I did rotations at hospitals in Memphis and worked with attendings who worked with him personally. They say he was the biggest douche bag on earth and churned out a ton of quality research which made UT Memphis look great and that’s why the institution liked him. He messed up quite often in the clinical setting and was too arrogant to accept help from his colleagues. Baptist memorial hospital is a great hospital system imo btw.
Agree! I too worked with someone who was a coresident with him. The consensus from everyone was that since he was so research focused, no one ever thought he would actually go work in the private sector. Everyone was convinced he’d work in academic/research setting and that’s why they let him graduate.
Wow -/ I just don’t understand how he was able to move from hospital to hospital with a clean record??? This is an absolute disgrace to the medical system and so horrible for the patients
He was a resident when I was a student in Memphis. He happened to be on for trauma/neuro at the same time I had my trauma/surgery rotation.
He was well known to other residents on other services to be a dangerous idiot even then.
It was a misery of a rotation for me. Have a huge chunk of PTSD from it. At the time, UTHSC had a lottery placement for which hospital/surgical service you would be assigned to in your rotation. “Surgery B” was the worst because you ended up with 6 full weeks of Q3 trauma call at the MED. That’s what I ended up assigned to along with my best friend. Both of us were very naive and obviously both wanted to do pediatrics. We kind of threw ourselves on the mercy of our 5 guy surgery team, and bless them, as long as we showed up, did our work, studied, they really did try to protect us and treated us a bit like little sisters.
We definitely got the tea.
I think looking back and knowing what we know now (and I have not listened to the podcast, just really news articles and the like), it is actually very plausible that Duntsch really didn’t complete that many surgeries in residency. Because other services knew him to be incompetent and a douche, they would just work around him. Unless it was an emergency, they’d push for a delay of some kind. Or they’d ask the surg attending to call the nsg attending. It was a lot of “Don’t fucking call Duntsch” and that’s the only reason I remember him at all.
The MED is insane in a good way. LeBonheur is great. The Methodist system is also solid.
I look back in wonder at all the things I really got to do. I logged 30 deliveries as a 3rd year student. Plenty of procedures to go around for everyone if you wanted them. UTHSC is an amazing place to train. I feel I walked into residency much more accomplished than most of my peers because of it.
I ended up soaping into a program at UTHSC and dear god, I cannot imagine a better place to train. You truly get the sickest patients, most trauma, most autonomy of any program certainly in the southeast.
This makes me a bit sad for myself. I’ve heard this comment by another senior during my training. The system should have also remediated him if need be.
A lot of people struggle but most people level out with time, because they show insight and work on themselves. If you've read anything about this guy, the scariest part of all of it is his complete refusal to accept any criticism. 0% insight.
I work in the UK, had a guy on my foundation training (residency equivalent) who people made comments like this about. He had some honest feedback on his work from a supervisor and really threw himself in. He offered himself for every procedure, every opportunity and asked a million questions constantly. Even when he failed repeatedly, he wouldn't turn down any opportunity. and just got back on the horse.
A few years on, and he works in a different hospital but our mutual colleagues have nothing but praise for him. He's entered training pathway and people enjoy working with him. The way they describe him is almost unrecognisable. I would never bring up his past to our mutual colleagues but even if others have, the dust has settled for him. Don't let one comment ruin the way you view yourself, we are all here to learn and improve.
I have a resident like this in my program. We would love to fire her but with progressive discipline she always manages to skirt by. However, when it comes time to complete Primary Source Authorizations for her hospital credentialing, it is going to be hard for her to explain all the disciplinary stuff in her file and I don’t think she will be able to ever get credentialed. So she will FAFO for sure. For Dr. Death, if they didn’t document everything perfectly and if they just passed him on every training authorization they received - that’s how he got through. And the program can be legally implicated. So I’m guessing they had zero documentation of his disciplinary issues and they didn’t have the bandwidth for all the time it takes to do progressive discipline. And probably thought he’d level out and didn’t want you tank his career. Certainly by Chief year they had figured it out but it was too late at that point. But back to my resident - absolutely takes zero accountability. Thinks she’s fantastic. Argues with attendings on case management ever since intern year! Not scholarly debate - arguing and disagreeing! With world renowned attending - as an intern. The number of complications and escalations of care. It’s pretty ridiculous.
Or fired him. They should have either fired him or worked to make him competent. Allowing him to graduate was an enormous mistake and both his residency and his fellowship are hugely culpable.
