"an occupational problem"

[izzygoer]

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Local heart doctor fined for striking another doc

The Daily Sentinel
Thursday, June 04, 2009

A local heart surgeon was publicly reprimanded and fined $5,000 last Friday by the Texas Medical Board for striking an anesthesiologist during an emergency operation two years ago at Nacogdoches Memorial Hospital, according to information released by the Texas Medical Board.

In the final judgment handed down against Dr. James Young, it states that the incident occurred after he had installed a pacemaker into a patient and left the hospital on April 2, 2007. When the man began bleeding in the intensive care unit, Young was called back to the ICU where the patient was already receiving CPR and it became necessary to open the man's chest then and there.

Young reported that at the time there were "several procedural failures" with regards to inadequately prepared equipment needed to perform the "tense" surgery properly.

Because of this, the man was rushed into the operating room, and when his blood pressure dropped significantly Young began screaming and verbally abusing medical staff, in particularly the anesthesia team as they tried to stabilize the patient, the report said.

When one of the anesthesiologists cursed back at him, Young struck the other doctor in the head, according to the report. The anesthesiologist then left the room, the situation calmed down and Young completed the surgery successfully. Following the incident, various staff members at the hospital reported concern over Young's anger level during the procedure, and he was subsequently suspended indefinitely by the hospital and reported to the Texas Medical Board.

Young is currently listed as the only heart specialist at Nacogdoches Medical Center with private offices in Lufkin and Nacogdoches, but their registry notes that physicians who perform services at the center are independent contractors and not employees.

In May of 2007, a preliminary psychiatric evaluation concluded that Young had no mental disorders and that the situation was merely an "occupational problem." However, it was recommended that he receive treatment for his anger issues from The Center for Professional Well Being in Durham, N.C.

In July of 2007, Young attended an intensive two-day course at the aforementioned facility where he fulfilled all the requirements of the course and in addition completed an anger management course at the University of California in San Diego. While this is the only time Young has been disciplined by the board he had twice before been reprimanded by hospital officials, the report said.

Several years ago, he was admonished for yelling at another doctor, and about five years ago he was suspended for two weeks for shouting at a female technician who was "not up to speed." Young was quoted as saying in the report.

Young has until the end of June to pay the fine. The Daily Sentinel placed phone calls to Young and Nacogdoches Memorial Hospital Administrator Tim Hayward, but neither men were available for comment and did not reply back by press time on Thursday.

http://www.dailysentinel.com/news/content/news/stories/2009/06/04/doc_fined060509.html?imw=Y

 

[Dejavu]

This is why if I never do another case in the cardiac corridor it will be too soon. It seems where ever I go, whoever I meet in cardiac, they all have "attitude".
If a surgeon ever struck me, he better be prepared to get his #ss kicked because I am coming at him. I still remember some stuff from my Marine Corps days.

This is typical unprofessional behaviour seen from surgeons everyday across the country, but since they bring pts to the hospital, everybody just looks the other way and says "Oh, yeah, that's just the way he is."

Totally inexcusable. Should lose his privileges and be fired.

 

[Jeff05]

if you have issues with surgeons, etc. (not just the typical once in a while b2tchy outbursts), PUT IT INTO WRITING. send it to your chair/program director.

JHACO has new guidelines regarding disruptive physician behavior and its influence on patient care. probably the one good thing they're doing. and you know how hospital administrators love to suck off JHACO. these things will be taken seriously, especially if there are multiple incidents.

as far as this particular story - the board MUST revoke this guy's license for a period of time. the anesthesiologist should press charges for assault. this kind of stuff (physical assault) should be ZERO TOLERANCE.

 

[ProRealDoc]

This is why if I never do another case in the cardiac corridor it will be too soon. It seems where ever I go, whoever I meet in cardiac, they all have "attitude".
If a surgeon ever struck me, he better be prepared to get his #ss kicked because I am coming at him. I still remember some stuff from my Marine Corps days.

This is typical unprofessional behaviour seen from surgeons everyday across the country, but since they bring pts to the hospital, everybody just looks the other way and says "Oh, yeah, that's just the way he is."

Totally inexcusable. Should lose his privileges and be fired.

You could use a bit more finesse. He should just feel the mild pinch of a 25g needle, with a syringe attached to the other end of it...full of sux.

 

[jetproppilot]

Had he hit ME,

I WOULDDA KNOCKED THE MUTHAF U K K A OUT.

COLD.

Then would've calmly walked over to the OR phone and dialed 0.

Operator picks up:

"Yeah, hey it's Doctor Jet. Who's on call for CT tonight?"

 

[Noyac]

Had he hit ME,

I WOULDDA KNOCKED THE MUTHAF U K K A OUT.

COLD.

Then would've calmly walked over to the OR phone and dialed 0.

Operator picks up:

"Yeah, hey it's Doctor Jet. Who's on call for CT tonight?"

That dude never would have thought about touching you though.😀

 

[Noyac]

This is a good thread. Let's say it happens to you. You retaliate and mop the OR floor with his sorry arse. Who's going to be reprimanded most, him for hitting you or you for finishing off the f*chchop?

Assuming there is no previous written complaints on either.

 

[Noyac]

I do feel as though these arrogant egotistical surgeons are becoming more and more rare.
Probably because the lesser achieved, lesser accomplished, less bright med studs are going into surgery these days.

 

[flashgordon]

Unacceptable behavior. Only problem is he's the only CT surgeon in the area, so knocking him the f*ck out would result in 2 lawsuits... I think the anesthesiologist did the right thing (except for swearing back).

