Two Medical Mistakes That May Cost You Your Job

March 6, 2023
With labor shortages in medicine as tight as they are, it seems pretty hard to get fired nowadays. The media has thrown stories like that of Christopher Duntsch (Dr. Death) into the limelight, and we have learned that even a surgeon with terrible outcomes and possible malice behind his actions still collected an enormous paycheck for years before being ousted. 
Job security in the medical field continues to be one advantage of this profession. However, this should not be used as permission to take your role any less seriously, both for your patients’ sake and your own. There remain two major fast tracks to getting a pink slip—make an error in one of these arenas, and you’ll be contacting your recruiter before you know it.

1. HIPAA violations

Patient privacy has been and continues to be a right that is held in the highest regard. In today’s world of never-ending digital sharing, the right to privacy is often hard to guarantee. But in healthcare, privacy remains a paramount, inalienable right. And violations against patient privacy are taken incredibly seriously.

Don’t Ignore the Warnings From Med School

I remember when our medical school deans planted these seeds of warning and fear into our fertile minds at the beginning of the journey. The story went something like this: 

A hard-working resident accidentally left their patient list in their car. Protected health information was left face-up in the back seat of his car in the parking deck. Somehow, it was noticed by a passerby, and the resident had to face “serious consequences.” 

No details were provided, and in retrospect, it came across more as medical urban legend than citable case law. Nonetheless, being sloppy with list stewardship instantly became inexcusable.

Fight the Temptation to Snoop or Gossip

Are you curious if your coworker delivered her baby yet? What time was the baby born? In two clicks you can find out. But it’s not your place to do so. Is the baby out of the NICU yet? Get over the curiosity, and don’t go snooping.

Oftentimes I have interesting echocardiograms that I want to share with my old cardiac co-fellows for educational purposes. But wait, is that a patient’s name up there in the corner of this picture? HIPAA is out to foil you at any attempt at sharing.

Honor Your Pledge & Avoid These Penalties

When you work in health care, protected health information is everywhere. It is your duty to keep it protected. Shred every document that needs shredding, and don’t use patient names in the elevator with non-team members within an earshot. 

Penalties for knowingly violating HIPAA are up to $50,000 with possible one-year imprisonment—plus, potential career derailment. Employees have even been fired for accidental HIPAA violations. So tread lightly, and cover your tracks, making sure you don’t create any needless ones.

2. Social Media Indiscretion

Nurse Duke’s Social Media Termination

Nurse Katie Duke was fired from a New York hospital after sharing a picture of an empty trauma room (the floor littered with used supplies) and the caption, “Man v. 6 train.”

While no HIPAA was violated, the post was flagged as insensitive which led to her termination. Maybe something about the language she used was frowned upon, interpreted as the victim “challenging” the train. In all likelihood, she was probably reporting it in shorthand trauma style, like we see all the time in notes: “Ped v. car.” “Bike v. car.” “Ped v. train.” 

Remember: you only need to offend one person, regardless of your intention, to be at risk for extreme ramifications. This nurse was trying to capture the stresses and dedication of a well-functioning trauma team, and instead, was forced to find a new job, carrying a recent administrative termination in her history.

We do know that this would not have happened if she simply abstained from taking pictures from inside the hospital and sharing them with the world. 

Big or Small, These Violations May Cost You

Sometimes the violations are egregious. Like the Texas dental practice that disclosed HIPAA information on Yelp. Or the nursing home workers who posted explicit pictures on Instagram and Snapchat. Or the group of L&D nurses who blew off some steam on TikTok about “annoying” patients and families and all lost their jobs. 

Other times, somewhat more benign infractions have led to termination. The Oregon nurse who posted a Facebook video and said she lives life unmasked during the pandemic? Promptly fired.

During my own training, a resident internally shared a picture of a specimen from an OR case, and despite being allowed to keep his residency spot, faced tremendous backlash from the administration. All because one of his 24 co-residents took offense to the image. I imagine he has to answer “YES” on all credentialing applications that ask if disciplinary action was taken against him in his career. 

A Texas nurse was fired for posting a comment about a patient with a rare disease. While she didn’t use any patient identifiers, she did mention the disease and included a general patient demographic (i.e., “young boy”) in the post. Along with having her employer listed on her profile, she disclosed enough information about the patient that he might have been able to be identified.

So, How Should You Post About Work on Social Media?

There’s an easy answer—just don’t do it. If there’s a 1% chance or less of this photo or comment having a negative impact on anyone, yourself included, just don’t post it. 

I was recently in this very position. I was alone in a totally empty OR—no scheduled cases and nothing in the room but equipment. I was enjoying the solitude, blasting some 1970s easy listening, and wanted to share the moment with a friend via a three-second video text message. 

But then the wheels started turning. What if, by chance, my friend is seated next to a hospital administrator, and somehow, this photo comes back to me?

The chances? Infinitesimal. Astronomical!

But still, the little voice inside said, “Maybe this isn’t a good idea to share.” That’s all it takes to say no.

Further Reading

Interested in more (free) content for physicians? Look no further than these blog posts:

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By Brian Radvansky, MD

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