Dr. Scott Green, a plastic surgeon, tried to appear before a judge during a remote video-conferenced traffic trial last week from his operating room, while he was working on a patient. This was not a reality show stunt: Green really attempted to do this. Saved time, you know. Busy, busy, busy. Sacramento Superior Court Commissioner Gary Link, presiding over a virtual courtroom at the Carol Miller Justice Center, couldn’t believe what he was seeing: a defendant in surgical scrubs, with his patient just out of view.
“Hello, Mr. Green? Are you available for trial?” asked a courtroom clerk. “It kind of looks like you’re in an operating room right now?” “I am, sir,” Green replied. “Yes, I’m in an operating room right now. I’m available for trial. Go right ahead.” The doctor had his head down, talking as he replaced a nose, pumped up some breasts, or something. Link was dumbstruck.
“So unless I’m mistaken, I’m seeing a defendant that’s in the middle of an operating room appearing to be actively engaged in providing services to a patient. Is that correct, Mr. Green? Or should I say Dr. Green?” Link asked. The video is on YouTube, and one can hear the sounds of medical devices at work, pumping and beeping.
“I do not feel comfortable for the welfare of a patient if you’re in the process of operating so that I would put on a trial, notwithstanding the fact the officer is here today,” the commissioner said.
Hey, no problemo, the multi-tasking doc assured Link. “I have another surgeon right here who’s doing the surgery with me, so I can stand here and allow them to do the surgery also,” Green said, reassuringly.
“I don’t think so. I don’t think that’s appropriate,” Link said. “I’m going to come up with a different date — when you’re not actively involved or participating and attending to the needs of a patient. Let me see if I can get a different date here…I’m concerned about the welfare of the patient based on what I’m seeing,”
The Medical Board of California is investigating. Ya think? It says it “expects physicians to follow the standard of care when treating their patients.” Wait—appearing in a trial while operating on a patient isn’t the standard of care? Was that wrong?
Prof. Turley points out what was wrong:
“One of the nine core principles of medial ethics is “A physician shall, while caring for a patient, regard responsibility to the patient as paramount.” There is also the duty to put a patient’s interest before your own as a physician:
“The relationship between a patient and a physician is based on trust, which gives rise to physicians’ ethical responsibility to place patients’ welfare above the physician’s own self-interest or obligations to others, to use sound medical judgment on patients’ behalf, and to advocate for their patients’ welfare.“
The problem for Dr. Green is multifold. First, the most serious consequence is if there were any complications or problems with the patient. Second, there is the potential violation of the patient’s privacy (though the patient remains off camera). Third, there is the obvious medical practice and ethics issue. On the ethical issues, it is not just the Board but the hospital that will have to review the matter. I would be surprised if Green would keep his privileges at hospitals active during the review. While some of the circumstances of the surgery must be determined (like an unforeseeable delay), the key facts are open and obvious. He elected to appear in trial while doing surgery. Most hospitals would be leery of the potential liability in continuing privileges for a physician with such a lack of judgment. If he were later involved in another malpractice case (particularly involving a lack of focus or attention), this case would be raised in court.“
Turley also alertly notes that the other surgeon was also failing his ethical duties by not objecting to the irresponsible multi-tasking, an intervention expressly mandated by the American Medical Association.
Doctors have an infamous reputation for being arrogant and overly confident of their godlike abilities, but the fact that this physician’s ethics alarms weren’t set to go off the second the little thought crept into his head, “Hey, why not operate on a patient while I’m in the trial?” is terrifying.