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Genital Exams: parent vs. patient


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Yeah, I am spending $200 bucks for an hour of an attorney's tine on this one.  That is complete and utter BS to the highest degree.  As egregious of a reprimand decision as I have seen.  YOU DID THE RIGHT THING.  PERIOD.  And yes, a reprimand will follow you around.  It's complete and utter BS.  Not sure what state you work in, but a blue state will have a much more supportive structure for the employee.  Right to fire your butt states....not so much.  Having said that, this is a medical/ethical question and you were right. That should be held true in any state.

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On 2/20/2022 at 9:03 AM, mgriffiths said:

Last note, as I am beyond the patient interaction my main point of concern is the "formal reprimand" and how that could potentially impact me in the future both with my current employer and potential future employers.  I am looking into the hospital bylaws and so forth to review. 

Well organized places will have some kind of stepwise, graded disciplinary policy, starting with counseling, then a verbal warning and going up from there. 

I would guess they didn't follow proper procedure. 

If they get prickly to the point you don't care anymore, this would be a great newspaper story. 

Edited by CAAdmission
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Honestly this is exactly why we need a union.  
 

was in one job that the union protected their own.  They never did any extra and saved a few people from getting outright fired.  Me on the other hand was not in union and when they demanded I violate x waiver regs and I refused they let me go.   Nothing I could do except a federal whistleblower suit (which I suspect I would have won but my career would have suffered).  

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So a good update...sort of.

I walked into clinic yesterday and noticed the last hour of my day had been cleared of patients and blocked.  I will admit this caused me some anxiety, which only increased when I was requested to attend a meeting with our CEO during that time.  Basically he apologized, provided me a glowing personal letter of recommendation and a separate letter stating that the "formal reprimand" has been rescinded as it was "inappropriate" and "never should have been placed."  My understanding is that admin realized their mistake rather quickly as they were contacted by the medical school, licensing boards, ethics boards, etc. that I contacted.

I asked what steps would be taken to educate the providers who voted that I failed to meet "standard of care."  The response was canned, "they didn't understand fully, so we will make sure to update them so they fully understand."  I did not accept this and stated the only appropriate response is mandatory ethics training regarding this situation for all providers who voted that "standard of care" was not meant.  They are "looking into it" and will follow up with me. 🙄

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47 minutes ago, mgriffiths said:

So a good update...sort of.

I walked into clinic yesterday and noticed the last hour of my day had been cleared of patients and blocked.  I will admit this caused me some anxiety, which only increased when I was requested to attend a meeting with our CEO during that time.  Basically he apologized, provided me a glowing personal letter of recommendation and a separate letter stating that the "formal reprimand" has been rescinded as it was "inappropriate" and "never should have been placed."  My understanding is that admin realized their mistake rather quickly as they were contacted by the medical school, licensing boards, ethics boards, etc. that I contacted.

I asked what steps would be taken to educate the providers who voted that I failed to meet "standard of care."  The response was canned, "they didn't understand fully, so we will make sure to update them so they fully understand."  I did not accept this and stated the only appropriate response is mandatory ethics training regarding this situation for all providers who voted that "standard of care" was not meant.  They are "looking into it" and will follow up with me. 🙄

Well done! Glad that it was resolved.

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1 hour ago, mgriffiths said:

So a good update...sort of.

I walked into clinic yesterday and noticed the last hour of my day had been cleared of patients and blocked.  I will admit this caused me some anxiety, which only increased when I was requested to attend a meeting with our CEO during that time.  Basically he apologized, provided me a glowing personal letter of recommendation and a separate letter stating that the "formal reprimand" has been rescinded as it was "inappropriate" and "never should have been placed."  My understanding is that admin realized their mistake rather quickly as they were contacted by the medical school, licensing boards, ethics boards, etc. that I contacted.

I asked what steps would be taken to educate the providers who voted that I failed to meet "standard of care."  The response was canned, "they didn't understand fully, so we will make sure to update them so they fully understand."  I did not accept this and stated the only appropriate response is mandatory ethics training regarding this situation for all providers who voted that "standard of care" was not meant.  They are "looking into it" and will follow up with me. 🙄

get even with them!!

 

Volunteer to TEACH THEM ethics!!   Come up with a great course, teach it as best you can - makes them look petty and stupid for their ignorance, and puts a feather in your hat that you took the high road and did the right thing!

