Not all residents are smart...

Re: Not all residents are smart...

I forgot to ask DH how his program handled this -- since he took a lot of photos and his patients were always awake. He would use either a personal camera or a department camera. But a cell phone camera? Has anyone here ever taken a crisp enough cell phone photo that it could be used in a research presentation? Department and personal cameras for legitimate I can understand (except that whole pesky sterile issue).

I'm pretty sure that the consent forms say something about photos and health information for research purposes, with any indentifiers removed. Obviously, since derm patients aren't under general anesthesia, DH would tell them/ask them about taking any photos and they could refuse. I forgot to ask him if they do an additional consent form at the time. From what he has said before this, most people are fine with having photos as part of their medical record and most people with really unusual skin conditions are willing to have photos taken so others can learn from it.

[Stella]

Re: Not all residents are smart...

Well, all I can say is this makes me want to get medical treatment even less than I ever did. It's skeevy and disturbing that personal cameras being used for the doctors' entertainment is apparently so widespread. I don't care if it's gallows humor - it's unacceptable to me.

There are plenty of remote outposts and probably a fair share of inner city hospitals that will take this guy. He'll end up somewhere, employed, and probably in medicine.

We discussed this briefly last night at the party I went to, and someone told a story about how a few years ago, a surgeon took a photo of an xray where a guy had a beer bottle up his rear. He then posted the pic online and it made the rounds on myspace and facebook, and the hospital found out about it. They traced it back to the surgeon because the patient ID# was legible on the photo. The surgeon was fired.

Um... THANK you.

I hope to god I never need emergency surgery. This to me is up there with the consent forms that say that when you're under anesthesia, you permit med students to practice pelvic exams on you, etc. That was horrifying to me and so is this! (That was in the NY Times several years ago).

Shut up. Seriously? *vomit*

Re: Not all residents are smart...

Isn't it interesting that the physician spouses seem to have more compassion for this guy's situation than many of us? i.e. that he was wrong, should be punished, but termination is too strict.

I'm going to guess that that's b/c most of them have probably seen it happen, whether they approve of it or not. It's a lot easier to pass judgement when it's not someone you actually know. Just like the people Alison knows who know this guy. For them it's a stupid lapse in judgement of a person they know as a "sweet Mormon guy", rather than an obscene abuse of power.

[alison]

Re: Not all residents are smart...

Can this guy redeem himself?

What if he were to come forward with an apology? What if he says that he is over-worked? Fatigued? That he had been working for X many hours at that point, and that it was the worst thing he'd ever done and it was a lapse of good judgment?

Re: Not all residents are smart...

It will always, always, always be on his record. Even if they suspended him and then took him back 1 minute later, he'd always have to answer "yes" when asked if he was suspended. He's seriously screwed.

[SuzySunshine]

Re: Not all residents are smart...

Since this has now been released locally - here is the formal statement:

As you may have seen, a news item broke… about an incident at Mayo Clinic in Arizona that violated a patient's confidentiality and privacy.

Ultimately this episode reduces to two actions by two different individuals who violated our policies concerning respect and privacy. One was the inappropriate cell-phone photograph taken by a resident physician, subsequently displayed to others internally but to our knowledge not shared in any other fashion. The resident responsible for the photograph is receiving appropriate disciplinary action.

The second breach by a different person was the reporting of the incident along with the actual patient's name to the media. The identity of the person who disclosed the patient's name is not yet known.

Both cases represent serious violations not only of our policies but of the sacred trust Mayo Clinic holds with its patients to respect their privacy and their dignity. The insult to our reputation, our patients, and our staff is the greatest outrage.

I want to reassure you that we are taking this extremely seriously and doing everything we can to correct the wrongs that were done and hold the responsible parties accountable. Such behavior is unacceptable at Mayo Clinic and always will be. It is our eternal obligation to uphold the sanctity of the trust our patients place in us.

Denis Cortese, M.D. President and CEO Mayo Clinic

This doesn't say he's been terminated, the internal statment DH saw did - I'll ask DH if he's heard anything.

ETA: The internal statement still says the appointment was terminated.

[PrincessFiona]

Re: Not all residents are smart...

Interestingly, if you go to the AZ Newspaper and read the comments on the article there isn't too much love lost for the hot rodder and...there seems to be sympathy for the doc.

http://www.azcentral.com/community/scot ... o1219.html

[JaneDoe]

Re: Not all residents are smart...

Well, I'm still in the camp that he deserves to be fired. This was a gross abuse of his position. IMO, the number years invested in his medical training should have no bearing on his punishment. If anything, the fact that he's a highly trained surgeon makes this case worse. Patient confidentiality is so high on hospital/physicians radar that he knew better.

Ruining his career? I just don't get that line of reasoning. No one but the resident, himself, has ruined his career. Neither Mayo nor the media is ruining his career. He brought this on himself. Even assuming the hospial didn't fire him for this incident, it would have been red-flagged in his file. He would have had a difficult time getting post-residency fellowship and/or job with this kind of breach of patient confidentiality. So, the firing itself is not ruining his career. His own conduct did!

My Dh is a surgeon. He often takes pictures of the eyeball for medical purposes only. The fact that surgeons routinely take pictures for medical purposes does not sway me to empathize with this resident what-so-ever. He used his personal cell-phone to take a picture of a very private body part for sh!ts and giggles, not medical necessity. Uh, duh, you could get fired for that!

