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Thursday, December 23, 2010

where are they now: update #12 - lazy doctor compromising patients' care

Remember the pediatrician with the lazy coworker who was compromising patients' care? Here's her update.

Here's what happened regarding my lazy coworker: 

I was taking a few days off to study for the board exam. I received a call one morning from a resident who had questions about the management of a patient who was admitted overnight. The same faculty physician was on-call and as usual, the resident had not been able to reach him. The resident and I discussed a plan for the patient. I then told the resident I would not be in the hospital that day, but would find an attending physician with whom he could coordinate care for the remainder of the day. I called our outpatient clinic and asked one of the nurses to have our division chief call me and explained why. I never received a call back from him. After a couple of hours, I started worrying about the situation and went up to the hospital. The following day I asked the nurse whether she conveyed the message and she swore she did. So I asked our division chief why he never called me and he denied he was ever given the message. I know the question everyone will have is why didn't I get the nurse and the division chief in one room and ask who was telling the truth, but I knew the only outcome would be that they would each be mad at me. I then told the division chief that I no longer felt safe accepting responsibility for all the inpatients without a faculty member for backup and I would no longer accept any calls when I was not on call. I followed this statement up with an e-mail to our entire division.

The university has recently instituted a system called "Illumine," which is modeled after a similar system at Vanderbilt. Anyone with a password for the computer system can file a complaint about physician misconduct. The administrators of the system will obviously have knowledge of who filed the complaint. The subject of the complaint is not advised who filed the report, though. There is a step-wise discipline process. I knew that this program would be instituted before I left the institution. I have encouraged people to use this system to report any further difficulties they have with this particular faculty member, and I have been advised that "Illumine" is now up and running. It remains to be seen if anyone actually follows through.

I have finished my training and moved to another state. I've had a little time to distance myself from the situation and to evaluate it with less emotion and more objectivity. Actually, with the anger and emotion mostly removed, I see even more clearly how egregious the irresponsibility was of several people involved in this situation. I predict that nothing will happen to this faculty member and he will eventually retire, have a big party, and a nice pension.
The lesson I've taken from it is that passivity is never acceptable. The passivity of those above me in the chain of command is what has enabled this person to continue with the same modus operandi over decades. (AAM note: Emphasis mine.) I really want to thank you for posting my question and I want to thank everyone who took the time to write great suggestions and comments.


clobbered said...

Of all the questions on AaM, this is the one that disturbed me the most (for obvious reasons - what if my child was a patient of this man?)

If I have ever seen a case for 360 degree assessment, this is it. Every nurse in that building seems to know the problem (and are doing the best to work around it by calling the useful docs). It is a disgrace that there is no way to tap that feedback into the process.

I too hope the whistleblowing system can help, but somehow I am sceptical whether that organisation can tackle anything that rocks the boat from the OP's description.

Down with passivity...

Sophie said...

I am coming late to this discussion so I might be off-base with this, but it sounds you are not alone with the problem you are describing. Here is some very interesting investigative reporting by my local newspaper, The Dallas Morning News.