 

[doctor712]

Unacceptable behavior. Only problem is he's the only CT surgeon in the area, so knocking him the f*ck out would result in 2 lawsuits... I think the anesthesiologist did the right thing (except for swearing back).

Then maybe he should have simply been knocked out, but with less depth of sedation. 😀

I couldn't turn the other cheek. Then again, I'm 6'4''. I'm not sure I would have had to.

D712

 

[seamonkey]

Knocking the mo-fo out seems like the right thing to do, but with the patient needing emergency surg, seems like one would be up a creek if you did so....its a shame, too, 'cause this guy really needs a boot to the head

 

[coprolalia]

I do feel as though these arrogant egotistical surgeons are becoming more and more rare.

Might be true, except for cardiothoracic and neurosurgery it seems.

Probably because the lesser achieved, lesser accomplished, less bright med studs are going into surgery these days.

Maybe has more to do with systematic changes and expecting residents to simply follow protocols instead of think, as well. When you create a "groupthink" system, everyone has a say and a valid opinion. And, therefore, no one is ultimately to blame when something goes wrong.

----------------------------------------------------

To me, sounds like a simple case of "over-frustration" and inability to effectively manage and cope with stress. Most strong-willed, opinionated people (doctors included) have a vision and idea about how things should go. When they don't see that vision being fulfilled, they get frustrated. Frustration leads to anger. That surgeon probably felt like the only way the problem was going to be fixed was for him to quickly get in there and fix it. He probably felt like, for whatever reason, he was being stalled by the anesthesia team. He was probably pissed that his trophy girlfriend/wife was still sitting in the nice restaurant where he left her to come back in. There could be a whole host of egocentric reasons why he reacted the way he did.

In that light, this also demonstrates lack of empathy on a fundamental level. Probably unchecked narcissism, too. It seems to be a common trait among CT surgeons. I've noticed many of them tend to exaggerate their successes and, at the same time, minimize or excuse their own failures. If an easy case goes well, then, "you know, you see, there's a reason why it went well because I'm great and whatnot." But, when a patient has a bad outcome it's blamed on piss-poor protoplasm, crappy targets, lousy veins, someone interfering with their ability to give care, etc., etc.

All in all, I think the situation was handled correctly by the State Board. But, a "two day" anger-management seminar? Come on. That's like trying to put a bandaid on a bleeding femoral artery.

We are incredibly bad, in general, in medicine at identifying and resolving problem physicians and nurses. We are bad personnel managers. The troubled employee's skills often trump their bad behavior, and people look away. What we don't need is more policy, though, to correct this bad behavior. There's already plenty of policy out there already. What we do need is strong leadership at the hospital administration level who state, without equivocation, when someone's behavior is out of line. This goes to the core values of being a physician, and the expectations that one will act professionally both with patients and work colleagues. And, sometimes people need to be reminded of that.

Also, some people in this profession, as many can attest, are bordering on mental illness. Maybe it's stress? Maybe it's a personality disorder that self-selects for the field? Could be a host of things. But, again, you have to identify the individual, call them out on it, and at the very least make their existence in an institution difficult... even to the point that maybe they leave the institution. For this, you don't need some document in a binder telling people how to act. You just need balls.

-copro

 

[pmichaelmd]

I tend to agree, if anybody thought about striking me, particularly in the head, they had better be ready to get mopped up. Like D712, however, I don't know that I'd have the same problem as I'm 6'5". Size tends to discourage that kind of nonsense. 👍

PMMD

 

[foil]

.

 

[pgg]

You could use a bit more finesse. He should just feel the mild pinch of a 25g needle, with a syringe attached to the other end of it...full of sux.

I think I'd go for the ultra-low resistance 16g short needle. It would take a long time to squirt 5 or 10 cc of succ through a 25g needle. With the 16g he'll feel the pinch, but he'll have 200 mg in his ass by the time he can do anything.

This is a good thread. Let's say it happens to you. You retaliate and mop the OR floor with his sorry arse. Who's going to be reprimanded most, him for hitting you or you for finishing off the f*chchop?

Depends - is this a real assault, or a furiously frustrated loss-of-composure girly-slap that's more insulting than dangerous? Immediate retaliation is a bad idea unless you're truly in danger of sustaining injury.

• The patient is now on his way to that cold room in the basement, because his doctors got sidetracked while he died.
• It probably hurts your own lawsuit prospects to be the one standing over the bloody remains of the other guy.
• And like you say, maybe it'll be you pleading your case before the medical board and/or jury. Life's not fair; I keep telling my kids it's the 2nd guy to throw a punch who gets caught and punished.

I think the delayed gratification from seeing his license suspended or revoked would outweigh the pleasant feel of inflicting an orbital floor fracture.

Like they'll tell you in every concealed handgun class, just because you may be clearly justified in shooting the other guy doesn't mean that the legal fallout (a guaranteed civil suit if nothing else) is a fair trade. De-escalation and avoidance is nearly always the better path, if your own stupid ego will allow it.

 

[Bertelman]

...Life's not fair; I keep telling my kids it's the 2nd guy to throw a punch who gets caught and punished.

Do you tell them right after you deliver a little "love tap"?

Just kidding, seriously, but I couldn't resist. I'm sure you don't really hit your kids.





I sure feel like hitting mine sometimes.

 

[pgg]

I sure feel like hitting mine sometimes.

Sometimes I imagine taking our rottweiler's shock collar off and putting it on my oldest son. The "5" setting gets the dog's attention, but it goes up to 10 (12 with the boost button) ...