Shaughnessy vs. Duke University (Anesthesiology)

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peachesorangesapples

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Current lawsuit between former anesthesiologist at Duke Dr. Shaugnessy and the Duke Anesthesiology department. Makes for interesting reading. The chair Mathew and his minions sound bat-**** crazy. God what a ****ty human being.

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Two sides to every story. These are allegations.
 
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Wible makes some good points though. And that’s the only narrative that I’ve seen.

I’ve never been in somewhere as big as Duke. Better/worse/same? Don’t know.
 
If there’s a mishap with a patient, you have a department wide M+M. When something like this happens, it is swept under the rug. There’s no effort to make any corrective actions or support the survivors. Leadership wants these events to be forgotten.....quickly.
 
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That part I understand very much. It looks bad, and everyone lose face and credibility.
Just thinking about Atrium Health and the anesthesiologist, all i know is what I’ve read from here. It’s fairly big deal, but will never know the whole story.
 
Duke offers fantastic training and there was nothing I didn't feel prepared for after residency. As I get farther and farther from residency and my N of non-Duke residents and fellows to compare to grows larger, I can say that Duke is probably one of the top 5 programs in the country.

BUT, that lawsuit and the Pamela Wible lawsuit are 100% fair representations of the culture. While the exact wording of the conversations may be off because it's hearsay, having known most of the major players in that lawsuit, I have no doubts the general gist of the meetings was exactly as described.

The anesthesia resident in question committed suicide the year after I left. She was an intern when I was a CA-3, so didn't really know her. The peds resident referenced in the Pam Wible article committed suicide my CA-2 year. His wife was an OB/GYN resident. I was with her in the OR the day before it happened. I didn't know about the IM resident/fellow. Duke draws highly motivated individuals, has very high expectations of them, and while I wouldn't describe it as malignant, offers very little support. It's a dangerous combination for people who are at-risk for such things.

I suspect Duke settles the lawsuit. Not because they'd lose (I think it'd be a tough one for Shaughnessy to win), but because so far this whole shebang has managed to stay on the hush-hush, even locally, and Duke has a vested interest in keeping it that way. Duke is all about "protecting the brand," which is what got them into this mess in the first place, but will also lead them to settle to keep it from being litigated in the news.
 
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Wible makes some good points though. And that’s the only narrative that I’ve seen.

I’ve never been in somewhere as big as Duke. Better/worse/same? Don’t know.
Same or worse. The best jobs are in small groups. In cacademia and anything bigger than about 10 people, one is as appreciated as the softness of one's tongue on the boss's butt. Nothing else comes close, except maybe how much profit one makes them.

No malignant program is worth the stress. I refused out-of-match positions at two good name programs, one being a huge brand in critical care and anesthesiology, for that reason. I may have a smaller brand on my fellowship diploma, but it was the happiest and most instructive year of my GME. Just my 2 cents.
 
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There’s a good chance that this Vice Chair was recorded making those threats about “sabotage” and “blacklisting.” Anyone who says those kinds of things these days is an absolute idiot. You must assume you are always being recorded. I bet this Shaughnessy guy gets a nice little payday and this Vice Chair gets to start checking Gasworks again.

No harm in pressing that record button on your iPhone whenever you have an important meeting. You never know when someone may say something useful.

It’s not just Duke that has a vested interest in keeping suicides hush-hush. It’s all hospitals and medical systems. A resident or physician commits suicide and it’s always swept under the rug. Anthony Bourdain kills himself and there is national outpouring of grief. A physician kills himself or herself and the local community doesn’t even find out about it. Not that there should be front page newspaper articles, but a candlelight vigil would draw attention to the fact that medical training and the healthcare system itself is rotten to the core.
 
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North Carolina is a one-party state. Ouch! You can bet that they are on tape.
 
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No harm in pressing that record button on your iPhone whenever you have an important meeting. You never know when someone may say something useful.

Some states require two party consent. Evidence obtained illegally might not be admissible, and might get you in legal trouble all by itself.

In those places, it's best to begin every conversation, with every person, every time, with "this conversation may be recorded for quality assurance purposes" to keep everyone off guard, just in case someday you need to secretly record a conversation. They'll think you're weird but you'll get the last laugh in court.
 
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Some states require two party consent. Evidence obtained illegally might not be admissible, and might get you in legal trouble all by itself.

In those places, it's best to begin every conversation, with every person, every time, with "this conversation may be recorded for quality assurance purposes" to keep everyone off guard, just in case someday you need to secretly record a conversation. They'll think you're weird but you'll get the last laugh in court.

Yes, it’s important to know your state laws. North Carolina happens to be a one-party consent state.
 
