August 05, 2009 | | Comments 26
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Nurses face felony charges after reporting doctor to the Texas Medical Board

texasAnne Mitchell, RN and Vicki Galle, RN, two nurses from West Texas, tried reporting a physician’s problem behavior through designated hospital channels. When their complaints fell on deaf ears, they took the next step and anonymously reported the physician to the Texas Medical Board.

If you’re a follower of Rita Schwab’s Supporting Safer Healthcare blog you already know what happened next – the medical board notified the physician of its investigation. In turn, the physician contacted the local sheriff to file a harassment report. The sheriff’s investigation led to third degree felony charges for the nurses.

The Texas Medical Board and the Texas Nurses Association both support the nurses’ actions, but that hasn’t stopped the sheriff’s office’s investigation.

Newspaper columnists have also come out in support of the nurses, saying the state’s whistleblower laws should offer more protection.

What do you think of the case? Do you think a similar situation could occur within your medical staff?

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Filed Under: healthcare newslegal and ethical issues

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Emily Berry About the Author: Emily Berry is an associate editor at HCPro in the credentialing market. In addition to managing information on CRC she writes the Briefings on Credentialing newsletter and the Credentialing Resource Center Connection weekly email newsletter. A native of Ohio, she graduated from Case Western Reserve University in Cleveland before moving east to attain her MS degree in journalism from Boston University.

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  1. I have to admit this case really surprised me. I suspect the Sheriff’s office in this small town has a limited background in healthcare law. What a way to get a crash course!

  2. It would seem that the sheriff’s office has a bias in this case. Perhaps someone there is friends with the physician, or worse, money has changed hands. it is inconceivable that these women are being charged with a felony for making a report. Maybe the physician would be able to file slander charges in civil court, but criminial charges is so out of proportion.

  3. I am glad the physician filed harassment charges. The nurses’ complaints were already addressed by the hospital’s process and ended there. Their further actions should be punished. There are enough rumors, gossip and slander occurring in hospitals that can negatively impact a physician’s practice. These nurses need to receive the full punishment of the law.

  4. HP, I hope you never have to be seen by a physician that has questionable behavior where your life may be put in danger from it. It’s nurses like them that protect the general population from physicians who may need to be removed from the medical world! I commend the nurses for reporting it! Way to go!

  5. Oh, by the way, why don’t you look up the story of Dr. Michael Swango. That’s all the more reason that if the hospital does not do anything, that the person reporting the problem should go ABOVE and BEYOND to protect patients.

  6. What a shame the hospital failed on their part to investigate and/or take corrective action if needed. The nurses are to be commended for their actions.

  7. HP, I think you need to check out the laws and regulations regarding disruptive behaviors in providers as well as whistleblower laws and protections. I do not think you have a clue. There is a duty to report and the nurses did the right thing. Any healthcare worker of any type can and should report this especially if the hospital ignores it. The sherrif’s office also needs to get a clue.

  8. I completely agree with the actions of the nurses. They are bound by professional ethics to make sure questionable medical practice is addressed properly. I feel for the nurses. In a similar case I dealt with, the whistleblower physician ended up suing the hospital. The physician was completely in the right, but now is having difficulty securing privileges at other hospitals. The hospitals fear the physician will sue them! It seems to me that Winkler County Memorial Hospital seriously needs to reevaluate its quality monitoring and investigation programs. Healthcare providers should never have to fear retaliation when reporting concerns with quality of care.

  9. HP, I have a feeling you have been investigated or punished in the medical field for poor ethics or poor care. I’m glad there are more of us and less of you.

  10. Those of us who have been around for a while know that there are a lot of politics involved, especially if the physician is a major revenue producer. I think the fact that the state medical board is supporting the nurses for reporting speaks volumes. Maybe the Sheriff’s Office should be investigated and charged with harassment.

  11. I am aphysician who trains other physicians on effective peer review. I am not critical of what the nurses did because I don’t think we have enough information. I think this case hinges on what the concern was and what the medical staff did. We don’t even know what the nurses were upset about. maybe the physician aleays left his coat on the chart rack, or forgot to wash his hands a lot. You don’t know what ot was. Peer review activities by a medical staff are confidential. Just because nurses feel like nothing has happened does not mean nothing has happened. Or maybe nothing happened because it was not a huge violation. Maybe the nurses had a big fight with the doctor because he thought their practice was poor. We don’t know any of this.

    A pattern of violations must be established for the medical staff to act. So it may appear that nothing is happening even though the medical staff is building its case by correcting the physician and seeing if s/he complies. Nurses will not be informaed of what is happening just like physicians are not informed when nurses are being advised to change their practice.

