Not all residents are smart...

Re: Not all residents are smart...

I'm not saying that people don't get terminated from residency. And I agree that if someone is considered on the the last day of residency to be unsafe, they should be terminated from the program.

In the case of that resident, Annie, I wonder if there was a process followed of warnings and a chance to correct problems. That gets to your point of handling this internally would be sooooo much easier.

I see your point. I just felt like stating another angle. It really does bother that there are some residents who are allowed to slide through because no one wants to deal with the fallout of dealing with them. This is especially true for situations where I know that similar wrongs would have been cause for dismissal in places I have worked. The training set up is a big part of it.

Re: Not all residents are smart...

That is true -- after all, don't most residents have a "provisional" license or something? I can't remember the term. It is a less stable career point. If he had done this weeks after finishing residency, I wonder what would happen. Moot point, of course. Same for wondering what would happen if this hadn't been leaked to the press but I wonder if Hot Rod would have gone to the media.

Re: Not all residents are smart...

I was wondering the same thing. If so, he gave someone the perfect opportunity.

[Tenacious_D]

Re: Not all residents are smart...

Throwing my hat in the ring of fire...I don't think he should be fired. Clearly a major lapse in judgement on his part. If he published the pics on the web with the guys face...that would be whole other story. I can't even think about the idiotic things that Dr's do while in surgery...I still laugh when people fart in public. I can only imagine what my reaction would be to penis tatooed with "Hot Rod." I know I am probably making this out to be less than it is but there are worse things doctors do and don't get fired for...i.e. the Doc who resued the syringes and gave people TB.

Anyway, just my opinion...doesn't really matter but I thought I would throw it in there.

[houseelf]

Re: Not all residents are smart...

Um, I know a surgeon with a ton of nameless, faceless pictures of kid genetalia on his computer because he is contemplating subspecializing in urogenital/anal malformations. In fact, several photos are "series" shots, depicting the original malformation and the evolution through subsequent surgeries. Indeed, these photos have been shared across state and international lines for research purposes, most recently teleconferenced to London for a symposium. Perhaps Dateline will arrive at soon?

Surgeons take LOTS of photos. Like many surgeons, DH keeps a small camera with him for interesting cases which he may later present. Surgeons get worn out, egotistical, and often partake in gallows humor. Additionally, physicians often work with individuals with unsavory lifestyles, often rendering them a little crusty around the edges. I've heard enough stories of gangbangers, prostitues, and meth lab users for a lifetime. To illustrate, DH has surgically removed both a beer bottle and a tree branch from a grown mens' anal cavities during his GS residency. I can only imagine the off color comments flying about during these (unconscious) procedures.

Unfortunately, "Hot Rod" was too specific an identifier, and as such, any picture could potentially violate HIPPA. Obviously, the bulk of this post is written tongue and cheek because there is a clear and obvious difference between recording anonymous photos for medical research purposes as opposed to recording an image for shits and giggles.

I'm in the camp that this guy needs the holy crap scared out of him and the program needs to mete out a harsh punishment. As Flynn astutely observed, he will get shit canned as a CYA move by the hospital. However, as aggriegous as this incident sounds at first blush, his actions were NOT *that* distinguishable from other infractions. He should not lose his entire life over this.

This case reminds me of another widely publicized case in which the physician should be banned because this he intentionally caused harm to unsuspecting patients just for kicks:

A Kentucky woman claims that a doctor branded her uterus with the initials of his alma mater during an operation to remove the organ last year, according to a lawsuit filed Wednesday (1/22). Stephanie Means, a 38-year-old school administrator, alleges that while Dr. James Guiler (picture at left) performed an August 14 hysterectomy at Central Baptist Hospital in Lexington, he "used a cauterizing instrument to intentionally brand the letters 'UK,' approximately 4-5 cm in height, on Plaintiff Stephanie Means's uterus." Means's lawsuit notes that since she and her husband were apprehensive about the surgery, Guiler filmed the procedure and gave the couple a copy of the videotape, which, the Fayette Circuit Court lawsuit states, "clearly showed the instrument being used to brand Stephanie's uterus." Guiler, a 1976 graduate of the University of Kentucky College of Medicine, was a sponsor of a 2001 fundraiser benefitting UK's basketball museum. (4 pages)

Kelly

[SuzySunshine]

Re: Not all residents are smart...

