The Colleague’s Billing and the Duty to Report
An optometrist shares an office suite with another optometrist. Over three months, the first optometrist notices that the colleague submits claims for “comprehensive exams” on days when the schedule shows only contact lens pickups; sample lenses disappear; and the colleague has twice smelled of alcohol during afternoon appointments. A patient tells the first optometrist that the colleague “seemed confused” during an exam. The colleague denies any problem and asks the first optometrist not to “ruin his career.” The first optometrist has no ownership interest in the practice and is unsure whether suspicions are enough to report.
1. Does the first optometrist have a duty to report the colleague? What patient-protection steps are required?
Read the worked answer
Yes. The facts are more than a vague suspicion: billing for services not documented, missing samples, the odor of alcohol, and a patient’s report of confusion together create a reasonable belief of unprofessional conduct and possible impairment. Alaska law and board rules impose reporting duties on licensees, and even where a report is discretionary, the professional duty is clear. The first optometrist should protect patients first: do not allow the colleague to see patients while impaired, arrange coverage, and document objective observations contemporaneously. The report should be factual, not speculative, and should go to the board and, for the billing issues, to the affected insurers. The colleague’s request not to “ruin his career” does not override the duty; silence could enable patient harm and make the first optometrist complicit in fraud. Disclosure should be limited to those with a need to know to avoid defamation claims.
2. How should the first optometrist handle the evidence and the colleague’s request, and what are the risks of doing nothing?
Read the worked answer
The first optometrist should preserve original schedules, billing records, sample inventory logs, and any patient statement, and should write a dated memo of direct observations. She should not alter or delete the colleague’s records, access them beyond authorized purposes, or confront the colleague alone if safety is a concern. A private conversation may be appropriate to urge the colleague to stop practicing and seek help, but it is not a substitute for reporting. Doing nothing creates several risks: continued patient harm, potential discipline for failing to report, civil liability, and complicity in insurance fraud. The board will evaluate the report based on observed facts and patient risk, not on whether the first optometrist had proof beyond a reasonable doubt. Reporting promptly and documenting the protective steps is the defensible course.