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  • Avatar RollieStrummer 
    Participant
    Status: Physician
    Posts: 17
    Joined: 11/07/2018

    Ugh. I’ve been through the ESA fight.

    We own a condo in a high rise in another city.  It has a very strict “no animals” policy.  It’s the type of place where everyone knows each other, and if you commit an HOA violation you are going to get a notice within 24 hours.

    A couple of years ago one of the units is sold and a woman moves in with her 2 dogs.  She is immediately told “no animals”, and responds that they are ESAs. This is followed by a letter from her lawyer to the HOA board outlining her rights under the ADA.  HOA board hires a lawyer, and after several thousand dollars in fees, realizes unless they want a very expensive fight that they will probably lose, they are going to have to let her have the dogs.  HOA board reluctantly allows the dogs, but everyone is steamed.  The dogs are poorly behaved (because they’re pets, not trained service animals), and cause some problems around the building. The dog owner becomes a pariah and gets glares from everyone in the building.

    A few months later, she “trips” on some “loose carpet” in the hallway, has a fall and suffers “soft tissue injury” to her chest and arm.  She then files suit against the building, the HOA and by proxy all the other owners.  Well.  Now the HSA mounts a vigorous defense, indicating that they won’t settle for nuisance value.  She is presented with a litany of documented HOA violations and also confronted with video of the alleged fall, which was nothing of the sort.  (She didn’t realize there were cameras in the hallway.)  This drags on for a few months, and eventually she drops the suit. (More likely her lawyer dropped her.)  She then moved out a year ago, and the saga came to an end.

    It seems that many ESA owners “know their rights” and are prepared to enforce them, so skirting the law or hoping that they go away is probably not a good strategy.

    I had my own fun experience about 3 months ago.  Woman comes into the hospital for her liver biopsy with her golden retriever.  He’s an ESA, and she demands to have him with her throughout the procedure.  I say no way.  I’m not doing a liver biopsy with a dog in the room.  She protests and I list all of the reasons why this is not going to happen:  It’s not safe for her, it’s not safe for me, it’s not sanitary for anyone using that room, etc.  After she realizes that she is not going to bully me into getting her way, we reach a compromise of the dog waiting outside the biopsy room in kind of a control area that’s not open to the general public.

    Biopsy goes fine.  We leave the biopsy room and discover that the dog is gone.  Somehow the door was opened and the dog took off.  The patient loses it and starts screaming.  She’s yelling at us, wailing in despair, creating such a racket that staff come running from all over the department to see what’s going on.  A couple of staff stay with her, while everyone else goes searching for the dog.  It’s found fairly quickly wandering down a hospital hallway, dog and patient are reunited and all are relieved, except for the patient who is now threatening all of us with lawsuits, formal complaints, medical board inquiries, etc.  It’s been a few months, and I have not heard anything, so maybe nothing is coming, but the whole incident did make me take a closer look at my FIRE projections.

    Should you sell the house?  I don’t know, but stuff like this is the exact reason I don’t own any SFH in the real estate arm of my portfolio.  If there is any legal way to avoid an ESA tenant, do it, but be prepared to be challenged.

     

    Click to expand…

    ESAs don’t have standing in the hospital. My system, much to my irritation, allows them, but the law says nothing. If they don’t have a caregiver for the animal, you are more than within your rights to say no and reschedule when dog caregiver is available, or you can just refuse to do the procedure. Given your experience, refusal is a much better choice. You were too nice. This is 100% a reason to cancel the procedure and reschedule. Psycho needs you more than you need her.

    As to OP-

    ESA lady has all the rights here, but she is liable for any and all damages caused by said dogs. You can, and I would suggest, consulting with a local attorney as to whether you can write fines and rules into the lease- if you find animal waste in the yard, $25, she must have renter’s insurance and umbrella that cover any and all liabilities (such as from her pet), if there are noise complaints she is liable, if the dog attacks, she is liable. She’s legally allowed to have an animal; she’s not legally allowed to be a nuisance.

