MMM, MANAGERIAL COMMUNICATIONS.

CASE REPORT #2

BY KOSI AVOTRI, M.D.


THEFT AT THE WORK PLACE.


One week prior to Christmas 2001, one of my associate physicians lost her purse. She had just returned to the clinic from her lunch break during which she used the purse at the bank. She placed the purse along with other personal items in her handbag behind the desk in her office and resumed patient care activities. After seeing the first patient she returned to her office and found that the purse had disappeared. This incident stimulated me to explore the issue of theft and loss at the work place and its implications for the small clinic like ours.

Scope.

The extent of loss of employee property is not reported in this estimate, but I suspect it is substantial. How much theft occurs in hospitals, clinics, doctors’ offices and other healthcare facilities is not known to me, but I assume it is included in the $52 billion estimate.



Types of theft

Theft can involve employers’ equipment and supplies, and money. Employees may also loose their property and money on the job as was the case in our clinic. Other types of theft reported include drugs, medical records and personal medical information, and personal identity theft. Information from personal medical records have been used mainly in credit card fraud and insurance fraud. In a different kind of scheme a temporary employee of Dana-Farber Cancer institute in Massachusetts allegedly used patients’ data to make $2500 in long distance phone charges. A report in Medical Economics journal indicated that in the year 2000 the California attorney general announced that six people had attempted to defraud the state’s medicaid program of more than $1.39 million using illegally purchased physicians’ licenses.

Suspects.

The natural suspects in a situation like our clinic include the staff, patients and their companions who were seen in the clinic that day, workers in the sister clinics located in our multispecialty complex and strangers. However, because of a similar loss just before Christmas 2000, the clinic staff became more strongly suspected. The prime suspect in my colleague’s case was one of our nurses. Her co-workers described her as having financial problems, which created or aggravated marital problems. The fact that she took the afternoon off after the theft was discovered only made the suspicion stronger. Mercifully, the actual culprits were apprehended trying to use my colleague’s credit for several purchases. An individual accompanying one of our patients and her mother to the clinic confessed to sneaking into the doctor’s office and stealing the purse while the doctor was examining the patient.

Implications.

The loss of property in the clinic creates tension, anxiety and fear among workers. If the lost items belong to the employer there is the added fear of job termination if the workers are suspected. There is also a sense of hopelessness or helplessness if the staff feel that patients are responsible for lost supplies but cannot prove it. If the prime suspect is a coworker (as in our case), team spirit and morale are severely tested. If the case remains unsolved suspicion and mutual mistrust can result. False accusations and the spread of rumors can result in personal animosity and even lawsuits. If the case is solved, what to do with the culprit has to be resolved. If the culprit is an employee, termination seems to be the best action. Retention of such an employee will perpetuate the sense of anxiety and suspicion in the clinic. If the culprit is a patient, a decision on continuation of care must be made. In the case of this incident in our office a decision to terminate care has been made but I am not sure if I will make the same decision in all cases.

Prevention.

While employers have the primary responsibility for safety and security at work, employees can do a lot to safeguard their property at work. People must avoid taking valuables to work, and lock up what they do take to work. Locking our offices was something we neglected until the recent theft. It creates a little inconvenience but our offices are now locked whenever the occupant is away from the office.


Conclusion.

Property loss at work is estimated to cost employers about $52 billion dollars a year. I do not know the extent of the loss to healthcare facilities or employees. Both employers and employees need to be aware of the problem and work together to decrease theft and loss at work. Medical record theft and identity theft of patients and health workers is an
emerging problem that deserves attention. This kind of theft is not limited to offices but has been reported to go as far as the internet.