Sunlight Peaks Into The File Cabinet At The NC Medical Board

In the wake of a burst of blogging this weekend (unplanned - because I have wanted to slow down/take a break - but there is just so much stuff out there), I found an old post (linked in Saturday's post on the legal hatchet job currently being done on Dr. Melvin Levine) that I want to put front and center again.

At that time, I was regularly reading Ed Cone's blog (I don't anymore and I'm happy to report that my blood pressure is way down). When this one flew out of my fingers, I remember that something he said (or the way he had said it) started the blood boiling.

A story wafting all over the Internet this week also kind of set me off - about bloggers blogging themselves to death. Given the reasons I came to the blogosphere in the first place, it actually wasn't the story that yanked my chain . . . it was Edward (again), who (of course) put up some snark about "getting a life" (something I've heard before from people purporting to "care").

It's not just the "big-time" bloggers who are pounding their fingers to the bone (trying to get that elusive "traction").

I really need to write off Cone completely and let Bubba carry the "Cone-Watch" water.

"Get a life," indeed. It is good to be Cone.

I have a life, thank you. But I'm in the blogosphere to get someone, somewhere to CARE about how I lost the one I had. It should not have been taken from me.

Anyway, the old post (you have to get past the rant on Ed), describes my profound frustration with the NC Medical Board . . . both in terms of protecting doctors who rescue & report bad situations, and actually protecting the patients caught up in those situations. The Board moves at a snail's pace or not at all.

In the post, I describe another PTSD-generating situation at another small town NC hospital (in 2006) in which I was called in to clean up a very bad mess made by an OB armed with a vacuum-extractor . . . who inflicted an injury upon a newborn Hispanic baby that, had it been inflicted in ANY other setting by anyone but a doctor, would have surely brought on criminal charges for child abuse.

"Tell Johnson I love her," burns in my memory to this day.

I want to "top-level" (again) one of my comments in the thread of that post . . . a response to an out-of-state nurse who wrote in incredulous at what she was reading. Of course, this kind of thing happens in Kentucky too . . . but she was amazed that a doctor was actually writing about it.

My comment speaks to many of the problems Pediatricians still face . . . as respect & reimbursement for the skills and expertise we provide dwindles and dissipates. We practice in a world of incredible entitlement . . . of WalMart medicine dictated by people with business degrees . . . and of "scum-sucking-excrement" (I love me some Orac) moronically second-guessing our every move:

Well, if you know exactly what I'm talking about, Lori, then I don't know why your colleague could not believe what she was reading;)

Maybe what she could not believe is that someone is finally talking about this kind of BS (*I'm trying to clean up the potty-mouth that I sometimes/regrettably revert to when I'm angry & blogging . . . I've decided to start using the term "cowpoopoo").

Because it's total BS (cowpoopoo).

A Pediatrician who recently left Asheboro called it "the cult of personality".

After the hospital did what they did to me, the VP of the hospital (trying to smooth it all over with the OB's who were upset about my sudden departure) told them that "good Pediatricians are a dime a dozen" .

Of course, time has proven that statement to be moronic (and him to be an idiot - not to mention a liar). But that's the attitude towards Pediatricians in most small towns.

We're the lowest docs on the totem pole . . . at the total mercy of the operating room machine. We're just there to dry off the baby . . . until someone needs much more than that in the middle of the night. Then we're heroes for a day.

But people forget quickly.

Before I was fired, I had a great relationship with the nursing staff at Randolph - both on the LDRP unit and the Pediatric floor. I stood up for these (mostly) ladies - fighting many small battles on their behalf - and called many of them friend. I valued their contribution to patient care, and always told them to NEVER BE AFRAID TO CALL ME when they needed help.

That's why a terrified charge nurse felt like she could call me that fateful night in 1998 . . . for a baby that was not my own patient. She reasoned that if a baby was dying (and this one was), Dr. Johnson would not yell at her, hang up the phone and roll over/go back to sleep.

Of course when the charge nurse called me, she did not have a clue about the threat I was was working under.

After "the incident" (which I reported to peer review the next day - defying the hospital/practice brass to do it), no one in administration had the good sense to de-escalate the situation by retracting their threat. But, by then it was all about power. Steven Eblin and Bob Morrison were going to prove they had it . . . and they were going to teach the troublesome/loud-mouthed bitchy doctor a lesson.

After I was fired, many nurses complained . . . several brave ones even wrote hospital administrators . . . knowing full well that the position they were taking could put their own jobs in the line of fire. At one point, the CEO called a meeting with the LDRP staff and tried to placate them - telling them that I had made wonderful contributions to the hospital, but that the decision (to terminate) was final. And OBTW (paraphrasing), "Dr. Johnson hired a lawyer - and you're not to speak to her because we'll call you as a witness if you do".

