Johnette's Daddy wrote:Few doctors make it through their training without being involved in at least one case that goes awry. I was no exception.
As an intern, I was assisting in a routine hernia operation when the attending surgeon cut the vas deferens, the tube that transports sperm from the testicle. I expected to be grilled by my colleagues afterward on the details, pressed to explain how this largely avoidable mistake possibly could have been made. That didn't happen.
Everyone already suspected what had gone wrong and who was responsible — the attending surgeon was notorious for his careless surgical technique — and they were simply willing to let it pass.
The surgeon's technical error was the first of two mistakes made in this case. The surgeon's colleagues committed the second error post-operatively: They chose to overlook a pattern of seemingly suboptimal care...........................................................
Ulene is a board-certified specialist in preventive medicine practicing in Los Angeles. The M.D. appears once a month.
My BS meter is going off on this one for a couple of reasons.
First if he was only aware of ONE mishap during his training, or even in his own practice then he isn't paying attention or isn't very good him/herself. Complications happen to everyone that is in medicine. Nobody is perfect.
Cutting the Vas is a big deal, but it can happen, to any surgen competent or not.
The next thing is he says he was assisting with a surgery as an intern, but he is not a surgeon, he is in preventative medicine. This means that he was doing a surgery rotation, which he wasn't likely fully participating. Our "guest" residents who were required to rotate through surgery (Family practice, some OB etc) participated at different levels based on their intrest but they missed one HUGE thing. Some little thing called M&M. Morbidity and Mortality conference is a huge part of surgery and I can dang well promise you cutting the Vas isn't overlooked in M&M and you better dang well know your stuff including why it happened, what could have prevented it or if it could have been prevented, the incidence of that complication and what you can do in the future to prevent it happening agian. It is brutal and there are no punches pulled. That is why outsiders are not allowed in to M&M, not even our FP and OB residents that rotate through.
I am betting he missed that and that somebody did indeed get grilled about it.
Aside from that I do see his point and it can be a problem because there is more than one way to skin a cat and lots of those differences depend on what level of training you had. If you don't have a tool in your toolbox you don't know how to use it and to someone that does have that tool it can look like incompetence.
And there is some incompetence too and that is hard to deal with because unless you were there in the room it's hard to know if the complication is due to negligence, incompetence unaviodable or even due to the patient themselves (in the case of them witholding information leading to a missed diagnosis etc).
I get what the article is saying, just think that he/she likely missed some of the repercussions of the conplication due to being a guest. Maybe not, I am sure there are some programs that would let it go, I would think it would be extremely rare.
