You Ain’t Right (and Neither Am I) by Pat Conrad MD

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Hmm, tough story. If you don’t follow the link, the short version: “A Seattle doctor has been suspended amid accusations he sexted during surgery — one time sending 45 dirty messages during a single operation, officials said”, citing “lack of focus” and allegedly putting patients at risk while he worked as an anesthesiologist during surgeries, including cesarean deliveries, labor epidurals, an appendectomy and more, according to a Washington state medical board’s statement of charges. “I’m hella busy with C sections,” one text message read, according to the statement.”

On the one hand, I really do feel sorry for this obviously screwed-up, no-boundaries gas passer. And there’s no way to excuse his behavior. On the other hand, it’s funny (can you administer anesthesia one-handed? Whoops, I did NOT say that!). For all the talk I hear and read from mainstream sources about how physicians are respected, I just don’t see it. I think doctors are by and large targets, with most people spring-loaded to jump on them about any slight or perceived infraction, on the strength of real, egregious, and relatively rare occurrences. This guy really didn’t help matters.

When I taught first year med students, one of the lessons I tried to impart was that doctors “ain’t right.” That means me, and that means you. This isn’t self-loathing, its just self-honesty. For crying out loud, we have all cut up dead bodies. We have all done the most intimate possible exams on both genders, heard countless stories in private that any decent person would take to the grave, and eaten lunch repeatedly amidst a maelstrom of pus, feces, blood, awful smells, and awful sounds, while still wondering what was for dessert. (I knew one classmate who toured his little kids through the gross anatomy lab during the abdomen/pelvic section, while there were hemi-sected bottom halves hanging off racks in a scene that would otherwise look like some terrifying torture chamber. That was just $*&^#’d up). We carpool with death and are never allowed to forget that the clock is ticking.

And the great majority of us manage to do a very good job year after year without succumbing to substance abuse, sexual misbehavior, Medicare/Medicaid fraud, depression/suicide, or terminal grouchiness. But the risk is there. I think back to a recent topic on this site dealing with physician suicide rates, and recall a colleague in our small town ER that blew his brains out one night in the back yard. All of us need hobbies and exercise, and some of us need shrinks and twelve-step programs. I don’t want to unduly dump on this latest miscreant, but get ready for another round of government and lapdog agencies propagating all sorts of guidelines, surveys, and mandatory CME’s, to be paid for by the would-be sext’r, on the grounds of protecting the public. We tiptoe daily through a minefield of our own choosing, and often of our own making. So DO make all the jokes you can, and make sure some of them are directed at you. And hey…let’s be careful out there.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  2 comments for “You Ain’t Right (and Neither Am I) by Pat Conrad MD

  1. Jim
    June 18, 2014 at 11:56 pm

    After I had to perform anesthesia for the patients that I operated on in Africa, my opinion that anesthesiologists have much too high an opinion of their worth was reinforced. I did not have any major anesthetic complications, though one patient gave me fits with high blood pressure after ketamine. The greatest complication to my patients there was their own doing, when they screwed around with a traditional healer (witch doctor, etc) for a week before they sought medical attention. Perforated ulcers and sigmoid volvuluses don’t tend to do well having no treatment for a week.

  2. June 16, 2014 at 8:21 am

    Whoa, there. The exciting part of the story is irrelevant; the less splashy version is damning.

    The doctor sent multiple sex-related messages to the same woman, a patient, and invited her to visit the hospital for sex, telling her she could park in the doctor’s lot to avoid paying for parking, according to the accusations. The pair allegedly arranged to meet in the doctor’s lounge or hospital call room for sexual encounters.
    Zilberstein obtained the unnamed woman’s medical records “not for medical purposes, but in order to view images of the patient for his own sexual gratification,” the statement said.
    He also prescribed drugs without keeping medical records, officials said.

    The headline presents the lascivious tale, and really, texting during surgery merits a reprimand, although it is not intrinsically obvious that it constitutes inattentive care, as it would for a surgeon. Anesthesiologists have some down-time during the surgeries. In spite of what the People’s Revolutionary Committee might wish to do, the severity of this infraction is not obvious. It needs to be assessed by professionals – anaesthesiologists – who examine the details of the case. It is best described as malum prohibitum at this point.
    Sexual involvement with a patient, though, is malum in se and is grounds for serious punishment from the Board, which they undertook. That is the most serious infraction; the ‘sexting during surgery’ is a separate concern.
    The press loves its chatterbox gossip, though.

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