Fired Hopkins doctor seeks $24M

Wow. Too bad this case isn't tried online and/or in the press... I'm ready to string up the PDs at this point. Best of luck to Oscar.

One quick comment, as to why Oscar's lawyers might be "unwilling" to pass on new employment/training opportunities to him... my assumption is that his claims for damages include some form of lost future wages. Until the lawsuit is settled, from an outcome point of view he shouldn't try too hard to improve his career prospects.

I've read this entire thread, and there seems to be an inherent and curiously biased theme...his reputation was "ruined" by the "stigma of mental illness," "defamed by a diagnosis of mental illness," "they told people he had mental illness"...So I assume that if this same resident, as so far described, was given a diagnosis of major depressive disorder with suicidal ideation (ie. burnout!) then we wouldn't be having this discussion. It would be case closed, justifiable termination, assumption of terminal incompetence, career ruined with no chance for redemption or compensation. It just seems odd that it's not okay to discriminate for being a "lazy latino," but somehow acceptable to discriminate for being a "crazy" (whatever that means).

exdoctor said:

I've read this entire thread, and there seems to be an inherent and curiously biased theme...his reputation was "ruined" by the "stigma of mental illness," "defamed by a diagnosis of mental illness," "they told people he had mental illness"...So I assume that if this same resident, as so far described, was given a diagnosis of major depressive disorder with suicidal ideation (ie. burnout!) then we wouldn't be having this discussion. It would be case closed, justifiable termination, assumption of terminal incompetence, career ruined with no chance for redemption or compensation. It just seems odd that it's not okay to discriminate for being a "lazy latino," but somehow acceptable to discriminate for being a "crazy" (whatever that means).

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That wasn't my impression at all.

I was my impression that most were appalled that it appears that the "diagnosis" was created out of thin air and used as a reason to terminate someone who didn't toe the line.

FWIW, it would be justifiable to terminate anyone for the fact of having a major depressive disorder if it became apparent that the resident was unable to return to the duties of their position safely.

exdoctor said:

I've read this entire thread, and there seems to be an inherent and curiously biased theme...his reputation was "ruined" by the "stigma of mental illness," "defamed by a diagnosis of mental illness," "they told people he had mental illness"...So I assume that if this same resident, as so far described, was given a diagnosis of major depressive disorder with suicidal ideation (ie. burnout!) then we wouldn't be having this discussion. It would be case closed, justifiable termination, assumption of terminal incompetence, career ruined with no chance for redemption or compensation. It just seems odd that it's not okay to discriminate for being a "lazy latino," but somehow acceptable to discriminate for being a "crazy" (whatever that means).

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We're upset because a process needs to be followed in order to establish that someone has a mental disorder. Doctors unaffiliated with the chain of command in Oscar's residency would have to make this determination. Once it is determined that someone has such a medical condition, the information is to be kept confidential in accordance with federal law, not blabbed like a juicy rumor to the next employer.

The lawsuit states that his PD decided that Oscar had such a mental illness, and she was not trained in psychiatry or qualified to make this determination. The psychiatrist Oscar was sent to did not find him to be ill.

I'm afraid you are not getting my point. I apologize if I am going off topic a bit from some obvious other issues in the case itself, but I think this case and some of the responses to it raise a subtle issue. I agree that we are all appalled that they could make up a diagnosis and use it against Dr. Serrano ("punitive psychiatry"), but my point is that it seems from the language of the responses that this particular accusation, mental illness in and of itself, is especially appalling. And my question is, what makes this accusation one of the worse things they could come up with? All they had to say is mental illness, which could mean anything from psychopathic serial killing to depression or adjustment disorder. But they didn't even need to give a qualifier. To make my point a little clearer, I think the following survey might be revealing:

It is disgusting that the department heads accused Dr. Serrano of a diagnosis he did not have in order to fire him. But on the disgusting scale, rank in order what would make you most to least disgusted for them to have made up:

1. Accusation of substance abuse
2. First time DUI after a fun night at a stripper bar
3. Mental illness

Another question might be, of the above, which would be most likely to permanently end his career (not should, would). Insight from any lawyers or experienced physicians, especially if they sit on licensing boards or are PDs, would be very interesting. Also, for physicians, which one of the above do you think if you were accused of, whether true or not, would carry the most stigma? What do you think your peers would think carries the most stigma? I wonder what the response would be across specialties. I don't propose to know the answer, all I meant in my OP is that my impression from some of the postings is #3. Of note, regardless of how you answer, #1 and #2 are deliberate ethical violations, #3 is not. I think it is an interesting question, especially given that mental illness like depression and suicide is so prevalent among physicians (JAMA 2003 consensus statement, also see the American Foundation For Suicide Prevention ongoing campaign for doctors at www.afsp.org, or just read all the posts on this site!). There are also highly competent and successful physicians with some form of mental illness, including professors, including historical physicians (Addison suffered from severe recurrent depression and eventually jumped off a building). I recall there is even a professor of psychiatry at John Hopkins who is openly bipolar and has written about it. Why is this particular accusation so defaming, and why is it so important that it be proven untrue? (not saying there aren't other issues in the case) Just a thought experiment.

I apologize if I've made this too philosophical for you literal-minded surgeons to wrap your head around, but don't worry, you're impervious to the above anyway (and if you're not, you should be d@mn it!) (apologies also to my best friend, who is a surgeon, but strangely has a sense of humor). BTW, Winged Scapula, were you practicing safe medicine when you were on duty, so sick, that you needed to walk around with an IV?

Options 1 & 2 are easily refutable by Dr. Serrano.
Option 3 requires the support of a psychiatrist. When the Chair and PD trained, disciplinary psychiatry was common. Learned in the old ways, they probably thought that this option would be the easiest to achieve.

