Dr. Death & Texas Hospitals --- Lessons in Crisis Communication, Leadership

A couple weeks ago I began watching the recently released miniseries "Dr. Death" by Peacock TV.  To date, I have only watched the pre-documentary which showcased the two Texas surgeons and plaintiff's lawyer who repeatedly blew the whistle on Dr. Christopher Duntsch; their heroic actions led to the eventual revocation of Duntsch's medical license as well as the criminal trial that resulted in a life sentence. The documentary lays out the timeline of Duntsch's wreckage: Over a year and half he badly botched 30+ surgeries, leaving a trail of crippled and dead patients. It was tough to watch. 

The documentary did a good job of trying to explain the 'why" of this tragedy, namely that a handful of Texas hospitals were overly eager to recruit a neurosurgeon to be a cash cow. Moreover, the film's producer implied that when these Texas hospitals learned their cash cow was in fact a butcher they quietly passed him down the line to avoid litigation from Duntsch and his lawyers. The hospitals worried that "firing" Duntsch and reporting him to regulatory authorities would get them sued, said the documentary. Until his final stop, Duntsch never faced an adverse action from a hospital -- his privileges were not revoked nor was he reported to the Texas State Medical Board or NPDB. He was allowed to resign and move along to his next victims. I can surmise the quiet parting of the ways was not only about fear of litigation but also fear of bad publicity -- and these hospitals now have both in spades. Furthermore, some or all of these hospitals may have not been eager to pay damages to Duntsch's victims, but they surely are now forking over big dollars to the injured patients and grieving families. Deny and defend strikes again! 

Everyone --- patients, families, referring physicians -- thought Duntsch was a gifted surgeon, a magician, until they learned he wasn't. In fact, Duntsch allegedly purchased one of those "Best Doctors in Dallas" magazine spreads to dupe patients and colleagues. Duntsch was a madman, but also a good marketer and charming. All along, the people in the know said nothing.  

The leaders of the Texas hospitals where Duntsch injured and killed patients failed spectacularly in this crisis. How different would things be for Dr. Duntsch's patients if the first of Duntsch's hospitals -- Baylor Plano -- stood up and said some version of the following: "Dr. Duntsch...you're a danger to your patients and society, and it stops here. Your repeated actions have violated every principle of Just Culture, and you should not be practicing medicine. We are revoking your privileges and reporting you to the Texas State Medical Board and NPDB. Moreover, we are going to share our actions against you with the media, including social media. The public and medical profession will know about you. If you want to sue, go for it because no deal will be worked out with your lawyers to allow you to quietly slip away.  We are going to put patient safety first and, going forward, whenever someone -- from anywhere in the United States --- Googles your name they are going to read about your horrific acts in our operating rooms.  You will not injure or kill any more patients."

That hypothetical statement exemplifies crisis communications. Such a statement would take courage and integrity and is what leadership is all about. Obviously, many lawyers would disagree with this tactic, but hospitals don't work for lawyers (it's supposed to be the other way around). Baylor Plano would have had to own the situation financially and emotionally with those patients injured in their hospital by Duntsch, but, again, that is another example of crisis communication chops and leadership. Baylor Plano could of have become patient safety heroes, but, instead, the documentary makes them look like schmucks.   

The classic textbook case of crisis communications is the Tylenol poisoning in Chicago in 1982. Tylenol wrote the book on how to run to a problem, own it, and fix it as best as possible.  Every time you open a glued-shut cardboard box containing some type of medicine and then have to navigate through plastic wrapping around the bottle of medicine itself think or remember Tylenol. Their crisis communications approach not only made right by the victims of the 1982 tragedy it also changed pharmaceutical safety in a profound and permanent way. Baylor Plano had their Tylenol moment, and missed. 

Dr. Duntsch is quite possibly the worst of the worst, yet there are other villains out there in the medical field who endanger patients by blowing through Just Culture principles as well as violating every shred of human decency and common sense. Hospital leaders should not cower behind their lawyers and give passes to truly bad doctors. Instead, these "doctors" need to be fired, reported to the proper regulatory authorities, and the world needs to be warned.  Consider the following: In most instances, American hospitals think nothing of defending medically appropriate care in negligence lawsuits...so why all the angst about defending ethically appropriately leadership in a patient safety crisis?

For years people throughout medicine and in the patient safety movement have wrung their hands over the National Practitioner Database (NPDB).  Almost all believe the databank is imperfect and not consequential enough for a variety of reasons. Patients and families do not have access to the NPDB -- they can't see a Duntsch -- and we have written in this space that the NPDB can hinder disclosure when otherwise good doctors make honest mistakes; many lawyers (defense and plaintiffs) and risk managers have agreed with us on this point.  Perhaps, though, the solution with these truly bad apples -- the Christopher Duntschs of the world -- is Google. If a medical professional repeatedly violates not only Just Culture but also common human decency and common sense, the world needs to be warned...full stop.  After watching "Dr. Death," it is painfully obvious any Texas judge would have laughed Duntsch and his lawyers out of court for contesting a hospital's actions against him. Duntsch was that bad. Too bad Baylor Plano and the other hospitals didn't roll the dice.   

Need help with your crisis communications issues?  Give us a call at 618-559-8168 or e-mail doug@sorryworks.net.  When the chips are down, we can help you communicate with internal and external stakeholders.  Also, remember to purchase your copy of our CME-accredited online course, "Cultural Diversity, African Americans, and Medicine."

Sincerely,

- Doug

Doug Wojcieszak, Founder and President
Sorry Works!
618-559-8168
doug@sorryworks.net