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Hospitals Tell Doctors They’ll Be Fired If They Speak Out About Lack of Gear

189 points by Reedx 7y ago

java-man 7y ago
we need to start firing administrators who issue these orders.
- lonelappde 7y ago
  We who? Administrators are the ones who hire and fire.
  - java-man 7y ago
    we, the people. raise the issue with our elected officials. ask the media to cover the issue. and, probably, the most efficient: vote for the people who are knowledgeable, listen to scientific advice. of course, a better solution would be to implement a system where the goal of healthcare will be not profit, but the health of the general population.
    - thendrill 7y ago
      You mean like Manning, Snowden and Assange? You want to point out that people in power are not competent and only care about personal profits, and you also want to point out that whole system is an abusive farce? Yehh good luck with that...
- tandr 7y ago
  Would be interesting to hear how would you propose to do so during on-going emergency?
  - java-man 7y ago
    @tandr: let's start with the government and other administrators listening to the experts in the field, instead of covering their aes. when the medical professionals who are fighting in the front line trenches say we don't have enough PPE, react by providing the said PPE to said medical professionals. when medical professionals say things are going to get worse exponentially, provide them tools to fight the contagion instead of proclaiming "it's a hoax" on the national TV.
Der_Einzige 7y ago
The publicity alone from something like this will backfire so so so hard. Those doctors or nurses fired will have no problem getting jobs. The people who do the firing will be roasted over a metaphorical fire for this. No, keep yelling about it loudly to everyone! We get that a hospital can't magically fix PPE issues - but that doesn't mean that you can just suppress stories about it.
- defterGoose 7y ago
  Exactly. If there's ever a time for propaganda, it's not now.
polotics 7y ago
In practical terms: is there any way to short / defund / LBO / reorganize the NYU Langone Health system. Who runs this?
- mancerayder 7y ago
  Can you kindly wait a few months first? Pragmatism before virtue.
  - toomuchtodo 7y ago
    Too much risk things go back to the status quo if we wait. You can still advocate for meaningful change without impacting care. Definitely do not impact care, but do not put yourself in harm's way if not necessary for the sake of management. If enough medical providers are fired who are desperately needed, the government will step in to replace health system administration.
  - noad 7y ago
    We already shut down our entire civilization so that the healthcare status quo could be maintained and bills can keep getting sent to the correct address. How on earth is that pragmatic? We could open up massive free clinics in every city tomorrow morning. Nothing is stopping us.
    - Loughla 7y ago
      >We already shut down our entire civilization so that the healthcare status quo could be maintained and bills can keep getting sent to the correct address. What a garbage interpretation of what is going on. Jesus Christ, I'm jaded and cynical, but that's just too much. Saying that we don't want to overwhelm our medical capacity because of the billing, versus the actual reason of human deaths. Too much. That's just too much.
      - zozbot234 7y ago
        The amount of medical capacity around is very much a function of "status quo" institutions and frameworks. Maybe not billing per se, but plenty of other stuff that's nonetheless quite relevant.
frandroid 7y ago
This is a self-solving problem for the doctors speaking out. If the hospital would rather fire them than ensure their safety, then getting fired can save these doctors' lives.
- save_ferris 7y ago
  It might be hard for them to get jobs after, though. I'm not in healthcare, and I know that doctors are always in high demand, but we can't ignore the cost to those protesting by risking their careers. So many whistleblowers face intense retaliation and career problems after coming forward, and I'm sure being perceived as a snitch wouldn't do one any favors down the road, even if you're a doctor.
  - micmil 7y ago
    "And why were you let go from your last position?" "I wore a mask in public areas during the COVID-19 outbreak." "holup..." Anyone fired like that would have ten job offers within a day and their former employer would have an unending media shitstorm on their hands.
- kingbirdy 7y ago
  Anecdotal, but all the healthcare workers I know (both nurses and doctors) entered their professions because they have a genuine desire to help people and save lives, so I don't think they'd be willing to endanger their jobs right now when they know their continued employment could be a matter of life or death for their patients.
dublinben 7y ago
