Q: I am an associate in an office where I have found there marketing practices are not legal and have put me in a liable situation. They are basically using runners to bring in patients. I am uncomfortable with this situation, and not sure how to go about leaving in a proper way. I just want to go about things in a professional way and not sure if there are some things I may need to know. I was going to give a letter of resignation, and be done with it. I know I am going to be in an awkward situation when they are asking me why I want to leave. I am sure they are going to try to convince me to stay and maybe offer me more as well as try to inquire why I am leaving. Should I be up front and say I am not comfortable with the practices that are going on here (meaning the runners) or should I say another reason and leave my knowledge of there activities out of it A: Thanks for the e-mail. I am not sure where you practice but the use of runners is more an unethical and possibly unprofessional situation rather than illegal. But .. there are states that have had their state board and attorney general offices clamp down of questionable marketing procedures. A recent account in the papers concerned dentists using runners bringing in children for care. It was a scam and the doctors and runners are in legal trouble. The concept is as old as the ambulance chasers. As long as the patients were involved in an accident and have legitimate problems you can justify the care. Problem is that the case can be traced to specific attorneys .. diagnostic testing facilitates .. higher than usual fees and procurement procedures that are very questionable. I have been asked on a number of occasions to use solicitors or runners or use outside diagnostic facilities to boost my patient load and income. It¼s not for me and it seems it's not for you as well. If you feel uncomfortable leave .. if the authorities crack down on a clinic they will go after the doctors that supplied the services. This will include you. To get out of the situation I wouldn't accuse anybody. I would simply speak with the office manager or head DC and just let them know that you are interested in moving on. If you are questioned why .. be honest. Just tell them that you are not comfortable doing mostly PI work and especially when patients are routinely brought in via runners. Honesty is always the best policy. If you feel like you need some legal backup .. write a short letter of resignation that someone in the office signs when you leave. This is the best you can do without accusing anyone Have a Great Day Dr. M