    Property manager (or you) need to inspect this place regularly if she rents.

    Your rental is doing OK, but it doesn’t meet the 1% rule, so selling would be reasonable, although you will pay mighty and awful taxes. At least you can deduct the 7k in damages when you sell. It sounds like the headaches of landlording are not your thing, which is completely understandable. If it’s not an ESA, it will be something else. The ways tenants can destroy a property are endless.

    Click to expand…

    You are correct.  I admit I didn’t know the hospital policy on ESAs, but she’d made it past the initial gatekeeper, so I followed the path of least resistance, which was to say “Your dog can wait there.  That’s your only option.”  As part of her ranting after the dog was found, she did mention that the competing hospital system across town has a special program for dogs, and has always been wonderful with her dog.  From now on I’m referring all ESAs to our competition.

    Avatar RollieStrummer 
    Participant
    Status: Physician
    Posts: 17
    Joined: 11/07/2018

    Ugh. I’ve been through the ESA fight.

    We own a condo in a high rise in another city.  It has a very strict “no animals” policy.  It’s the type of place where everyone knows each other, and if you commit an HOA violation you are going to get a notice within 24 hours.

    A couple of years ago one of the units is sold and a woman moves in with her 2 dogs.  She is immediately told “no animals”, and responds that they are ESAs. This is followed by a letter from her lawyer to the HOA board outlining her rights under the ADA.  HOA board hires a lawyer, and after several thousand dollars in fees, realizes unless they want a very expensive fight that they will probably lose, they are going to have to let her have the dogs.  HOA board reluctantly allows the dogs, but everyone is steamed.  The dogs are poorly behaved (because they’re pets, not trained service animals), and cause some problems around the building. The dog owner becomes a pariah and gets glares from everyone in the building.

    A few months later, she “trips” on some “loose carpet” in the hallway, has a fall and suffers “soft tissue injury” to her chest and arm.  She then files suit against the building, the HOA and by proxy all the other owners.  Well.  Now the HSA mounts a vigorous defense, indicating that they won’t settle for nuisance value.  She is presented with a litany of documented HOA violations and also confronted with video of the alleged fall, which was nothing of the sort.  (She didn’t realize there were cameras in the hallway.)  This drags on for a few months, and eventually she drops the suit. (More likely her lawyer dropped her.)  She then moved out a year ago, and the saga came to an end.

    It seems that many ESA owners “know their rights” and are prepared to enforce them, so skirting the law or hoping that they go away is probably not a good strategy.

    I had my own fun experience about 3 months ago.  Woman comes into the hospital for her liver biopsy with her golden retriever.  He’s an ESA, and she demands to have him with her throughout the procedure.  I say no way.  I’m not doing a liver biopsy with a dog in the room.  She protests and I list all of the reasons why this is not going to happen:  It’s not safe for her, it’s not safe for me, it’s not sanitary for anyone using that room, etc.  After she realizes that she is not going to bully me into getting her way, we reach a compromise of the dog waiting outside the biopsy room in kind of a control area that’s not open to the general public.

    Biopsy goes fine.  We leave the biopsy room and discover that the dog is gone.  Somehow the door was opened and the dog took off.  The patient loses it and starts screaming.  She’s yelling at us, wailing in despair, creating such a racket that staff come running from all over the department to see what’s going on.  A couple of staff stay with her, while everyone else goes searching for the dog.  It’s found fairly quickly wandering down a hospital hallway, dog and patient are reunited and all are relieved, except for the patient who is now threatening all of us with lawsuits, formal complaints, medical board inquiries, etc.  It’s been a few months, and I have not heard anything, so maybe nothing is coming, but the whole incident did make me take a closer look at my FIRE projections.

    Should you sell the house?  I don’t know, but stuff like this is the exact reason I don’t own any SFH in the real estate arm of my portfolio.  If there is any legal way to avoid an ESA tenant, do it, but be prepared to be challenged.

