Phoebe Barker, MPH Student, Intern, Patient Safety Movement Foundation
Episode 1 Synopsis
The new series Dr. Death is based on a true story and adapted from the brilliant and scrupulous Wondery podcast, Dr. Death. The first episode of Dr. Death begins with a foreboding scene of the main character and antagonist of the show, neurosurgeon Dr. Christopher Duntsch, better known as Dr. Death, staring menacingly into the screen. At the same time, survivors give a riveting recount of the nightmare they faced as patients of the doctor. The Patients explain how the charismatic and confident doctor was able to reassure and gain their trust so much that they felt no need to ask questions or advocate for themselves before going under the knife with Dr. Duntsch as their neurosurgeon. Neurosurgeons typically perform surgeries on the nervous system, consisting of the brain and spinal cord, very complex and high-risk procedures. Patients have to put complete trust in doctors to perform these life-changing surgeries. The Doctor continuously bragging about his expertise and education intimidated not only his patients but also the staff. The patients felt as though they no longer needed to worry about their care because they were in the hands of a renowned doctor who graduated with such honors and ran well-established labs doing commendable work in the field of neuroscience.
Dr. Duntsch has gotten away with these troublesome procedures on several patients under the eye of dozens of medical staff and with other experts having to remedy his mistakes through revisions of Dr. Duntsch’s surgeries, showing the more significant problem with the medical system, creating a culture where it is difficult to speak up when something isn’t right. Not only did other medical professionals see the errors happening in front of them, but they also did not step in to stop the Doctor due to his reputation and prestige. During the episode, when the surgery staff questioned the Doctor, the hostile and degrading answers he provided caused staff to recoil and follow his directions even though they knew the patient was in harm’s way.
The staff is indeed catching on to the botched procedures Dr. Duntsch has performed on patients through the episode while he is continually doing surgeries. Although there is little the staff feel they can do to inform patients and supervisors due to the medical pecking order and fear of retribution. When approached by staff members and patients about the deaths and injuries of his patients, he blames others or ridicules the staff who dare question his expertise. Unfortunately, due to gaps in the way these incidents are reported new patients are not informed of the errors of past surgeries. He was able to lie about his skills and patient success rates.
Under the guise of being an excellent charming doctor, the cracks begin to show during the episode’s duration. Not only is the staff he is working with at the hospital noticing issues, but we, the viewer, come to find out his family has caught on to his monstrous actions. He accomplishes his manipulation by using his charismatic egocentric personality to dampen concern, and when this does not work, he resorts to volatile intimidation tactics. We find out that not only does he have a rocky relationship with his family, but his wife has a restraining order against him, and his family knows he has hurt patients during surgery during his time working in other hospitals. They are shocked to find out he is continuously practicing neurosurgery elsewhere.
A surgery nurse who was on several of the doctor’s cases that resulted in harm reports to his supervisor the subpar performance of Dr. Duntsch. The doctor is then confronted by the supervisor. He challenges the nurse telling him he has no idea what it takes to be a surgeon and should never question his practices. He then demeans the nurse telling him how he lacks the expertise and is “just a nurse,” which is laughable because nurses are well-educated and necessary members of the medical system. He then attempts to put the nurse in his place by telling him to prepare his next patient for surgery, although they have a complication with one of his previous patients that needs immediate attention.
During this time, other doctors and experts in neuroscience who are working at the same hospital who have seen Dr. Duntsch’s performance questions his background due to how poorly his surgeries have been since starting service at this new hospital. They are catching on to the fact that the doctor is either incompetent and unable to perform such intense surgeries and stealing the identity of another doctor, or is simply performing poorly on purpose, trying to hurt his patients. These experts decide to contact the university where he completed his residency and find out that he has completed his training and that he isn’t actually stealing the identity of another doctor. They conclude that he is a sociopath trying to hurt any patient that falls within his grasp. Although these experts are finding out this information and have these suspicions, Dr. Duntsch is continuously performing surgeries, not being stopped or held accountable for his actions. These actions show the lack of oversight within medical systems. Dr. Duntsch should have been stopped and investigated after the first bad surgery, but he continued to perform several more.
