Experiences with angry general surgeons tipping into impairment?

[nopain1234]

We have a guy who’s been on a terror the past two months. Actively berating staff and anesthesia providers to the point where people are afraid to interact with him.

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[Arch Guillotti]

We have a guy who’s been on a terror the past two months. Actively berating staff and anesthesia providers to the point where people are afraid to interact with him.

Document everything. Start a paper trail. If it isn’t doxumented it didn’t happen.

 

[nimbus]

We had a new orthopod who was berating our OR front desk staff because of an unexpected delay. He got called in to c-suite director of medical affairs office in a couple days and his own partners/new bosses told him to knock it off and it stopped right there. They need a firm unified message that it will not be tolerated. It’s like training a puppy.

 

[ChiDO]

If/when we get complaints about our newer partners or partnership track Drs, we'll have a come to Jesus talk with them.

You need his partners to snip it in the butt now.

 

[nimbus]

Also if your hospital has a physician well being committee, he may need a referral. Especially if it’s a new behavior change.

 

[narcotics999]

We had a new orthopod who was berating our OR front desk staff because of an unexpected delay. He got called in to c-suite director of medical affairs office in a couple days and his own partners/new bosses told him to knock it off and it stopped right there. They need a firm unified message that it will not be tolerated. It’s like training a puppy.

I am wondering what would have happened if he had berated the anesthesiologist? Anesthesiologist's fault again?

 

[IlDestriero]

There are advantages to being a big dude. These things tend to not happen to me. I heard one dunce yelling over the phone at a kind and quiet female anesthesiologist about legitimately significant delays, caused by his partners, and recommended she ask him to come down so I could laugh at him in person and not just virtually, but she didn’t. She also didn’t chose to follow up on it. Her choice.
Having said that I know people that have had complaints against them escalated to HR who will investigate and send the offender to an anger management training program. It also gets noted “in your permanent record” and will 100% guaranteed derail your promotion for 3 years here. I know our system asked one physician to find another job after a second incident. They had a leave of absence and evaporated into the ether. Probably for the best. The chief of surgery isn’t a warm guy, but he won’t tolerate this disruptive and disrespectful garbage on his team.
Workplace violence is a broad term, and some people are just jerks, but it sounds like this person is in need of an intervention. If you like them, try their boss first. If you don’t, present the stack of evidence to HR and let them deal with it.

 

[Hoya11]

We have a guy who’s been on a terror the past two months. Actively berating staff and anesthesia providers to the point where people are afraid to interact with him.

What no one else has said so far is that very often nothing is done about this . Especially if this is a poor hospital and he is an outside surgeon bringing cases or someone who may be hard to replace .

Then it just becomes personal where you have to each individually stand up to the guy until he realizes he can’t act that way around you , so he’ll just take his act to others .

 

[D P356]

Also if your hospital has a physician well being committee, he may need a referral. Especially if it’s a new behavior change.

If there’s something going on in their personal life, hopefully they get some help.

What no one else has said so far is that very often nothing is done about this . Especially if this is a poor hospital and he is an outside surgeon bringing cases or someone who may be hard to replace .

Then it just becomes personal where you have to each individually stand up to the guy until he realizes he can’t act that way around you , so he’ll just take his act to others .

I’m a big guy, if I raised my voice at work, something must be very wrong. I’ve gotten a snarky comment or two directed at me before, but they generally won’t look me in the eyes and say it.

We had a busy surgeon that was told to leave due to that kind of behavior.
If it’s a MAC case and surgeon/GI is getting loud, loudly say, “Oh, that’s Dr ___ yelling at staff. No, it’s not your fault. Go ahead and go back to sleep.” Learned that one on SDN.

If they’re really going off, record it on your phone and send it to your administration. Or even send it to the surgeon or their partners.

Whenever someone is a jerk (myself included during/after the fact), it always serves as a reminder to treat people how I want to be treated and take care of the patient to the best of my ability.

 

[DirtDocMD]

If legal in your state (“the one party consent rule”), to record without his knowledge, then do so.

I’ve done my fair share of bi**hing about equipment issues/“the system”/scheduling, but making it PERSONAL is a whole other issue. Folks shouldn’t have to deal with that.

While some “poor” hospitals are more likely to tolerate that, MOST are owned by a much larger corporation, and if an anonymous tip to “corporate” (not just local admin), gets made, things might get taken WAY more seriously (when threats of $$$ lawsuits are concerned)...