Deference is given to phsyicians. If a psychiatrist says you're crazy, who will society believe? You or the psychiatrist?

In the old days, the psychiatrist would do whatever the Chairman asked. Psychiatry has a dark past that it would sure like to forget.

However, the psychiatrist that examined Serrano maybe did not want to get involved in a litigious situation. I would be curious to know if the Chair and PD contacted the psychiatrist before the examination and asked for a certain diagnosis. Maybe forcing the psychiatrist to testify under oath would put pressure on him or her to tell the truth.

If such a scenario happened and a member of the conspiracy was leveraged to come clean, then Serrano's lawyers may ask the Assistant District Attorney to look into the possibility of RICO violations of Title VII or Title IX of the Civil Rights Act of 1964. RICO is usually used to go after gangsters, mafia, and physicians who engage in fraud.

Of course, Serrano's lawyer cannot explicitly threaten criminal prosecution in order to extract more money from the defendants. However, there are ways around this rule. Remember Kobe and the girl he bought off in Colorado? Or the pro-football player who killed a pedestrian while driving drunk?

I was going to respond to your well thought out and cogent reply below until you derailed your thoughtful comments with personal insults. It might behoove you to read my bio and understand that I have a fair bit of psychological training and knowledge even for a "literal minded" surgeon.

And frankly the fact that you would question me about rounding with an IV tells me that you may, in fact, have never completed a medical or surgical residency in which such decisions are not made by the ill resident but by their faculty. There are also the expectations and needs of one's colleagues to consider. Since I was allowed no sick leave and was told I had to be at work when I was ill, it's a cheap shot to blame me for it. You gave Dr Serrano the benefit of the doubt, I'll ask you to do the same for your former colleagues who may not have the luxury of not coming in and rounding when ill.

exdoctor said:

I'm afraid you are not getting my point. I apologize if I am going off topic a bit from some obvious other issues in the case itself, but I think this case and some of the responses to it raise a subtle issue. I agree that we are all appalled that they could make up a diagnosis and use it against Dr. Serrano ("punitive psychiatry"), but my point is that it seems from the language of the responses that this particular accusation, mental illness in and of itself, is especially appalling. And my question is, what makes this accusation one of the worse things they could come up with? All they had to say is mental illness, which could mean anything from psychopathic serial killing to depression or adjustment disorder. But they didn't even need to give a qualifier. To make my point a little clearer, I think the following survey might be revealing:

It is disgusting that the department heads accused Dr. Serrano of a diagnosis he did not have in order to fire him. But on the disgusting scale, rank in order what would make you most to least disgusted for them to have made up:

1. Accusation of substance abuse
2. First time DUI after a fun night at a stripper bar
3. Mental illness

Another question might be, of the above, which would be most likely to permanently end his career (not should, would). Insight from any lawyers or experienced physicians, especially if they sit on licensing boards or are PDs, would be very interesting. Also, for physicians, which one of the above do you think if you were accused of, whether true or not, would carry the most stigma? What do you think your peers would think carries the most stigma? I wonder what the response would be across specialties. I don't propose to know the answer, all I meant in my OP is that my impression from some of the postings is #3. Of note, regardless of how you answer, #1 and #2 are deliberate ethical violations, #3 is not. I think it is an interesting question, especially given that mental illness like depression and suicide is so prevalent among physicians (JAMA 2003 consensus statement, also see the American Foundation For Suicide Prevention ongoing campaign for doctors at www.afsp.org, or just read all the posts on this site!). There are also highly competent and successful physicians with some form of mental illness, including professors, including historical physicians (Addison suffered from severe recurrent depression and eventually jumped off a building). I recall there is even a professor of psychiatry at John Hopkins who is openly bipolar and has written about it. Why is this particular accusation so defaming, and why is it so important that it be proven untrue? (not saying there aren't other issues in the case) Just a thought experiment.

I apologize if I've made this too philosophical for you literal-minded surgeons to wrap your head around, but don't worry, you're impervious to the above anyway (and if you're not, you should be d@mn it!) (apologies also to my best friend, who is a surgeon, but strangely has a sense of humor). BTW, Winged Scapula, were you practicing safe medicine when you were on duty, so sick, that you needed to walk around with an IV?

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"Also, for physicians, which one of the above do you think if you were accused of, whether true or not, would carry the most stigma?"

The accusation of Substance abuse would be much more damaging to a doc's career than non-psychotic mental illness (depression, anxiety, etc). I know several docs on antidepressants.

Roofie said:

However, the psychiatrist that examined Serrano maybe did not want to get involved in a litigious situation. I would be curious to know if the Chair and PD contacted the psychiatrist before the examination and asked for a certain diagnosis. Maybe forcing the psychiatrist to testify under oath would put pressure on him or her to tell the truth.

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I'm pretty sure the psychiatrist said he didn't have anything, and that is what has most people up in arms.

exPCM's first post said:

After Lipsett and Freischlag fired Serrano on April 10 for performance reasons, Freischlag announced at a faculty meeting that Serrano was "undergoing counseling and was mentally ill," when in fact he was undergoing counseling only at Lipsett's insistence and his evaluators found no mental disorder, the complaint says.

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That, and the way they called all potential future employers and basically breached confidentiality/lied to ensure he wouldn't have a job is what disgusts me.

As for the mental health issue vs substance abuse issue, I agree with the replies; I see reports of far more physicians that have their licenses suspended for substance abuse than mental health issues. Granted, many substance abusers are probably self-medicating, but I don't think the taboo is still attached with mental illness so long as the physician isn't a danger to his/her patient.