    What if the medical staff was preparing to disciplint the physician? Would that change your mind on this? What if only a few weeks had passed before the nurses went to the Texas Board? Would that be a factor? What if the physician was negotiating with the medical staff for retraining or something else appropriate and then found himself reported to the Texas Boatrd by nurses who had no idea what was going on? Would that change the way you see this? Unfortunately none of this information is provided.

    While it may be true that the nurses’ concerns fell on deaf ears, there is no information provided about whther this is or is not true, whjether their concerns were petty or whether they were out to get this doctor. This is an interesting debate but, unfortunately, none of us has the enough information to say whether the nurses’ actions were justified.

  12. Dr. BL –

    The nurses were not required to report the physician to hospital authorities. They are mandated by the Texas Nurse Practice Act to report suspect behavior to the proper regulatory agency, in this case, the Texas Medical Board (TMB). The TMB makes the decision as to whether the information is substantial enough to investigate and they obviously made that decision.

  13. The bottom line is that the nurses were reporting a concern to the medical board, who in turn would investigate. If the hospital had done due dilligence that would be discovered as part of the investigation. If patients were not concerned that would also be discovered in the investigation. The TMB would then take necessary action or non action which would be the end of story. While a board investigation can be stressful and time consuming, it certainly cannot be as bad as this “mess”.
    There is more to the story than a complaint. I would say there is a negative history between the doctor and nurses to result in this type of response. I would think the doctor without issue would welcome the TMB to put the nurses concerns at rest.

  14. Good luck aunt vicki. You did nothing wrong. For those of you who think she did wrong you haven’t been around the medical field.

  15. Everyone needs to read the book “Blind EYE” by James Stewart.. If you disagree with what the nurses did… you will change your mind after reading this book..

  16. If these nurses were nuns who had worked at this hospital for a long time, the Sheriff would’ve told this doctor to go home & cool off. The hospital where my children were born were run by nuns & the nun in charge of the OR at a bigger hospital threw the surgeon’s instruments out the window simply because of he acted like a jerk toward the OR nurses. His surgical privileges were reinstated only after he apologized to the nurses. The nuns respected doctors, but didn’t put them up on a pedestal nor put up with bad behavior, let alone bad practice of medicine. Read “Sisters: Catholic Nuns and the Making of America” by John Fialka (WSJ reporter) to learn how they built & operated over 800 hospitals in the USA.

    My family includes 3 doctors who welcome nurses & patients coming forward to report bad doctors who need removing to protect patients as well as our health care system. They are shocked a local sheriff would intervene during a medical board investigation of reports by nurses with first-hand knowledge. It certainly has a chilling effect.

  17. This just sickens me. Obviously the sheriff has been lucky enough not to have experienced a sentinal event.

    Maybe the sheriff should be charged with harrassment. He has received information from a state agency through his friend and acted on it. The nurses followed the proper process in reporting.

    Has he pursued charges against his physician friend for the harm he has imposed to any of his patients due to negligence? I think it is time for patients to step forward and pursue assault charges against the physician.

    I think this is a case of revenge and this small town sheriff has overstayed his office. Maybe this officer of the law should read some current information about how many people are harmed each day by hospitals due to actions similar to his friend.

    I have never heard of a more abserd example of a law official over stepping his scope in my entire life. Well this doctor is definitely making a name for himself. Hopefully he gets to keep his job(not). Because now he has a Scarlet letter on his chest.

    Would he prosecute me if I called 911 because one of his friends was shooting at me?

  18. It is too sad that the relationship between nurses and doctors is sometimes so adversarial. We are supposed to be on the SAME TEAM!! The nursing profession has deliberately positioned themselves as “patient advocates”. What does this imply about the doctors? The reality is that everyone is supposed to be working for the best good of the patient at all times. I’ve seen a lot of damage done, unintentionally, by nurses who just didn’t know what they were doing. With a little education and gentle correcting, that has been remedied. I particularly appreciated the comments by Dr. LeTourneau. There is a lot of information missing in this report, and there seems to be a general rush to conclude that the nurses are right and the doctor is wrong, as well as concluding that the hospital’s review process is somehow in efficient. What outcome were these nurses anticipating when they reported to the hospital? (before they reported to the medical board?) What are the reasons they expected a different outcome than they received from the hospital review process? Without the information, I could just as (il)logically conclude these nurses simply had it out for this doctor and were determined to “get him in trouble” no matter what lengths they had to resort to.