     

    Avatar RollieStrummer 
    Participant
    Status: Physician
    Posts: 17
    Joined: 11/07/2018

    I am definitely not happy with our level of debt but I don’t think it is as unusual or terrible as others may believe.

     

    Click to expand…

    You have almost a million dollars in debt.  That is terrible.  By just about any definition.

    Your financial house is on fire.  You are fighting it with a fire hose, but that fire hose makes your arms hurt.  You are now going to put down the fire hose and pick up a garden hose while you go in search of a similar sized fire hose that doesn’t make your arms hurt.  This is not a good idea.  Your house is going to burn down.

    There is no solution to your problem that doesn’t involve some sacrifice on the part of you and your family.  You seem to think that you can get out of this situation without suffering.  You can’t.

    If I were you, I’d start looking for other anesthesia jobs that pay more.  Yes, you’ll have to move, maybe across the country.  Yes, you may have to supervise mid-levels more than you like.  There is no solution to this that doesn’t involve you doing something you don’t want to do.

    At the very least, stay where you are, suck it up and try to get some of this debt knocked down.  You want to be there for and take care of your family, I appreciate that.  But making poor financial decisions when your family is already in a massive financial hole is not good for them either.

     

    Avatar RollieStrummer 
    Participant
    Status: Physician
    Posts: 17
    Joined: 11/07/2018
    alpha investing

    I never thought I would hear so much crying about the difficulties of realtors.

    Click to expand…

    It’s certainly not crying about the difficulties of anyone.  I probably dislike residential realtors more than anyone on this board.  However, I personally feel that if I engage the services of someone (ANYONE even a realtor), then I should be prepared to compensate them for their time.  Whether I have a legal obligation, or whether someone else feels differently, is irrelevant to me.  In this case the agent obviously isn’t needed going forward and isn’t doing the entire scope of work, so I wouldn’t feel obligated to compensate them 3% of the purchase price (or close to it) but I would certainly do something for them.  To each their own, I just don’t see this as a “legally you don’t have to use them or pay them so you should just save your money” type of question.

    Click to expand…

    Ha.  I may dispute that.

    I might feel differently in another situation, but with realtors, they have set up the rules of the game, and they vigorously protect their commission fee structure with one of the biggest lobbies in DC.  If someone operates within the contract that the realtor themselves sets up and promotes, I don’t feel any further moral obligation if the encounter does not result in a commission.  I totally respect that you feel differently.

    in reply to: Buyer’s Broker #219921 Reply
    Avatar RollieStrummer 
    Participant
    Status: Physician
    Posts: 17
    Joined: 11/07/2018

    Lol @creguy

    ” I think some nominal offer of compensation for services rendered so far would be a fair gesture.”

    Do you flip the car salesman a $100 after you take a test drive but buy something else, too.

    Click to expand…

    Not at all the same situation.

     

    If the agent had simply emailed a couple of listings to the OP, that would be one thing.  OP engaging the agent to take them on a tour of multiple properties, and arranging for them to get OP’s parents through another house they were interested in is a bit more involved than that.  Ultimately OP happened to stumble into a situation where the house that they wanted to proceed with was through a friend of a friend.  Per the OP, this resulted in a significantly reduced price on the purchase.  Again, I’m not advocating that they pay them 3% of the purchase price out of their pocket, but hell even a small amount of compensation or even a gift card to a nice restaurant wouldn’t be outrageous.  OP clearly engaged their services even if they didn’t ultimately consummate the deal.  Perhaps I’m an outlier in this little forum where I have an appreciation for the value of others’ time and I don’t think it’s crazy to offer up nominal compensation for using a pretty significant amount of someone’s time (who OP obviously saw value in doing or they wouldn’t have engaged them).  Is there some sort of legal obligation?  Of course not.  Is it something OP has to do?  Nope.  Just offering a differing opinion, and I’m not surprised others here don’t agree… To each their own…

    Click to expand…

     

    I disagree here.  If the realtors want to put a value on their time, they certainly can, by introducing an hourly rate fee structure or a flat fee structure that includes a certain basket of services.  They don’t.  They hold on to the commission model.  One argument they make for commissions being so high is that sometimes their work results in no payment at all, such as in the OPs case.

