Dr. Sievers' RHHC Medical Practice - Operations & Website

Oh - that's not the way I read the news article. To me, "phone consultations" means that the Orlando doctor would bill the patient directly for the consultation. It would be her billable patient fee.

http://www.abc-7.com/story/30028774/sievers-murder-suspect-person-of-interest-in-another-case
As Teresa's husband, Mark Sievers, searches for a replacement doctor, patients were able to schedule phone consultations with a doctor in Orlando -- Dr. Sangeeta Pati.
According to Dr. Pati's staff, she is no longer doing those consultations. In fact, we're told she stopped weeks ago.
When we asked why she stopped the consultations, we were told because of "legal concerns."

Possible, I just can't think of any legal concerns due to new patients calling. When I hear consultation, I think free. If Dr. Pati saw patients in Bonita Springs and/or was paid by MS, she was in murky legal territory if she stayed on.
 
Possible, I just can't think of any legal concerns due to new patients calling. When I hear consultation, I think free. If Dr. Pati saw patients in Bonita Springs and/or was paid by MS, she was in murky legal territory if she stayed on.

It appears that not many things in the practice were free...

And I can't imagine a doctor agreeing to do follow up care without ever having a face-to-face visit with the patient. *Maybe* in a very remote area where telemedicne is one of the only options? It's all very odd.
 
Maybe the other doctor's "legal concerns" were that she might find herself getting mixed up with a murderer!
 
I think this is really odd. I can't imagine what legal concerns would prevent her from talking to patients. No matter what's going on with the murder and investigation, it really shouldn't impact the patients and their relationship with a subsequent doctor. The only thing I can think of is that maybe she had concerns about the prior course of treatment? Could she have been asked to sign off on prescription renewals that she wasn't comfortable with?
I am gonna guess that the new Dr. wasn't comfortable with Dr. Sievers plan of treatment- standard of care- or medication dosage/frequency...
Perhaps this Dr. unlike Dr. Sievers felt like "out of the box" was a legal concern?
Moo

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Maybe the other doctor's "legal concerns" were that she might find herself getting mixed up with a murderer!

Yes, it occurred to me that the "legal concerns" were just an excuse because she put two and two together and decided to keep her distance from MS. Maybe he was trying to recruit her to be the new doctor, replacing Teresa, and she got creeped out.

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I am gonna guess that the new Dr. wasn't comfortable with Dr. Sievers plan of treatment- standard of care- or medication dosage/frequency...
Perhaps this Dr. unlike Dr. Sievers felt like "out of the box" was a legal concern?
Moo

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The doctor mentioned in the article was also appearing to primarily practice integrative medicine.
From her practice website: "specializes in bio-identical hormones, hormone replacement therapy (Hormonal Restorative Medicine), weight management programs, detoxification, nutrition, anti-aging, and ob/gyn"
I imagine she and Dr Sievers were long-standing medical colleagues.
 
Here are a few LEGAL CONCERNS:facepalm:

"The Florida Board of Medicine recently adopted a new rule ("Rule") that addresses standards of practice in non- physician owned offices. The Rule states that physicians and physician assistants may neither delegate to others nor reasonably rely upon others to insure compliance with certain clinical and quality responsibilities.
According to the Rule, any licensed physician or physician assistant who works in a practice that is not owned and under the control of an actively licensed Florida physician or who does not work in a hospital, ambulatory sur- gery center, nursing home or similar setting must have a physician in charge of the practice who completes a nota- rized statement which must be filed with the Board of Medicine. In this statement, the physician in charge must specifically agree to accept the following responsibilities on behalf of himself or herself and any other licensed physi- cian or physician assistant under the practice setting:

1. Ensure that all staff in the setting are licensed or certified as required by law and that documentation is maintained at the practice setting regarding such licensure or certification;

2. Ensure that any medical services provided by staff at the practice setting are appropriately supervised as required by law;

3. Ensure that the practice setting complies with all the relevant sections of the Florida Statutes, and the relevant rules of the Board of Medicine, including, but not limited to, the rules governing office surgery, medical records, and reporting adverse incidents; and