 

[ValentineD]

What no one else has said so far is that very often nothing is done about this . Especially if this is a poor hospital and he is an outside surgeon bringing cases or someone who may be hard to replace .

Then it just becomes personal where you have to each individually stand up to the guy until he realizes he can’t act that way around you , so he’ll just take his act to others .

This. I have worked at a variety of hospitals. The surgeons at the larger academic centers are generally more well-adjusted individuals and socially capable. I once worked at a rural hospital, there were certainly mild-mannered and easy going surgeons but man, the outliers were B-A-D. All it takes is one threat to leave and administration is kissing their feet and groveling for forgiveness.

 

[jwk]

This. I have worked at a variety of hospitals. The surgeons at the larger academic centers are generally more well-adjusted individuals and socially capable. I once worked at a rural hospital, there were certainly mild-mannered and easy going surgeons but man, the outliers were B-A-D. All it takes is one threat to leave and administration is kissing their feet and groveling for forgiveness.

Then elevate complaints to TJC which has some pretty stringent requirements about physically or verbally attacking staff members. Those rules apply to everyone in the hospital - physicians, nurses, staff, etc. That's something hospital administration can't ignore.

 

[OptionOffense]

. It also gets noted “in your permanent record” and will 100% guaranteed derail your promotion for 3 years here. I know our system asked one physician to find another job after a second incident.

Some places you get rid of a physician depending on the specialty you will be interviewing for 3 years for another one. i guess they can get a nurse practitioner

 

[Arch Guillotti]

Document everything. Start a paper trail. If it isn’t documented it didn’t happen.

Rat him out to HR. They are the ones that can really put the screws on. Otherwise just laugh in his face and/or ask him why he is being such a horses @ss. Bullies back down when they are stood up to.

 

[Arch Guillotti]

If all else fails, generate multiple reports that label him a “disruptive physician”

 

[PainDrain]

We have a guy who’s been on a terror the past two months. Actively berating staff and anesthesia providers to the point where people are afraid to interact with him.

As others have alluded to, is this a complete change in the person’s behavior or is this someone who has always been a jack@$$ being more of a jack@$$? If this is someone with no hx of this type of behavior then I would think this person may be having serious personal issues, substance abuse or major psychiatric illness comes to mind. Not sure how to best handle it but the safest way would be to escalate it to HR; last thing you need is someone literally “going postal.”

 

[kidthor]

It depends on what kind of place you work at.

If you work at a professional place then I'd voice concerns about this person in writing to someone in the chain of command (your chief, the chief of surgery, CMO, etc). You can always also do so anonymously via an event reporting system. In my experience written concerns to a superior require some form of action - that person is now on legal notice.

In less professional places I'd be a bit wary because they may or may not use a written complaint against you. In those places often a problem worker has persisted due to lack of institutional spine, even if the whole place isn't too bad. Some places don't want to rock the boat but also don't generally want to do the wrong thing. So... hit or miss on what do there.

In $hithole places you need to just eject yourself ASAP. I've been at such a place where the entire institution is corrupt and reporting anything to anyone will absolutely be entirely your problem, as there is an actual criminal enterprise afoot.

Luckily most places are mostly to fully professional.

 

[Blockit]

It depends on what kind of place you work at.

If you work at a professional place then I'd voice concerns about this person in writing to someone in the chain of command (your chief, the chief of surgery, CMO, etc). You can always also do so anonymously via an event reporting system. In my experience written concerns to a superior require some form of action - that person is now on legal notice.

In less professional places I'd be a bit wary because they may or may not use a written complaint against you. In those places often a problem worker has persisted due to lack of institutional spine, even if the whole place isn't too bad. Some places don't want to rock the boat but also don't generally want to do the wrong thing. So... hit or miss on what do there.

In $hithole places you need to just eject yourself ASAP. I've been at such a place where the entire institution is corrupt and reporting anything to anyone will absolutely be entirely your problem, as there is an actual criminal enterprise afoot.

Luckily most places are mostly to fully professional.

This! This! If you are involved in a facility where the institution is corrupt, YOU will absolutely be the one to have privileges suspended or be fired, especially if you also work for the same medical group.

 

[kidthor]

This! This! If you are involved in a facility where the institution is corrupt, YOU will absolutely be the one to have privileges suspended or be fired, especially if you also work for the same medical group.

An example is MGH where several had complained about concurrent spine surgeries with grave bad outcomes. The justified whistleblowers were punished by MGH and they let the surgeon keep maiming people and violating the law in the name of money (for him and for the hospital).