    When I bought my house, I used a buyers agent.  I was an easy client by any definition.  I did a lot of the leg work, saw only a few houses and had an easy controversy free transaction.  If I calculate commission/hours spent with me, my realtor was earning well over $1000/hour, and I did not buy a very expensive house.  If someone else used her time and then didn’t buy, well, my commission more than made up for it.

    We are currently looking for a house, without a buyers agent.  My wife is a real estate attorney who also has an active real estate license.  Although she works on commercial projects for national firms, not residential, we are more than capable of handling a house purchase.  Every time we have looked at a house with a sellers agent there, even knowing my wife’s background, they still give us the pitch to become our buyers agent.  The pitch is the same, every time, from every realtor.  “My services are free.  In this state, the seller pays all the commissions.  It costs you nothing to use me.  Why wouldn’t you hire a buyers agent?”

    Realtors can’t market their services as free, protect a fee structure that results in outsized commissions compared to the time spent, and still expect something when their services are used in a way that does not result in a commission.

    The buyers agent gets nothing.  That is the cost of doing business.  I often get paid nothing for my work with uninsured ER patients.  I don’t expect non-paying ER patients to give me a gift card.  Part of choosing to work as a doctor means that I do fine at the end of the year, even if compensation for individual encounters is widely disparate.  Same rule applies to realtors.

     

     

    in reply to: Buyer’s Broker #219895 Reply
    Avatar RollieStrummer 
    Participant
    Status: Physician
    Posts: 17
    Joined: 11/07/2018

    They do have to do it if you pay more than 10,000 in cash. (Patriot Act, I think). A check is fine though, just not cold hard 100’s.

    Click to expand…

    If a business receives over 10,000 in cash they have to file IRS form 8300 within 15 days of the transaction, but that doesn’t have anything to do with a credit check.  I don’t think auto dealers are subject to the CTR requirements of banks, but with the way dealers are practically financial institutions, maybe I’m wrong, but even that has nothing to do with a credit check.  The Patriot act has money laundering and anti-terrorism provisions, but none of them involve requiring a business to pull someones credit.

     

     

    The last car I bought was with a personal check and they asked me to prove I had the funds in my account to cover the cost of the check, so I pulled up my account on my phone and the guy glanced at it, and that was it.

    They are trying to build a profile on you and get as much info as they can to upsell you financing or something else.  It’s totally shady.  I would have walked at that point.  In any case, I’d never go back to that dealer.

    Avatar RollieStrummer 
    Participant
    Status: Physician
    Posts: 17
    Joined: 11/07/2018
    Earnest refinancing bonus

    What if patient has cardiac arrest on plane and it is discovered that there was a emergency room physician or cardiologist sitting in the next aisle over who just sat there. Seems like that would be a slight problem.

    Click to expand…

    Not in the USA.  There is no legal duty to intervene.  Not the case in some other countries, France, for example.  It would be pretty bad PR, though.  Someone could say they violated the Hippocratic oath, which is probably true, but that’s not legally binding.

    in reply to: Another in flight emergency… #210200 Reply
    Liked by Zaphod
    Avatar RollieStrummer 
    Participant
    Status: Physician
    Posts: 17
    Joined: 11/07/2018

    I posted earlier with the perspective as a pilot, and I went back and dug up one of my aviation law books.  I’m not a lawyer, so don’t take this as legal advice.  However, 49 USC 46501 addresses special aircraft jurisdiction of the United States.

