Healthcare Heroes? Lot’s of Times They Happen to be Nurses

Here’s a story with a cool ending:

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Healthcare Heroine: Doctor Colleen Coleman in Southern California

It might go without saying that as a surgeon, Doctor Colleen Coleman in Orange County California has saved a few lives. But up till recently the folks she helped were people she didn’t know.

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Dr Colleen Coleman

But not long ago the good doctor learned that a coworker – a man on staff at Hoag Hospital in Newport Beach where she works –was in dire need of a kidney. And the man’s name is Brian Dunn, a physician himself. In fact, Doctor Dunn is an anesthesiologist. They worked together. And he was a very sick man.

After ensuring that her blood matched that of her coworker, Colleen Coleman made the decision to donate one of her own two kidneys. She says it was not a hard choice to make.

“I truly believe if I, as a physician, couldn’t do this, after having participated in transplantation as part of my training and experience as a surgeon, how could I ask other people to be donors when needed,” Colleen said.

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Dr Brian Dunn

The surgery worked out just fine, and Doctor Brian Dunn no longer needs to undergo the grueling ritual of dialysis. In fact, he gets to go home from the hospital today.

“I can’t tell you how much I appreciate that someone would make this sacrifice,” Dunn said. “But that’s Colleen.”

Doctor Dunn is looking forward to returning to the operating room in March. And when he does, he’ll be working side-by-side with an extraordinary lady-doc with only one kidney.

We tip our cap to Doctor Coleman for her extraordinary generosity.

Yes, Medical Miscreants Looks Out for You. So Does ProPublica

propublica-logoDrug cartels and medical device makers are required by the Physician Payment Sunshine Act to release details of their payments to doctors and teaching hospitals.

As a regular reader of Medical Miscreants, you should know by now that you have at your disposal yet another independent, non-profit watchdog site that is just as concerned about your safety as we are. And that nifty service is called ProPublica.

As a regular reader of Medical Miscreants, you should know by now that you have at your disposal yet another independent, non-profit watchdog site that is just as concerned about your safety as we are. And that nifty service is called ProPublica.

So look ‘em up.

ProPublica offers up a terrific tool called “Dollars for Docs”, which exposes which physicians are getting cash payments from drug cartels and medical device companies. The money is paid out to these doctors in exchange for consulting and promotional PR of their products.

And this week ProPublica provides its annual updates for all to see – the wretched billions of dollars doled out to physicians and teaching hospitals with their hands out – always available for a handout. And bless their little hearts – just like Medical Miscreants ProPublica has the ethical backbone to name names.

This year’s report offers some new features, making it easier for the citizenry to see just how much doctors are getting paid to tell each other how much they love the latest drugs and the niftiest medical devices. You can check to see if YOUR doctor is on the list.

Here’s a cogent point ProPublica makes:

“Two years of data gives us the chance to compare year over year. Although spending by companies stayed constant, the numbers are nevertheless huge. Companies paid about $2,000,000,000 to 618,000 physicians each year, in addition to another $600,000,000 a year to teaching hospitals.”

Typically, payments to doctors cover promotional speaking, meals, gifts and travel. Many doctors have earned millions in royalties based on higher sales of products they tout.

Consider Doctor Roger Jackson, for example, who is the highest paid physician in the study. An orthopedic surgeon, Jackson raked in $54,000,000 by owning patents on surgical instruments and devices.

At least one recent study shows that physicians who receive even as little as a free meal from a drug maker, are far more likely to use and promote that company’s products.

So the beat goes on, as America’s greatest influencers in 30,000 overdose deaths each year, are those who profit from an increasingly drugged-up society.

We just don’t learn very fast, do we?

 

 

Hats Off to Doctor John Hall in Mississippi. The Man is Simply a Modern-day, Healthcare Hero

“No doctor should ever look at a patient as ‘prey’.” (Dr John Hall)

University of Mississippi Medical Center physician shines a much-needed light on wimpy discipline of physician sexual predators. Mississippi ranks 51st in patient protection.

Last April a Consumer Reports investigation found that the state of Mississippi ranked dead-last, among all medical boards nationwide, when it comes to physician discipline of sexual misbehavior. And now, Doctor John Hall, Mississippi Medical Board’s Executive Director, has a plan to change that ugly reality. He is working with state legislators to make any and all sexual behavior with a patient, by a physician, a felony.

“The goal here is to include this in the Mississippi Criminal Code. As a felony penalty, this would include permanent revocation of the medical license, which is not possible by current medical practice statutes, The plan is for a conviction to include mandatory restitution and possibly a prison term.”

Hall’s aggressive tact matches an investigation done by the Atlanta Journal-Constitution, which found that Mississippi ranked 51st, including Washington DC, in protecting patients from sexual predator doctors.

