OB-GYN-L Messages for March, 2006: Re: Brain damaged baby case (long)

Re: Brain damaged baby case (long)

From: Joanne Bulley, MD

islesannie@yahoo.com

Wed Mar 29 11:32:51 2006

When I was in residency the department was in the process of de-frocking one of the OBGyns. It was quite the process. They had to document the deficiencies - develop a retraining program that required the oversight of other ObGyns in teh dept (so they had to get up for their own deliveries as well as this guy's) and they had to document the results and progress and testing etc etc.

The succesfully did all that - pulled his hospital priveleges but they could not get the State of Michigan to pull his license. He still say the patients antenatally then they'd show up on the hospital doorstep and we'd have to care for the L&D. There was another ObGyn who was supposedly "on" for all of this docs antenatal patients - but it was the one doc who missed most of his own deliveries.

Yes - if we can't police ourselves we have a problem. I am not supporting the many lottery style cases that the lawyers bring but some of this is our own doing.

Joanne

At Wed, 29 Mar 2006, Lynn Montgomery, MD wrote: >
>Now I am not advocating suing physicians, but let me play the devil's
>advocate here based on my personal experience:
>
>-Current hospital setting without ANY quality assurance in the OB Section
>for eight years.
>
> -Two JCAHO inspections during that time and passed
>with flying colors.
>
>-Several previous hospitals with QA programs, but when deficiencies
>identified, no action is taken.
>
>-At least two instances where a significant problem was identified with
>patient management where the physician refused to respond to any inquiry on
>advice from his counsel - despite the supposed confidentiality of peer
>review. No action taken regarding the cases.
>
>-Two and now possibly three physicians with a literal stack of charts with
>untoward outcomes. QA recommendation that privileges be suspended pending
>additional training, etc, only to be laughed at by hospital counsel who
>state that we will all be sued and the suspension will not likely stand.
>
>So, given these issues, how are we supposed to accomplish "Physician police
>thy self". And if we cannot police ourselves, which we have apparently shown
>we can't; who is going to?
>
>It is easy to be critical of lawyers suing us, but I feel that we bear a
>good share of the responsibility by engendering a "good ole boys club" and
>rubber stamping our peer's practice patterns, whether appropriate or not -
>fearing that if we are critical of a peer's practice patterns, we may be
>next.
>
>I learned quality assurance from Bob Carpenter and Ray Kaufman and have been
>struggling my entire career to duplicate their approach, only to be met with
>frustration at every turn.
>
>Lynn

-- Joanne Bulley, MD Keene, NH, USA

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