    US Law applies to all US registered aircraft.  This means any plane with a N number in the registration (usually located near the tail on either side).  All US military aircraft. Any aircraft within the US (for example a foreign airline in US airspace arriving/departing a US airport).  Any aircraft outside the US that has either its next scheduled destination or last point of departure in the US.

    Thats all pretty broad, but favors enforcing US Good Samaritan/med mal laws.  The other point to consider is that the US is often a favorable jurisdiction compared to many other countries because we allow all sorts of litigation, meaning people would rather sue in the US than overseas.  Other countries are much quicker to shut frivolous litigation down.

    This all favors having protection under US Good Samaritan laws.  I think with a US based airline, US registered aircraft, US based crew, you should have strong defenses, especially if you act with good judgement and intentions.  I wouldn’t think about cautioning my spouse about rendering medical assistance with my knowledge of aviation, but again, I’m not a lawyer.

    Click to expand…

    In flight medical liability is addressed specifically in the Aviation Medical Assistance Act of 1998.  This supersedes any broader good Samaritan protections or state med/mal laws.

     

    As far as I am aware, no physician has ever been successfully sued for responding as a Good Samaritan. And the courts would certainly take that issue into account if a physician without a duty to the person in distress were to respond in an emergency.

    In the future, I will continue to respond as a Good Samaritan. I feel it is my ethical obligation to do so. And it is further the obligation of the justice system to protect me when I respond as a Good Samaritan.

    Perhaps you may think I am naive, but so be it. I feel strongly about my personal conviction that the right thing to do is to assist a person in distress in a limited resource environment.

    Click to expand…

    “Successfully sued”.  You are probably right.  That would set a precedent that we as a society don’t want.  However ask any physician who has been “unsuccessfully sued” and many will tell you it was one of the worst most stressful situations of their life.  Society may not reward the plaintiff, but it also won’t protect the defendant from the harm of an “unsuccessful”suit.

    I’m not saying you shouldn’t help, but be aware, there is personal risk in helping.  Don’t think the airline is in any way “grateful” for your assistance or will reward you in any way.  You may get a token of appreciation, but if it comes to the airline protecting itself or standing behind you, you’ll find no support.

    in reply to: Another in flight emergency… #210194 Reply
    Liked by Zaphod, MaxPower
    Avatar RollieStrummer 
    Participant
    Status: Physician
    Posts: 17
    Joined: 11/07/2018

    Here’s the flip side of responding:

     

    https://www.nytimes.com/2018/04/27/travel/american-airlines-brittany-oswell-death.html

     

    The doctor was not named, presumably because she is an ally in the fight against the airline, and also because the “gross negligence or willful misconduct” standard in the AMAA is a pretty high bar.  It’s not a stretch to see how an in-flight misdiagnosis leading to death could lead to a claim in another case.  This doctor will certainly be deposed, and called to testify if the case goes to trial.  Even though she won’t suffer a financial judgement, certainly the defense lawyer will make her initial misdiagnosis a central part of the case and paint her as responsible.  That’s not a pleasant thing to go through.

     

     

    in reply to: Another in flight emergency… #210145 Reply
    Liked by Zaphod
    Avatar RollieStrummer 
    Participant
    Status: Physician
    Posts: 17
    Joined: 11/07/2018

    A 1cm piece of glass is often not going to be visible on an x-ray.  If it is lodged in the neck, it may be seen on a soft tissue neck x-ray, but if it is in the esophagus, it’s probably not going to be visible on a chest x-ray, and is less likely to be visible on abdominal x-ray if it has passed into the stomach or small intestine.

    I’ve done hundreds of x-ray series for ingested foreign bodies, including dozens for glass specifically, and most of the time we don’t see glass, even if we know it is there.   Glass doesn’t block most of the the x-ray beams, so it doesn’t show up as a dense spot on an x-ray.  Since we don’t see the glass itself very well, what we are looking for is an interface between tissue and the glass.  If it is stuck in the esophagus, for example, on an x-ray taken from the front, superimposed on the area are the airways, the heart, the spine, etc, which makes it really hard to see.