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10 hours ago, mgriffiths said:

Basically he apologized, provided me a glowing personal letter of recommendation and a separate letter stating that the "formal reprimand" has been rescinded as it was "inappropriate" and "never should have been placed." 

One more piece of evidence for the medical board complaints against the licenses of the "medical professionals" who voted to sanction you.

They have taken effective action to mitigate the damage to your career and personal standing, sort of. You must still answer 'yes' to "Have you ever been formally reprimanded?" for the rest of your career.

They have not yet taken effective action to root out the dangerous numbskulls on the disciplinary committee. They should not be practicing medicine, or nursing, or whatever else it is, based on the egregiously bad judgment they showed in your case (again, like all of this, assuming you've told the whole story, which we have no particular reason to doubt, but this is still just Internet advice).  One of the basic tenets of disciplinary proceedings is that when someone brought up on charges says, "I did it, I was right to do it, and I would do it again" you need to be VERY VERY sure that you know what you're talking about before you place sanctions.

I would advise you to let it lie for a bit and see what else happens, but definitely keep building your evidence file.

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Again, I'm not sure what state you are in but as an inspector who investigates exactly this kind of thing I would say this.....Seriously consider lodging a formal complaint with your state medical board agency against those providers who voted to reprimand you.  They deserve to be deep investigated. Also remember that you can lodge a formal complaint against the FACILITY you work for as well although the agency who governs medical facilities is usually different then that the governs the medical providers.  

Consider this....walk into any entrance of the facility you work for...look at the wall and you will see a posting that says this:  "If you have a complaint, this is how you lodge it....". That is required by law and where I would start.  I investigate as many complaints from employees as I do patients....

I am not a litigious person, but this facility needs to be held accountable for the pain and suffering and damage they have done to you and your career.

Good luck.

Edited by Cideous
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  • 2 weeks later...

Another update: complaints were lodged against the providers who were part of the meeting back when I initially was contacting licensing boards, med schools, etc.  No idea where that will go...my guess is nowhere.  My guess is the providers will pin the blame on someone in administration because that individual "didn't explain the situation fully" during the meeting so they all misunderstood the situation...🙄...of course that administrator won't have anything to do with actual healthcare, and therefore won't have an ethics board, licensing board, etc. to answer to...

I have tried to follow up regarding the ethics training and have yet to hear anything.

As for effects on my career...I really don't expect anything.  Maybe I'm being unethical (🙃) but I don't plan to ever check the box: "Have you ever been formally reprimanded?" I have a letter in hand that states the reprimand shouldn't have occurred and the reprimand has been removed.  Why would I put myself into that box needlessly?  I was terminated from my first PA job...I've written about it here some when that occurred many years ago.  I was 100% partially at fault, and my employer was 100% partially at fault...and each of our faults exploded.  In every interview I've had since then I've been forthright about exactly what happened and what I learned from the situation.

Lastly, this situation has the potential of moving me into a partial admin position.  It has been brought up twice and I'm open to it.  It would be focused on ethics...and potentially grow from there. We'll see...I don't know how I feel about possibly being involved with the admin side of healthcare...but also could open doors to jump out of healthcare entirely.

Edited by mgriffiths
clarified some wording
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Yea.... this could leave a pretty sour taste in your mouth.

Here's the deal with the "they didn't explain it fully" excuse. These people practice medicine. What could have been omitted from a "you have to fondle this child's genitalia to make his mom happy"? The kid begged for the exam but you wouldn't do it? It defies credibility.

They are responsible for making high quality decisions every day. That excuse doesn't cut it. It is a weak excuse and no kind of justification. I have said for years.... there is always an excuse...there is rarely a justification.

I have generally been a "pound of flesh" kind of guy. In this case you have been vindicated and in writing no less. What is the upside to getting your pound of flesh? It sounds like a lot of energy so there should be some personal profit that outweighs the time and work and emotional energy having them flogged would require.

Cost/benefit. Does it balance?

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2 hours ago, sas5814 said:

I have generally been a "pound of flesh" kind of guy. In this case you have been vindicated and in writing no less. What is the upside to getting your pound of flesh? It sounds like a lot of energy so there should be some personal profit that outweighs the time and work and emotional energy having them flogged would require.