This is probably illegal retaliation. Organizing with coworkers about workplace conditions is a protected activity.
- frandroid 7y ago
  You're probably right that this is technically illegal, but talking to the media is a different action than organizing with coworkers...
Reedx 7y ago
There's also this: "Many hospitals bar doctors and other staff members from wearing protective masks in public areas. Some have been disciplined for pushing back." https://www.nytimes.com/2020/03/31/health/hospitals-coronavirus-face-masks.html https://www.nytimes.com/2020/03/31/health/hospitals-coronavi... How do we put a swift end to this nonsense? Surely the public will be overwhelmingly on the side of doctors, nurses and other healthcare workers.
- sneak 7y ago
  Doctors and nurses get to choose the hospitals they work for/with. Unfortunately, new entrants to the hospital market are prevented by large state-sponsored moats, and most of the large incumbents are shady in similar ways, so the ability of the staff to choose employer based on ethics/practices is basically meaningless. More options for medical care and medical employment is the answer; the vast majority of people in society are not greedy/shady. Fix one, and you fix the other. You might also bring prices down, too. (Caveat: it's not "swift", as you requested.)
  - amarshall 7y ago
    > Doctors and nurses get to choose the hospitals they work for/with. Not always or completely even. Medical residents and fellows enter a legally binding contract to work at the hospital they match with as part of the application process, and opting to change hospitals during one’s program is nigh impossible.
  - londons_explore 7y ago
    A lot of doctors move across country borders for their careers. Ethics/practices vary a lot between countries, and it only takes a small percentage of professionals moving away from one country to a better one to motivate change.
  - travisgriggs 7y ago
    "Choice" and the "US Healthcare Industry" are two words that shouldn't be used in the same sentence. If you think you have choice in this system either as a caregiver or a carereceiver, then you are under the sad delusion that those are beads the emperor has hanging between his legs.
wayanon 7y ago
It's weird that if anyone's being fired it's the doctors - who needs them afterall !
covid_stassi 7y ago
Anonymous new profile, my apologies. My partner wasn't comfortable with me saying this stuff in a public way. They work in the emergency department of a hospital in North America. It's not just that they'll be fired if they speak out... The hospitals are also threatening to withhold worker's compensation payouts if a staff member is caught using anything brought from home, even if it's real, name brand equipment. Got some N95s leftover from that home improvement project? Leave them at home and use this surgical mask instead (still better than nothing, to be fair). They are asking staff members to inform on other staff. To be clear: these policies were in effect for an area with coughing COVID patients. They do put surgical masks on the patients, which is very helpful, but I'm livid that they then ask the nurses to NOT use N95s in this scenario. They are also undertaking dubious re-use and cleaning procedures that are not scientifically proven. For example, masks (both surgical and N95s, which are only for workers doing things like intubation) are being used for an entire day (also not correct usage) and then placed in paper folders for a week. At the end of the week, the masks are deemed 'clean' and reused by the same staff member. Kind of like a mask for each day of the week. There is not strong scientific evidence this is an effective or safe procedure. These procedures might work, but there isn't testing proving that fact. I understand hospitals are in a bind here. There are simply not enough masks available (both surgical and N95) in the world. If the hospitals admit their ad-hoc procedures are ineffective they risk short term mutiny in their staff ranks. They also risk long term litigation by admitting they can't protect staff. Unfortunately their approach of 'clamp down hard on dissent' is preventing the real message from being broadcast loudly enough: It should be blindingly clear we need a crash program to ramp domestic PPE manufacturing by an order of magnitude (or two). As an aside, please call your senators and representatives and ask them to force the Trump administration to use the DPA to bring more PPE capacity online. It's really too late now, but better late than never. We'll need to establish permanent manufacturing capacity for this anyways so we never get caught out like again.
- op03 7y ago
  What is the rationale for not being allowed to bring stuff from home?
  - 7y ago
jacquesm 7y ago
It's not hospitals that do this. It's management, and management has names and faces, they're people. Expose the fuckers.
vkou 7y ago
Remember when authoritarian countries were punishing doctors for whistle-blowing? Anyone who has ever worked for a living should not be surprised that this sort of behaviour is alive and well here, too.
