no way any of these therapies could have a positive physiological affect on the patient’s health in this time period. Placing them on these therapies only allowed the patient to verify that they received a therapy if asked. The patients were ignorant to any other factors. Please see the attached pages from the Hollern training manual regarding the 7 minute office visit. Any updated information about the patient’s case, the adjustment and all therapies were to occur in 7 minutes. This is despite the fact that the minimum time for one therapy is to take no less then 8 minutes. The only reason patients ever exceeded this time period was when the office was running behind. Time then increased due to waiting and not as a result of patient care. Attached is an example of “Daily Notes” one of my first attempts to improve the Hollern note taking system. This form was rejected by Hollern for two reasons. First because it only allowed three visits to be recorded per page and second because I listed 8 minutes as the time for EMS 97014 and traction 97012. He said, “This would get out to the doctors in the field (Hollern graduates) and I don’t want them to think that I want them to do therapy for 8 minutes. It’s too long”.
- I was instructed to develop a new examination procedure for the Hollern offices. I developed several versions. My initial efforts were refused by Hollern because they would take too much time. He refused to allow me to include the taking of blood pressure and auscultation of the carotid arteries because he did not want the doctors to take the time get the equipment, use it and replace it. The only equipment he would allow was a reflex hammer. Patient entrance forms, history, examination and x-rays were to occur in 13 minutes. See the attached notes from the Hollern training manual regarding the 13 minute first visit. This clearly places the doctor’s time management and office flow above patient care. Hollern also felt that since this service was usually free in his clinics that the doctor should not spend a lot of time with the patient. A copy of the 50 Point examination I developed for Hollern is attached.
- Failure to render a proper diagnosis is another problem. My first review of the Hollern system showed that they were not rendering proper diagnoses for their patients. I wrote an extensive set of notes on proper diagnosis and taught a class for the students and training doctors at least twice during my 3 month employment. Despite the classes and extensive notes my former staff in Shelbyville (Finnell and Swartley) repeatedly complained to me about how Stapleton listed or failed to list the patient diagnoses. In fact the staff was placing the diagnosis in the file for Stapleton.
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