Clash in the name of care - A Boston Globe Spotlight Team Report

A Boston Globe Spotlight Team report on concurrent surgery practices at MGH

apps.bostonglobe.com

 

[coffeebythelake]

An example is MGH where several had complained about concurrent spine surgeries with grave bad outcomes. The justified whistleblowers were punished by MGH and they let the surgeon keep maiming people and violating the law in the name of money (for him and for the hospital).

Clash in the name of care - A Boston Globe Spotlight Team Report

A Boston Globe Spotlight Team report on concurrent surgery practices at MGH

apps.bostonglobe.com

Bottom line, its all about the $$$.
Hospital administrators only care about that.
Even places like MGH.
The supply / demand is completely off. There are too many patients and not enough physicians. This problem will only get worse.
Kudos to the surgeons and anesthesiologists who fought against this to improve patient care, even if they were ultimately suppressed by the businessmen in suits. This story should be widely shared.

 

[Urzuz]

We have a guy who’s been on a terror the past two months. Actively berating staff and anesthesia providers to the point where people are afraid to interact with him.

Afraid to interact with him? JFC. Granted I work in an MD-only practice where we know the surgeons we work with very well, I can’t imagine being ‘afraid’ of someone.

I feel like this just goes back to basic social interactions when dealing with someone who is raging dingus - keep your cool, don’t get emotional, address the actual topic as to why they’re getting upset, and don’t be afraid to ask why they’re yelling or getting so upset. Calling it out to their face will usually result in people having insight into the fact that they are 1) being a prick for no reason, and 2) you aren’t going to take their bull****.

As long as you keep it professional and topical (and your administration has some semblance of a spine), you won’t have anything bad happen to you.

 

[kidthor]

As long as you keep it professional and topical (and your administration has some semblance of a spine), you won’t have anything bad happen to you.

Administration having a spine is key. Many do not.

 

[Blockit]

Administration having a spine is key. Many do not.

Agreed.
I think it is also extraordinarily important to convey to every person who reads this thread that the human resources department at your particular facility is not there to help you. They are there to protect the interests of your facility. You may think that if you witness wrongdoing that going to HR is the right thing to do. You are wrong.
You may go to HR to complain about Dr. X because Dr. X has been tearing stuff up recently (as the OP said). HR will take your information and run it up their corporate flagpole. If the people in the C suite are ineffective, or crooked for that matter, they may decide that the revenue that Dr. X brings is more important than whether Dr. X behaves properly in the workplace.
If they decide this, they will send HR on a witchhunt to find out negative information about YOU. They will then use that negative information, even if it’s bull crap, to retaliate against you.
Depending on the laws in your state, your employer could mark up your career with a privilege suspension, a termination, etc. and they will do that with impunity. And then for the rest of your career you will have to explain those events and potentially be denied licensure or employment based on the actions of that employer.

 

[OptionOffense]

Rat him out to HR.

HR is not there to help YOU, they are there to help themselves help the company. Most employment attorneys will agree.

 

[jwk]

New Workplace Violence Prevention Requirements Coming in 2022

After an extensive literature and public field review, we are pleased to announce that The Joint Commission is introducing new workplace violence requirements, effective January 1, 2022. They will be applicable to hospitals and critical access hospitals.

www.jointcommission.org

 

[shepardsun]

An example is MGH where several had complained about concurrent spine surgeries with grave bad outcomes. The justified whistleblowers were punished by MGH and they let the surgeon keep maiming people and violating the law in the name of money (for him and for the hospital).

Clash in the name of care - A Boston Globe Spotlight Team Report

A Boston Globe Spotlight Team report on concurrent surgery practices at MGH

apps.bostonglobe.com

The primary whistleblower did sue for wrongful termination and won $13 million and a forced offer of re-hiring (the hospital also "named a hospital safety initiative after him" lololol), so I guess sometimes the good guys win

MGH Settles With Doctor Critical Of Concurrent Surgery For $13 Million

Dr. Dennis Burke was fired in 2015 for allegedly violating patient confidentiality, but he contends he was dismissed for raising safety concerns about colleagues performing two operations at once.

www.wbur.org

 

[kidthor]

The primary whistleblower did sue for wrongful termination and won $13 million and a forced offer of re-hiring (the hospital also "named a hospital safety initiative after him" lololol), so I guess sometimes the good guys win

MGH Settles With Doctor Critical Of Concurrent Surgery For $13 Million

Dr. Dennis Burke was fired in 2015 for allegedly violating patient confidentiality, but he contends he was dismissed for raising safety concerns about colleagues performing two operations at once.

www.wbur.org

Eventually that surgeon won after great personal sacrifice. One of the anesthesiologists involved is still involved in a lawsuit with them that she filed in 2017... it's now almost 5 years later. I'd rather work somewhere that did the right thing where I didn't have to sue to protect patients and myself.

