Snitches Get Stitches- Protecting the Guilty

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For weeks, I have been conflicted about talking about a situation in my work world. I am not sure what the “right” thing to do is. No, that is a lie. I know right from wrong, damnit and what is going on is wrong.  I worry about big scary words like slander and liable.  I know that my vocation calls me to protect my patient from harm. Sometimes, that harm is another health care provider.

On the other hand, we all have this not quite unspoken code of keeping our mouths shut when we are all aware of another health care provider who is dangerous.  We talk among ourselves. We roll our eyes. We call someone to the computer and say- “Did you see this?”.  We ask each other how that person gets away with this. Of course, that is as far as it goes, right?

There is a physician who is routinely seeing 70 patients in 5 hours. We joke that on the evening he works later, the whole waiting room looks like a scene from the Walking Dead.  I found myself humming the Leper’s song from Jesus Christ Super Star.  They are all there for Norco, Xanax, and Soma as a cocktail along with more other drugs that I can count. We know this is wrong.  We worry. We whisper. No one says anything to him though.

Yesterday, I shared clinic hours with him. In my defense, I was in and out of rooms too, and doing some much needed catching up on four inch stack of labs and images. I was working as hard as I could to stay on task and focused. Once, I walked into the common nursing area and heard folks talking about “not responding right” and he was standing the doorway and I assume this is his patient and he is a physician who has this handled. I went back to office/charting area a few doors away.  In the hallway I heard someone say something about an ambulance and again, assumed he was taking care of his patient and had called the ambulance. I was only mildly concerned because I had worked in clinics where it is just protocol to call 911 for things as minor as elevated blood pressure. I briefly wondered if one of the COPD patients was having a very hard time.

I went back to the nurses station area to get some forms as ambulance was arriving, the physician wasn’t in sight, so I assumed he was in the room with the patient. I had called 911 in other clinics and stayed with the unstable patient until care is turned over to the paramedics.

But no. Later, several assistants came in the providers charting area and asked me if I knew what happened. The physician walked into the room, the elderly female patient seemed groggy to him. He came out after a minute and told the assistants- “She won’t answer my questions” and said something like she had probably taken too many medications. He gave no orders, no concerns and moved on to the next patient. It took a few minutes for the assistants to figure out to go in the room and check, and they found her nodding out and barely responsive. One got a blood sugar of less than 30 and called the ambulance. On their own because he was ignoring the whole situation.  They didn’t come to me, because HE is the DOCTOR.  He continued seeing all his patients and ignoring the whole scene and the patient who became completely unresponsive before the ambulance arrived.

I find this out after the ambulance has gone.  We are all not as shocked as we pretend to be. We know he is horrible. We know he doesn’t examine patients. We know. We talk. We DO nothing.

I came in this morning and looked for a trusted colleague and he told me he had just heard the whole story. I told him, I am not staying silent. I am going to the clinic director.  We each spoke with her today.  I doubt anything will happen. Not for her lack of trying, but he is a powerful person in this community.  This is not the first or even second time I have been to a clinic that is so scary.

I am scared for his patients.  When I see them and update the problem and medication list, explain that some medications are not safe to be taken together or shouldn’t be taken with their condition, or that they need some tests and I do a physical exam, they tell me that it is the first time someone has touched them or examined them in 3,5, or 7 years.  I am quiet.  I don’t criticize other providers.  I think I am a coward.

Who are we protecting when we stay silent? Are we protecting the other provider? Are we trying to protect the patient? Are we protecting ourselves?

I am the locums. I am the outsider. I was raised that tattling is the worst thing you can do. No one likes a tattletale. “Snitches get stitches”. “Not my circus, not my monkeys”

What do you tell yourself when you protect the dangerous provider with your silence? We all know these “bad apples”, don’t we?  Have you confronted them personally? Do you think administration will handle this?  What do you do? I really want to know.

6 responses »

  1. I did that today. We all did that today. We are promised that there will be some sort of formal investigation on Monday.
    The local newspaper is carrying stories about another provider who just recently left this clinic who is being investigated for malpractice for similar behavior. But it is rare, isn’t it? I think we all know these worrisome things long before the patient knows. We keep silent.

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  2. Last year I walked in a room (outpatient pediatric clinic) after a group of medical assistants looking very worried, standing in a group near the room, flagged me down and asked for help. “Dad doesn’t seem right, go see”.
    I walked in to find a very very kind physician having a one sided conversation with a parent that was almost unresponsive slouched over in a chair.
    As soon as the MD saw me she stood up and walked out. She was headed to a phone to call the patient’s Mom. Her concern was that she could not get the information she needed from Dad. Not that they were 3 hours late to the appointment and the child stated clearly that he was so tired from driving and walking and driving and walking all day to get to the doctor.
    I started to assess dad and as I took his bp he started drooling on me. He could not answer any questions until i told him I was calling an ambulance. “Do they have medication? I need flexeril for my pain”. Buddy you have had ENOUGH flexeril and whatever else you took.
    Md talked to mom on the phone and was done with the visit. Moved on to the next room. Dad left in handcuffs out the back door when he miraculously sobered up enough to refuse transport and then get aggressive with PD.
    My mind was stuck on how does this kid get home with an impaired driver? MD was stuck on getting through clinic. She is a very kind person. But REALLY??
    There is more to our day than getting to the next patient. Sometimes….shit happens and you have to use your brain. You can’t be nice to everyone.

    Liked by 1 person

    • Thanks for commenting. Thank you so much for saving that child! We called 911 on an intoxicated parent and CPS. Sadly, they delayed. The next week, Mother was involved in MVA. One of the children critically injured. We NEED to speak up and speak out!

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