  19. Emily Berry

    Thanks to everyone for sharing your comments and sparking a great conversation on the blog. For those of you wondering how this court case ended, here is the blog post that provides a trial summary: http://blogs.hcpro.com/credentialing/2010/02/not-guilty-verdict-for-nurse-who-faced-charges-for-reporting-to-texas-medical-board/

  20. I have been a nurse for thirty years and the simple matter of the fact is that as nurses’ become more empowered in their profession, the physician feels more intimidated and irritated. Undeniably, a physician spends much more time learning, working, residency etc. But in that process, they lose social networking skills. They could never actually team up with the nursing staff and work as a ‘team’ to promote and ensure adequate patient safety and quality care.
    Going to the hospital board to report the behavior usually never results in the physican being the one reprimanded but always the nurse getting either written up, suspended or even terminated.
    The physician is the hospital’s ‘real’ clients, not the patients. The hospital leadership will do everything in its power not to lose the services of a physician who brings in the money and adds to the bottom line.
    This alone is the very simple reality of the ‘business’ of health care. A nurses’ frustration with the healthcare system has only increased over years, not diminished as has the nursing work force. It’s a shame and it always will be.

  21. I have had simular experiences reporting to Hospital Management and, the Board of Health.

    Ohio Board of Health would not take my complaint. They accept from Patients only. I advised patient to make their complaints directly. The Investigator, (who they had no badge on) asked “why I would tell patients this”. “We have to investigate every complaint and, do not have manpower to do so”.

    My employer started files “complaints” by my peers/patients against me. I was encouraged to go else where. Methods included, heavy patient loads-and high ratios, Patient assignments on three sides of the Hospital’s, max. distance apart, sent home early, sent to ER- cracks on my hands, made to pay the co-pay, told not to work until healed. (from allergy to powered gloves -they would not provide alternatives), when made to provide powerless gloves they were two sizes to small. “Complaints by peers/Patients”, I was not allowed to know sources or facts of. etc etc.

    We were told to be Patient advocates in nursing school. Bull…, I have seen patients/staff “murdered”, mistreated and lied to and about. When will this stop?

  22. I received my training in a diploma school back in the 70’s. My education was of the highest caliber and we also received college credits for courses taken at IU Perdue at Fort Wayne. From the beginning we were taught respect for our doctors, fellow nurses and most importantly for our clients (then called patients). We were not only taught that the nurses were the patient’s advocate but were shown by example what that meant. It is not necessary to be adversarial with the doctors, it means that you, as a nurse, use your education and more frequent interaction with the patient to help the doctor do what is best for the patient. Nurses are highly trained professionals but they are not doctors, we don’t write orders and are not ultimately responsible for the medical care given. We have a legal, moral and ethical responsibility however to make sure that the care given to any patient is the very best available.

    I am glad that the courts upheld the legislated “right” of the two nurses to report the unprofessional behavior of a doctor. I would expect to feel the same way if a doctor reported a nurse for unprofessional behavior and faced felony charges. Reporting inapproprate behavior is part of being ethical and unfortunatly this country has seen and tolerates way too much unethical and illegal behavior from our top officials. It is time to return to the values of our ancestors when a man’s (or woman’s) word was worth something

  23. Something similar happened to me. After going up the hospital chain, where nothing was done, I annonamously reported a physician and his NP to their respective boards. THey later accused me of falsification of records (correcting facts on a discharge summary) and it became a he-said-she-said issue. I was fired. The physician flat out told me, I bring millions of dollars of business to this hospital each year, who do you think they will believe. About a month after I was fired the CEO was fired and about a month later the physicain withdrew his priveledges from the hospital and no longer practices there.

    I pride myself in being the most honest person I can be. I was most dissapointed in the system. I had proof and facts that I did not falisfy anything but by that point the issue was public in the small hospital and there was no going back. It was scary that this physician and NP were harming patients and the one who lost was the person who was trying to protect them.

  24. “Stand up for what is right even if you stand alone”.

  25. If I had to guess, I would say that HP is an MD himself. Go nurses!

  26. I admire any nurse who is willing to challenge the concept of the Parent-child interaction that exists in the doctor-nurse relationships. It is this aged view that defeats the team concept in patient care today. A few years ago I used a tool that was developed at a Texas teaching hospital to measure the culture of safety among our ER staff. This tool was recommended by AHRQ and Joint Commission as a best practice method to determine the attitudes and behaviors related to safety in the environment of care. At our facility I found that my staff were reluctant to report a physician they felt was performing unsafely due to fears of reprisal and that the hospital would not support their actions. Nursing has advanced so much in the 20 years I have practices and yet, there has been no commensurate acceptance by the Physicians or sheriffs I guess that our observations and concerns truly reflect “do no further harm”!

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