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letters of recommendation

Discussion in 'Anesthesiology' started by urgewrx, Apr 8, 2007.

  1. urgewrx

    urgewrx 2+ Year Member

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    Mar 16, 2007
    There is an interesting article in the Anesthesiology Newsletter about the liability of writing a LOR. Basically, an anesthesiologist was "allowed to resign" from a group based on suspected drug diversion and failure to answer his pager. He goes to work in another group in the same state. He had 2 letters of recommendation from his old group that read "he will be an excellent asset to you group" with no mention of the reason he had to leave the group. Some time later the guy gets sued for a cardiac arrest during a simple case and he accepst his drug diversion. The injured part wins the case for 8 million and the 2 anesthesiologists who wrote the LOR are liable for 5% and 20% of the 8 million.

    Makes you think twice before writing a LOR.
     
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  3. Hawaiian Bruin

    Hawaiian Bruin Breaking Good 10+ Year Member

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    Mar 13, 2003
    Fixed your post.
     
  4. Gern Blansten

    Gern Blansten Account on Hold 10+ Year Member

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    Failure to mention narcotic abuse and diversion of narcotics is a pretty big oversight. One way to approach it is to simply write:

    Dr X X was in this group from date x to date x. If you desire any further information, please feel free to contact me at 555-1234.

    The problem you get into is with the person that left saying that you slandered them if you write anything disparaging and the above situation if you do not.

    I think the way I would approach it is the following:

    If narcotic abuse was known and proven, mention it in the letter (note, you don't necessarily need to say that he/she is a bad person, just state the facts) In fact you may feel that they are a wonderful person with a terrible disease. It is okay to mention their good qualities as well, but to leave out something known or proven that could put the group and their patients at risk is not ethical IMHO.

    If narcotic abuse was suspected but never proven, I would approach it as above by simply stating the dates of employment and stating that the person should contact you for further information. At that point, terms of the seperation from the group could be discussed candidly with the person without having to commit it to writing for lawyers to dissect.

    These are simply my opinions. I would love to hear others thoughts on this. It is definitely a touchy subject.
     
  5. urgewrx

    urgewrx 2+ Year Member

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    Mar 16, 2007
    It's a delicate issue. It's easy to agree that nobody wants to lie and thus, be liable. But, when nothing has been proven, can you go around saying that you suspect drug abuse? What are the chances of a person getting a job if somebody unjustly, because they don't like the person, says they are suspect of drug use? is it fair to ruins somebody's career based on suspicion?​
     
  6. Gern Blansten

    Gern Blansten Account on Hold 10+ Year Member

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    For me, it would have to be beyond the shadow of a doubt to state that it was supected. Of course, if it was suspected, they would be tested. If they left the group after refusing to test, to me that would be almost as good as an admission of guilt. So, I can think of few times when it would be suspected, but unproven. Options for those who go down this path are quite limited. I would not say that no one would ever intentionally raise that suspicion based solely on their dislike of a person, but there will be a special place in hell for anyone who would do that to another human, no matter how despicable they might be.
     
  7. urgewrx

    urgewrx 2+ Year Member

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    Mar 16, 2007
    Fentanyl does not show on tests and is the most abused drug in anesthesia. Unless they confess, or are found unconscious on the floor, it's hard to prove anything.
     
  8. Stimulate

    Stimulate 2+ Year Member

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    Nov 9, 2006
    To me there are two ways to handle it:
    1) Gern's post
    2) Simply do not write a letter of rec for someone unless you would want them taking care of you or your family. There is no shame in telling someone you don't feel comfortable supporting them with a letter. If they really persist in asking I would ask them to write a sample for me, including a fair description of their narcotic-related issue. Then you can negotiate with him/her about what you will or will not be willing to sign. This would dissipate their ability to sue you later because they agreed to the wording of the letter.
     
  9. Gern Blansten

    Gern Blansten Account on Hold 10+ Year Member

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    That is an interesting idea that I had not thought of. It may be pure brilliance.
     
  10. huron

    huron 2+ Year Member

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    Nov 14, 2006
    Letter of recommendation serves no purpose whatsoever. The add nothing of value to screening potential employees. Any information supposedly obtained from a LOR suspect at best.

    They can easily be faked, only 1/5 of people I write letters of recommendation do I get a phone call and if someone was really adamant or has something to hide they could get a friend to pretend to be an ex colleague. With prepaid cell phones you can pretend to live anywhere for less than $40.

    Even if you really want to use a real person are you going to ask anyone who will evaluate you poorly? I have done locums so I burn though recommendations. Ever job I go to one of the first things I do is size up the anesthesiologists and surgeons and look for the best bet for letters for my next gig. Most locums people know how the game is played and will gladly write you a glowing recommendation if you will do the same for them.

    From a liability stand point unless you have personal knowledge that someone is an addict or grossly incompetent . Your liability should be next to none so long as you write a positive recommendation.
     
  11. zippy2u

    zippy2u Senior Member 5+ Year Member

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    Feb 19, 2005
    Huron is spot on in regards to this LOR matter. LORs are rather ridiculous and juvenile. Credentialing time comes around, I just throw 3 names down and provide their phone #s. I don't even bother asking the physicians personally for a reference. It is rather lame, but does give the credentialing staff the idea that this LOR thing is totally bogus. While I'm on my rant another bogus issue is to pay the credentialing staff extra money to credential you-- it varies from $50-$150.00. I never pay it and if asked about it I tell the head credentialing squirrel that their job is to credential physicians and should pay their workers an adequate wage to do their job. I don't pay the garbage men extra to pick up my trash. Dammit don't beg from me. Regards, ---Zip
     
  12. urgewrx

    urgewrx 2+ Year Member

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    Mar 16, 2007
    Dude, I got charged $250 for credentialing at a university hospital. WTF!! I'll see if I get reimbursed.
     

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