The rags-to-riches story of a Burnaby doctor unravelled in a B.C. Provincial Court room last Friday after he pled guilty to defrauding the public health-care system of more than $20,000.
Dr. Vu Ngoc Truong was handed a nine-month conditional sentence and will spend the next three months under house arrest. After that, he faces an 11 p.m.-to-6 a.m. curfew for another three months and 80 hours of community service to be completed by Oct. 20.
He’s not allowed to consume alcohol or any other intoxicating substance; he has had to quit coaching his son’s soccer team; he has a criminal record.
In a coup de grâce Monday, Fraser Health suspended his hospital privileges, and he faces a further investigation by the College of Physicians and Surgeons of B.C. that could see him lose his licence to practise medicine.
Truong wept as his lawyer Terry Robertson laid out the local urologist’s rise in the medical profession: first-class honours at UBC, medical student, specialist, mentor to UBC medical students and urology residents.
The 43-year-old father of three came to Canada with his parents as a baby in 1975 – a refugee from the Vietnam War.
His father was a dishwasher at the Georgia Hotel and his mother a housekeeper at St. Paul’s Hospital.
After his brother was born, the family of four lived in a one-bedroom apartment in Vancouver’s West End, with the boys sleeping in the bedroom, while their parents slept on the couch in the living room.
“He came from a deprived background and made something of himself for the public’s benefit,” Robertson said.
Calling for a six-month conditional sentence, the defence lawyer presented letters of support from physicians in hospital administration and in Truong’s field who described the local doctor as collegial, professional, innovative, capable and well-respected.
But Crown prosecutor Shelley Hulko argued it was precisely Truong’s high standing in the community that allowed him to perpetrate his fraud.
“It was the regard in which he was held in the community that facilitated, that gave him the opportunity to commit the offence,” Hulko said.
Calling for an 18- to 24-month conditional sentence, Hulko argued the court needed to send a strong message of deterrence to other health-care practitioners tempted to take advantage of their positions of trust.
“There is no ability on the part of the billing integrity program or the audit section to audit every doctor or anywhere close to every doctor,” she said. “The system functions as best it can because of trust placed in health-care practitioners who are responsible and who can be trusted to do their own billing.”
Truong’s case is at the front-end of a new approach by the Ministry of Health toward medical service plan (MSP) misbilling by medical practitioners, Hulko said.
His fraud charge was the result of work by a special investigations unit set up by the ministry in 2015, and he is the first doctor in 25 years to face criminal prosecution related to improper MSP billing.
He came to the attention of the ministry’s billing integrity program in February 2011, when 50 of his patients were sent random service-verification letters.
The program sends out about a 100 such letters a month, Hulko explained, and looks for “outliers” in the patients’ responses.
It turned out Truong was one of the highest billers when it came to certain procedures, she said, and that sparked an audit in November 2012.
The audit revealed Truong had billed MSP numerous times for one kind of laser surgery (Holmium) to treat non-cancerous enlargements of the prostate while, in fact, performing a less complex procedure (Greenlight).
Each time, he pocketed $465.20 extra.
A subsequent probe by the special investigations unit, which pulled Truong’s patient records and compared them against laser logs at Fraser Health hospitals, showed he had taken in an extra $16,282 by improperly billing for the more complex procedure.
Another $3,741.55 came from overbilling for other procedures.
Both Hulko and Robertson pointed out Truong did not falsify patient records to perpetrate the fraud and the only inaccurate entries he made were in the billing system.
The two lawyers also agreed on other mitigating factors in Truong’s case, including his remorse, his cooperation with the audit team, his quick guilty plea, his repayment of the money even before criminal charges were contemplated, his ready payment of the audit costs and his “extensive efforts” to rehabilitate himself, which have included 70 sessions with a clinical psychologist who wrote a letter to the court saying he “could not realistically imagine” Truong reoffending.
Judge Patrick Doherty, in delivering his sentence, agreed with Hulko that he needed to send a message of deterrence to other medical practitioners.
“It is relatively easy for some physicians, if they want to, to overbill for services and not get caught,” he said. “I must be mindful that the sentence I impose takes this into account.”
He added, however, he also needed to take Truong’s individual circumstances into account, including his remorse, his restitution and his “exceptional efforts” at rehabilitation.
Doherty also noted the further disciplinary action Truong faces from the College of Physicians and Surgeons of B.C.
The message the judge sent to that body had a sympathetic ring.
“I sincerely hope the college takes into account the fact that Dr. Truong has gone through a very public criminal process with great remorse and shame for his actions,” Doherty said. “I hope the college takes into account the very important role he has as a preeminent physician in his field and that suspending him would not just penalize him but perhaps many British Columbians who would be deprived of his capable treatment.”
The college, which has now launched its own investigation, does not automatically suspend or cancel the licence of a doctor who pleads guilty to a crime, according to spokeswoman Susan Prins.
“There are many factors that the Inquiry Committee will need to consider, just as in a criminal sentencing,” she said in an emailed statement. “In terms of general process, the College’s Inquiry Committee opens a file and considers the nature of the offence and whether the circumstances give rise to a registrant’s competence or fitness to practise.”
The Fraser Health Authority medical advisory committee, meanwhile, has 14 days to review its suspension of Truong’s hospital privileges, spokeswoman Tasleem Juma told the NOW, after which the committee could lift the suspension or make recommendations to the Fraser Health board to extend it or cancel his privileges altogether.