I have been in similar but not quite the same situations like that.

The first one was when I was a very new doctor and I was taken in by a hospital for Internal Medicine residency training. It was very difficult to land an accredited residency program then and I was very glad. Part of my responsibilities was to sign Medicare claims every morning. I enquired why the attending physicians aren't the ones signing these and I was told it is very hard to get hold of the busy specialists, so we resident doctors have to do this to 'help' the patients process their claims on time. I went along but there was this feeling that something is not right. One morning, I made a list of the claims I signed and counter-checked it with our census. More than half of the claims were not patients, i.e., they weren't in the hospital at all. I asked for an explanation and I was told to keep quiet and I will be getting a 'share' of the claims (it seems healthy people are in cahoots with the hospital and they share whatever is paid by Medicare). I resigned, not just out of my principles but because I was afraid of getting caught, my signatures were in a hundred or so claims.

I reported this to Medicare and they said they'll look into it but they never got back to me. I think they did because the hospital was shut down after three years. Medicare became bankrupt too, a few years later so maybe the illegal practices weren't in just one hospital. PhilHealth was set-up to replace Medicare, I hope this won't get bankrupt too.

The second was overpricing of medicines when I was a volunteer doctor in the mountains. Medicines being purchased by the local government were priced more than 200%. I was offered 20% share of the overprice but i refused and I was able to put a stop to it but the mayor and councillors wrote the Dept. of Health in Manila asking for a replacement because they said I am not able to adjust to their tribal culture. I was interviewed in Manila and they believed me, so I was just transferred to another place.

In both instances I wasn't afraid to lose my job because in the former I was single and has little needs. In the latter, it was a volunteer job and the stipend I was getting wasn't much. There were other instances but these happened when I was self-employed and didn't have any risk of losing my job although there were risks of losing clients.

I'm not sure what I will do in your predicament. If a similar situation on my present job arises though, I wouldn't risk losing my job even if I don't actually relish it. I'll just close my eyes, take a deep breath and grin.