Hall, who is also an attorney, takes the position that mutual consent between a physician and a patient is impossible, because of the “insurmountable power barrier.”

According to the Atlanta Journal-Constitution investigation, “only 11 states have laws requiring medical authorities to report to police suspected sexual crimes on adults.”

Hall said that the state of Washington has an excellent program in place, and one that would be proper and effective for Mississippi.

Doctor Lee Voulters, Mississippi State Medical Association President, says, “We all agree that a physician should not have sexual relations with a patient. They are in a position of power and influence. It’s unethical, it’s immoral and it shouldn’t happen. Our number one goal is patient safety,” Voulters said. “My only hesitation is, what should the punishment be?”

He observed that attitudes toward physician misbehavior have changed. “Fifteen years ago, we didn’t even talk about disruptive physicians.”

 

Surgeon Confesses That He Lied to Cover for an Incompetent Doctor

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Dr. Lars Aanning, seen at his home outside Yankton, S.D., said he lied to protect a colleague in a malpractice case. Now, Aanning is a patient safety advocate.

A surgeon who lied about his partner’s skills on the witness stand has been haunted by the deception for nearly two decades.

Readers: We do not normally cut and paste other stories. We almost always investigate, then write our own assessment of a case. However here, we make an exception, for a story that perfectly addresses a point we strive to make:

Almost two decades ago Doctor Lars Aanning sat on the witness stand in a medical malpractice trial and faced a dilemma.

The South Dakota surgeon had been called to vouch for the expertise of one of his partners whose patient had suffered a stroke and permanent disability after an operation. The problem was Aanning had, in his own mind, questioned his colleague’s skill. His partner’s patients had suffered injuries related to his procedures. But Aanning understood why his partner’s attorney had called him as a witness: Doctors don’t squeal on doctors.

“No, never,” Aanning said.

Now, Aanning, in a stunning admission for a medical professional, has a blunter answer: “I lied.”

While it’s impossible to know to what extent Aanning’s testimony influenced the outcome, the jury sided in favor of his colleague — and, ever since, Aanning said, he has felt haunted by his decision. Now, 77 and retired, he decided to write about his choice and why he made it in a recent column for his local newspaper, The Yankton County Observer. He also posted the article in the ProPublica Patient Safety Facebook group. Aanning, who is a member, called it, “A Surgeon’s Belated Confession.”

“From that very moment I knew I had lied — lied under oath — and violated all my pledges of professionalism that came with the Doctor of Medicine degree and membership in the [American Medical Association],” Aanning wrote.

Aanning, who has become an outspoken patient advocate, now assists the medical malpractice attorney who represented the patient in the case in which he lied for his partner.

There’s no way to tell how often doctors to lie to protect their colleagues, but ProPublica has found that patients are frequently not told the truth when they are harmed. Studies also show that many physicians do not have a favorable view of informing patients about mistakes and that health care workers are afraid to speak up if things don’t seem right. Many doctors and nurses have told ProPublica that they fear retaliation if they speak out about patient safety problems.

ProPublica spoke to Aanning about his unusual column and why he decided to confess all these years later. This interview has been edited for clarity and length.

Why did you tell the lie?

I did it as a matter of course. And I did it because there was a cultural attitude I was immersed in: You viewed all attorneys as a threat and anything that you did was OK to thwart their efforts to sue your colleagues. I just accepted that as normal. It wasn’t like, “I’m going to lie.” It was, “I’m going to support my colleague.”

Did you feel pressure from your peers to never criticize a colleague?

Pressure is the prevailing attitude of the medical profession. The professional societies like the AMA and the American College of Surgeons say you should be a patient advocate at all times. But that goes out the window because here you are, banding together with your peers. Because if you don’t, you’ll be like a man without a country.

Why are you telling the truth now?

I’m retired now. The big benefit is they can’t hurt me, but I can’t go to the clinic for any help. All my doctors are out of town. I came to America from Norway in ‘47 and grew up in New York. I’ve always been a rabble rouser. This testifying falsely at this trial was not like me, so it stands out. It’s not how I do stuff.

I also told the truth about my lie because I have been helping some of these plaintiffs’ lawyers with their cases. It seems that the courtroom is not the arena for adjudication of medical right or wrong. I shared my story to give an explicit example of why you can’t always rely on physician testimony in court. I think that’s the big reason. There’s got to be a different way to help people who have been medically harmed. Looking to the legal system is like mixing oil and water.

Do you feel like it’s your fault the patient lost the case?

I haven’t touched on that question. It would make it painful for me. I would be moved to tears if that whole case revolved around just my testimony. I was on the stand so briefly. But cumulatively between what I said and the other testimony — it was never a level playing field for the plaintiff. People don’t recognize it. How the judges don’t recognize it and the system doesn’t recognize it is beyond me. It’s something I’m coming to grips with.

