The AdvoKayte Podcast: Holding Healthcare Accountable

Summary (38m 15s).
Episode 9: Dr. Henderson and Dr. Lazar on the lessons learned from Dr. Death and implications for doctors and patients.(Part 1)

No More Dr. Deaths - The Lessons Learned from Christopher Duntsch

Charter members of the No More Dr. Deaths Group, Dr. Robert Henderson and Dr. Martin Lazar return to the AdvoKAYte podcast to talk with Kay about what they learned from their involvement in the Christoper Duntsch case about the challenges our medical systems face trying to regulate and police themselves.

While there are tools and procedures designed to weed out and report bad practitioners like Duntsch, the reality is that our self-regulating systems tend to err on the side of self-protection rather than toward public safety. As Kay notes, the systemic failures that happened during the Duntsch case existed long before his criminal malpractice was exposed and prosecuted, and 99% of those failures continue to persist today. Case in point, over 50% of US hospitals have never reported a single physician to the National Practitioner Databank despite federal law requiring them to do so.

Dr.s Henderson and Lazar discuss how the residency systems designed to train practitioners and the reporting systems designed to protect patients are actually built on foundations of fear, avoidance, personal and institutional greed, along with the breathtaking pretense that the myriad of exceptions and loopholes riddling those systems don’t regularly produce adverse outcomes for patients, practitioners, and hospitals.

When asked to grade the healthcare industry's ability to police its small percentage of dangerous doctors, Dr. Lazar responds, "Poorly". Hospitals commonly allow poor-quality physicians to resign and move on without disclosure to avoid being sued by a disciplined doctor.

Dr. Henderson outlined how, even after he had committed several grievous malpractices in quick succession, Duntsch was allowed to quietly resign his privileges at a Dallas area hospital rather than see the removal of those privileges placed on his record or in the Databank. An administrator at the hospital told Dr. Henderson that reporting Duntsch would have cost the hospital an estimated $600,000 in litigation costs. Instead, his resignation resulted in a formal letter stating Duntsch had no ongoing disciplinary actions against him. That letter helped Duntsch secure surgical privileges at yet another Texan hospital, where he again committed several acts of surgical malpractice, leading to the most severe of outcomes for several victims.

The problems Drs. Henderson and Lazar talk about the ones that enabled a Dr. Death like Duntsch, are not unique to a specific hospital or region or state. Systemic negligence happens all the time throughout the American healthcare industry, driving up the costs while radically lowering the quality of healthcare for the American public. It touches all levels of the medical system from the training of new residents and specialists to the processes involved with public oversight of doctors’ work and professional conduct.

Dr.s Henderson and Lazar both express their concerns about the future of healthcare in the United States citing the corporatization of the healthcare industry and pressures exerted by private equity firms. Both see promise and challenges of integrating AI into all levels of healthcare. Both agree that the future of healthcare is based on how the integrity of the physician is preserved. Both call for serious reforms and, in one case, a complete overhaul of the reporting tools and accountability systems we rely on to ensure the safety of our healthcare.

This is the first of a two-part interview with Dr.s Henerson and Lazar.