- lonelappde 7y ago
  In the USA we have free market oppression, not State-controlled.
  - kwhitefoot 7y ago
    Presumably that makes it much more efficient and cost effective.
quercus 7y ago
A friend is an MD at a large Bay Area hospital. He actually quit his job over this situation, just didn't feel safe going to work. I can't imagine being put in that position by an employer.
k__ 7y ago
Friend of mine, a nurse, told me she shouldn't get herself tested so she could keep working and don't get isolated at home.
- stallmanite 7y ago
  Can we agree that that is severely misguided?
throwawaylalala 7y ago
Isn't this a violation of OSHA safe workplace conditions? It's a known, lethal, virus, and they're not letting people protect themselves, especially if they aren't providing that protection themselves. They must "Provide a workplace free of health and safety hazards that can cause death or serious injury;" https://employment.findlaw.com/workplace-safety/protecting-yourself-from-unsafe-working-conditions.html https://employment.findlaw.com/workplace-safety/protecting-y... Perhaps they'd rather get a call from OSHA? Would they perhaps prefer their nurses call OSHA first? In Florida, there's a law for whistle blower healthcare workers. https://www.nationalnursesunited.org/whistleblower-protection-laws-for-healthcare-workers https://www.nationalnursesunited.org/whistleblower-protectio... If the choice is be fired or die (or have a better chance of dying), they should file an OSHA violation and call out.
- joshstrange 7y ago
  > Isn't this a violation of OSHA safe workplace conditions? The practices nurses/doctors are doing today are in violation of OSHA (mask/shield re-use and the like) and they would have been fired or strongly reprimanded just a few months ago for doing what they are being told to do now. To add insult to injury they aren't letting them protect themselves because it would further prove how unprepared these hospitals were.
anorphirith 7y ago
I hope they get fired, it'll save their own lives
freepor 7y ago
What an empty threat. A hospital is not going to fire staff at the moment of greatest demand, and a doctor with an intact credential can get hired anywhere they want in a split second. Maybe the hospitals can bully the nurses assistants and support staff, so the doctors need to step up and speak on their behalf too.
- segmondy 7y ago
  but they are, search the news.
  - freepor 7y ago
    Yeah, and a doctor can get a job anywhere else in a heartbeat. Doctors effectively do all their “whiteboard interviews” up front and don’t have to deal with it later in their career.
deleted 7y ago
[deleted]
deleted 7y ago
[deleted]
ashildr 7y ago
Well, what do you expect from China? They are not exactly known to value human rights and safety of their workers...
thendrill 7y ago
Awww is it not beautiful having free speach everywhere except places owned by private corporations? Now repeat after me : U S A... FUCK YEH
davidg109 7y ago
Former PM for a hospital. Listen, I have a lot of trust and respect for physicians, moreso now than ever. Unfortunately, there are some bad apple physicians who are very aware of the power they wield and if they feel something needs improvement, they will be extremely vocal... Sometimes at the detriment of the truth. I've been subject to the spread of misinformation by a couple of physicians related to some past projects, and it's not pretty. All you can do is try to re-educate these same physicians who are misunderstanding some facts, and as you can imagine, it's an uphill battle. I would make the effort to understand both sides of the coin before assuming these "big, bad" hospitals are in the wrong. As they say, the truth is often somewhere in the middle.
- vsskanth 7y ago
  The ask in this context seems to be simple - adequate PPE while treating a highly infectious virus. Evidence from Spain suggests medical professionals on the frontline are at very high risk. maybe you can share why you think it is unfair on the hospitals in this case ?
  - verylittlemeat 7y ago
    I'm not the OP but I have read a bit about how "adequate PPE" can be controversial. It really boils down to how long certain ppe can be used, what is the risk of infection from reused ppe and how to sanitize ppe effectively. I'll leave the dispute over the facts to the experts but from my understanding that is the source of the conflict over ppe.
artur_makly 7y ago
someone just spin up a whistleblower site/twitter account ;-)
Shorel 7y ago
I am no doctor. But if I have to choose between speaking out and dying, I would probably speak out.
thebiss 7y ago
This will not prevent professionals with strong morals from speaking out. Instead of giving their names, they should carefully proceed as confidential sources or anonymous sources. https://en.wikipedia.org/wiki/Reporter%27s_privilege https://en.wikipedia.org/wiki/Reporter%27s_privilege