 

Completely agree...I've made the complaints to licensing/ethics boards...beyond that I'm leaving it alone.

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8 hours ago, sas5814 said:

It sounds like a lot of energy so there should be some personal profit that outweighs the time and work and emotional energy having them flogged would require.

This an entirely utilitarian approach, but not necessarily principled.  The principled approach considers the effect to society of such bad decisions, and the ripples therefrom, and so principled people endeavor to Right Wrongs even if the math doesn't add up for their own benefit.  This is a large part of the reason by only 12% of rapists get convicted: the utilitarian approach says "I've been victimized enough!" which is certainly true.

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13 hours ago, rev ronin said:

This an entirely utilitarian approach, but not necessarily principled.  The principled approach considers the effect to society of such bad decisions, and the ripples therefrom, and so principled people endeavor to Right Wrongs even if the math doesn't add up for their own benefit.  This is a large part of the reason by only 12% of rapists get convicted: the utilitarian approach says "I've been victimized enough!" which is certainly true.

The principled approach, if that is a value to you, would meet my definition of upside. Its an individual choice.

I have mellowed in my old age. I used to use "scorched earth" and my go-to move.

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18 hours ago, rev ronin said:

This an entirely utilitarian approach, but not necessarily principled.  The principled approach considers the effect to society of such bad decisions, and the ripples therefrom, and so principled people endeavor to Right Wrongs even if the math doesn't add up for their own benefit.  This is a large part of the reason by only 12% of rapists get convicted: the utilitarian approach says "I've been victimized enough!" which is certainly true.

While I agree with you...I really don't have much recourse beyond making complaints to their licensing and ethics boards.  It's unfortunately similar to when I have made complaints against the NP I've posted about previously.  I am not her employer and don't make the decisions regarding her employment.  All I can do is inform management and report her to the state licensing boards...at that point it is up to them...which sadly seems to have done nothing...ever.

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  • 1 month later...

What is likely the final update: after 6+ weeks of no communication regarding the ethics training for the providers involved in the original "conviction" I followed up with the CEO requesting a meeting.  He agreed, but when we met I was surprised to find multiple individuals of upper level management present.  When I inquired about the ethics training I received a snarky response from our chief of staff and chief medical office that they both are being required to complete a "long, annoying" ethics course by the state, and was told that several other providers on staff were required to do so as well including PAs and NPs.  I'm not sure if it was the ethics board, licensing boards, or what...but I simply responded with, "Good."

Also, the chief of staff lost his part-time teaching job with the local medical school as they found the ethics violation "compromising and therefore unfit to train future physicians."

So...there's at least that!  Felt good...and another good thing relating ethics that will be a separate post.  Today was a good day.

 

Relaxed Natalie Dormer GIF

Yeah...I'll be pretty smug for a while.

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It has always interested me that when I am the aggrieved party I never got any feedback about the remedy.

Long story short I gave a 19 yo 1 dose of prednisone for a severe sore throat. Turns out she was the daughter of one of our pharmacists who was on the "steroid reduction team". He badged his way into my clinic and basically started a fight and told me I was making up studies to justify misuse of steroids. I made a formal complaint and, when months went by with no response, I insisted on a response. I was taken to task for being difficult.

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On 4/11/2022 at 6:25 PM, mgriffiths said:

What is likely the final update: after 6+ weeks of no communication regarding the ethics training for the providers involved in the original "conviction" I followed up with the CEO requesting a meeting.  He agreed, but when we met I was surprised to find multiple individuals of upper level management present.  When I inquired about the ethics training I received a snarky response from our chief of staff and chief medical office that they both are being required to complete a "long, annoying" ethics course by the state, and was told that several other providers on staff were required to do so as well including PAs and NPs.  I'm not sure if it was the ethics board, licensing boards, or what...but I simply responded with, "Good."

Also, the chief of staff lost his part-time teaching job with the local medical school as they found the ethics violation "compromising and therefore unfit to train future physicians."

So...there's at least that!  Felt good...and another good thing relating ethics that will be a separate post.  Today was a good day.

 

Relaxed Natalie Dormer GIF

Yeah...I'll be pretty smug for a while.

Strong work!!!

and him lousing part time job is awesome!!!

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