This article recently appeared in Medscape. It is presented today because the premise is both disturbing and controversial.
Can Doctors Speak Their Minds Without Getting Into Trouble?
When physicians speak their minds in exam rooms, committees, and the courts, they are expected to have a strong opinion and advocate forcefully on behalf of patients. But in a number of cases, doctors who speak out have met with harsh retribution that has cost them their jobs and hospital privileges, and permanently marred their reputation.
According to these doctors and the lawyers and consultants representing them, hospitals and other healthcare entities use several powerful tools against them. These include peer-review panels that have sweeping powers over disciplined physicians; nonspecific charges, such as labeling them “disruptive” physicians; and, when doctors are employed by the hospital, firing them without having to state a reason.
“Hospitals are run more and more like corporations, where earning money has become more important than human relationships,” said Derek Kerr, MD, an internist in San Francisco who was fired for speaking out and sued his hospital.
Speaking Truth to Power
According to Dr. Kerr, physicians can get into trouble when they challenge people who are more powerful than they are. Nabbing a low-level employee on the take might even make you a hero, he said, “but if you go after someone in a position of a power, you’ll find you’re no longer welcome.”
In 2009, while employed at a public hospital in San Francisco, Dr. Kerr claims “If you go ahead and look into it, you could be damaged professionally, but if don’t, you’d be dodging your responsibility.”
Challenging powerful individuals is “career suicide,” he said. He says he won’t return to the hospital, because he feels that many people there view him as a troublemaker. “When you turn somebody in, there is an element of perceived disloyalty, because you’re not acting like you’re part of the team,” he said. It will also be hard to move on and find a new job, because for many potential employers, “there is the feeling that you might tell on them, too,” he said. Currently, he spends his time helping other whistleblowers.