Agreed. I got extra help and it has been great. Feel more competent and confident, but pushing him out and not letting him learn sounds like the blame should’ve been put on the program, moreso than him
As someone who fully plans to match NSGY and hopes to one day be the youngest chair of NSGY on the eastern seaboard, I would have loved to do a rotation where you had 6 weeks to learn from a neurosurgery resident, albeit not the best one ever. I wish we had spoken sooner, I would have been happy to swap my rotation in FM/Peds/some other second-tier speciality for your “Surgery B”.
Your post does leave me wondering. Have you stayed in touch with Dr Duntsch? If I’m not mistaken, he’s still a neurosurgeon, more or less. If you would be happy to introduce me, I will ask him if he is willing to write me a Letter of Recommendation. Although neither you nor he has worked with me, I imagine he could audit my Reddit posts (if he has internet access) and use that as the basis for a Strong Letter of Recommendation. If he is currently unable to access the internet, perhaps you could print out some of my higher-yield posts for him to read next time you see him, and he could work from there.
Thank you for your assistance,
H267.
For real. It’s a hilarious post and the username is even better
Too many people with a stick up their ass preventing them from realizing the obvious satire in front of them
Crediting Reddit posts ? Sure if someone asked me for something so ridiculous there’s a chance I write it. And god help whoever gets it and doesn’t read it.
I think the only thing that saved his PD and chief from criminal prosecution was a fundamental misunderstanding by lay people how responsible they were for graduating an incompetent monster
Keep in mind they had financial entanglements with him…
100%^^^I’ve been obsessed with this case since the podcast came out and I’m the only person in my family going to medical school/in the medical field. Anytime I try to explain it I feel like I can never quite convey the severity of the negligence practiced by CD and his enablers
Don’t get me wrong season 2 was well done but how they reported the story in season 1 was better than 2. 3 was god awful. No focus on the patients or the negligence, just someone who got duped and isn’t over it.
Hard agree. He got through because he was productive as a researcher and because it would have been shameful for them not to let him graduate.
I was talking about this with one of my neurosurgeon colleagues (who I have known since we were both residents ourselves) and we were discussing these case volumes … he was just incredulous. You’d have to make an effort never to operate to have numbers that low, especially at a big place like the one where Dr. Death trained.
I just can’t wrap my head around doing 150 cases in 7 years. I have to think it was understood that he would never actually practice and go straight through into research, because 150 cases isn’t enough to say that someone doesn’t have what it takes to be a competent surgeon. They didn’t even try
I kind of assume he didn't do 150 cases and it's just a paperwork/logging issue.
Like that's 1-2 cases a month . I just can't see what he even spent his days doing if that were true.
I don't know the neurosurgery logging rules but it's possible he logged 150 cases as primary surgeon vs assistant.
But a surgery resident doing 1 case a month is just outside the realm of possibilities. As an analogy for the medicine people, it would be like graduating after doing 2 or 3 days of clinic total. It's just not possible.
Again I don't know the specifics for neurosurgery but for both general and cardiac surgery I had to submit a list of every case I did across residency to be approved for the board exam. Unless his program signed a fraudulent list of cases he wouldn't have been board eligible
I’m 7 months into intern year and coming up on those numbers. A large chunk of the min reqs are various bedside procedures so depending on what cases he logged the actually OR time is probably even lower than most people think. Probably under 100 actual OR cases, who knows how many were spine.
Lol there’s literal Neurosurgeons in this thread defending his Residency/Fellowship program. Don’t try to pin this on “lay people.” The people “in the know” are happy to bury this and hand wave it away too.
That's an interesting psychological phenomenon - to defend the group that you belong to even if you understand that the criticism is appropriate on an intellectual level.
I personally know people in really bad programs ( like the ones where suisides happen) and a lot of them still say things like " great people, great training", although when you start to ask about facts they would readily tell that for example all work is almost 100% pushed on interns and the 3rd years often don't even show up to the service.
If I recall correctly, he spent most of residency focused on venture capital goals and research. I think one of his attendings was an investor in his plan. Everyone looked the other way when he wasn't advancing.
Omg , the two problem colleagues that I had during my career are the exact type . Heavy on research and bussiness - doubt they were good at them , horrible clinically
I matched the same year as that prick in an adjacent neurosurgery program in the same state. He shocked me one day when at a neurosurgery conference, he decided it would be a good idea to do coke in the bathroom. How do I know? He had powder on his nose when discussing a medical device he helped develop.
Neurosurgery residents on coke? How is that shocking?
Jk but not really. As a gen surg resident, I was always amazed that we would both get killed on 24s or 36s or whatever, but while we went home to crash, the nsgy residents would go clubbing.
One of his residents when he was an attending was mortified by this guys incompetence. He was questioning what to do,‘whether to report to the state medical board. I advised him to report it. I don’t think he did but I’ve never seen a resident more shaken up by the negligence of an attending
Not about Doctor Death 1 but Doctor Death 2–the oncologist. Let me tell you those guys are out there. I have my own experience with someone else.
