Attitude ... it does matter...

We had an ex colleague rejoining us few weeks back…W is Burmish who graduated from top medical school here in Taiwan. He had failed to pass the board and later ended up working in some construction site down south. He was introduced to our boss many years ago, I had just returned from Malaysia then. He was posted to ICU and ward to freshen up his skill and knowledge. He had shown poor skill and knowledge and lack of working passion then. Posted to ICU and he had placed himself in the discussion/resting/office of ICU after the morning rounds instead of busying with order and charting. The skill parts were worst as he had no idea of sterile technique… Well, Boss had asked him to leave after few months of effort. Lem had given him some ref. material for the board examination on his leaving.

Few years later, boss had told us that he had passed the board and currently undergoing training in orthopedic. Good for him, a shame seeing a medical grad earning a living on hard labour.

Well, aprox. 1 + month ago, boss had introduced him to both of us while Lem and I was doing the morning Passover.

The introduction was a little bit weird,

Boss had told us that

1.W would be standing by for trauma case in the night
2.our senior orthopedic surgeon would be covering for him /going in with him for ops in OT.

3.We can call W for large/contaminated wd which need to be done in ED

W had told us that,

1.He is good at ankle – his mentor is an ankle expert

2.He can do trauma and nerve repair is not a problem

3.He is keen to learn everything – even medical management

Boss impression – he is under probation,

W impression – he is good….

Few days later, Lem told me that he had overheard a conversation between W and the management – it seems that W is still staying in a motel rather than a unit rented by the hospital. The management had never treated a doctor in such way - > rooms/house would be ready / almost ready on arrival…Lem told me that W might be still having attitude problem…

1.W is always playing with his Ipad – whenever he sits down, no matter where he is, no matter how busy is the environment

2.A case was send up to the OR and he had sit in the ED (With his Ipad of coz)  for 30-40 mins after the patient was sent up.

Another few days later, Lem had told me that Boss is going to let him go…. And Lem told me the incident that happen for the past few weeks..

1. 1.    OR (boss doesn’t know about this…)

He had done a few ops. He had done a Total hip replacement, which had taken him a long time to decide how to make the 1^st incision, and later the procedure was completed by the surgical aide and the prosthesis sales rep.

He had done a plating which later re-ops by the senior surgeon, the plating took him 4 hrs to complete…

1. 2.    Pharmacy

He had called up the pharmacy on his OPD session asking for drug info(mainly the use, QID or TID , AC or PC) for most of the drug (Except acetaminophene and some antacid). The pharmacists were irritated by his act…

1. 3.    Ward and OPD

The nurse had complaint about his attitude and prescription…

He was in a fuss when the management asked him to leave…. He had threatened to let the hospital suffered in the future after the meeting….

This was the 2^nd orthopedic surgeon I encountered who cannot operate properly… There was this urban legend about surgical training – the senior surgeon would bar those incompetence and attitude problem training resident from entering the OT. These residents would still pass their board but eventually ended up as one who cannot operate….I think I had seen one again….

Boss might had heard some rumor in prior to hire him and that was why he had no hostel to stay in…..

Well, it is not the knowledge nor skill, it is the attitude that matters…