November/December Ethics Reader Poll Results
Noam Stadlan, MD
Chair, NASS Committee on Ethics & Professionalism Department of Neurosurgery, North Shore Hospital Evanston, IL
November/December poll results:
You find out that your superior (chairman, group owner, etc) is providing below standard care and/or billing inappropriately. What do you do?
Report them to those higher up in the group
Talk with them
Report them to hospital administration
Do nothing
Response from Dr. Stadlan
How to deal with bad behavior by a superior can be complicated. Hopefully there is an inclination to do the right thing; report or address it the same way it would be addressed if the person did not hold power.
Unfortunately, there can be consequences and certainly a fear of consequences. It is morally appropriate to place value on avoiding possible retribution. One is not obligated to sacrifice one’s career over minor infractions by a boss.
On the other hand, if they are putting patients or the organization at risk, at some point there is an obligation to take action. Hopefully the organization has standards and policies in place that allow reporting without retribution- in reality, not just in name. But if they don’t, one has to make a difficult choice.
I think that if one has a decent relationship with the boss, a discussion prior to reporting is an option. This gives them a chance to explain and/or remedy the situation themselves. But on a practical level it would be important to have thorough documentation so that one cannot wind up being the person blamed for the malfeasance.