 

[nimbus]

Eventually that surgeon won after great personal sacrifice. One of the anesthesiologists involved is still involved in a lawsuit with them that she filed in 2017... it's now almost 5 years later. I'd rather work somewhere that did the right thing where I didn't have to sue to protect patients and myself.

She’s the one who went to look for the attending ortho while the cement was hardening to let him know, “your resident needs you.” She was rebuffed.

 

[Velefunt]

An example is MGH where several had complained about concurrent spine surgeries with grave bad outcomes. The justified whistleblowers were punished by MGH and they let the surgeon keep maiming people and violating the law in the name of money (for him and for the hospital).

Clash in the name of care - A Boston Globe Spotlight Team Report

A Boston Globe Spotlight Team report on concurrent surgery practices at MGH

apps.bostonglobe.com

Interesting read - thanks for sharing.

 

[coffeebythelake]

Eventually that surgeon won after great personal sacrifice. One of the anesthesiologists involved is still involved in a lawsuit with them that she filed in 2017... it's now almost 5 years later. I'd rather work somewhere that did the right thing where I didn't have to sue to protect patients and myself.

might be easier for the surgeon as they bring in the patients. it'll be harder for the anesthesiologist who is employed and will forever be known as a "troublemaker" by hospital admin simply because she was advocating for patient safety. also i thought there were whistleblower protections that exist??

 

[kidthor]

might be easier for the surgeon as they bring in the patients. it'll be harder for the anesthesiologist who is employed and will forever be known as a "troublemaker" by hospital admin simply because she was advocating for patient safety. also i thought there were whistleblower protections that exist??

There are plenty of protections but good luck exercising them without great personal sacrifice, as this whistleblowing surgeon experienced.

 

[Blockit]

There are plenty of protections but good luck exercising them without great personal sacrifice, as this whistleblowing surgeon experienced.

Exactly. The law is not there to help you. You will hire lawyers, which will cost you tens to hundreds of thousands of dollars.
They will hire lawyers. It’ll take five years off your life. With no guarantee of success. All it takes is some legal technicality and you lose.

 

[deleted126335]

There are plenty of protections but good luck exercising them without great personal sacrifice, as this whistleblowing surgeon experienced.

The reality is that "doing the right thing" will often have tremendous negative professional and personal consequences.

Eventually that surgeon won after great personal sacrifice. One of the anesthesiologists involved is still involved in a lawsuit with them that she filed in 2017... it's now almost 5 years later. I'd rather work somewhere that did the right thing where I didn't have to sue to protect patients and myself.

Yeah. That place is near the Unicorn Reserve in Neverland.

 

[coffeebythelake]

The primary whistleblower did sue for wrongful termination and won $13 million and a forced offer of re-hiring (the hospital also "named a hospital safety initiative after him" lololol), so I guess sometimes the good guys win

MGH Settles With Doctor Critical Of Concurrent Surgery For $13 Million

Dr. Dennis Burke was fired in 2015 for allegedly violating patient confidentiality, but he contends he was dismissed for raising safety concerns about colleagues performing two operations at once.

www.wbur.org

"Hospital officials said in a statement they're grateful Burke brought attention to questions of surgical safety and quality."

The hospital admin at MGH are such bitches

 

[Neopolymath]

Most people in medicine aren't very tough despite all the hot air. They just talk too much so you have to act in ways that allow the person to either diffuse the situation when they realize they are having a toddler tantrum or do something dumb enough to get punished for it. Either thing will help you get rid of the person/behavioral problems.

When faced with people like this, I've found it highly effective to say this verbatim in a very unimpressed and uninterested tone: "Wow! You are obviously really upset about this. Come back and talk to me when you calm down." Then make it clear you will ignore them.

This has worked in every industry and with every type of person I have interacted with in my life from ****ty customers at menial jobs to attendings acting like *****s. People either get really upset and do something irreversible (Great! You got rid of them through their own actions) or it causes an epiphany that quickly diffuses the situation and future ones when they realize they are being wildly inappropriate.

