Read the case entitled "Dr. Osso's New Practice" and answer the following: Does Dr. Osso's inexperience and lack of knowledge protect against liability/accountability? Provide a rationale for your response. Who should report these issues and to whom? Explain.
A young and dedicated Doctor of Osteopathy, Dr. Osso, who specializes in osteopathic manipulative treatment (OMT), has just been offered a beautiful, large space to open a private practice. Dr. Osso was previously part of a large group practice and had no managerial responsibilities. Dr. Tanner, a physician, and Hannery Conn, a medical assistant, have just opened a pain management clinic in a new clinical building they purchased. With the influx of retirement communities in the area, there is a growing Medicare population. The office is an ideal location. Dr. Tanner offered to rent a spacious office to Dr. Osso for a terrific monthly rent, thinking that Dr. Osso’s practice would be very complementary to theirs. Dr. Osso had never negotiated a real estate contract like this before and breezed through the fine print. Dr. Osso was required to provide a client list from the previous practice, so they could be certain Dr. Osso was an established and well-respected physician and could generate enough revenue to keep up with rent. They assured Dr. Osso that this was for vetting purposes only and that the patients would not be contacted, nor the list shared. The pain clinic offers a variety of therapies, including trigger point injections. Indeed, it was apparent how the various clinicians renting in the building had complementary practice areas, and together provided one-stop shopping, especially for aging patients who suffer from chronic pain. The other tenants in the building included a small independent pharmacy, an acupuncturist, a massage therapist, and a biofeedback practitioner. Many patients from Dr. Osso’s previous practice transferred their care over to the new office and word of mouth brought in many new patients. This success did not go unnoticed. Dr. Tanner soon visited Dr. Osso to follow up on their agreement that Dr. Osso would refer at least 10 patients a month to the pain clinic for trigger point injections or start paying a higher monthly rent. Sure enough, embedded in the fine print in the contract was a clause stating this, although the language was vague on the exact terms. To avoid a rent hike, Dr. Osso began referring patients with the most acute localized pain to Dr. Tanner for trigger point injections. One of Dr. Osso’s patients, Ms. Hope, went to the pain clinic for trigger point injections, and at her next appointment with Dr. Osso she mentioned that she felt no real pain relief from the red injection that Hannery gave her. Several other patients recounted the same thing to Dr. Osso, who became concerned that Hannery, rather than Dr. Tanner, was giving the injections, and that Hannery was perhaps not using the correct trigger point medications, such as anesthetics or cortisone combinations, but was instead injecting the patients with Vitamin B12. The difference in cost was significant: the trigger point medication was reimbursed by Medicare at $60 per shot, but Vitamin B12 was reimbursed at $0.66 per shot. Ms. Hope also mentioned that the pain medication that Hannery prescribed is doing wonders, and Hannery even authorized multiple refills from the pharmacy conveniently located next door. However, Ms. Hope has begun complaining about new ailments that she had not previously mentioned, such as chronic constipation, nausea, and dry mouth. Is Ms. Hope perhaps exhibiting signs of an unwitting opioid addiction?