4. Review all practice billings to ensure that the billings are not fraudulent, including a systematic review of medical servic- es provided, the dates of service, procedure and diagnostic codes, and the name of the provider."
http://www.broadandcassel.com/articles/Lester Perling Board of Medicine 2001 article.pdf

"While Florida does not expressly forbid the "corporate practice of medicine" (physicians working for non-physician-owned entity), there are *numerous* complexities under Florida and Federal law that must be navigated in order to do so legally. Further, Florida law compels an office owned by a non-practitioner to have an appointed "medical director" whose contract must meet state law requirements in order to operate legally. Anyone contemplating such an arrangement should consult with an attorney experienced in these health law issues."http://www.avvo.com/legal-answers/can-a-non-physician-start-a-clinic-in-the-state-of-2001252.html

"In response to perceived abuses by some nonphysician-owned clinics, specifically in the area of fraud and abuse, the Florida legislature recently enacted a law to require any clinic owned or partially owned by a nonphysician to meet certain requirements (including having a medical director) and to register with the state" http://www.thehealthlawfirm.com/res...rate-Practice-of-Dentistry-and-Optometry.html

Very informative article, as were your responses. TY
 
I wonder if this replacement doctor concerned about "legal issues" coincides with the sudden shut down in the office around the time of RR arrest announcement. Would be interesting.


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Legal issues. At one point, weeks ago, I saw on her website a page with information about the doctor providing letters to lawyers and would help to apply for disability or personal injury accidents, etc. I thought it strange at the time, because it was sounding awfully close to ambulance-chasing. That would definitely be a legal issue and a temporary doctor might balk at performing since they don't know the history of the patient. Add to that, the prescribing of painkillers... I can't find the page, if someone can, could you please post it?

There was also a list of lawyers she recommended. That in itself isn't suspicious, I thought it was very cool that she had a page of all kinds of service providers that she worked with and recommended. To me, that would be part of whole package health care.

But, to be repetitive, the advertising of (paraphrasing) we'll help you apply for disability, get a personal injury lawyer, etc. was unusual. Not the act, but the statements on a website. Doctors can and do help with letters for application to collect disability or present in lawsuits (but not advertise it), but I can imagine some less-than-moral patients lining up to get an appointment.
 
That medical practice is MS' bread & butter. It would behoove him to get a "like-minded" doc in place asap before the practice falls apart. For some reason, I thought MS already had a replacement waiting in the wings waiting for the dust to settle. Not sure where I got that idea.
 
One legal issue may be that a Medical Director is not available in this office. Having this Dr. do phone consultations, she is not interested in following all the Legal Rules
that have been posted above for a non-physician owned office. This is presuming MS is the owner of the practice now.

All your other ideas are right on point too. What physician is going to refill a prescription more than once without meeting you?
 
Sorry for quoting my own post, on thread for theories about motive and whether MS was involved in Dr TS's death, where I wrote ~ the following. Now thinking this thread is more approp place.
_________________________________________________________________
Could Dr TS's practice/business continue without Dr TS or without any MD at all?

I wondered if ^ it's poss, but not sure how to make comparison to another med. specialty. My attempt:

Ex: Dermatology office w one MD (w or w'out Bd Cert in Derm) sets up practice and offers auxiliary or affiliated type services, such as massage, facials, botox, some laser-treatments, skin care products & techniques, diet supplements, etc. Self-pay pts for these services, no med ins coverage or billing.
Some of ^ services and/or products do not require provider to be MD-licensed, perhaps not req any med-related license.
The derm'ist's employs people, w approp licenses to provide those services. Some patient/clients do not see or consult w the derm'ist at all, leaving derm'ist time to provide MD services (e.g. skin cancer). Now back to Dr TS.

IIUC from Dr TS's vid-pt education "Why People Don't Heal' seminar (linked earlier to her med website and/or youtube), her co-presenter, LS(?) had operated independently of Dr TS for years.