Have you thought about talking to the patient’s family?

The attorney said something about meeting the patient’s widow in his office, or something like that. I worry about whether my testimony weighed on the final verdict or not. It’s something that you just have to face up to. It’s too late to deflect it.

Do you feel any better or worse now that you’ve gone public with your moral failure?

I’m not altruistic. I’m not a crusader. I got into writing this column accidentally so I just kind of find myself in this position. I get a great satisfaction out of defining what I see and writing about it. I hope nobody’s going to come back at me and accuse me of bad conduct. Although that’s what it was. I felt bad about it.

(We are indebted to ProPublica Investigative Reporter Marshall Allen for this terrific – and important – story)

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Healthcare ‘Whistleblowing?’ Not Good for the Health of the Whistleblower

The Russell Crowe movie, The Insider, was an Academy Award-nominated film based on the true story of a corporate Big Tobacco whistleblower. Until he went public, Dr. Jeffrey Wigand had been Brown & Williamson’s $300,000-a-year research director, described by the Wall Street Journal as “the highest-ranking defector in the history of the tobacco industry.”

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One of the finest books ever written

Dr. Wigand decided to go public by delivering a damning courtroom deposition against his employer – a move that eventually led to the tobacco industry’s $246 billion litigation settlement in 1998 to help pay for smoking-related health care bills in the U.S.

But it turns out that a conscientious employee like Dr. Wigand who blows the whistle on dangerous or illegal acts faces a significant personal health risk, too, according to research published in the British Medical Journal.

An Australian study, called “Whistleblowing: A Health Issue“, examined the responses of organizations to whistleblowing employees, as well as the effect on individual whistleblowers themselves.

Researchers interviewed 25 men and 10 women from various occupations who had exposed corruption or danger to the public, ranging from a few months to over 20 years before the interviews were done.

The results were uniformly negative for the whistleblowers, according to the study:

  • All subjects in this sample suffered adverse consequences
  • For 29 of the whistleblowers, victimization started immediately after their first internal complaint
  • Victimization at work was extensive: dismissal (8 subjects), demotion (10), and resignation or early retirement because of ill health related to victimization (10) were common
  • Only 10 still had a full-time job at the time of the study
  • Long term relationships broke up in 7 cases
  • 60 of the 77 children of the subjects were adversely affected
  • 29 subjects reported a mean of 5.3 stress related symptoms
  • 15 were prescribed long-term treatment with drugs
  • 17 considered suicide
  • Income was lost by up to 75% for 14 subjects
  • Total financial loss was estimated in hundreds of thousands of dollars in 17
  • Whistleblowers received little or no help from statutory authorities, and only a modest amount from workmates
  • In most cases, the corruption and malpractice continued unchanged.

But far more troubling was the study author’s conclusion:

“Although whistleblowing is important in protecting society, the typical organizational response causes severe and long lasting health,  financial and personal problems for whistleblowers and their families.”

Like those interviewed in the Australian study, Dr. Jeffrey Wigand paid a big price for going public with what he knew about his employer.

Amid lawsuits, countersuits, and an exhaustive smear campaign orchestrated by the company, Dr. Wigand was fired and lost his family, his privacy, and his reputation. His wife divorced him, and their two daughters went to live with her. Eventually, he left his home in Kentucky and moved to South Carolina, hoping to start over. Dr. Wigand later told Fast Company.

“I had to heal. I had never expected death threats against me and my family. I never expected to find a bullet in my mailbox. I never expected a 500-page dossier that was part of a company campaign to ruin me.”

Unable to find work in his field, he took a job teaching high school science at one tenth of his former salary.

Catastrophic career damage is not uncommon among whistleblowers. In fact, New Zealand sociologist Dr. Nick Perry calls this “occupational suicide”. In his March 1998 report called Indecent Exposures: Theorizing Whistleblowing published in the journal, Organization Studies, he describes an employee’s act of whistleblowing as:

“… available for interpretation as either heroic or pathological.”

Meanwhile, Dr. Wigand has received numerous awards and public recognition for his action in revealing illegal tobacco company research and marketing practices. He continues his efforts to reduce teen tobacco use.  He also told Fast Company interviewers that he hates being called a whistleblower.

“The word ‘whistleblower’ suggests that you’re a tattletale or that you’re somehow disloyal. But I wasn’t disloyal in the least bit. People were dying. I was loyal to a higher order of ethical responsibility.”

He simply told the truth, he says, about what he saw and experienced as the head of B&W research and development.

Read about the whistleblowing study from the British Medical Journal. Or learn more about Dr. Wigand’s personal story.

(We are indebted to investigative reporter Carolyn Thomas for her terrific research)