(Monica Akhtar,Lenny Bernstein/The Washington Post)

From the time she was 8 years old, Michele Martinho wanted to be a doctor. The daughter of immigrants, she focused single-mindedly on that goal, shaping her education and extracurricular activities toward gaining admission to medical school and then finding a medical residency.

Fate seemed to cooperate. Soon after she finished her training, an opportunity came along to buy a medical practice on the Lower East Side of New York, not far from her childhood home in New Jersey. She borrowed money from her parents and began to set up the career of her dreams.

On Tuesday, she spoke to a small audience at the Georgetown University School of Medicine as both a physician and a felon, her world upended by an aspect of medical practice for which she received no training despite all those years of education.

In 2014, the internist pleaded guilty to one count of accepting a bribe. She accepted monthly payments of $5,000 to refer patients to a New Jersey facility, Biodiagnostic Laboratory Services, for blood tests and other screenings. Such referrals are illegal in medicine because of the potential that doctors will put their financial interests ahead of the needs of their patients.

Blood test sample. (luoman/Getty Images/iStockphoto)

To date, 43 people have been convicted in the multiyear investigation, 29 of them doctors. The U.S. attorney’s office in New Jersey said the case involves more than $100 million paid to the testing lab by Medicare and private insurance companies. The company is out of business and the government has recovered more than $12 million through asset forfeiture.

Martinho accepted $155,000 — always, she said, in monthly envelopes full of cash. She blames only herself for her situation, acknowledging that she knew when she started taking the cash in 2010 that she was evading tax laws. But she said she didn’t understand that the referral itself was considered a kickback. The idea had been suggested by a friend who helped set up her office and subsequently a rep from the laboratory itself.

Now, Martinho said, she speaks at any health-care or ethics institution that will have her, hoping to warn future doctors about how much they don’t know. Her advice: Accept nothing from the parade of drug, device and other representatives who will try to gain access to your office, and always seek the advice of an attorney who specializes in medical practice.

“I want them to know, ‘Wow, this is how it happens,’ ” she told about 25 people at the lecture, some of them medical students. “Slowly it infiltrates into your practice, and you didn’t see it coming.”

A single mother of two small children, Martinho faces the possibility of jail and loss of her medical license when she is sentenced. The maximum penalty she is facing is a five-year prison sentence and a $250,000 fine. She said her future employment prospects are bleak as a felon. Already, she has had a bank account closed and she believes many institutions have ignored her requests to address their students because of the conviction. Her life, she said, has been “destroyed.”

“All of these things from one decision, one crime, which is huge. But I want to make sure this rings in the minds of future medical students.

“We have not been prepared for the business of medicine,” she added. We were taught the medicine of medicine.”

After taking an ethics training course, Martinho said she hit upon the idea of “restorative justice” by speaking to medical students and others. She said she has emailed about 350 medical schools, health groups and other institutions. Tuesday was her 25th lecture.

She said she has no deal with prosecutors and does not know whether her effort will help at sentencing time.

“I am hoping it makes a difference overall in my future,” she said in an interview after she spoke at Georgetown.