    The glass may be seen with at CT scan, but that comes with a lot more radiation than an x-ray, and I’d avoid it in an 11 month old, unless there was a really compelling reason to do it.

     

    in reply to: Baby swallowed broken piece of glass #198511 Reply
    Avatar RollieStrummer 
    Participant
    Status: Physician
    Posts: 17
    Joined: 11/07/2018

    Aren’t gifts with the intent to reward referrals against anti-kickback statutes? Just thought it’s worth discussing the extent to which this can become illegal.

    Click to expand…

    Yeah, I think this is correct.  But I’m guessing it’s a matter of degree. I heard of a guy who bought referring docs final four tickets.  I’ve got to imagine there has to be something wrong with that.  I don’t think anyone needs to worry about a box of chocolates, though.   I’m just guessing on all of this, though.  Perhaps someone with actual knowledge will come along.

    Click to expand…

    Non-monetary compensation is prohibited by the anti-kickback provisions in the Stark legislation.  There is a safe-harbor value ceiling, though.  It’s about $400 per physician and about $30 per staff member.  It’s indexed and goes up a little each year.  I can’t recall the exact amounts off the top of my head.

    In short, a nice box of chocolates is fine and legal, an all expenses paid trip to the Caribbean is not.

    in reply to: Best way to increase referrals? #197550 Reply
    Avatar RollieStrummer 
    Participant
    Status: Physician
    Posts: 17
    Joined: 11/07/2018

     

    Click to expand…

    yeah, there’s no getting the horse back in the barn and from what I googled, an exception to the privacy rule is

    “Covered entities may also use and disclose protected health information without individual Authorization for certain public interest-related activities. These include:

    • oversight of the healthcare system, including licensing and regulation”

    Certainly, this whole self-prescribing concern could have been handled without disclosing the specific med I’m taking.

    Also, the reason three (actually four, including one I’ve never even met) medical directors found out is because my immediate supervisor reached out to others for “guidance” after consulting the AMA’s ethics handbook.

    This whole thing is such a tempest in a teapot.  It should have just been a 2 minute phone call.  The more I think about it, the more irritated I get.

    Click to expand…

    Your supervisor may have thought they were doing the right thing, but they are actually on thin ice here themselves.  As you say, they didn’t need to disclose the actual medication.  Or, for that matter, that it was you specifically.  The issue could have been discussed as pertaining to “an individual I work with” or in other non-identifying terms.

    I don’t know how far you want to take this, but you could certainly cause some problems for anyone who disclosed that information.  At a minimum, I’d ask for a meeting with my supervisor and say “I’m very uncomfortable that my private health information was shared with others in the organization without my consent.”  Since they are in the medical field, they should be well versed in HIPPA, and should quickly realize that they have made a colossal error in judgement.

    in reply to: Self prescribing versus asking MD friend to do it for you? #190264 Reply
    Liked by Seabass, Anne, Peds
    Avatar RollieStrummer 
    Participant
    Status: Physician
    Posts: 17
    Joined: 11/07/2018

    My issue with this is that whichever pharmacist raised a stink about this said nothing to me, yet decided to disclose medical information I consider private to my workplace.  As a result three medical directors found out about that I’m taking a particular medication, which is really none of their damn business.  Fortunately it’s not something really embarrassing like Viagra, or anything for depression, anxiety, etc.  It’s one of those meds that you can’t infer what it’s for but you could speculate whatever you want if you think something is off.

    Anyway, I hope this is a cautionary tale for anyone reading.

    Click to expand…

    Isn’t this a HIPPA violation?  I’m struggling to come up with a scenario where it is appropriate to call your workplace about a medication you are taking.  If the pharmacist was not comfortable with your prescription, he/she should have told you that, and asked you to get another physician to sign off.  If you take the most extreme scenario (which is clearly not the case here) of a pharmacist thinking a physician may be impaired based on what they are self prescribing, the correct course of action is not to fill the prescription, and call the state medical board to investigate.