Hoping not to offend posters here who were pts of Dr TS, I'll prepare for responses by putting on my flame proof suit. {ETA: thinking that I personally could benefit from some services they described, so not bashing ideas, or Dr TS or LS, just thinking more about different business models}
Parts of their presentation focused on services which seemed non-med imo. Maybe more positive-thinking, life-coachy, or day-spa (or IDK)? IOW, some services offered would not require traditional med-licensing.
Ultimately, trying to ask whether it's possible that w'out Dr TS, by modifying office's services and dropping true MD's med services, business could run without her. And by employing more ppl w other (different) health-affiliated licenses or accreditations, income wd not dry up. The patient-clients would be self-pay, no med ins, Medicare, etc. And/or poss'ly MS wd locate another like-minded MD? And/or poss'ly even expand the business w these other no-so-med-services?

IDK, could be all wrong about this ^. Merely speculating - MS may have thought it possible and that could explain his involvement (if he was). Again, seems DrTS was a wonderful, knowledgeable, energetic professional and a terrific mother, sister, etc.

I know many posters here are far more familiar (than I am), w med & health care licensing issues & services, e.g., where lines are drawn for which services, which services req. which licenses, and which require none. Hoping they will share benefit of their knowledge & experience.
 
Sorry for quoting my own post, on thread for theories about motive and whether MS was involved in Dr TS's death, where I wrote ~ the following. Now thinking this thread is more approp place.
_________________________________________________________________
Could Dr TS's practice/business continue without Dr TS or without any MD at all?

I wondered if ^ it's poss, but not sure how to make comparison to another med. specialty. My attempt:

Ex: Dermatology office w one MD (w or w'out Bd Cert in Derm) sets up practice and offers auxiliary or affiliated type services, such as massage, facials, botox, some laser-treatments, skin care products & techniques, diet supplements, etc. Self-pay pts for these services, no med ins coverage or billing.
Some of ^ services and/or products do not require provider to be MD-licensed, perhaps not req any med-related license.
The derm'ist's employs people, w approp licenses to provide those services. Some patient/clients do not see or consult w the derm'ist at all, leaving derm'ist time to provide MD services (e.g. skin cancer). Now back to Dr TS.

IIUC from Dr TS's vid-pt education "Why People Don't Heal' seminar (linked earlier to her med website and/or youtube), her co-presenter, LS(?) had operated independently of Dr TS for years.

Hoping not to offend posters here who were pts of Dr TS, I'll prepare for responses by putting on my flame proof suit. {ETA: thinking that I personally could benefit from some services they described, so not bashing ideas, or Dr TS or LS, just thinking more about different business models}
Parts of their presentation focused on services which seemed non-med imo. Maybe more positive-thinking, life-coachy, or day-spa (or IDK)? IOW, some services offered would not require traditional med-licensing.
Ultimately, trying to ask whether it's possible that w'out Dr TS, by modifying office's services and dropping true MD's med services, business could run without her. And by employing more ppl w other (different) health-affiliated licenses or accreditations, income wd not dry up. The patient-clients would be self-pay, no med ins, Medicare, etc. And/or poss'ly MS wd locate another like-minded MD? And/or poss'ly even expand the business w these other no-so-med-services?

IDK, could be all wrong about this ^. Merely speculating - MS may have thought it possible and that could explain his involvement (if he was). Again, seems DrTS was a wonderful, knowledgeable, energetic professional and a terrific mother, sister, etc.

I know many posters here are far more familiar (than I am), w med & health care licensing issues & services, e.g., where lines are drawn for which services, which services req. which licenses, and which require none. Hoping they will share benefit of their knowledge & experience.

I had also wondered about this as well, although I don't think the overall income would be as high as it was before when Dr Sievers was there. I'm not familiar with the rules and regulations of a practice like this. Perhaps certain parties thought they could make a decent income this way, even if it wasn't as much as before - this all falls under my mystery questions that I would love to have answered some day soon. Trying to be patient :waiting:
 
Without TS there is no practice. MS is an LPN/owner but it is highly doubtful that a fill-in Doctor would work for him. Not necessary---they don't need MS.
If any similarly practicing Doctor wants to add to their patient-base right now, they could simply advertise as such in the local area where TS formerly practiced. They will pick up her client base & not have to pay MS, LPN a dime!