To address which is more disgusting to make up, I agree that making up a mental health issue is more disgusting. Why? Because it takes a lot more effort on their part to make it up (must get a psychiatrist to corroborate their claims), thus making it more disgusting. It is easy to say he smells of EtOH when he comes to work; refuting it would simply be he-said, she-said (much more difficult to disprove). I guess, technically, making up the DUI would be the most disgusting because that would require the fabrication of a legal document (his ticket), but that is so near impossible that I can't see it being made up. My level of repulsion doesn't depend upon which false claim they make, but rather the effort they put into substantiating it.

The other thing to consider is that most posters here are medical students and residents. Most of us are still in an ego-centric stage of development despite our best efforts (and claims) to put the patient's needs first. Right now, it may be more frustrating for a resident to have a colleague who has to take two weeks off for "mental health reasons" than a colleague who comes in late occasionally because of a bender the night before, as the former increases the resident's workload more than the latter, thus making it a more damning diagnosis in the resident's eyes, especially because there is always some sort of oversight (the attending physician) to minimize any potential screw-ups made by the "drunk" or the "crazy" while in residency. However, when an attending I become, I'd much rather have a colleague who can safely take care of a patient than one who can't, regardless of the reason behind the inability to properly perform his/her job.

So much for philosophical discussions being over the head of this literal-minded surgeon...

SocialistMD said:

The other thing to consider is that most posters here are medical students and residents. Most of us are still in an ego-centric stage of development despite our best efforts (and claims) to put the patient's needs first. Right now, it may be more frustrating for a resident to have a colleague who has to take two weeks off for "mental health reasons" than a colleague who comes in late occasionally because of a bender the night before, as the former increases the resident's workload more than the latter, thus making it a more damning diagnosis in the resident's eyes, especially because there is always some sort of oversight (the attending physician) to minimize any potential screw-ups made by the "drunk" or the "crazy" while in residency. However, when an attending I become, I'd much rather have a colleague who can safely take care of a patient than one who can't, regardless of the reason behind the inability to properly perform his/her job.

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This is a great point.

I also agree w/the above comments that someone having depression or dysthymia (and being treated) who can think/function adequately, or only need a short leave of absence, would be far less damaging to a career than someone who is a substance abuser.

However, exdoc makes some important points, mainly regarding the stigma that mental illness still has in the medical community (and society at large) and the feeling that we docs should be "above it all" and able to withstand and and all levels of mental and emotional stress without any problem/weaknesses shown. I also think that treatment of students or residents with depression and other mental illnesses varies greatly among specialties and even among various hospitals/training programs within the same specialty. It's not uncommon to find a psych resident with some h/o mental illness, but much less common to find a surgical resident with one. Overall it is a complex issue - of course patient safety has to be our number one priority, but we can't, and shouldn't, throw away potentially good physicians because of a problem that is often treatable.

dragonfly99 said:

It's not uncommon to find a psych resident with some h/o mental illness, but much less common to find a surgical resident with one.

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That's right; we only carry axis II diagnoses...

Labslave said:

It really speaks to how unhappy people are that everyone is just blindly backing this dude. I met him personally and can say that he's one of the most arrogant, condescending people I've ever met in my life. Even if he was being worked to the bone and mistreated and abused, he's not going to have many of his fellow colleagues backing him because of his personality issues.

Although he may have your sympathies, I think many people that actually know him are going to have a much harder time feeling sorry for him...

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EXACTLY. My sister-in-law, a solid gold JHU grad, was his co-resident for three years. He was arrogant, condescending, and one of the biggest *******s to walk the earth. No one liked him-- co-residents, seniors, attendings.

He volunteered for the Hopkins TV show. Not many were interested.

There is so, so, so we can't know about this. What if, for example, his entire resume was a pack of lies? Trust me, I've seen stranger things-- entire fantasy candidates, in medicine/science/the Oxford scene whose resumes were nothing but paper dragons. It might well have merited a phone call to NIH (where many Hopkins residents do their lab years) for a blanket "do not hire." Perhaps his ABSITE scores were reflective of poor boards scores too, and poor grades, etc etc etc, which JHU was willing to overlook a first, a second, a third time... Perhaps a lot of things-- we don't know.

Hopkins is by no means pure as the driven snow, but they do in general have better things to do than systematically destroy someone's life just for kicks.

The use, however, of "disciplinary psychiatry" in medicine is disgusting. Of all fields, we should be the most sensitive and sympathetic to *real* mental health issues, let alone fabricate and stigmatize fake ones.

Medicine is about taking care of patients. I have known mean and arrogant physicians who really cared about their patients and took good care of them.

Although being popular will make it easier to work in a hospital environment, it should not be mandatory. Your personality should not place a target on your back that "nice and popular" physicians do not have.

It is ironic that sometimes the most liberal people are the most intolerant.

There is probably no merit to the claims of a paper dragon resume. These credentials were verified in the matching process as well as by his attorneys. The attorneys will not waste their money on a case that has no merit despite popular notions to the contrary.

Finally great ABSITE scores will not guarantee a great surgeon. The fact that the program graduated surgeons scoring in the bottom 1% who went on to be competent surgeons militates against the notion that great test scores make great surgeons. The test is easily passed by most people who devote several months to studying for it. Nobody graduates medical school without a proven ability to pass exams when it counts.

The reason their residents scored poorly on the ABSITE is an institutional one. Programs violate work hours thus reducing study time. Programs do not make a passing score mandatory and well known for promotion. Seniors tell juniors that it is ok to do poorly on the ABSITE. Seniors do poorly on the ABSITE and still pass their written boards.