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Beware of reading a lawsuit and taking it for gospel - it’s nearly always just one side and facts are typically exaggerated.

I have close friends that have trained and now work there... it’s a rough atmosphere and a demanding post but pays significantly better than other comparable institutions (and much lower cost of living than say, Boston). The surgeons there are often legendary d-bags who you really don’t want to cross. Those who are successful there play a much more political game than is typical in academic posts.
 
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I have close friends that have trained and now work there... it’s a rough atmosphere and a demanding post but pays significantly better than other comparable institutions (and much lower cost of living than say, Boston).

UNC and Wake Forest pay better than Duke. Their starting salary for an attending barely tops $200K. They do have some nice benefits, but they don't pay significantly more than anybody. And while cost of living is certainly cheaper than Manhattan or San Francisco or Boston, well you still aren't making bank.
 
UNC and Wake Forest pay better than Duke. Their starting salary for an attending barely tops $200K. They do have some nice benefits, but they don't pay significantly more than anybody. And while cost of living is certainly cheaper than Manhattan or San Francisco or Boston, well you still aren't making bank.

Your salary is highly dependent on which division you join. And I was comparing to Boston and NYC high-level academics more than nearby ones.
 
Your salary is highly dependent on which division you join. And I was comparing to Boston and NYC high-level academics more than nearby ones.

no it isn't. I received written offers from two of their divisions and know people that work in several of them. Their is very minimal variance. They don't pay squat. And they certainly aren't paying a lot more than MGH or BWH.
 
Your salary is highly dependent on which division you join. And I was comparing to Boston and NYC high-level academics more than nearby ones.

From what I can tell, Mount Sinai pays more than Duke. Some NYC and Boston academic places start you in low 200s, but not all.

What does that have to do with the lawsuit? The vast majority of academic places have borderline intolerable politics to deal with.
 
no it isn't. I received written offers from two of their divisions and know people that work in several of them. Their is very minimal variance. They don't pay squat. And they certainly aren't paying a lot more than MGH or BWH.

Me as well, and there was a 6 figure difference between theirs and BWH’s just last year. But I went private practice. This doesn’t really have anything to do at all with the post, though - my original point is that it’s a pretty tough place to work, that’s all.
 
Ive worked with a good amount of people who trained at big names that arent very good. My theory is that people from those programs have the opportunity to come out well trained, but are of the mind set that their **** dont stink. They then fail to work on further professional developement and wind up as mediocre physicians or maybe even hacks.
 
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Ive worked with a good amount of people who trained at big names that arent very good. My theory is that people from those programs have the opportunity to come out well trained, but are of the mind set that their **** dont stink. They then fail to work on further professional developement and wind up as mediocre physicians or maybe even hacks.

Can confirm, am hack
 
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Ive worked with a good amount of people who trained at big names that arent very good. My theory is that people from those programs have the opportunity to come out well trained, but are of the mind set that their **** dont stink. They then fail to work on further professional developement and wind up as mediocre physicians or maybe even hacks.
very true.
 
Ive worked with a good amount of people who trained at big names that arent very good. My theory is that people from those programs have the opportunity to come out well trained, but are of the mind set that their **** dont stink. They then fail to work on further professional developement and wind up as mediocre physicians or maybe even hacks.

Depends on the individual. If your statement were true, having a big name residency or fellowship wouldn't matter when applying for non-academic jobs. But it does help.
 
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Sorry, didnt mean that everyone was like that. Ive worked with good ones too. Meant my theory about the ones that werent good.
 
Depends on the individual. If your statement were true, having a big name residency or fellowship wouldn't matter when applying for non-academic jobs. But it does help.
Yeah, but it often comes with arrogance and entitlement, which is toxic to the team.
 
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lol i remember, one of my junior residents that i am great friends with decided to stay on one year as an attending where he finished his anesthesia training, the chairman offered him 150k for full time with benefits and q3 weekend call.

this was a couple of years back.

he still regrets that he was suckered into that. wayyyy underpaid.
 
lol i remember, one of my junior residents that i am great friends with decided to stay on one year as an attending where he finished his anesthesia training, the chairman offered him 150k for full time with benefits and q3 weekend call.

this was a couple of years back.

he still regrets that he was suckered into that. wayyyy underpaid.

Our crnas make way more than that working three days a week.
 
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Ive worked with a good amount of people who trained at big names that arent very good. My theory is that people from those programs have the opportunity to come out well trained, but are of the mind set that their **** dont stink. They then fail to work on further professional developement and wind up as mediocre physicians or maybe even hacks.
+1. I get to train some of them. Big names don't mean crap, except that the trainee was exposed to a certain level of pathology. But that doesn't guarantee good judgment or competence as an attending. At the same level of exposure to sick patients, I would argue that smaller programs with more autonomy produce better graduates.
 
