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Full Narrative of Events (Structured Version)

Background

  • Internal medicine physician with:
    • Medical school → residency → ~15 years as attending
  • Took position with REDACTED in Cincinnati because:
    • Father diagnosed with multiple myeloma
  • Significant delay between signing contract and start date:
    • Caused financial strain before starting job

Orientation and Start

  • August 15, 2025
    • Orientation in Columbus
  • August 26, 2025
    • Training with Dr. REDACTED in Columbus
  • Completed ~1 week training:
    • Approved to work independently
  • September 16, 2025
    • Started working at:
      • REDACTED REDACTED Hospital (LTAC)
      • Located within The REDACTED Hospital (Cincinnati)

Early Red Flags

  • CEO (REDACTED) made comment:
    • Joked that the group would “someday have a private jet”
  • This stood out as inappropriate:
    • Not aligned with a hospitalist group focused on patient care

Clinical Practice Conflicts

  • Practiced standard internal medicine:
    • Ordered CT scans and appropriate workups
  • Was told:
    • Ordering “too many CT scans”
  • Impression:
    • Cost concerns prioritized over patient care

Patient Care Concerns

1. Length of Stay / Discharge Issues

  • Patients kept in LTAC:
    • Even when medically ready for discharge
  • Appeared tied to:
    • Insurance reimbursement windows (~30 days)
  • Result:
    • Patients stayed longer than necessary
    • Developed infections:
      • Acinetobacter
      • Other multi-drug resistant organisms (MDROs)
  • Pattern:
    • Ready for discharge → kept longer → infection → longer stay

2. Transfer Issues (Platelet Case)

  • September 21, 2025
    • Patient platelet count = 26
    • Required:
      • Hematology consult → transfer
  • Another REDACTED physician:
    • Tried to keep patient in LTAC
    • Appeared related to census/revenue
  • Action taken:
    • Transferred patient anyway (medical necessity)

3. Pain Management Disparities

  • Observed repeated pattern:
    • Black patients:
      • Not maintained on IV Dilaudid
    • White patients:
      • Continued receiving IV Dilaudid
  • Actions:
    • Added IV pain meds for Black patients
    • Returned later:
      • Medications removed by other physicians
  • Raised concerns with colleagues

4. Family / Non-Clinical Influence

  • Nurses relayed:
    • Family wants tube feeds started/stopped
  • Response:
    • Clinical decisions should be made by physicians
  • Concern:
    • Non-medical influence on medical care

Breathing Treatment Incident

  • October 1, 2025
    • Respiratory therapist gave breathing treatment (asthma)
  • CEO later questioned:
    • Claimed I self-administered (incorrect)
  • Nurses reportedly:
    • Provided inaccurate account
  • Issue escalated unnecessarily

Compensation Concerns

  • Seeing:
    • ~20–25 patients per day
  • Monthly pay:
    • ~$9,000
  • Compared to billing:
    • ~25 patients/day ≈ ~$2,500/day generated
  • Raised concern:
    • Pay did not reflect workload or revenue

Reassignment Before Boards

  • November 10, 2025
    • Told being moved to Columbus
    • Occurred day before board exam
  • November 11, 2025
    • Took Internal Medicine boards
  • Added:
    • Significant stress before exam

Columbus Issues

1. Telemedicine

  • November 12, 2025
    • Asked to:
      • Round in person
      • Also see telemedicine patients
  • Response:
    • Refused
    • Stated:
      • Unsafe
      • Disservice to patients
      • Liability concern
  • Example:
    • Telemedicine doctor cleared patient
    • In-person exam:
      • COPD exacerbation → IV steroids required

2. Note-Writing Requirements

  • Required:
    • Same structure, wording, phrasing
  • Instruction given:
    • Change one word in each sentence daily
  • Action:
    • Did not follow this

3. Shadowing Requirement

  • Asked to:
    • Have another physician “shadow” me
  • Context:
    • ~15 years attending experience

4. Workplace Treatment

  • Staff behavior:
    • Disrespectful
    • Did not address me as “Doctor”

Driving and Physical Stress

  • Required:
    • Drive ~2 hours each way (Cincinnati ↔ Columbus)
  • Hotel not feasible due to:
    • Medical needs (IBS/bidet requirement)
    • Family obligations
  • Result:
    • Significant stress
    • Family conflict
    • Emotional strain

Blood Clot Event

  • November 16, 2025
    • Ultrasound → superficial blood clot
  • November 17, 2025
    • Reported to leadership
    • Shared concern:
      • Possibly from excessive driving
      • Concern for malignancy
  • Context:
    • Father has multiple myeloma
    • Physicians aware:
      • Blood clots can be associated with cancer
  • Sent report to:
    • CEO and CMO

Complaint Email

  • November 24, 2025
    • CEO sent multi-page complaint email
  • Included:
    • Minor documentation issue (telemedicine wording)
    • Subjective complaint (“too aggressive”)
  • Reaction:
    • Other physicians:
      • Said complaints did not make sense

Telemedicine / System Concerns

  • Asked to:
    • See Cincinnati patients via telemedicine from Columbus
  • Concern:
    • Used to increase billing
    • Not appropriate for LTAC patients

Termination

  • December 22, 2025
    • Asked to meet CEO after shift
    • Contract terminated without cause
  • Timing:
    • Right before Christmas
  • Actions:
    • Badge and phone taken
    • Lost access to communications

After Termination

  • Severance:
    • Only 2 months
  • Issue:
    • Credentialing takes ~6 months
  • Result:
    • Severe financial hardship

Additional Concern About Evidence

  • Most communication:
    • On employer-issued phone
  • Phone taken at termination
  • Concern:
    • Loss of access to communications
    • Potential evidence retained by employer

Summary

  • Took job to be near family during serious illness
  • Fully trained and qualified before starting
  • Observed:
    • Patient care concerns
    • Operational and financial pressures
  • Raised concerns internally
  • Subsequently:
    • Reassigned
    • Scrutinized
    • Terminated without cause

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