The program's citing a low ABSITE score is a pretextual reason for Dr. Serrano's dismissal. If what you say is true, then the reason that Dr. Serrano got terminated was unrelated to the doctor-patient relationship but rather the doctor-doctor relationship. Often doctors, who have a poor relationship with another doctor, will use that animus to impart incompetence on the target of that animus. There is something just inately unfair and unjust about this common practice. There is a grave ethical problem in this profession, when its practitioners think it is acceptable to end another practitioner's career, based on subjective emotional feelings about that practitioner un-related to the doctor patient relationship.

In private practice, most physicians work independently of other physicians. I would not consider calling a consult "team-work." So even if Dr. Serrano was an A-hole, he could have still functioned effectively in the profession.

Roofie said:

Options 1 & 2 are easily refutable by Dr. Serrano.
Option 3 requires the support of a psychiatrist. When the Chair and PD trained, disciplinary psychiatry was common. Learned in the old ways, they probably thought that this option would be the easiest to achieve.

Deference is given to phsyicians. If a psychiatrist says you're crazy, who will society believe? You or the psychiatrist?
In the old days, the psychiatrist would do whatever the Chairman asked. Psychiatry has a dark past that it would sure like to forget.

However, the psychiatrist that examined Serrano maybe did not want to get involved in a litigious situation. I would be curious to know if the Chair and PD contacted the psychiatrist before the examination and asked for a certain diagnosis. Maybe forcing the psychiatrist to testify under oath would put pressure on him or her to tell the truth.

If such a scenario happened and a member of the conspiracy was leveraged to come clean, then Serrano's lawyers may ask the Assistant District Attorney to look into the possibility of RICO violations of Title VII or Title IX of the Civil Rights Act of 1964. RICO is usually used to go after gangsters, mafia, and physicians who engage in fraud.

Of course, Serrano's lawyer cannot explicitly threaten criminal prosecution in order to extract more money from the defendants. However, there are ways around this rule. Remember Kobe and the girl he bought off in Colorado? Or the pro-football player who killed a pedestrian while driving drunk?

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In order to be legally insane one must be ajudicated to be insane. The protection of the law may be the only protection a wrongly accused person would have, especially when dealing with well positioned people with the power to kill careers. I don't think $24 million is enough to reclaim his good name.

Most of you should build a statue to Troy Madsen for bringing down the work week for residents from 120 hours to 80 hours. He faced the Hopkins bully machine and was forced out but they had to change the way they do business. His suffering is why you only have a mere 80 hour work week.

Hail, Hail Troy.

DadofDr2B said:

======================================================
Most of you should build a statue to Troy Madsen for bringing down the work week for residents from 120 hours to 80 hours. He faced the Hopkins bully machine and was forced out but they had to change the way they do business. His suffering is why you only have a mere 80 hour work week.

Hail, Hail Troy.

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Actually, that would be a coke fiend named Libby Zion, her rich dad, and the Bell Commission.

BlondeDocteur said:

EXACTLY. My sister-in-law, a solid gold JHU grad, was his co-resident for three years. He was arrogant, condescending, and one of the biggest *******s to walk the earth. No one liked him-- co-residents, seniors, attendings.
He volunteered for the Hopkins TV show. Not many were interested.

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My experience is that there are a lot of " arrogant, condescending, big ****s" at Hopkins so that shouldn't really be a reason to do what they allegedly did to him.

I agree w/the above statement, but I think that's true about most all of the "famous" medical institutions. There are also a lot of really smart and capable people there, but some of them just aren't that pleasant as people.

I am sure Serrano's grades were good in medical school, and he did go to a pretty competitive medical school. He must have also had decent USMLE scores to get into the Hopkins surgical residency, and likely has research publications, etc.

If he is a jerk then that is a point NOT in his favor. I don't think it is irrelevant but I also think that we should be very, very careful before canning someone from a residency just over personality issues, unless those include extreme things like cussing people out, screaming and throwing surgical instruments, etc. Honestly, there were a couple of people in my residency who were just not popular, and one that I think had a personality disorder, but honestly was smart and medically competent...although I couldn't stand him, would not have wanted him fired...
There IS something very wrong in our medical system where people with just so/so skills and medical knowledge sail on in their training without a hitch, whereas oftentimes smarter and more competent people who have doctor/patient relationships that are just fine get canned because of some conflict(s) with a nurse or other doctors. Docs are a competitive bunch, particularly at a place like Hopkins, and sometimes it is easy for someone to become the "odd one out", so to speak. I'm not sure that being in such a position merits canning Dr. Serrano. If he was really so unbearable that it affected the overall atmosphere such that others couldn't do their jobs, then that could be grounds for corrective action - hopefully there could be something done short of firing him and ending his career. I'm also very skeptical that it was necessary to try and keep him from getting another job (in research...which requires a different skill set than clinical medicine anyway). I think Hopkins should have stayed out of that, even if they felt compelled to fire him from residency.

BlondeDocteur said:

Actually, that would be a coke fiend named Libby Zion, her rich dad, and the Bell Commission.

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Things are being conflated here. Troy Madsen "anonymously" reported multiple work hour violations to the ACGME, who clearly made it evident as to who he was (if you saw their report to JHU, the effort at confidentiality was almost nil), and then JHU just pilloried him, until he resigned. That led to JHU being sanctioned for work hour violations, and all sorts of Hopkins people defending their university, first as "we're not like that" (specific examples notwithstanding), then "my department is different from those departments".