Comedy option from my veteran friends: "I was in the military. Do you think yelling is going to intimidate me?" Even works on CT surgeons

 

[pastafan]

When I was hospital chief of staff I had to deal with an ortho surgeon who was disruptive. Despite his revenue being the lifeblood of the hospital the administrator was supportive. The surgeon was forced to get help. His behavior was found to be due to a major depressive disorder. The intervention process was stressful on me but in the end the surgeon thanked me for what I had done.

 

[nimbus]

An example is MGH where several had complained about concurrent spine surgeries with grave bad outcomes. The justified whistleblowers were punished by MGH and they let the surgeon keep maiming people and violating the law in the name of money (for him and for the hospital).

Clash in the name of care - A Boston Globe Spotlight Team Report

A Boston Globe Spotlight Team report on concurrent surgery practices at MGH

apps.bostonglobe.com

Mass. General pays $14.6 million to settle whistle-blower suit over concurrent surgeries - The Boston Globe

Anesthesiologist Lisa Wollman alleged that at least five orthopedic surgeons regularly kept patients under anesthesia longer than medically necessary because the doctors were juggling two operations at once.

www.bostonglobe.com

Globe link is paywalled so…

MASS GENERAL HOSPITAL TO PAY $14.6 MILLION TO RESOLVE OVERLAPPING SURGERY CLAIMS; STANDARDIZED CONSENT FORMS TO BE AMENDED

BOSTON, Feb. 19, 2022 /PRNewswire/ -- Massachusetts General Hospital (MGH), the clinical teaching arm for Harvard Medical School and one of the world's most prestigious hospitals, has resolved a federal whistleblower case stemming from allegations that some of the hospital's orthopedic surgeons enga

apnews.com

 

[nimbus]

Clash in the name of care: The e-mails - A Boston Globe Spotlight Team Report

A Boston Globe Spotlight Team report on concurrent surgery practices at MGH

apps.bostonglobe.com

Horror show of complications.

 

[nimbus]

We have a guy who’s been on a terror the past two months. Actively berating staff and anesthesia providers to the point where people are afraid to interact with him.

Vladimir Putin?

 

[Gilakend]

Maybe I'm just a naive med student and I'm definitely also a little less refined than most medical students, but can you not just tell him to **** off? You could dress up the sentiment however you want to make it so you don't get in trouble yourself, but what is the advantage of not just doing this? The surgeon is not the boss of the anesthesiologist?

Again, I could be way off base here, but to me, I'm reading it as "my coworker is being an ***hole" and I'm not sure why them being a surgeon and you being an anesthesiologist would make that any difference in how you'd handle it with any other coworker.

 

[nimbus]

We had a new orthopod who was berating our OR front desk staff because of an unexpected delay. He got called in to c-suite director of medical affairs office in a couple days and his own partners/new bosses told him to knock it off and it stopped right there. They need a firm unified message that it will not be tolerated. It’s like training a puppy.

This guy has now moved on to another ortho group and doesn’t come to our hospital any more. Bad cultural fit with both his group (who are all incredibly courteous gentlemen) and our hospital.

 

[jwk]

This guy has now moved on to another ortho group and doesn’t come to our hospital any more. Bad cultural fit with both his group (who are all incredibly courteous gentlemen) and our hospital.

We've had several surgeons like that. Usually (but not always) right out of residency with a really bad "I'm the boss" attitude.

Funniest thing I ever saw was a surgeon waiting in the outer office of our chairman for a meeting with "the boss", who some of you older guys would likely know by name. Surgeon looked like a whipped puppy when he came out. Attitude was much improved, although it took a medical-staff mandated anger management course to fully correct the problem.

 

[rakotomazoto]

Again, I could be way off base here, but to me, I'm reading it as "my coworker is being an ***hole" and I'm not sure why them being a surgeon and you being an anesthesiologist would make that any difference in how you'd handle it with any other coworker.

The issues happen in places where the administration doesn't have your back. Some places really let surgeons run rampant, the culture varies widely from place to place. Who is more replaceable, one anesthesiologist or one spine surgeon? Maybe the only spine surgeon in the area? Just food for thought that the direct approach might not always work out in your best interest if the surgeon develops a grudge and plays politics to make your work life miserable. People can be so petty.

So always ask yourself, is the hill that you want to die on? If it is not, then you should probably find another way to address the misbehavior than just being equally abrasive in response. I am not suggesting that you ignore the problem, but there are very valid reasons why we don't just say what might feel good at the moment. Think about your behavior with more care and forethought than your coworker. You will definitely come out ahead in the long term.

 

[kidthor]

So always ask yourself, is the hill that you want to die on?

This is often the question regarding how aggressively you want to pursue something, especially in the workplace.