At least here, I assume AZ and FL are the same, only official cameras are allowed in the OR's. If you have something you want recorded for research purposes an official photographer must take it with an official camera. No personal cameras, no cell phones.

Re: Not all residents are smart...

But they have to get consent for the photos, correct? Is that a separate permission or is it part of the signed consent for entering the hospital?

DH takes a lot of photos too, for research or presenting (as a resident) and as part of the medical record. He asks and explains why but his patients are awake.

[SuzySunshine]

Re: Not all residents are smart...

I think it is just part of the standard consent you sign when you go into the hospital. Any photos taken by the official photographer become part of your medical record.

[houseelf]

Re: Not all residents are smart...

Really? This program paid for cameras for each fellow specifically for the purpose of research and presentation. Sometimes they take pictures of ribs, sometimes of internal organs, and occasionally, the goods. They are all done anonymously though, with faces uninvolved.

Kelly

[DCJenn]

Re: Not all residents are smart...

The patient would have had to have signed a consent saying that they acknowledge and give permission for pictures of their procedures would be used for research and study.

and if the program didn't do that, then they're signing themselves up for a big consent issue.

It doesn't matter whether there are identifiers on the pictures or not.

Jenn

[spotty_dog]

Re: Not all residents are smart...

The other thing I wonder is what this guy must be like. I suspect he's a world class asshole because #1 what he did and #2 somebody hated him that much. I wonder if it was a colleague or a scorned lover. I mean who destroys someone this close to the end. WHat did he do to them? Someone hated him in a crazy, irrational kind of way and it sounds like he gave them lots of rope to tie that noose with.

He is, in fact, a "sweet Mormon guy". Well liked by the surgeons from DH's hospital who rotate with him.

Just thought I'd throw that out there.

[Stella]

Re: Not all residents are smart...

I think part of the reason that he needs to be fired is that people all over are going to be even more terrified to go under anesthesia than ever. I know that this story (and the subsequent comments) have me now questioning what talk may have gone on during my surgery in '05 for my endometriosis. My vajajay was there for all to see and if I ever found out that something inappropriate was said about me, I'd be horrified.

I don't CARE if it happens all the time, that doesn't make it right or even okay. If you go on with that argument then I guess wife beaters, murderers, and others should be let off the hook, too, because... ya know... it happens all the time. I'm not comparing the stupid resident with the murderers but once you start saying "Everyone else does it," you're asking for trouble.

[SuzySunshine]

Re: Not all residents are smart...

Alison, are the ones that know him just scratching their head and saying "what was he thinking?"

[planet]

Re: Not all residents are smart...

Maybe there is a cultural (as in hospital cultural) difference at play here. It sounds like some places don't have issue with pics being taken personally. I have only known it to be not an ok thing to do unless "official." If there is precedent for folks using cells for training pics then this isn't quite as awful as I first thought, then it's more the stupidity of passing the photo around.

Also, I still think it falls to the resident to have made a good/bad call. I certainly have heard of nasty hospital staff who would do rotten things just because they suck and want others to be as miserable as they are. So I don't think this resident necessarily is hated, but at the same time, he should have known if he was making himself vulnerable to a jerk.

[SuzySunshine]

Re: Not all residents are smart...

I guess as a patient if I consent to having pictures taken for my official file and research purposes, fine. But pictures taken for any other reason are not ok with me and I definitely don't think the picture in question was official or for research purposes. If pictures are being taken of me when I'm under I want to know about it and if they become part of my official record then I would be able to request copies of them, if they aren't I wouldn't have any idea they were out there.