Libby Zion died from what we now (years later) believe was the serotonin syndrome. The Bell Commission led to New York State-specific work hour regulations (by law), which did not apply, and were not applied, elsewhere in the US, with many, many of the "old guard" holding to the mantra of "I did it, so you will" (it was at Duke, and it was David Sabiston, Jr, who said "Q2 call means you miss half of the good cases").

The Bell Commission did a lot for NY residents. Until the Troy Madsen case, the rest of the country paid lip-service only to work hour limits.

Anyone seen or heard anything more about this story?

EaglesPA said:

My experience is that there are a lot of " arrogant, condescending, big ****s" at Hopkins so that shouldn't really be a reason to do what they allegedly did to him.

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I'm calling BS on this. Please cite your level of experience, years at Hopkins, and specific names.

BlondeDocteur said:

EXACTLY. My sister-in-law, a solid gold JHU grad, was his co-resident for three years. He was arrogant, condescending, and one of the biggest *******s to walk the earth. No one liked him-- co-residents, seniors, attendings.

He volunteered for the Hopkins TV show. Not many were interested.

There is so, so, so we can't know about this. What if, for example, his entire resume was a pack of lies? Trust me, I've seen stranger things-- entire fantasy candidates, in medicine/science/the Oxford scene whose resumes were nothing but paper dragons. It might well have merited a phone call to NIH (where many Hopkins residents do their lab years) for a blanket "do not hire." Perhaps his ABSITE scores were reflective of poor boards scores too, and poor grades, etc etc etc, which JHU was willing to overlook a first, a second, a third time... Perhaps a lot of things-- we don't know.

Hopkins is by no means pure as the driven snow, but they do in general have better things to do than systematically destroy someone's life just for kicks.

The use, however, of "disciplinary psychiatry" in medicine is disgusting. Of all fields, we should be the most sensitive and sympathetic to *real* mental health issues, let alone fabricate and stigmatize fake ones.

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I disagree with this characterization, especially with the blanket statement that "nobody" liked Serrano. Thats clearly and demonstrably false. I can list at least 8-10 names of surgical residents at Hopkins who liked Serrano and got along with him fine. I can also say that your description of Serrano "volunteering" for the TV show while everybody else declined it is misleading. ABC approached several people at Hopkins in the upper levels of management, including the president/CEO, the dean and vice dean, and the chairmen and program directors for surgery, pediatrics, internal medicine, EM regarding possible TV candidates. The Hopkins powers-that-be submitted a list, and then ABC contacted each of those people to determine if they were interested. Out of the 15-20 people they contacted, somewhere between 4-6 of them declined (Dr Cameron was one of these people). Out of the remaining 10 or so people, the ABC crew narrowed their focus to whom they thought would be the "most interesting" candidates, and Serrano made that list. If Serrano faked his resume, then Hopkins would have listed it as a reason for firing him, because its the only "slam dunk" reason they would have had for dismissing him among all the random BS they cited. Cmon, do you really think that Serrano indeed faked his resume but Hopkins chose to ignore that and just cite the psychological crap instead? No way. If Serrano faked his resume, then Hopkins woulda just cited that without going thru all the psychological stuff as a back door.

BlondeDocteur said:

EXACTLY. My sister-in-law, a solid gold JHU grad, was his co-resident for three years. He was arrogant, condescending, and one of the biggest *******s to walk the earth. No one liked him-- co-residents, seniors, attendings.

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There were a lot of people who liked Oscar. Still are. Residents and attendings (and even OR and office support, gasp and a half).

Is your SIL still @ Hopkins-- and where'd she come from? How was she liked? Her pic up on the Blalock walls?

Also, really? Arrogant? Condescending? Like that doesn't describe 96% of doctors, much less surgeons.

but they do in general have better things to do than systematically destroy someone's life just for kicks.

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I think you're underestimating their workloads.

Soc25, do you really want names?

ok, back 2 work.

I am not a resident but I have worked at Hopkins in 2007-2009 and I am very familiar with all the docs that works there since I deal with them all the time, in the vendor/doctor capacity.
Dr. Oscar Serrano, has always been professional in his dealings with anyone, even with someone such as myself who is not his peer nor his superior nor his staff in a work environment. Basically, whether he is nice to me or not, he has nothing to gain from it. And Dr. Serrano is truly a very nice person. He is humble yet confident and self assured, highly superior intellectual, he has a great understanding for human suffering. Dr. Oscar Serrano has never appeared to have any signs of mental illness nor WHY IN THE WORLD SHOULD HE? Dr. Serrano was featured in the ABC Hopkins series, if he was mentally ill, wouldn't you think the movie directors will see that? Movie directors are the most keen on human characterizations and what makes people tick. Dr. Serrano was appeared as the best/strongest first year resident surgeon/doctor representing Hopkins. Dr. Serrano always carries himself in an outstanding manner as a physician.
I am confident to say that Dr. Pamela A. Lipsett is the one with the mental illness and unscrupulousness for she kinda looks like she does, Shame on her for slander/defamation of Dr. Oscar Serrano's character and what she's doing is doing whatever it takes to ruin his career. Perhaps He refused her sexual advances and she hates him now. (You never know) The whole story doesn't make any sense, how they like him so much and now hates him and wants to destroy him, that goes for the sister-in-law who was co-resident with him 3 years and who is badmouthing him on this site as well.>Dr. Julie Ann Freischlag looks like she is too afraid to speak up what is right to keep her present position with the hospital so she is selling her soul to the devil. What they accused of Dr. Oscar Serrano is unfounded and a complete lie. I would not want her or Dr. Julie Ann Freischlag to touch me or operate on me. period.