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+1. I get to train some of them. Big names don't mean crap, except that the trainee was exposed to a certain level of pathology. But that doesn't guarantee good judgment or competence as an attending. At the same level of exposure to sick patients, I would argue that smaller programs with more autonomy produce better graduates.
exactly, and even if a trainee is fortunate enough to be exposed to certain type of pathology, it does not mean that it is all what encapsulates the practice of anesthesia and you are automatically a God because you can do those types of cases. I chuckle when I hear this from some residents that rotate through our department for intubations: 'i picked this program because of pathology' - yea, pathology is important, but not as important to know how to facilitate surgery in light of their pathology - you are not their PCP managing their underlying disease. The best anesthesiologists admit that there is no way they know about everything, and actually read all the time - especially before big and complex cases and have a game plan way before the patient even arrives in the hospital.
I mean its cool that you did 2 months of liver transplants in residency, but can you do 20 tonsils a day safely, with quick turn over and no complications? The acuity may not be the same, but efficiency, timeliness, professionalism are equally (if not more) important skills for an anesthesiologist that is not dependent on which residency program you happen to go to.
 
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I think they will end up settling. I feel bad for Dr Shaughnessy - seems that the environment is very toxic. One minute he is getting awards and recognition, the next minute his reputation is destroyed and he's disposed off. That cannot be good for his mental health. I do not know the whole history, but unless he is an unreasonable person (there is no evidence to suggest he is), I do not know why he would go out of his way and go after them - unless he is being honest. I get that impression after reading the complaint. Seems very comprehensive and multi-layered.

Actually, this is the biggest fear I had about anesthesia practice that pushed me to do pain. Its the ability to go independent if needed, and not have some 'chairman' decide your life. If your chairman doesnt happen to like you, wtf are you supposed to do?
 
Any other current residents or recent grads who can speak to how accurately (or not) this reflects the culture and environment at Duke? (Particularly the characterization of the current Chair)
 
Need to Google Dr Eugene Tom if you want to see how public Atrium made his death 3 days before American Anesthesia lost its contract in Charlotte.....
 
Not sure I really follow....

especially in this thread that has nothing to do with Mednax. I mean we have plenty of other threads that would be more appropriate, including at least one specifically about the Charlotte Mednax implosion.
 
Man was hoping for more duke gossip especially with cardiac apps opening up
 
especially in this thread that has nothing to do with Mednax. I mean we have plenty of other threads that would be more appropriate, including at least one specifically about the Charlotte Mednax implosion.

Exactly. I think we all have our opinions on AMCs, no need to add someone’s death in the mix.
But that was a comment from a first time poster. I am sure there is no other motives than letting us know that Dr. Tom passed away.
 
Exactly. I think we all have our opinions on AMCs, no need to add someone’s death in the mix.
But that was a comment from a first time poster. I am sure there is no other motives than letting us know that Dr. Tom passed away.


User name is “not a scab” so possibly a current or former mednax doc.
 
Any other current residents or recent grads who can speak to how accurately (or not) this reflects the culture and environment at Duke? (Particularly the characterization of the current Chair)
I can't speak for Anesthesia directly, but as a former Duke resident, I can attest to this culture being quite accurate. Duke does what it wants.
 
I can't speak for Anesthesia directly, but as a former Duke resident, I can attest to this culture being quite accurate. Duke does what it wants.
Duke: where residents turn blue and get to know the Devil.
 
Duke is being held up as an example of bad behavior and a toxic culture (which exists at every major institution to some degree), but physician suicide transcends any single training institution. When I was in med school, there was a psych fellow who committed suicide. Internally, the residents were supported (counseling, meetings, time off, etc) but other than those of us who were on the rotation at the time, no one ever heard a word about it happening. No press, no public acknowledgement. It was a former resident who had stayed on, someone who was well-known, respected, and liked. Even now when I bring it up, former classmates tell me that they had no idea that had happened. This kind of behavior is one of those dark sides of our medical culture that seems to make people really uncomfortable.

There is no quick or easy solution to fixing our broken system, but as individuals please be aware and empathetic if you have any concerns. So often, there are no overt indications of what someone else is going through.

If anyone who is reading this is depressed or considering suicide as a way out, please talk to someone about how you are feeling. Life sucks sometimes and it is not bad or wrong to feel that way, it is just a sign that you are in a particularly bad state of mind and/or situation. There are people who love you and will help you. Getting help can be done discreetly and in a way that will not ruin your career. It's not a sign of weakness.

Sorry. I will get off of my soapbox now.

*Internet rant complete*
 
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