The importance of patient advocacy is exemplified in the show. The series reveals patients and their family members having bad feelings about the captivating doctor and his need to dismiss them if they question his abilities. The lack of rapport is a total red flag in the medical community, and patients need to ask questions to anyone and everyone in their care team and speak up for themselves if they do not feel as though their current provider is the person they would like to receive care from. Throughout the show, patients and their loved ones have concerns with the treatment they are receiving, which the doctor then brushes off. If these patients would have continued to question the doctor’s practices, they may not have gone through the life-altering and deadly procedures that occurred after agreeing to be treated by Dr. Duntsch.
What Patients Can Do To Protect Themselves
- Take Control of Your Care
The Patient Safety Movement Foundation worked alongside Public Citizen and Littleton Road Philanthropy to develop a step-by-step guide on what patient safety is and how to enhance safe care. The most important is knowing your rights as a patient which include; advocating for yourself, demanding mutual respect from your medical providers, access to your medical records, asking for resources to better understand your doctor (translator, written information, health educator, etc.), the importance of building rapport with your doctor, and asking for your healthcare options. In addition, knowing how to be an active participant in health care includes advocating for a federal bill to be passed about patient rights, finding out if your state has a medical reporting system, and learning more about your state’s medical board.
- Research Your Doctor
In the show, you see that due to HIPPA laws that protect patient’s medical information, a lot of data about practitioners are not accessible to the public. Still, the Patient Safety Movement Foundation provides information about how you can do independent research on your Doctor to make sure they are the right fit for you as a patient. Patients are encouraged to use DocInfo.org to research their doctor’s background and license information. Although this does not tell you about possible errors they have performed it can ensure that you are receiving care from a licensed physician. A red flag that you may be able to find in a doctor is if they have moved location often or from state to state, this can be a warning sign of a doctor being able to keep their license even though they may have had issues in other areas. There are various websites one can check to find out more information about their doctors performances. The way we can make a change is to advocate for more openness within the medical community about mistakes that occur and providers should be held accountable for the errors they cause.
- Research Your Hospital
The importance of researching your hospital is crucial to find out if a hopital suits you the patient and to find out the standing of the hospital with its patients/benefactors. Steps you can take to ensure your hospital is in good standing is to search your hospital’s patient outcomes. This includes patient readmissions, complications, and if patients have received timely quality care. Another way you can research your hospital is to check the hospital’s grade, the grade includes; the performance of staff, measures taken to prevent errors from occuring, issues with care, and safety prioritization. Lastly, find out your communities inequalities within the medical system, if you are in a community that experiences disparities due to socio economic status or race, call upon policymakers to create new policies to end patient provider bias in the medical system.
- Seek Help If You’ve Been Harmed
If you have been harmed as a patient and you feel as though nothing is being done it’s important to take action to protect yourself and to ensure that this doesn’t happen to anyone else. The steps that the Patient Safety Movement Foundation suggests are highlighted in a webpage that they created with feedback from family members of loved ones who were harmed. Some of the takeaways are to; take care of yourself, connect with others going through similar situations, be sure to record all information about your treatment (pictures, emails, prescription, etc.), be vocal about the treatment you have received if you feel it has been subpar, and finally report your experience if it was indeed a preventable medical error. Having an active voice when experiencing a medical error can not only give you the patient the justice you deserve but it can prevent others from going through similar experiences.
The show Dr. Death brings up far more concerning events that continue to happen in the medical world. Explaining the intimidation staff and patients feel while working with providers and how a doctor could perform such atrocities on patients. A lack of questioning due to the hierarchy of the medical system cost many patients of Dr. Duntsch their quality of life after being severely harmed and maimed as well as several people who unfortunately lost their lives due to his deliberate harm.
The good news is there is currently a movement to remedy many of these issues. The hierarchical issue by balancing out the members who sit on the State Boards – medical, nursing, etc. One way to balance out the boards is to include experienced and well-informed patient advocates on any board that oversees the conduct of practitioners. With this effort to round out the board members, there will be more accountability and a better division of power within the medical community. Although based on actual events, the show exhibits the extreme of what can happen in a medical system without the proper checks and balances in place. We will all become patients one day or another so I hope the resources and information provided above will help you become a more empowered and educated patient and advocate for your loved ones while seeking care.