"Toxic Culture" at Montréal Hospitals Putting Patient's Lives at Risk: Physician
Montreal Hospitals Facing a "Toxic Culture": St-Mary's Physician
Junior doctor says his name is being defamed because he reported medical errors.
By Brendan K-Edwards; March 25, 2013 - Coop Média de Montréal
MONTREAL — According to Dr. Alexander Nataros, the McGill Faculty of Medicine has launched personal attacks against him that have “sent chills to the depths of the McGill system.”
A hierarchical professional culture at McGill affiliated hospitals in which senior doctors are viewed as intimidating and unassailable is putting patients lives at risk, said Dr. Nataros, a junior doctor at Saint Mary’s hospital.
Dr. Nataros who is currently on a forced paid leave of absence from his family practice, claims that members of the McGill Faculty of Medicine are attempting to defame his name because he reported an incident in which serious errors were made by senior doctors.
Dr. Nataros said that the incident, which took place in November 2012, and is still under investigation by an independent ombudsmen, had near fatal consequences. “It was more than just the wrong treatment, there was a missed diagnosis that made it infinitely worse and the patient almost died,” said Nataros. “It was only very quick treatment and a transfer to a tertiary care centre that saved that patient’s life.”
According to Dr. Nataros, his decision to report the errors made by senior physicians prompted these doctors to target him with a barrage of personal attacks. He notes that in a meeting last December, two of the physicians arrived with numerous letters collected from different doctors stating that they found it difficult to work with Dr. Nataros. “The accusations were that ‘Alex is challenging; ‘Alex is argumentative;’ ‘Alex does not respect authority,’” said Dr. Nataros. “But, there has never been an issue with my clinical competency or my patient care.”
In January, Dr. Nataros was placed on academic probation. Since then he has accumulated more than a dozen letters from doctors who have worked with him (left anonymous out of fear of putting their careers in jeopardy) stating that he is an exemplary physician. According to some of these doctors, Dr. Nataros stood up to authority only out of concern for patient safety. The doctors also cited Dr. Nataros’ work with the Red Cross and his former position as Oxfam Canada’s national youth director as evidence of his strong character.
Despite the availability of positive testimonials from many doctors Dr. Nataros has worked with over the last five years, two review panels failed to clear his name and members of the McGill Faculty of Medicine allegedly launched further personal attacks.
Evidence of the administration’s attempts to have Dr. Nataros expelled includes a letter written by the Postgraduate Director of Family Medicine at McGill University that question’s Nataros’ mental health and requests that he take a medical evaluation. The letter, which Nataros has now made available to the media, includes a written account from a second-year medical student, who claims that Nataros displayed “bizarre, unpredictable behaviour” at a public McGill event. Nataros said that, although he attended the event and participated in the question and answer period, the story about his behavior is completely fabricated. He also said that he has done an independent psychiatric evaluation to disprove any rumours that he is mentally ill.
The alleged attempts made by the McGill Medical Faculty to discredit Nataros’s claims come at a particularly sensitive time as there was a full accreditation of McGill’s post-graduate residency training program from March 17 to March 24.
Although Dr. Nataros is intent on clearing his name, he said that he is also focused on creating new ways to promote patient safety in what he sees as a dysfunctional health-care system. He is quick to argue that his case is not unique but emblematic of a hierarchical medical culture in which few young doctors choose to question authority out of fear of reprisal. “In Montreal, we have a very, very, toxic culture…many of us that are trying to strive for improvement in patient safety, in helping our patients, when we try and do that, it is applauded everywhere else, but here at McGill we are shamed and intimidated and beat down,” said Dr. Nataros.
There is no doubt that the choice to stand up to members of the McGill medical community whom he refers to as “bullies,” has dramatically altered the young doctor’s life. “This process is rewarding for me because I went into medicine to help improve our health-care system,” said Nataros. “But, at the same time, it’s crushing for me because I am now forbidden from serving my patients. So I have an entire practice of patients in the family medicine centre at Saint Mary’s hospital that are now deprived of their family doctor.”
Despite all this Dr. Nataros remains optimistic about the potential for reform within the Quebec Healthcare System. “We have legions of whistle-blowers, they are called residents, they are called medical students, they are called nurses,” said Dr. Nataros. “All we need to do is provide protection. We need transparency and honesty and we need a system that identifies mistakes because that will protect the patients”
Brendan K-Edwards is a Montreal writer.