To start off I'm an occupational therapist that specializes in upper extremity injury rehab (I'm practicing in CA where they allow us to treat these types of injuries if we are approved by the OT board).

I started this job last month and in the interview the PT owner said I would be the first OT to start a hand therapy program in their ortho PT clinic. He told me I would be expected to see 3 patient treatments an hour and I would have an hour for my evals that are 30 min eval/30 minute treats, but will get help from aides and students doing their clinicals. He assured me that he would review the schedule everyday and provide the help needed depending on how busy the schedule was. I'm used to 2 patients an hour with no help from aides so I figured 3 patients would be fine as long as I get help with patient setup and cleaning post Tx. A little background on the owner, he only comes into the clinic 1 day a week in the afternoon (I did find this a little odd at first, but the other PT co-owner also comes in 1 day a week so I didn't think much of it).

On my first day working there were already treatments scheduled for OT hand patients. This was the first red flag I realized since the patients scheduled were already seen for evaluations and scheduled for Tx, when he told me in the interview that I would be the first OT hand therapist there. I looked at the original evals and it was signed by an OT with no advanced practice approval for hand therapy (I checked the licensure search online). I asked the office manager if they had an outside OT come in for these evals or something and he said yes, but in a bit of an unconfident way which I found a little weird. Nonetheless, I finished the day without issues.

The second day of work is where there were huge red flags. I do not have access to the schedule or EMR from outside the clinic so the owner would set the schedules for all employees the night before and tell us what time to come in and what time to leave. The owner told me to come in at 9:00am, but when I arrived there was a patient already waiting in the treatment room on a heat pack that was on the schedule for 8:30am. I found this extremely odd and just figured it was a mistake by the owner. The second red flag was that I had new evaluations schedule that day and still had 1 patient scheduled for Tx at the same exact time as the eval. I found this really odd and borderline unethical since there would be no way I could see a treatment at the same time I am expected to be with an eval patient 1 on 1 for a whole hour. The only way I could make this happen was I would have an aide help supervise exercises while I did the eval and I would go into check on the patient a few times during their hour. I found it annoying that this type of scheduling was happening when the owner told me that I would have a full hour 1 on 1 with the eval patients.

The third day came around and the same exact issue happened again where the same patient from the day before was scheduled at 8:30am and the owner told me to come in at 9:00am. This time I could tell the patient was visibly upset that no one was with her for 30 minutes while she was on a hot pack. I knew at this point that the scheduling was not a mistake and the owner was running a mill type of PT clinic. The owner was supposed to come in later that day in the afternoon so I texted him if I could speak to him once he got into the clinic. When we spoke I brought up the scheduling issue and he did not take accountability for his scheduling error and told me it was something he didn't realize (which I knew was a lie since he looks at the schedule every night prior to telling us when to come in). I also brought up the fact that I shouldn't have to have a treatment and evaluation scheduled at the same exact time if I'm expected to be 1on1 with evals. He said he would talk to the schedulers, essentially blaming it on them, and he would make sure it didn't happen again.

While he did fix the glaring issue of telling me to come in 30 minutes after a patient is scheduled, the eval/treatment double booking persisted. Again, I told him the scheduling was still double booking me and that I was uncomfortable having an aide be with the patient the majority of the time during Tx and he said he would work with the schedulers to fix it. This time I wanted to give them another chance to try to fix the issue so I tried to stay patient. This actually happened for another day or two where I was continuously double booked eval/Tx at the same time and the straw that broke the camel's back was that the last day I worked there before I quit, he did not schedule any aide to be with me and it was just me and the receptionist. It was extremely stressful and upsetting on this day because I had a one hour time slot where I was schedule with 4 patients in 1 hour with no help, in addition to another double booking eval/Tx 2 patients at the same exact time. I spoke to the owner after I finished with the patients and essentially told him I was quitting.

The problem is I'm a little worried that it would not be out of character for this type of shady owner to continue using my license after I had quit and have the aides complete the treatments and they have access to my eSignature to sign the documentation. To cover my ass I sent an "official" letter of resignation to the company's email address with a word document attached stating the exact dates of my employment and specifically saying to please not use my license outside these dates. Would this be enough to cover my ass if they do decide to be scummy and use my license? Is there any risk for me if they do use my license and get caught? I'm hoping that the owner would be wise enough not to do this but you never know with these types of owners who only care about money and not quality of care.