BTW, it doesn't matter if you are an arrogant jerk at Hopkins you can still succeed. This one doc who always screams at me (I guess he can't control his temper) still works there and has became chief resident with his own corner office and a secretary. He never yelled at me again thou, I showed him that this is not okay and I always give him a hard time when he wants something. Now he is very nice to me but seldom stops by and avoids me by sending his secretary for things he needs. He is very afraid!!And unlike others, I know how to complaint to his department head if I am unhappy with the way he is acting towards me, since Hopkins are really easy to tackle when you are fearless. (but don't take my advice, find your own way to deal with mean Nurses and Bad people) And I believe that being an arrogant doctor is a beautiful thing, as long as the arrogance is not combined with traits of abusiveness. The abuse rate at Hopkins is so high I go home each week at least one day being angry (mostly from incompetent medical assistants). I guess bullies exist in all levels, even for the top of the pyramid. Most residents at Hopkins are outstanding consider all the pressures they go through and very little sleep.


Baltimore City is one of the worst cities I have ever lived in with integrity points in most people close to none.

After reading this thread, I think most people are missing the point. A lot of people here are talking about whether this guy is arrogant or caring. It is irrelevant. This isn't a popularity contest and that's not how you determine whether someone should or should not be fired. If it was, then 95% of the hospital, including nurses and attendings, should be homeless bums. People are talking about his ABSITE scores. Also irrelevant. The ABSITE cannot be used as a determinant in any way to fire someone. That is in-and-of-itself illegal.

What this all speaks to is the ease for institutional abuse. It is rather incredible that this case became public and it demonstrates, if anything, institutional arrogance. Hopkins clearly thinks that it can do anything it wants. Most residencies are like this, actually. The difference is that when it happens at a "big name" program, it becomes harder for someone to be maligned out-of-hand. If Bumble-eff County Community Hospital fires a resident, even if it becomes public, I bet 99% of you here just assume that it was deserved or no big deal. But if someone gets fired from BID or Stanford, suddenly everyone at least considers the possibility that the resident was unfairly fired.

Every move that was made by this program and this Program Director has been made or experienced by someone on this forum. Let's bring this thread back to where it really belongs, scrutiny of the program and NOT of the resident. Breaking work hours rules? That happens at lots of programs and guess what? People always try to excuse it by saying it happens "at lots of programs." If programs demand that residents follow rules, then there is no defense for a program breaking a rule. No resident should feel pressured or uncomfortable to report a program for breaking any rule. All of you holier-than-thou people who get off talking about medical ethics and care processes suddenly disappear when it comes to talking about making the program follow the rules. A Program Director can talk for hours on end about "your duty as a resident" or "what is expected of you" but as soon as the program is being investigated "standards aren't really important."

Coaching people what to answer to investigators? Guess what? That should immediately prompt the Program Director to be axed without any further question. That, in and of itself, demonstrates that the PD doesn't care about truth or regulations or rules. This is the entire problem. The ACGME has an expectation that the residents will report things, but how can they when they are essentially destroying their own careers, either by retribution or by the threat of closing their program? The fact that we have supposedly intelligent people on these committees who can't even figure out what every intern in America has realized demonstrates how out-of-touch all these bureaucrats are. It's why I have a total disdain and hatred for medical education as it is currently set up.

And now this guy has his background and performance being picked over by all of us, like we know or are qualified to do that. Instead, why don't we get people do that to the program or the Program Director? Let's talk about her deficiencies and look at her behavior with a microscope. Let's talk more about how underhanded she is and how she's trying to use institutional power to bully someone without power. Let's talk about how she tried to game the system by coercing residents to do what she wanted.

This guy has my total and undivided support and if he brings down Hopkins to its knees, even better.

BlondeDocteur said:

Actually, that would be a coke fiend named Libby Zion, her rich dad, and the Bell Commission.

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You really need to step back and keep your comments in check. You come across very arrogant yourself and spreading rumors about someone who you directly have not worked with is a red mark in my book. I certainly would not tolerate your BS in my residency. Talk when you have been through some sort of residency, especially a surgical one, and then maybe you would have some ****ing credibility. Until then, shut the **** up.

It is funny how everybody wants this to be true, so they can say "Big bad residency program got screwed just like they screw us! Yes!!"

Please, Hopkins isn't stupid. They didn't fire this guy without cuase and blame it on psych issues. THere is more there. The initial article even states that he was fired for performance reasons, not for mental illness. Actually the fact that he has no mental illness, makes his case worse. If he can't blame his performance problems on a medical/psych illness, JHU should fire him.

And please, the comments that "I knew him, and he couldn't be crazy" are just ludicrious. How many times do you hear this when the media interview the family or neighbors of a person who was arrested for some crime. You don't know the guy.

And people are ALWAYS coached to answer the ACGME. It's a problem if residents are asked to lie. But there is a proper way to answer questions posed by ACGME, JCAHO, etc. and employees are frequently coached to mention the key buzzwords that those guys want to hear.

wine is good said:

You really need to step back and keep your comments in check. You come across very arrogant yourself and spreading rumors about someone who you directly have not worked with is a red mark in my book. I certainly would not tolerate your BS in my residency. Talk when you have been through some sort of residency, especially a surgical one, and then maybe you would have some ****ing credibility. Until then, shut the **** up.

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For everyone else on this forum, your suggestion applies. For her, not so much. As far as I know, she's a Rhodes scholar and married to a hotshot Manhattan lawyer/trader. She basically walks on water and can say what she wants because she already has the "**** you money and cred" that the rest of us so desire to obtain.

tibor75 said:

Please, Hopkins isn't stupid. They didn't fire this guy without cuase and blame it on psych issues. THere is more there. The initial article even states that he was fired for performance reasons, not for mental illness. Actually the fact that he has no mental illness, makes his case worse. If he can't blame his performance problems on a medical/psych illness, JHU should fire him.

