One OB Short

Once again, another fine case of a hospital deciding to target a physician, in this instance, an OB/GYN named Rebecca Denman, MD.  “In December 2017, a nurse practitioner at St. Vincent Carmel Hospital reported that Denman smelled of alcohol while working an overnight shift” and reported her … the next day.  Was Denman drinking on duty?  “She noted that she was not promptly assessed, sent for blood testing, or relieved from duty on the day of the incident — all of which contradict the hospital’s substance abuse policy.”  So we can’t know, because the circumstance was not investigated on the spot, as owed to both the physician and to patient safety.  

“About a week after the incident, officials from the St. Vincent Medical Group informed Denman that they had reviewed the allegation against her, and that she was required to leave work immediately until she was evaluated for substance abuse by the Indiana State Medical Association. Denman claims that at no point was she given the opportunity to respond to the investigation.”  After bringing suit, Denman successfully argued that proved that the Ascension-owned hospital did not follow their own substance abuse protocols, that she was denied the opportunity to disprove untrue allegations, and she won a jury award of $4.75 million for various fraud and defamation claims.

So the dastardly hospital corporation was wrong, right?  Well, yes and no.  “After stating that she was an impaired physician and entering treatment with a substance abuse counseling center in Chicago, Denman returned to work about three months after the incident. She entered a monitoring contract with a term of five years.”  A different source notes “a previous concern about Dr. Denman’s drinking was raised, according to deposition information included in court documents. In 2015, two physicians had suggested Dr. Denman consider an assistance program after expressing concerns that she was arriving late to work and missing partner meetings. At the time, Dr. Denman did not enter an assistance program, but she changed her drinking habits, began seeing a therapist, and started arriving on-time to work and to partner meetings, according to court documents.”  There were already concerns that this was an impaired physician, so the hospital was correct in its action, right?  Not really.

“According to the Indiana Peer Review law, a health care provider under investigation is permitted to see any records accumulated by a peer-review committee pertaining to the provider’s personal practice, and the provider shall be offered the opportunity to appear before the peer-review committee with adequate representation to hear all charges and findings concerning the provider and to offer rebuttal information. The rebuttal shall be part of the record before (my emphasis) any disclosure of the charges and before any findings can be made, according to the statute.”  St. Vincent Carmel Hospital reviewed the incident, and then turned the investigation over to the St. Vincent Medical Group, which “informed Dr. Denman they had reviewed the allegation through its peer-review process and that she was suspended with partial pay until she underwent an evaluation for alcohol abuse…”  Denman’s attorney stated “They falsely misrepresented to her that peer review had been done.  In spite of that statement, they never offered her a hearing before a peer-review committee, they never shared with her the substance of any evidence they had against her, they never gave her an opportunity to respond to the allegations.”  The Indiana State Medical Association referred Denman to an addiction treatment center that diagnosed her with an “alcohol use disorder,” and has her on a monitoring program including daily breathalyzers, random drug screenings, and mandatory AA.

Where does this leave us?  The physician may well be an alcoholic in need of ongoing recovery.  Or in the face of a corporation wielding state force, she may have rolled over in order to preserve her livelihood.  We can’t know for sure without trust in the process, trust misplaced when given to a hospital, a corporation, and a medical group that did not follow their own rules and gave the appearance of a very strong possibility that they railroaded a doctor.  Whether or not she is an addict, there was no excuse for not ensuring immediate, transparent evaluation in order to ensure patient safety, and to be fair to all concerned. 

This site has cited repeated instances of physicians abused simply for the crime of their profession, their civil liberties trampled because they subjected themselves to an often merciless, and too often arbitrary impulse to protect public safety.  Hospital corporations, corporate medical groups, and state governments are NOT ever on the side of the physician, and will target and punish them as often as necessary to protect their interests.  I’m glad that Denman won her suit, and if she needs help, I hope she is getting it.

And I hope she starts by giving the middle finger to the Ascension Corporation, St. Vincent Carmel Hospital, and the Indiana State Medical Association, and then I hope she can retire to leave these vicious bastards one OB short.

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Pat Conrad MD

Pat Conrad is a full-time rural ER doc on the Florida Gulf Coast. After serving as a carrier naval flight officer, he graduated from the University of Florida College of Medicine, and the Tallahassee Family Medicine residency program. His commentary has appeared in Medical Economics and at . Conrad’s work stresses individual freedom and autonomy as the crucial foundation for medical excellence, is wary of all collective solutions, and recognizes that the vast majority of poisonous snakebites are concurrent with alcohol consumption. 

  4 comments for “One OB Short

  1. arf
    February 24, 2020 at 6:09 pm

    I can’t believe anyone would willingly go into obstetrics.
    You willingly put your head on the chopping block.
    You willingly put a target on your back.
    And you buy a gun for the trial bar.
    And you buy the administrators an axe.

  2. Celia B
    February 16, 2020 at 10:17 am

    well I thought alcoholism (for non physicians) was a disease. So if she has a disease, I hope she also files for disability that her former employer must pay. She certainly could have PTSD now, and she could claim disability for that as well. I hope she can get even more money out of the system.

  3. Sir Lance-a-lot
    February 16, 2020 at 8:48 am

    “… Denman smelled of alcohol…”

    Errm… Correct me if I’m wrong, but aren’t those hand-disinfecting foam things made of ethanol? I mean, they’re like 95% ethanol, right?
    It says so on the label. And I can tell you that when I rubbed some on my mouth after a baby with the flu had globbered me there, it tasted just like Everclear (Ah, college…) and gave me a nice feeling.

    So, if we are following the recommended infection-control procedures, don’t we all smell like alcohol? I mean, aside from testing me, if I had a toot and you smelled it and I said I’d just washed my hands, how could you possibly tell?

    • Stephen O'
      February 16, 2020 at 8:56 am

      When asked about his infernal program for throwing millions into the Gulag never to return, Stalin showed his innate understanding of Bayesian statistics. If the goal is to maximize the true positives (i.e. catch a real spy), then certain laxity about the false positives (i.e. sending an innocent person to Siberia) must be tolerated. He gave the ratio of 10% true positives/total positives as a goal (i.e. “It’s better to send away ten innocent men to catch one spy.”) Any self-aware medical board should admire the statistical finesse of uncle Joe Stalin.

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