The Trouble With Surgeons - UPDATE

My write-up reporting the incident with the on-call surgeon who wouldn't come in for the emergency splenectomy made it's way to hospital administration and the shit hit the fan. Within 72 hours of the incident, the surgeon had "resigned."

Really he had been under scrutiny for some time for similar occurrences, and my incident with him was just the straw that broke the camel's back. But, nonetheless.... Don't mess with Doctor Mom!!

Within a week of hearing about the surgeon getting the ax, I had another coup in the continual struggle against grumpy specialists: This past Friday in the middle of the night an ambulance brought in a little 7 months old girl who had stopped breathing in her sleep. She had no spontaneous respirations and no pulse and, to make a long story short, I got her back in a resuscitation effort that I'm pretty proud of. We have no pediatric ICU (PICU) in my little hospital, so it was a no-brainer that she needed transfer to a facility with a PICU since she was on the ventilator. I called the helicopter to come get her and simultaneously began calling around for an accepting facility. Any facility with a PICU bed is legally obligated to accept her since they offer a higher level of care. The first place I called had no available PICU bed. The second place I called had a bed, so that should have been the end of it -- accept the patient and let me send her. But they gave me the royal run-around. The pediatric ER doctor wouldn't accept and referred me to the pediatric ICU doc. She accepted the patient but only after asking me 101 ridiculous questions about what the patient ate for breakfast, what her favorite color is, etc., etc. (Okay, maybe not that painful... but nothing I said was going to change her management at that instant and the fact that she was keeping me on the phone playing 20 questions when all the patient needed was to get flown out was ridiculous) and THEN... Then she reamed me out on the phone for launching the helicopter BEFORE I had an accepting physician. Hello! If I waited to jump through all the hoops these docs were giving me before calling the helicopter, the baby's transport would have been delayed an hour or more. Besides, it is totally the standard of care to call the helicopter first and figure out were you're sending them second if the patient is unstable. So she REALLY pissed me off by fussing at me, especially because everything I was doing was in the patient's best interest.

Well, lo and behold, the following night toward the beginning of my shift this doctor called me back and said "I owe you an apology"!!!!! She ate a big piece of humble pie and told me I was right and she was sorry.

What a rare pleasure for an ER doc to have this kind of validation... two times in one month!! Next time I'm getting an earful from a grumpy specialist, I'll think about these two coups and keep my chin up!