Clerkship evaluation

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<threadtitle>Whistle-blower MD fired</threadtitle>

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<username>Lactic Folly</username>

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<title>Whistle-blower MD fired</title>

<pagetext>From Canada.com - The StarPhoenix

 

The head of emergency medicine at Royal University Hospital has been fired less than two months after he wrote an alarming letter to the provincial minister of health about unsafe patient care and overworked emergency room physicians at the hospital.

 

An emotional and frustrated group of doctors, nurses, aides and support staff were told of Dr. Jon Witt's dismissal at a meeting on Tuesday night. More than 40 people attended the hastily called meeting at Royal University Hospital (RUH).

 

Saskatoon Health Region's chief of medical staff, Dr. Ronon Conlon, and the region's physician vice-president, Dr. Barry Maber, confirmed what some of the staff members have dreaded since Witt wrote the letter. He was fired as the administrative head of the emergency department earlier Tuesday afternoon. Maber says Witt can continue to work as a doctor in the department.

 

On Jan. 20, Witt wrote a bluntly worded letter to Health Minister John Nilson saying physicians felt patients had died and others had been permanently disabled because they waited at RUH emergency for too long before they received care.

 

The letter also said unless the government increased funding by Feb. 1 so more doctors could be hired, the emergency doctors at RUH would stop treating children and accident victims.

 

"We feel that it would be unsafe to continue to offer a service that we cannot provide in a safe and timely manner," he wrote in the two-page letter that was leaked to the media. Witt was not responsible for the letter's release to reporters.

 

Conlon told the group that he conducted a review of patient files and found "no validity" to Witt's statements. He also said he met with Witt on two occasions and asked for names of people who either had died or had been disabled because they didn't receive care quickly enough. The chief of staff said Witt did not provide any names. Conlon called Witt's letter "inflammatory."

 

But at the meeting, doctors corrected Conlon that Witt did not say people had died but that physicians felt patients had died or were permanently disabled. They also pointed out that in his letter, Witt said "to my knowledge, we have not had children die." And several times the doctors said Witt had written the letter on behalf of all emergency room physicians at RUH.

 

"You have to look good to the government and you're using Jon Witt as a fall guy," said one physician to applause in the room.

 

According to Conlon, the decision was "not punitive" but there had been some issues regarding Witt's performance.

 

"If you hold a position, you have certain obligations and require a certain skill set. Dr. Witt didn't have the skills and he didn't demonstrate to me that he would change," he said.

 

When Conlon and Maber questioned Witt's ability to provide solid leadership to the emergency department at RUH, the room erupted. Doctors and nurses came to Witt's defence saying his coming to RUH emergency almost two years ago was the best thing that had happened to the department for many years.

 

"At least Jon went in there and fought for issues that we have been complaining about for 10 years," said one nurse.

 

In explaining how he came to the decision that Witt must go, Conlon said he talked to emergency room physicians at Saskatoon City and St. Paul's hospitals.

 

"Why not to emergency room physicians here?" he was asked.

 

"Why haven't you been in emergency?" asked another.

 

"Why are you making a major decision and nobody here recognizes you?" demanded someone else.

 

Conlon, who is an ophthalmologist, repeated that he had been to emergency twice to meet with Witt. Conlon has taken over as interim administrative head of the department.

 

When staff members wanted to know what he knew about emergency medicine, Maber came to Conlon's defence saying he would be doing administrative, not clinical duties.

 

In an interview after the meeting, doctors who asked their names not be used because they fear retribution said that as a physician group they have asked for a meeting with administration but haven't been granted one.

 

And during the meeting, they suggested that Witt is taking the fall because of tension that exists between the emergency departments at all three Saskatoon hospitals, tension that pre-dates Witt.

 

"We want him to be a team leader in the context of the region," said Maber.

 

When asked by a doctor what he would do if the entire emergency room walked out over the decision to fire Witt, Conlon replied, "Personally, I think that would be a poor decision."

 

Other comments made during the meeting suggested the doctors were incensed with the administration of the health region.

 

"This problem could get bigger very quickly," one said.

 

The decision would have "severe ramifications" and "destroy moral" among all who work in emergency at RUH.

 

"This has gone too far. It's one thing to reprimand him (for writing the letter) but another thing to fire him," one said.

 

The doctors pleaded with Conlon and Maber to reconsider their decision to strip Witt of his leadership responsibilities but they said the decision had been made and would not be reversed.

 

At one point, Maber who called the group "a mob," demanded to talk and threatened to leave the meeting if they didn't show more respect. He finally did leave about 50 minutes after the meeting began.

 

"We're repeating ourselves. I'm leaving," said Maber and he walked out.

 

Staff members starting filing out shortly after. "They've just killed emergency medicine (at RUH)," said one physician after the meeting.

[Guest kosmo14]

Interesting, although you always wonder what other issues are at stake here. The Star Phoenix is well known for its one sided presentation of facts, particularily if it is going to sell some papers.

[Guest jmh2005]

Now why does this opthomologist think he fit to run this ER???...now that is frightening....

[Guest klukyboy]

"If you hold a position, you have certain obligations and require a certain skill set. Dr. Witt didn't have the skills and he didn't demonstrate to me that he would change," he said.

 

Sounds to me like they wanted a yes-man and got someone who took the job seriously and personally. There had better be more to the story, because if he was only fired for being a whistle-blower I would say that this is the management equivalent of trying to put out a fire with gasoline. I've seen what can happen when you demoralize a team. Worker efficiency plummets, mistakes get made because people don't care. It just makes a bad situation worse. At the place I worked at, this ultimately ended in a plant closure (but somehow I doubt they'll be able to transfer health-care to a cheaper Malaysian facility :rolleyes ). Even if there isn't a formal walkout, I would suspect that stress LOAs will spike.

 

What are the legal implications of firing a whilstle-blower in Canada? (I should know this )

[Guest macdaddyeh]

I understand that during clerkship (upper med student years) med students are evaluated often during their various rotations?

 

Of what do these evaluations consist?

 

For example, are evaluations

1) sit-down tests where one must calculate doses, answer multiple choice questions etc

2) oral-based

3) clinical skill-based (ie, graded according to your ability to do stitches or casting or delivery of a baby etc).

 

Perhaps every hospital/clinic and every city and university is different, but can y'all comment generally please:D

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