MDLinx readers respond to survey on unethical physician behavior

By Liz Meszaros, MDLinx
Published January 17, 2017

Key Takeaways

A recent news release from the Associated Press detailed proceedings against a Detroit-area neurosurgeon, Aria Sabit, MD, who had allegedly performed poor or unnecessary spinal surgeries in California and Michigan. Dr. Sabit pleaded guilty to conspiracy and fraud, admitting that he hurt patients and cheated insurers.

MDLinx queried the 1,503 readers who read the original article as published on the site on January 9, 2017. Forty-one readers responded to the survey, for a response rate of 2.7%. Here, MDLinx shares some of the findings of this survey.

When asked whether they believe that Dr. Sabit deserves a prison sentence, 79% responded “Yes, prison sends a strong message,” and 21% responded “No, I think these lawsuits are dangerous.”

Respondents’ comments ranged from “In my opinion, he committed assault on these patients, who put their faith in him. He betrayed them” and “The doctor is guilty of mayhem and deserves the prison term,” to “I think it is only appropriate if it is totally clear that the doctor knowingly caused significant physical harm in order to get money, not for other ‘unethical’ reasons.”

In all, 9% of respondents reported that patients can do nothing to protect themselves from unethical medical practitioners, while a full 91% felt that “There are many ways for patients to get good treatment.”

One respondent commented: “There are many ways for patients to get good treatment. However, when a person is already ill or injured, they are fatigued and in pain, and running around getting second opinions and investigating the doctor is not always an option. If the doctor sounds confident and has certificates on the walls claiming to be a prominent surgeon, most people will give him the benefit of the doubt.”

Another respondent noted: “The medical community needs to educate patients on how to avoid unethical providers as well as the need for second and possibly third opinions for certain surgical procedures.”

When asked how the medical establishment could be better protected from unethical medical practitioners, 85% noted that “There are many ways to protect ourselves,” including more aggressive peer review, due diligence, more rigorous checks on board exam attempts.

Another 15% responded that there is no way to safeguard the medical establishment. One respondent commented, “Unfortunately, the unethical practitioner probably started out ethical and then started cutting corners and stretching the rules slowly, and overtime becomes unethical. In the times we live in, it seems no matter how hard we try to prevent crime and abuse, the criminal will find another way to shock us.”

Another noted, “The profession is inherently lazy in identifying and restricting these practitioners. Unfortunately, it is ‘easier’ for physicians to let someone else do the job of vetting and to assume due diligence has been done.”

Six percent of respondents reported that if they had knowledge of unethical behavior in their practice or institution, they would ignore it. This is in sharp contrast to the 94% who would report it.

Comments from respondents for this query were plentiful and detailed, and included the following:

  • “As professionals, we have a duty to police ourselves. To do any less violates the oath we swore as physicians.”
  • “It depends. What is the ‘knowledge?’ Is it a rumor or hear-say? How would I have actual irrefutable, first-hand knowledge of this allegedly unethical behavior?”
  • “It is very difficult, but there are hospital committees where you may solicit audits about certain procedures, particularly when the number of complications is high.”
  • “We have done exactly that. It takes forceful leadership by physicians to get anything done before very bad things happen.”
  • “We have a standard operating procedure for it.”
  • “Most information I get is second-hand, but I would certainly encourage people with direct information to report it. I have also gone to the medical staff office to identify issues.”
  • “No, you MUST report it. This is the first step in the process of detecting, correcting, and punishing this type of behavior.”
  • “We report unethical behavior for human and animal studies - people who receive treatment are no less important than animal welfare! Again, physicians need to develop better ways to monitor unsafe practitioners. I know this is not an easy task for surgeons who take on difficult cases at academic medical centers where the acuity is high and co-morbidities are challenging. But IMHO, we all know that there are a few individuals who often need to rethink their career path and be counseled out of medicine - sometimes this can be done in medical school - doing it as early as possible is best. We have to develop a system to do this or else the medical profession will have the system developed as case law by lawyers - so either do something ourselves or have someone else do it for us.”

Respondents also voiced their general concerns about the issue of unethical medical professionals. Said one: “As medicine becomes more regulated and anonymous, I expect more, and I expect that innocent practitioners will be wrongly identified.

Another stressed the need to implement changes: “Global changes need to be made that would protect a whistleblower when reporting unethical medical professionals. Unfortunately, that would require anonymity of the whistleblower. I don't see anonymity happening. Politics would have to be removed. I don't see that happening. Patients need to be able to report unethical issues and still receive excellent care from an excellent provider. Unfortunately, patients are labeled and no one wants to have that patient on service. Therefore, there needs to be a much stronger M&M and QA program that includes every provider with the oversight coming from third party disinterested providers. Just thoughts. It's unfortunate that there are some who do not have the interest of the patient, only the interest of the provider pocketbook. But then, it happens in all professions.”

Finally, another physician cited the lack of regulation in reporting and/or policing such procedures: “I believe the other issue is where/how can we report irregularities in practice? The system seems intractable to responding appropriately - I remember several/many years ago an article in the New York Times editorial pages where a physician was trying to safe guard his hospitalized father - who as I recall was also a physician - and another brother who was an attorney against unnecessary medical tests and procedures and despite this fact were not successful in preventing many tests and minor procedures for their elderly father. As I recall their conclusion was that if a son who is a physician and another son who is a lawyer can't prevent this - how can we possibly think the average person even has a chance.”

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