It was Draconian: the employment politic of fear. And it was very effective in terms of destroying relationships and friendships with many of my friends in nursing. I've keep in touch with a few close nurse-friends to this day (I took care of their children). But just a few.

The years went by . . . and I became more publicly critical of the place where these nurses worked. I'm sure there is some resentment now. These ladies (and some gents) work hard at what they do, and I know it. But that does not change what happened. And I simply cannot let it go.

Because what was done to me was wrong.

My "advocacy" and regulatory organizations, for years (like so many of my "friends" and medical colleagues in Asheboro), have just stood on the sidelines and watched. One doctor (of many) who ultimately left Asheboro said it was like watching a "slow-moving-train wreck". And as long as these doctors could collect their big/easy salaries and go home and not have their lives disrupted, these doctors rationalized that all was well.

Who cares what happened to one doctor . . . whose life was destroyed for doing the right thing?

It's one of the reasons I am enjoying watching my (North Carolina) Medial Board squirm now . . .in the face of its past inadequacies and slights. Where executions are concerned (one could argue just like the AMA and the beast that became managed care), the Board did not pay any attention to the ethical/practical side of the equation until it was far too late.

Now that battle too, is really about power. And trust me, in any battle with lawyers for power, doctors will loose.

Back on point, Randolph Hospital administrators circled the wagons and turned a deaf ear (to both nurses and angry patients).

A small clique of people run Asheboro (and the hospital) and they are going have their way (and cover one another's messes) no matter what.

And to this day, I have NEVER been afforded a meeting with the hospital's Board of Directors. It's just the epitome of small town/good-ole-boy arrogance and bad management.

As for the hospital involved in the (2006) situation I cite in this post, yes, I actually do think they have tried to do the right thing . . . and have really done all they can do. I know the legal hoops are complex. But this particular doctor has had many chances to change his behavior . . . in my opinion, he has literally medically-terrorized the LDRP staff at this tiny rural hospital . . . because he thinks no one (for all of the reason$ you cite) can touch him.

So far he's been right.

The nurses at this hospital said, I was one of only a few doctors who ever "had the balls" to stand up to him . . . and the only one really willing to go the extra mile to stop him from hurting another baby. Of course, it's easier when you're a temp doc and can walk away.

When this case when down, I literally suffered pangs of PTSD (given what I had already been through in Asheboro). But this hospital, when confronted with irrefutable evidence of bad care, really did step up to the plate in terms of a fair and balanced peer review process (which included outside review . . . to avoid to charge of conflicted interests).

But the Medical Board still sits in the ivory tower. The irony remains that ten years ago, I was fired for saving a baby's life . . . and cannot get anyone to give me the time of day in terms of justice and fair restitution for a life completely disrupted (the NC Medical Board will not even discuss the situation in Asheboro with me . . . and, as I have blogged, would rather change the law than make a simple referral to the AG's office).

But this OB is still practicing in his small town . . . and is being given every benefit of the doubt . . . despite having hurt many people in one fashion or another.

You see, hurting people is not just about the patients. It's about the doctors and nurses who step in to clean up the messes . . . and who have to cope with whatever they find.

The Family Practitioner involved in the 1998 incident I rescued . . . the one that cost my my job/life/practice in Asheboro barely got a behind-the-scenes slap on the hand by the Medical Board (i.e., no public file). His practice (a Cone affiliate) continued to employ him. His privileges remained intact at Randolph and he eventually served as the hospital's Chief of Staff.

Meanwhile the North Carolina Medical Board has not lifted a finger to help me . . . the Pediatrician whose life was destroyed because, when faced with her own destruction, she put this doctor's patient before his arrogance and ego.

But here is the most compelling reason to top-level this comment again: I went to the NC Medical Board's website today and looked up the doctor involved in the 2006 incident.

Two years after the fact, he finally has a public file. A hearing is scheduled for later this month. The Board is apparently considering sanctioning or revoking his license.

I wonder how many of his patients know about this? I wonder how many patients have crossed his path between then and now - before the Board finally decided it was time to do something? I've been very reluctant to call any of my old friends or contacts at the hospital where it happened to find out what is going on . . . as (referencing the "Draconian" intimidation/scare tactics I spoke of earlier), I do not want to make anyone uncomfortable or put them in the legal line of fire.

As the Pediatrician who was called in to take care of the "Baby A" identified in the Board's (January) "Notice of Charges & Allegations: Notice of Hearing", I've not been invited to the party.

If I were, ALL parties present would get an earful. These days, I REFUSE to cower in fear - and I talk back to "scum-sucking pieces of excrement" (no matter who they work for - and how important they think they are).

I am going to wait until the results/findings of that hearing to link the public file. But it's there.

About darned (watching the potty-mouth) time.

And oh baby (forgive the pun) I am watching!