By the way, I think the person who disclosed this incident to the media should also be canned. His actions were no better than the resident's. If the informant truly cared about patient confidentiality than he should have addressed this internally. Whoever it was must have had an ax to grind.

[Rapunzel]

Re: Not all residents are smart...

Extremely mixed feelings here. In no particular order here is the jumble of thoughts:

1) My understanding is that the medical release forms for surgery at an educational hospital (one with a residency program) do include the taking of and use of pictures for teaching and research purposes. My son had three surgeries at a teaching hospital and I do seem to recall that being in the release.

2) That being said I am absolutely horrified that there are people who will abuse patients under anasthesia. I know that at dh's medical school they DID have medical students literally line up to do practice pelvic exams on patients who were under anesthesia for other reasons (surgery). A surgery patient could wake up from sedation having had the surgery AND a dozen pelvic exams along with it - and never know it. The hospital wasn't about to tell the patient about all of those practice pelvic exams!!! If I ever, ever have surgery I want someone who is a close, personal friend of DH's IN THE ROOM to prevent any crap like that from happening to me.

3) Someone REALLY hated this guy. I don't think it was about the policy. It appeared to be quite personal. I would bet that hospital administration wouldn't blink at a surgeon taking pictures in a teaching hospital where the patient has signed a consent form allowing it. That WOULD probably horrify the public - even though they all sign those consent forms. DH pointed this out -radiologists also have TONS of scans that they use for teaching files and the patients don't know it. The patients give permission for all of their images to be passed around and used when they sign those consent forms at a teaching facility. So, this leads me to believe that someone in that room really had it in for the "sweet Mormon guy". It could have been a nurse, another surgical resident, a surgical attending (!), anesthesia resident or attending, tech, etc, etc. The patient was being prepped for surgery - there were a lot of people around.

4) Something else dh pointed out: The person who contacted the press may be protected by whistleblowing laws. In that case if the hospital administration figures out who the blabbermouth is and fires or disciplines the person that person may sue - and win.

5) If what this guy did was par for the course in the profession then firing him is extreme and was done for political purposes related to the story being told to the press.

[Rapunzel]

Re: Not all residents are smart...

Mom (nurse) and dh both said that the whistleblower is in deep doo-doo. By telling the media the patients name this person committed a HIPAA violation which brings along possible jail time and a $100,000 fine. If they wanted to make the thing public then they could have done so without mentioning the patient's name.

Question: Could the PATIENT have called the media? If someone on staff mentioned to him that this had happened in the OR then he might have for the attention. The guy does own a strip club - it would be good publicity for him.

[SuzySunshine]

Re: Not all residents are smart...

4) Something else dh pointed out: The person who contacted the press may be protected by whistleblowing laws. In that case if the hospital administration figures out who the blabbermouth is and fires or disciplines the person that person may sue - and win.

#4 - the person would have been protected by whisleblowing laws if he had not given the patient's name to the press. By disclosing the patients name he/she broke HIPAA rules just like the surgeon and termination is the hospital's right. At least that is my understanding of reading the HIPAA laws.

[Rapunzel]

Re: Not all residents are smart...

Suzy - we posted that at the same time.

[peggyfromwastate]

Re: Not all residents are smart...

Here, here Heidi. Me too.
DH does take pics in the OR for research/papers. If they want to use photos in a paper, there are lots of forms to be signed by the patients specific to those photos.

So the pictures are taken without written approval but cannot but used unless there is written approval? That's okay in some programs? Wow. (I apologize if I read this wrong.)

.

They are approved for general educational purposes, through the initial paperwork the patient does. If someone wants to use a picture for a research paper, or a formal presentation, there is a slew of paperwork that must be signed by the patient for that use. It is really common to take before/after pictures of surgical procedures, from what I understand.

Re: Not all residents are smart...

I live in the area where this happened, although my DW is not a resident in that program. But we did have a good talk, and a little laugh about the whole situation. She even half-heartedly said she might have done the same thing.

But considering I know what I know about the field and patient’s rights and all, I think he should be canned too. Would any of us want to have that happen, funny tattoo or not, when you are completely at the mercy of the doctor? And I don't think I saw it above, but it looks like he was let go: http://www.azcentral.com/community/scot ... 222ON.html

The other thing that really caught my attention about all this is that the whistleblower went to the paper instead of a superior. My DW said he/she must have had some beef with the resident. And I have no problem with what the whistleblower did, if he/she would have done it without revealing the patient’s name.

Also, as a journalist, I am surprised the Republic printed the patient’s name. They eventually quoted him, so I guess he at some point consented, but it is still an odd move. Of course, given his profession, he probably likes the publicity. And the reporter of the first story actually used the word "member" to describe the penis, but that is a whole other comedy of errors.

Re: Not all residents are smart...

someone is in cahoots with Hotrod

You had me until that point. Hotrod couldn't have an associate planted in the OR who would be there at the opportune moment (that I thought would be so statistically impossible -- the flash point -- until everyone upthread talked about all the shutterbugs in the OR).

But you are right about the vendetta. My theory -- someone who had been recently reprimanded his/herself with a chip for that. Lower level -- OR tech or lower-level nurse muttering to him/herself since his/her discipline "those docs get a way with murder... I'll show them [or one of them] and Mayo to boot.