To Resign or Not to Resign

[Scapel]

I am looking for some advice. I am a practicing OBGYN in a midsize town. I am 2+ years out of residency and I have found myself in a dilemma. Last year was particularly rough surgically. I performed >75 robotic procedures last year and of these, there were 2 ureteral injuries, 2 incidental enterotomies and 4 postop pelvic abscesses. All the pts eventually did well. No lawsuits (at least not yet).

However, as a result of these complications, my division leader is up in arms and has dragged me before the surgery committee for a review of these cases. While the review is pending, they have requested a voluntary suspension of my privileges, but if I refuse to sign, they will initiate a mandatory precautionary suspension. Possible committee actions could be nothing (highly unlikely), separation, some kind of remediation plan, or who knows what. I can’t afford a lawyer at this point. My question is: will it be reasonable to preempt committee decision by resigning (I have 5 months left in my contract) to avoid the risk of forced separation or suspension of privileges on my record or should I await committee decision and hope for the best? Thanks!

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[anonperson]

I am looking for some advice. I am a practicing OBGYN in a midsize town. I am 2+ years out of residency and I have found myself in a dilemma. Last year was particularly rough surgically. I performed >75 robotic procedures last year and of these, there were 2 ureteral injuries, 2 incidental enterotomies and 4 postop pelvic abscesses. All the pts eventually did well. No lawsuits (at least not yet).

However, as a result of these complications, my division leader is up in arms and has dragged me before the surgery committee for a review of these cases. While the review is pending, they have requested a voluntary suspension of my privileges, but if I refuse to sign, they will initiate a mandatory precautionary suspension. Possible committee actions could be nothing (highly unlikely), separation, some kind of remediation plan, or who knows what. I can’t afford a lawyer at this point. My question is: will it be reasonable to preempt committee decision by resigning (I have 5 months left in my contract) to avoid the risk of forced separation or suspension of privileges on my record or should I await committee decision and hope for the best? Thanks!

Were the complications related to particularly difficult cases? Do you think you should keep doing these cases? 2 ureteral injuries in a year is a lot for what I assume are benign hysterectomies. Were the enterotomies during laparoscopic entry or during the case?

Are you in a group or running solo?

Does the division leader not particularly like you and going after you?

Do you mean resigning from your current contract or giving up hospital privileges?

When you get a new job at a different site, hospital credentialing will typically want references and will also ask about resigning privileges etc or having them suspended.

Honestly, now is not the time to skimp on legal advice.

This can potentially follow you around. Could you get a job elsewhere even if you get nailed? Yes, there are places desperate for OBGYNs that will take a run at you but if you %#ck up enough times, a patient will get permanently harmed or die. You have to perform some self introspection on if you should be operating to the degree you have been.

 

[Scapel]

Were the complications related to particularly difficult cases? Do you think you should keep doing these cases? 2 ureteral injuries in a year is a lot for what I assume are benign hysterectomies. Were the enterotomies during laparoscopic entry or during the case?

Are you in a group or running solo?

Does the division leader not particularly like you and going after you?

Do you mean resigning from your current contract or giving up hospital privileges?

When you get a new job at a different site, hospital credentialing will typically want references and will also ask about resigning privileges etc or having them suspended.

Honestly, now is not the time to skimp on legal advice.

This can potentially follow you around. Could you get a job elsewhere even if you get nailed? Yes, there are places desperate for OBGYNs that will take a run at you but if you %#ck up enough times, a patient will get permanently harmed or die. You have to perform some self introspection on if you should be operating to the degree you have been.

I mean resigning from my contract altogether, which will invariably mean giving up my hospital privileges as well since we are in a multi speciality group and all employed under the same decent-sized hospital system.

The ureteral injuries happened during benign but difficult cases with very large, fibroid uteri in morbidly obese pts. The enterotomies were during lap entry in pts with multiple previous abd surgeries.

As for our division leader, tbh, even before all of these happened, I don’t like him and I assume that feeling is mutual. I don’t think he is a good manager at all. 3 of my colleagues left abruptly since I started here. Lots of grumbling by physicians. I hate to think he is going after me, but I certainly won’t put it past him to do something like that.

I have definitely done (and continue to do) self introspection. Sometimes, when you get referrals from colleagues who have been practicing since you were in high school, there is a tendency to get overconfident. I feel I can continue to practice safely although I plan to scale back and be much more selective in my surgical cases going forward.

 

[Sushirolls]

Lawyer.

Lawyer.

Don't have money? Can't afford the lawyer? Get a Lawyer. Figure it out. Get a Lawyer.

 

[anonperson]

I mean resigning from my contract altogether, which will invariably mean giving up my hospital privileges as well since we are in a multi speciality group and all employed under the same decent-sized hospital system.

The ureteral injuries happened during benign but difficult cases with very large, fibroid uteri in morbidly obese pts. The enterotomies were during lap entry in pts with multiple previous abd surgeries.

As for our division leader, tbh, even before all of these happened, I don’t like him and I assume that feeling is mutual. I don’t think he is a good manager at all. 3 of my colleagues left abruptly since I started here. Lots of grumbling by physicians. I hate to think he is going after me, but I certainly won’t put it past him to do something like that.

I have definitely done (and continue to do) self introspection. Sometimes, when you get referrals from colleagues who have been practicing since you were in high school, there is a tendency to get overconfident. I feel I can continue to practice safely although I plan to scale back and be much more selective in my surgical cases going forward.

As has been mentioned by the previous poster and myself.

Don't be cheap with your career. Now is the time to get professional legal help.

You've been in practice for nearly 2 years, how do you not have enough money for a lawyer saved up?

 

[Dr G Oogle]

Same as above regarding lawyer. Are you a generalist or MIGS or other fellowship trained. Is there an MIGS person at your practice for these difficult cases or are you the person? If generalist and have MIGS perhaps the compromise Can be made and all complex cases can be referred to that person. If you’re the complex case person than you really can’t be held at fault for doing complex cases and then getting a complication unless they want to refer all complex cases out the closest academic program. In my hospital this happened to one person and she was let go but there were a lot of issues with management decisions and clinical practice etc.

 

[deleted480308]

Lawyer

 

[Sushirolls]

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