They don't need MS for nuttin', baby. And especially with that envelope of suspicion thingy! :scared:
 
Depends on the supplement, the manufacturer and the relationship of the physician with the supplement company. Regardless, it is an income stream and MS was sure to point patients to continuing use of the supplement linked to TS practice - when it would seem that there is no time to get patient records forwarded to new doctors. The pattern of money grubbing has been firmly established in my eyes. IMO.

I have not posted a lot on this thread, but I wanted to add something regarding this "type" of medicine practice. We have a nurse practitioner that worked near me. She was under a physician at his clinic, but garnered quite a LARGE following of women when she started prescribing holistic medicines. It seems like every time I turned around, I found another friend, neighbor, co-worker that had recently become a patient of this NP. She left the physician's office and started up another clinic which - coincidentally - did not take insurance and worked on a cash basis only. All of these new patients followed her over to her new clinic. This NP did not have the heart, the schooling, or the knowledge that TS had. In fact, there were doctor's in the area that were beginning to notice that although she didn't have the credentials, she was using a doctor's name to prescribe medication without having a doctor actually in the clinic with her.

This particular NP did not last a long time once she moved to her own clinic. Soon, it became apparent that she was prescribing the same round of vitamins and supplements to every woman that came to her as a new patient. She would "read" blood test results in any way that she wanted. I admit that I did visit this NP, and she had blood tests taken, she read them to me, then I took them to my own doctor. He took my blood and the results were dramatically different than hers!! I sincerely believe that this NP was enthralled by the money that she was making. I believe that she started out with good intentions, but she was lulled by the money she could see that she could make. She set up the blood testing in her own clinic to make money on that, she set up selling the supplements to get in on that side of the business too, and then she didn't have to share her "profit" with a doctor in her own clinic. I know that money can and is a horrible draw for some people and they lose their own self-worth in the process.

In other words, my opinion on the motive in this case, follow the money...
 
I will say this again: you must know your boundaries & your licensure do's & don'ts if you are representing yourself as a healthcare professional. This applies at every level.

Each State establishes the laws/responsibilities. Don't exceed your boundaries; for instance & recently, in **Florida** there was a big hullabaloo regarding Physician Assistants (aka PA's) being able to prescribe controlled substances (aka narcotics).
 
Do we know if TS had malpractice insurance? It's not unusual for doctors in FL to "go bare".
 
Do we know if TS had malpractice insurance? It's not unusual for doctors in FL to "go bare".

Hopefully she had basic malpractice insurance, TS seems like a smart woman. Especially when you consider her removal as member of the Limited Liability Company operating her practice.
 
Today I remembered that I had the personal cell phone number of MS in my phone and decided to do a reverse google search on the number. Interesting that it led me to this - it would seem that MS has reserved many domains this year, including ftmyerspainfree.net ; esteropainfree.net ; naplespainfree.net ; pathways2healingtv.com ; pathways2healing.tv (link: http://reversewhois.domaintools.com/sievers-and-company-pllc) you will notice with a little digging that the phone number associated with these registrations is not the phone number for patients at the practice etc.... This phone number MS has had for well over 8 years, it is his personal number - so I know these registrations were done by him, not to mention that they are affiliated with Sievers and Company, registered under the name of MS with sunbiz.org . A cached page also shows that MS was working with a (slimy IMO) multi-level marketing company out of Utah, although much of his association seems to have been deleted on 9/16/15 ( http://webcache.googleusercontent.c...naplespainfree.com/+&cd=4&hl=en&ct=clnk&gl=us ). There is also an email address associated with the phone number of MS on this cached page - never have seen that email address before. So, I am done sleuthing for the day - it exhausts me. In my opinion, it looks like MS was gearing up to peddle some type of pain free supplement. And again, in my opinion, I can't help but think that the "computer whiz" was involved with all of this "digital footprint" activity.
 

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