Thursday, October 30, 2014

Malignant

The place where I did my residency had a really horrible urology program. It was extremely malignant due to the program director, who was apparently always threatening to put residents on probation. A friend of mine, who I will call Angela, was having an especially horrible experience.

When Angela was in her R2 year, she was put on probation... she couldn't even write tylenol without calling an attending for approval. So she'd get called at home for a temp and she has to come in, evaluate, and then call the attending at home to find out if it's okay to write for tylenol. The rest of us could give a verbal order for tylenol and maybe some pan cultures and that's it. She had to drive to the hospital.

What happened was angela was presenting a patient and said something about the patient's code status. The director was the attending doing rounds and he went on a huge speech about how R2s don't understand code status and how they shouldn't be dealing with it, and she never finished presenting this patient. So what happened is the director never heard about the patient's primary diagnosis of a fistula because he wouldn't let her finish presenting.

So later on in the day when something came up regarding that patient he ended up looking like a fool cuz he didn't know the patient had a fistula. He went ballistic, called the R2 an inaccurate and messy doctor who presents inaccurate information. She got angry and started to talk back, and he yelled at her and said she needed to understand her place. And she was so angry that she started to tear a little, and he told her she obviously had some psychiatric disturbances cuz she obviously couldn't handle stress. He told her she'd have to undergo a psych eval and she dug in her heels and it went on like that.


And then he announced she'd have to be in remediation, and then put her on probation. Indefinitely. And then after he did that to her, he kept saying he wasn't going to renew her contract, and that she'd better contemplate not being there the next year.

That's so unbelievable to me that a person could go through all those years of schooling and hard work, just to have it ruined by one asshole.

18 comments:

  1. Story of my life. I feel her pain. People in my part of the world are really comfortable in bullying juniors. They know there is nothing they can do. I feel like a slave sometimes.

    ReplyDelete
  2. It makes me incredibly sad how many in the medical world will eat their young, so to speak.

    ReplyDelete
  3. For those residents out there who feel bullied by their program directors, there is a force in the universe called karma, and its a real bitch. You may not be around when it comes around and bites your tormentor in the ass, but take comfort in the knowledge that it always does.

    ReplyDelete
    Replies
    1. Bull. The worst of the worst are living large, and always will.

      Delete
  4. Ouch. Don't your residents have a union? I know the ones I worked with did, and when there were issues, they were worked out, I think more fairly. The whole eat-your-young mentality applies to nursing too, btw.

    ReplyDelete
    Replies
    1. Doctors are not allowed to form unions in the States. It violates anti-trust laws. I'm not making this up.

      Delete
  5. It's a violation of another person, plain and simple.He took advantage of his
    authority and her vulnerability to cause her harm. God is watching sir, and
    should you make it through the pearly gates, you'll have to answer for it.

    ReplyDelete
  6. Forgive my ignorance, Dr. Fizzy. Not renewing her contract? Does that mean she
    can't complete her last year of residency?

    ReplyDelete
    Replies
    1. Yes, that is what the result would be. This would force her to try to Match again in a year for an advanced spot or start residency over or go fold jeans at the Gap...

      Delete
  7. I had a surgeon like this. Scares you to know that this piece of garbage made it to become a doctor. I know a bunch of nice docs. They need to start taking bad docs like this out of the game. All they do is just make problems worse for everyone all the way around. Bad things happen, it gets reported in the newspapers, and bit by bit, the trust is gone between doctors and patients.

    ReplyDelete
  8. There are a lot of physicians in academic medicine who could not make it in the real world and that is, unfortunately, why they are in academic medicine. This guy would have been sued in his first year as a practicing physician in the real world, and probably every year afterwards.

    ReplyDelete
    Replies
    1. Pretty much business as usual in my surgical training experience. It is frustrating to be abused by those incompetents for whom it is impossible to generate even a shred of respect.

      Delete
  9. So did they renew her contract?

    ReplyDelete
  10. I'm embarrassed to admit that I don't know what happened with her.

    ReplyDelete
  11. Surgeons, man. Fuck.

    I came really close to this in residency a couple times. Oddly the big explosions were never over things I really screwed up (of which there were instances aplenty, believe me) but invariably over things were I was either completely right, or it was total insignificant bullshit (like responding to a code and having my name badge facing the wrong way.)

    Absolutely the closest I can to being fired was on the trauma surgery service. A floor patient were peri-arrest with severe hypoxia -- 60s bagging 100%, HR 140s, unresponsive. They had a tension. I needled it. Rush of air, sats came up to 98%. And that was very close to the end of me as a doctor. Major explosion, multiple calls to the program director, senior residents screaming at me.

    I don't know how people survive 5+ years in some of these programs, honestly. I could barely last a few months.

    ReplyDelete
  12. Anonymous Nov. 8 - if you are still out there - why did you get screamed at for fixing the tension pneumo? What was the (supposed) substance of the issue? Just curious.

    ReplyDelete