189 points by Reedx 7y ago

java-man 7y ago

we need to start firing administrators who issue these orders.

lonelappde 7y ago
We who? Administrators are the ones who hire and fire.
- java-man 7y ago
  we, the people. raise the issue with our elected officials. ask the media to cover the issue. and, probably, the most efficient: vote for the people who are knowledgeable, listen to scientific advice. of course, a better solution would be to implement a system where the goal of healthcare will be not profit, but the health of the general population.
  - thendrill 7y ago
    You mean like Manning, Snowden and Assange? You want to point out that people in power are not competent and only care about personal profits, and you also want to point out that whole system is an abusive farce? Yehh good luck with that...
tandr 7y ago
Would be interesting to hear how would you propose to do so during on-going emergency?
- java-man 7y ago
  @tandr: let's start with the government and other administrators listening to the experts in the field, instead of covering their aes. when the medical professionals who are fighting in the front line trenches say we don't have enough PPE, react by providing the said PPE to said medical professionals. when medical professionals say things are going to get worse exponentially, provide them tools to fight the contagion instead of proclaiming "it's a hoax" on the national TV.

Der_Einzige 7y ago

The publicity alone from something like this will backfire so so so hard. Those doctors or nurses fired will have no problem getting jobs. The people who do the firing will be roasted over a metaphorical fire for this. No, keep yelling about it loudly to everyone! We get that a hospital can't magically fix PPE issues - but that doesn't mean that you can just suppress stories about it.

defterGoose 7y ago
Exactly. If there's ever a time for propaganda, it's not now.

polotics 7y ago

In practical terms: is there any way to short / defund / LBO / reorganize the NYU Langone Health system. Who runs this?

mancerayder 7y ago
Can you kindly wait a few months first? Pragmatism before virtue.
- toomuchtodo 7y ago
  Too much risk things go back to the status quo if we wait. You can still advocate for meaningful change without impacting care. Definitely do not impact care, but do not put yourself in harm's way if not necessary for the sake of management. If enough medical providers are fired who are desperately needed, the government will step in to replace health system administration.
- noad 7y ago
  We already shut down our entire civilization so that the healthcare status quo could be maintained and bills can keep getting sent to the correct address. How on earth is that pragmatic? We could open up massive free clinics in every city tomorrow morning. Nothing is stopping us.
  - Loughla 7y ago
    >We already shut down our entire civilization so that the healthcare status quo could be maintained and bills can keep getting sent to the correct address. What a garbage interpretation of what is going on. Jesus Christ, I'm jaded and cynical, but that's just too much. Saying that we don't want to overwhelm our medical capacity because of the billing, versus the actual reason of human deaths. Too much. That's just too much.
    - zozbot234 7y ago
      The amount of medical capacity around is very much a function of "status quo" institutions and frameworks. Maybe not billing per se, but plenty of other stuff that's nonetheless quite relevant.

frandroid 7y ago

This is a self-solving problem for the doctors speaking out. If the hospital would rather fire them than ensure their safety, then getting fired can save these doctors' lives.

save_ferris 7y ago
It might be hard for them to get jobs after, though. I'm not in healthcare, and I know that doctors are always in high demand, but we can't ignore the cost to those protesting by risking their careers. So many whistleblowers face intense retaliation and career problems after coming forward, and I'm sure being perceived as a snitch wouldn't do one any favors down the road, even if you're a doctor.
- micmil 7y ago
  "And why were you let go from your last position?" "I wore a mask in public areas during the COVID-19 outbreak." "holup..." Anyone fired like that would have ten job offers within a day and their former employer would have an unending media shitstorm on their hands.
kingbirdy 7y ago
Anecdotal, but all the healthcare workers I know (both nurses and doctors) entered their professions because they have a genuine desire to help people and save lives, so I don't think they'd be willing to endanger their jobs right now when they know their continued employment could be a matter of life or death for their patients.

dublinben 7y ago

This is probably illegal retaliation. Organizing with coworkers about workplace conditions is a protected activity.

frandroid 7y ago
You're probably right that this is technically illegal, but talking to the media is a different action than organizing with coworkers...