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Actually, there isn't more there. If you're a physician, you're well aware that "performance reasons" is about the most vague criteria in the world. I could take almost anyone you wanted and make them look like an incompetent dolt if you knew nothing about them. Throw in the fact that when residencies fire people, they tell all the attendings what story to tell, and it's pretty open-and-shut. I mean, unless you're completely clueless because you're some new junior attending. In that case, sorry.

tibor75 said:

And please, the comments that "I knew him, and he couldn't be crazy" are just ludicrious. How many times do you hear this when the media interview the family or neighbors of a person who was arrested for some crime. You don't know the guy.

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And yet you're relying on the same argument when it comes to Hopkins, which doesn't make you look that intelligent.

tibor75 said:

And people are ALWAYS coached to answer the ACGME. It's a problem if residents are asked to lie. But there is a proper way to answer questions posed by ACGME, JCAHO, etc. and employees are frequently coached to mention the key buzzwords that those guys want to hear.

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That just means that you're aware and complicit with lying to an institutional oversight body. No wonder you're on the side of marvelous, wonderful Hopkins.

Substance said:

For everyone else on this forum, your suggestion applies. For her, not so much. As far as I know, she's a Rhodes scholar and married to a hotshot Manhattan lawyer/trader. She basically walks on water and can say what she wants because she already has the "**** you money and cred" that the rest of us so desire to obtain.

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That explains everything. I did not know that, but, now it all makes sense. I should have known, given that she lists all of her accomplishments in her signature. I still think she should shut the....well you know.

As for Serrano, I feel bad for this guy and hope he has his day in court. We RESIDENTS know how it feels to be bullied, and mistreated and should be careful not to belittle one of our own, especially someone who seems to have been a star at some point.

By the way, there's a website that publicly explains this lawsuit, I don't know if anyone else posted it. It's a good read and should be seen by anyone who wants to know Serrano's side of the story.

http://www.semmelweissociety3.net/oskarkserranomd/

tibor75 said:

Please, Hopkins isn't stupid. They didn't fire this guy without cuase and blame it on psych issues.

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You are right.

There was a cause.

That cause is most likely not something you could get fired for, because interpersonal differences aren't adequate to terminate someone... officially

Which is why Hopkins has to blame it on psych issues, or at least tried. And then resorts to something vague, and hopes the court will rule that there is no possibility to overthrow the decision due to inadequate medical authority of the court and impossible evaluation of his performance without resorting to circumstantial evidence.

How I wish Hopkins got screwed over. I think it will end with a wish.

glade said:

Actually, there isn't more there. If you're a physician, you're well aware that "performance reasons" is about the most vague criteria in the world. I could take almost anyone you wanted and make them look like an incompetent dolt if you knew nothing about them. Throw in the fact that when residencies fire people, they tell all the attendings what story to tell, and it's pretty open-and-shut. I mean, unless you're completely clueless because you're some new junior attending. In that case, sorry.



And yet you're relying on the same argument when it comes to Hopkins, which doesn't make you look that intelligent.



That just means that you're aware and complicit with lying to an institutional oversight body. No wonder you're on the side of marvelous, wonderful Hopkins.

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Being coached by a residency program does not equate lying.

Please point out the provision in ACGME guidelines that prevent programs from having informational sessions (i.e. coaching) iwth their housestaff.

Residencies fire incompetent people. But if you read this board, they fire the best and brightest. Comical.

Not surprising there are those here that feel sorry for a ex-resident who murders the person responsible for his (correct) firing.

tibor75 said:

Being coached by a residency program does not equate lying.

Please point out the provision in ACGME guidelines that prevent programs from having informational sessions (i.e. coaching) iwth their housestaff.

Residencies fire incompetent people. But if you read this board, they fire the best and brightest. Comical.

Not surprising there are those here that feel sorry for a ex-resident who murders the person responsible for his (correct) firing.

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Murdering is not sufficient in my book, if the SOB ruins the career of that individual. What's comical is that you think that's okay. But, I'll chop it up to you being on the side of the higher up. Which is fine. We all have our opinion. But, if they did ruin his career by making phone calls, then...I think it speaks for itself.

KInd of reminds of me of the movie "Philadephia." They have an ace junior lawyer, who they say they were testing out by giving him their most important account, but who they thought was not very good. Didn't make a whole lot of sense to the jury, as it shouldn't.

tibor75 said:

Being coached by a residency program does not equate lying.

Please point out the provision in ACGME guidelines that prevent programs from having informational sessions (i.e. coaching) iwth their housestaff.

Residencies fire incompetent people. But if you read this board, they fire the best and brightest. Comical.

Not surprising there are those here that feel sorry for a ex-resident who murders the person responsible for his (correct) firing.

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Hey, I know, since you don't think being coached on how to respond on residency surveys is a crime or a violation, please tell us which program you're from that does that. You don't have to tell us which specialty it was and you're presumably anonymous. Also, nobody will mind, so that's not even an issue. Ball's in your court, tough guy.

Also, residencies fire incompetent people. They also fire people who are competent and they also promote people who are incompetent. Residency is more about being able to navigate political waters than anything else. I'm sure you were a star resident, regardless of whether or not you were a great physician, seeing as you're a total kiss-up to residency administration.

I think it is far too easy to fire residents.

glade said:

Hey, I know, since you don't think being coached on how to respond on residency surveys is a crime or a violation, please tell us which program you're from that does that. You don't have to tell us which specialty it was and you're presumably anonymous. Also, nobody will mind, so that's not even an issue. Ball's in your court, tough guy.
.