    If the pharmacist didn’t like what you were doing, that’s fine, but the way he/she handled it resulted in private health information being disclosed to at least 3 people at your workplace.  That’s a pretty big breech, in my opinion, and the type of thing the law was designed to prevent.  I’d be pretty miffed.  I suspect you just want to let this all blow over, but if you wanted to file a complaint, I think you’ve got a pretty valid case.  I can tell you from previous experience at a sister hospital, HIPPA complaints are taken very seriously.

    in reply to: Self prescribing versus asking MD friend to do it for you? #190201 Reply
    Liked by Anne, Craigy, Seabass
    Avatar RollieStrummer 
    Participant
    Status: Physician
    Posts: 17
    Joined: 11/07/2018
    Click to expand…

    No examples. Apparently, this is SOP for recommendations in the HR circuit. If you recommend someone, and it does not work out, yeah, you might have some theoretical liability, hard to prove, expensive to litigate, but perhaps damaging to you or your organization’s reputation. Think of the scenario where the next handful of your graduating trainees (hypothetically) wash out of their first jobs for being lazy, incompetent, and fraudulent billers. Sure, no one is going to sue you, but your word and the reputation of your program will certainly suffer. Re: Dr. Death, while they may not suffer financial loss from the fiasco, how highly regarded do you believe is the U of Tenn neurosurgery program? Probably the laughing stock of the neurosurgery world, no? No doubt that they are under a lot of scrutiny internally and from accreditation boards.

     

    Click to expand…

    There is a lot of truth to this.  A few years ago we hired a new Dr. from a big name academic program.  Top 3 in the country.  He’d done his residency and fellowship there, then stayed on as an attending for a few years before we hired him.  We did our due diligence on him, talking to the department chair, division head, residency director and a couple of others who knew him well.  All gave him glowing recommendations.

    Well, he was a train wreck.  He was a terrible physician, and his personal behavior was worse.  He was fired less than a year into the job.  This is extremely rare in my specialty, as it is in much of medicine.  Usually someone is told, “You won’t make partner” or “Your contract won’t be renewed” or “It’s not working out, you should start looking for other opportunities”.  This was “You are fired.  Please turn in your badge and vacate the building.  Your final check will arrive by certified mail in 2 days.”  He was so bad we had to go that route.

    About 6 months later, one of our current partners got a call from a friend of his who is now an attending at the big name academic program, albeit in a different division than the Dr we fired.  “Hey, I heard you fired Dr. X.  What happened there?  Yeah, we were all surprised when you hired him, since he was well known to be a disaster by everyone here.”  We suspect they wanted to get rid of him, and giving us good recommendations was a way to help themselves by helping him out the door to some private practice clear across the country.

    We are not going to sue the academic program for what we believe was intentionally misleading us, but in future hiring, any resident or fellow from that program is going to be at a significant disadvantage vis-a-vis someone who trained elsewhere.  It’s not fair to them, but we don’t feel that we can get an honest assessment of a potential hire from that program.

     

    in reply to: How much should I share? #183897 Reply
    Avatar RollieStrummer 
    Participant
    Status: Physician
    Posts: 17
    Joined: 11/07/2018

    Sounds like the OP has decided to stay, which is the right decision IMHO.

     

    I’m curious about signing out a newborn AMA, though.  Can that be done if the medical staff deems it inappropriate?  When my last child was born, she had an RFID bracelet which would set off an alarm if she was taken out of a defined area.  I think there was some mechanism to prevent it from being defeated by simply being cut off as well.  I think this is pretty standard procedure at most big hospitals these days.  The last thing I want to do is to set off a “Code Stork” alarm while running out of L&D with my 3 hour old infant in one arm and waving my AMA form with the other.

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