Reedx 7y ago

There's also this: "Many hospitals bar doctors and other staff members from wearing protective masks in public areas. Some have been disciplined for pushing back." https://www.nytimes.com/2020/03/31/health/hospitals-coronavirus-face-masks.html https://www.nytimes.com/2020/03/31/health/hospitals-coronavi... How do we put a swift end to this nonsense? Surely the public will be overwhelmingly on the side of doctors, nurses and other healthcare workers.

sneak 7y ago
Doctors and nurses get to choose the hospitals they work for/with. Unfortunately, new entrants to the hospital market are prevented by large state-sponsored moats, and most of the large incumbents are shady in similar ways, so the ability of the staff to choose employer based on ethics/practices is basically meaningless. More options for medical care and medical employment is the answer; the vast majority of people in society are not greedy/shady. Fix one, and you fix the other. You might also bring prices down, too. (Caveat: it's not "swift", as you requested.)
- amarshall 7y ago
  > Doctors and nurses get to choose the hospitals they work for/with. Not always or completely even. Medical residents and fellows enter a legally binding contract to work at the hospital they match with as part of the application process, and opting to change hospitals during one’s program is nigh impossible.
- londons_explore 7y ago
  A lot of doctors move across country borders for their careers. Ethics/practices vary a lot between countries, and it only takes a small percentage of professionals moving away from one country to a better one to motivate change.
- travisgriggs 7y ago
  "Choice" and the "US Healthcare Industry" are two words that shouldn't be used in the same sentence. If you think you have choice in this system either as a caregiver or a carereceiver, then you are under the sad delusion that those are beads the emperor has hanging between his legs.

wayanon 7y ago

It's weird that if anyone's being fired it's the doctors - who needs them afterall !

covid_stassi 7y ago

Anonymous new profile, my apologies. My partner wasn't comfortable with me saying this stuff in a public way. They work in the emergency department of a hospital in North America. It's not just that they'll be fired if they speak out... The hospitals are also threatening to withhold worker's compensation payouts if a staff member is caught using anything brought from home, even if it's real, name brand equipment. Got some N95s leftover from that home improvement project? Leave them at home and use this surgical mask instead (still better than nothing, to be fair). They are asking staff members to inform on other staff. To be clear: these policies were in effect for an area with coughing COVID patients. They do put surgical masks on the patients, which is very helpful, but I'm livid that they then ask the nurses to NOT use N95s in this scenario. They are also undertaking dubious re-use and cleaning procedures that are not scientifically proven. For example, masks (both surgical and N95s, which are only for workers doing things like intubation) are being used for an entire day (also not correct usage) and then placed in paper folders for a week. At the end of the week, the masks are deemed 'clean' and reused by the same staff member. Kind of like a mask for each day of the week. There is not strong scientific evidence this is an effective or safe procedure. These procedures might work, but there isn't testing proving that fact. I understand hospitals are in a bind here. There are simply not enough masks available (both surgical and N95) in the world. If the hospitals admit their ad-hoc procedures are ineffective they risk short term mutiny in their staff ranks. They also risk long term litigation by admitting they can't protect staff. Unfortunately their approach of 'clamp down hard on dissent' is preventing the real message from being broadcast loudly enough: It should be blindingly clear we need a crash program to ramp domestic PPE manufacturing by an order of magnitude (or two). As an aside, please call your senators and representatives and ask them to force the Trump administration to use the DPA to bring more PPE capacity online. It's really too late now, but better late than never. We'll need to establish permanent manufacturing capacity for this anyways so we never get caught out like again.

op03 7y ago
What is the rationale for not being allowed to bring stuff from home?
- 7y ago

jacquesm 7y ago

It's not hospitals that do this. It's management, and management has names and faces, they're people. Expose the fuckers.

vkou 7y ago

Remember when authoritarian countries were punishing doctors for whistle-blowing? Anyone who has ever worked for a living should not be surprised that this sort of behaviour is alive and well here, too.

lonelappde 7y ago
In the USA we have free market oppression, not State-controlled.
- kwhitefoot 7y ago
  Presumably that makes it much more efficient and cost effective.

