Dozens of radiologists from state hospitals “sell” their signatures to private clinics, without actually being present, while the analyzes are interpreted by other doctors with lower qualifications. Both doctors and private clinics collect thousands of lei monthly, although the services are not provided according to the contract with CAS.
A journalistic investigation carried out by G4Media.ro during six months revealed shocking situations in the medical system. It is about dozens of cases in which radiologists from state hospitals “sold” their initials to private clinics, so that they could obtain contracts with the County Health Insurance Houses (CJAS), without the doctors actually being present in the respective locations, sometimes hundreds of kilometers from the public hospital where they work.
The journalists cite two sources who stated that in these situations the interpretation of the analyzes is carried out by other doctors, with lower qualifications, but they are initialed by the doctor who was not even present at the clinic.
Based on the official answers of some CJAS and hospitals, the investigation revealed incredible situations: a doctor worked simultaneously at the County Hospital in Suceava and at a private clinic in Târgu Neamț, and another medical staff appeared to finish the program at the hospital at 2:00 p.m. every day and, at the same time, start work at a private clinic located 100 kilometers away.
In a specific case, CJAS Alba representatives, informed by journalists about such a situation, carried out an unexpected check at a private clinic and did not find the doctor. As a result, the clinic was sanctioned by cutting 5% of the deductible amount from the state budget.
Contacted by journalists, the doctor explained that he was on vacation that day.
How the mechanism works
A source from the medical system explained how he got into this situation and how much a doctor who “sells” his initials can collect.
“According to the law, imaging clinics that have a contract with the Insurance Companies can have it ONLY if they have a radiologist with a PFA, SRL (doctor’s) contract or employment contract. If they do not have such a contract, they cannot provide services settled by the Insurance Company.
Through the contract that the provider has with CJAS, the provider (clinic) undertakes that the doctor will be present in the clinic in the program declared at CJAS. Almost everyone puts in at least 6 hours a day.
The more doctors you have, the longer your schedule and the more substantial service settlement. Due to the fact that there are not enough radiologists or there are few in certain geographical areas, radiologists from the state ended up “selling” their initials. the source explained.
“Most doctors work at a state hospital. Official hours are 7:00am to 1:00pm or 8:00am to 2:00pm. Normally, these state doctors should be under contract with CJAS for the hospital – which would benefit the hospital (outpatients billed by CJAS). But they refuse to contract with CJAS for the hospital where they are employed so they can contract with a private. Which most of the time it is far from the city where he works and lives.
Now comes the even more interesting part: for the contract at the private clinic, the radiologist asks for approximately 10,000 RON per month! But he does not work and does not go to the private clinic! Other doctors give the results, and they put their initials! It is called “ghost-reading”. Besides, they also get a good salary from the government hospital.
The vast majority are not present at the private clinic according to the contract with CJAS, but they are not checked. Only in certain counties are checks carried out and only for certain purposes (“reports”, eliminating competition for a “favorite” of the CJAS (…)), elaborated on the quoted source, continuing: “What is incredible is that no one questions how a radiologist who works until 2:00 p.m. in the county hospital in Cluj, Timișoara, Arad, Bucharest, etc. can be on schedule with CJAS from 2:00 p.m. in Vaslui, Piatra-Neamț, Turnu-Severin, etc. which is hundreds of kilometers away.”
She admitted that she owns a private business in the field and that, initially, she also “bought an initial”.
“I’m tired of blackmailing doctors and the fact that we pay their initials and that’s why I decided that a change is needed. (…) I think there are several dozen if not more than 100 in this situation in the country”, the source added.
“The contract with CJAS should be made per clinic, NOT PER DOCTOR! In this way, the disadvantage with vacations would be solved and the examinations could be distributed according to the sub-specialties of doctors, which would significantly increase the quality of the medical record. Plus, the “mafia” of initials would be eliminated. All this would be to the patient’s advantage, in the end, because the quality of the medical record would increase.” a second source told reporters.
Concrete cases
Based on the answers from the state hospitals and CJAS regarding the work schedule of several doctors working in the imaging domain, the journalists identified several suspicious situations, of which they signal only a few:
* Doctor at Pediatric Hospital 1 Cluj-Napoca: schedule Monday-Friday 8:00–14:00 / private clinic 14:00–20:00. Distance Cluj–Alba Iulia: 99.2 km.
* Doctor at Negrești Oaş Hospital: schedule 8:00–14:00 / Baia Mare private clinic. Distance: 50.5 km.
* Doctor at “Sf. Ioan cel Nou” Suceava Hospital: schedule 8:00–15:00 / private clinic Târgu Neamț, Monday, Tuesday and Thursday 8:00–11:00, Wednesday and Friday 15:00–18:00. Distance: 60 km.
* Doctor at Cluj-Napoca County Emergency Clinical Hospital: 12-hour shifts / Alba Iulia private clinic 8:00–14:00. Distance: 99.2 km.
In contracts with CJAS, clinics must demonstrate that the radiologist is present for the duration of the requested schedule, which cannot be less than 6 hours per day, Monday through Friday, for each radiology/medical imaging laboratory or workstation.
In other words, to enter into a contract with CJASs, the private facility must have the physician physically present for the entire stated program period.
In reality, the vast majority of doctors do not show up according to the contract, the analyzes are interpreted by other doctors, with lower training, while private clinics receive settlements of thousands of lei through the Health Center.