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Uh, actually no, genius, the ball is in your court, "tough" guy (telling somebody to be tough on the internets...always a laugh). If you claim something is illegal, you have to point out why it is. So, please tell me where in the ACGME guidelines, it says that residents are to be given no guidance when answering questions.

kavedweller said:

I think it is far too easy to fire residents. It is my opinion that after so many years of sacrifice it should take an act of congress to fire a resident. You are earning miserable wages which is not even paid for out of the pocket of the program but the taxpayers. Then the system is set up in such a way that the resident can't have a fresh start elsewhere. They will always have to get explain the circumstances of their termination or non-renewal. Since the ACGME has all the power of accredidation and number of positions open in a program, they should have a proactive resident advocacy group. They should have a means of moving residents to other hospitals if their employment is not working at their current program. It is such a shame that after so much work and sacrifice you can be fired and you are out on your own to hunt down another spot.

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Too funny. THe level of arrogance and entitlement is amazing.

In no other job do you have any say if you get fired or not. Your boss is almost any profession can fire you on the spot. No questions asked. In fact, it is the low pay of residents/fellows that makes them hard to fire. Why would you fire cheap labor?

but of course programs left and right fire competent people. Suuuuure...

tibor75 said:

Uh, actually no, genius, the ball is in your court, "tough" guy (telling somebody to be tough on the internets...always a laugh). If you claim something is illegal, you have to point out why it is. So, please tell me where in the ACGME guidelines, it says that residents are to be given no guidance when answering questions.

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I see you're not willing to identify which program participates in "legal" practices for some reason. You don't sound that intelligent.

wine is good said:

That explains everything. I did not know that, but, now it all makes sense. I should have known, given that she lists all of her accomplishments in her signature. I still think she should shut the....well you know.

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someone needed to say it

tibor75 said:

Your boss is almost any profession can fire you on the spot. No questions asked. In fact, it is the low pay of residents/fellows that makes them hard to fire. Why would you fire cheap labor?

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This statement is almost as dumb as it gets. It demonstrates a total lack of understanding of the residency system as it exists today. Either that or his lips are locked with the behind of the residency program concept, so he can't see anything else.

Well this story has thoroughly scared the crap out of me.

I start residency in a few weeks. A hopkins resident getting fired... Does hopkins just fire a lot of residents or was this relatively rare. How common is it to get fired from any program?

exPCM said:

It looks like the ACGME reports 279 residents were fired in 2008-9.

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And 28 died?!?

tibor75 said:

In no other job do you have any say if you get fired or not.

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In no other job, you are trapped at your employer's whim in order to be allowed to use your acquired knowledge.

Political issues galore in job life, but people with different educations can go elsewhere and start over.

The regulation of the medical profession, allows for great abuse.

tibor75 said:

Too funny. THe level of arrogance and entitlement is amazing.

In no other job do you have any say if you get fired or not. Your boss is almost any profession can fire you on the spot. No questions asked. In fact, it is the low pay of residents/fellows that makes them hard to fire. Why would you fire cheap labor?

but of course programs left and right fire competent people. Suuuuure...

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Well, I thought residency is part of medical education in the form of clinical training instead of a regular job, am I wrong?? If we look at it as part of education, then i don't see there is any entitlement issue here. An advocate party for residents is appropriate to make sure the education is adequate and make sure residents are not being exploited in all aspects or being wronglfully fired.

deuist said:

And 28 died?!?

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Wouldn't it be interesting to know the causes of death? How many car accidents, how many suicides, things like that. The only residents I have ever known who have died were accidents or horrible rapidly progressing cancers.

exPCM said:

It looks like the ACGME reports 279 residents were fired in 2008-9.

http://www.acgme.org/acWebsite/annRep/an_2008-09AnnRep.pdf

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lipomas said:

Wouldn't it be interesting to know the causes of death? How many car accidents, how many suicides, things like that. The only residents I have ever known who have died were accidents or horrible rapidly progressing cancers.

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So from the report it looks like there were 109,482 residents that year. If 28 died that's 0.03%. How does that compare to the death rate for a comparalbe cohort of young people?

I think the death rate for 25-35s in the US is something like 0.1%.

I think this site confirms that: http://www.data360.org/dsg.aspx?Data_Set_Group_Id=587

I did not look into the most common causes of death, but I am pretty sure that the #1 cause of death is still Chuck Norris.

Interesting. So for American teenagers 12-19 which was the closest to a young, healthy population that might be extrapolatable to residents I could find the death rate is about 0.05%

What is the risk of dying for teenagers 12-19 years?
Each year from 1999 to 2006, the annual death rate for teenagers has averaged 49.5 deaths per 100,000 population.

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Link to above stats at CDC

Now the higher rate than the 0.03% for residents might be attributable to the relatively high rate of homicide and traumatic death from risk taking behaviors seen in that age group which would presumably be less in residents. It doesn't appear though that the resident death rate is an anomaly due to residency. Having causes on those 28 would be illustrative although the traffic accident issue would bear further study. Unless you looked at the actual particulars of each accident it might not point to a greater incidence among residents. When people in that age group die it tends to be from accidents like car crashes.

lipomas said:

I think the death rate for 25-35s in the US is something like 0.1%.

I think this site confirms that: http://www.data360.org/dsg.aspx?Data_Set_Group_Id=587

I did not look into the most common causes of death, but I am pretty sure that the #1 cause of death is still Chuck Norris.

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Although all Chuck realted fatalities get listed as "natural causes" because Chuck Norris is a force of nature.

I want to know how many of those residents who "left/withdrew" were pretty much fired (i.e. told to leave or else they'd be fired). There is probably a fair number.