quercus 7y ago

A friend is an MD at a large Bay Area hospital. He actually quit his job over this situation, just didn't feel safe going to work. I can't imagine being put in that position by an employer.

k__ 7y ago

Friend of mine, a nurse, told me she shouldn't get herself tested so she could keep working and don't get isolated at home.

stallmanite 7y ago
Can we agree that that is severely misguided?

throwawaylalala 7y ago

Isn't this a violation of OSHA safe workplace conditions? It's a known, lethal, virus, and they're not letting people protect themselves, especially if they aren't providing that protection themselves. They must "Provide a workplace free of health and safety hazards that can cause death or serious injury;" https://employment.findlaw.com/workplace-safety/protecting-yourself-from-unsafe-working-conditions.html https://employment.findlaw.com/workplace-safety/protecting-y... Perhaps they'd rather get a call from OSHA? Would they perhaps prefer their nurses call OSHA first? In Florida, there's a law for whistle blower healthcare workers. https://www.nationalnursesunited.org/whistleblower-protection-laws-for-healthcare-workers https://www.nationalnursesunited.org/whistleblower-protectio... If the choice is be fired or die (or have a better chance of dying), they should file an OSHA violation and call out.

joshstrange 7y ago
> Isn't this a violation of OSHA safe workplace conditions? The practices nurses/doctors are doing today are in violation of OSHA (mask/shield re-use and the like) and they would have been fired or strongly reprimanded just a few months ago for doing what they are being told to do now. To add insult to injury they aren't letting them protect themselves because it would further prove how unprepared these hospitals were.

anorphirith 7y ago

I hope they get fired, it'll save their own lives

freepor 7y ago

What an empty threat. A hospital is not going to fire staff at the moment of greatest demand, and a doctor with an intact credential can get hired anywhere they want in a split second. Maybe the hospitals can bully the nurses assistants and support staff, so the doctors need to step up and speak on their behalf too.

segmondy 7y ago
but they are, search the news.
- freepor 7y ago
  Yeah, and a doctor can get a job anywhere else in a heartbeat. Doctors effectively do all their “whiteboard interviews” up front and don’t have to deal with it later in their career.

deleted 7y ago

[deleted]

deleted 7y ago

[deleted]

ashildr 7y ago

Well, what do you expect from China? They are not exactly known to value human rights and safety of their workers...

thendrill 7y ago

Awww is it not beautiful having free speach everywhere except places owned by private corporations? Now repeat after me : U S A... FUCK YEH

davidg109 7y ago

Former PM for a hospital. Listen, I have a lot of trust and respect for physicians, moreso now than ever. Unfortunately, there are some bad apple physicians who are very aware of the power they wield and if they feel something needs improvement, they will be extremely vocal... Sometimes at the detriment of the truth. I've been subject to the spread of misinformation by a couple of physicians related to some past projects, and it's not pretty. All you can do is try to re-educate these same physicians who are misunderstanding some facts, and as you can imagine, it's an uphill battle. I would make the effort to understand both sides of the coin before assuming these "big, bad" hospitals are in the wrong. As they say, the truth is often somewhere in the middle.

vsskanth 7y ago
The ask in this context seems to be simple - adequate PPE while treating a highly infectious virus. Evidence from Spain suggests medical professionals on the frontline are at very high risk. maybe you can share why you think it is unfair on the hospitals in this case ?
- verylittlemeat 7y ago
  I'm not the OP but I have read a bit about how "adequate PPE" can be controversial. It really boils down to how long certain ppe can be used, what is the risk of infection from reused ppe and how to sanitize ppe effectively. I'll leave the dispute over the facts to the experts but from my understanding that is the source of the conflict over ppe.

artur_makly 7y ago

someone just spin up a whistleblower site/twitter account ;-)

Shorel 7y ago

I am no doctor. But if I have to choose between speaking out and dying, I would probably speak out.

thebiss 7y ago

This will not prevent professionals with strong morals from speaking out. Instead of giving their names, they should carefully proceed as confidential sources or anonymous sources. https://en.wikipedia.org/wiki/Reporter%27s_privilege https://en.wikipedia.org/wiki/Reporter%27s_privilege