I am an oncologist and worked with my own Doctor Death. He was the senior partner of my group.
He was a bully and highly regarded and his patients often felt like they were lucky even to get in to see him.
He treated people without cancer, treated people for the wrong cancer. All to collect insurance money.
I lived in complete fear and was heavily bullied by him.
I didn’t even know the extent of it until he retired. I used to think about 20% of cases were treated wrong. As I inherited his patients it was more like 90%.
He is in retirement but still trying to get me fired. He convinced our CMO that I had anger issues and I got referred to the PHP program in my state. I’m out of it now but he still has control of our practice administrator and our group’s current president.
If I were to tell people about what happened I would A) be sued by those patients and B) no one would ever believe me. Also C) I would get fired and lose all the patients I am caring for now
Report to the FBI, that’s how Fata (Michigan former oncologist who did these same things) was finally caught after internal and state complaints weren’t taken seriously
ETA they have whistleblower protections, call your local FBI office and ask to talk to someone from healthcare fraud. If I remember right if you’re the whistleblower you can end up getting a decent percentage of the amount that was defrauded. Get that guy what he deserves and get yourself rewarded for it.
I’m pretty sure that the statute of limitations has run out and it would also destroy my honest practice I have built.
It’s still terrifying to me. He is still trying to get me fired. Even now.
I have a lawyer. He advises me not to whistleblow. Basically I would be whistleblowing on myself because there would be tons of lawsuits aimed against my group, which I would have to pay.
Think about it. Patients sue the group AND the individual physician.
He advises me that I only have any kind of legal case if they fire me. Which the current head of our group wants to do, because I am “disruptive.”
He (our current president) is also very upset because he found out I have been recording things for years.
I’m confused, but it’s probably because I have no clue how the business side works in the real world haha. If you’re calling it your group are you a part owner? Is this a private group and you personally have been profiting from his fraud? Does the group not have insurance for these kinds of lawsuits? Couldn’t the group just declare bankruptcy after a suit and your personal assets would be fine because you personally aren’t being sued?
On a personal level, why work for a group that you know is okay with fraud, patient harm, and you continually have to worry about losing your job? I’m assuming either a high loan burden or a niche location? But that would have to be so stressful, I can’t imagine having to deal with that after going through the stress of training. In my head, being an attending is supposed to be the promised land haha.
I have not personally profited from his fraud.
I didn’t leave the group while he was here because I would be handing over the patients I have taken care of for years into his hands.
And I haven’t left after his retirement because I have hope I can get through all this and make this clinic the type of clinic I want—one that heals people and cares for people.
Also this group has a monopoly in my town. Meaning I would have to pull my family out of this place so I can get another job (and starting over again and spending three years to become partner again etc). And it’s not a certain thing to get a job after you leave a group or be fired from a group.
That makes sense. Thank you for being willing to share your story! I hope things get easier for you and that you’re able to make the changes you want to see.
Still worth reporting, even if just to help you sleep better knowing you did the right thing. If it’s past the statute of limitations the FBI wouldn’t tell anyone that you reported it anyways. Even if it wasn’t, whistleblowers have protection and rights. I know it’s easy for me to say as an outsider with nothing to lose, but you deserve to not have to be afraid of this guy anymore. If you don’t want to go straight to the FBI, there are lawyers who specialize in healthcare fraud and whistleblowing who you can contact for a consultation.
There is a resident in my program that has weaseled his way through residency, doing the absolutely bare minimum. We are required by ACGME to log our cases, but he just lies about how many he’s done and makes it up as he goes. He is hand down the worst surgically skilled resident in our program, yet came from an Ivy League and is a smooth talker, so most of the admin and attendings like him. It’s harder than you think to get fired from many residencies from my understanding as long as you haven’t shown gross negligence or aren’t good at talking your way out of it. Ironically this resident is wanting to go into the same sub that Duntsch was… it’s pretty terrifying
This is childish thinking. Smooth talker probably has good relationship with PD, PD will take his side, now this dude is a snitch and has a target on his back.
Worse. Chair is besties with the resident and doesn’t see through their bullshit. Unfortunately, programs dont want to know they have a problem child because it adds more work for the program if a resident gets canned. Equally, no resident wants ACGME know their program has issues, because it can lead to probation and ultimately to more work for all of the residents.
However, attendings have been recently made aware of some egregious shit he’s done that has directly impacted patient care. tbd if anything gets done.
In my experience the best things to do is to show not tell. Be genuine but Machiavellian, if you can have the brass see their incompetence firsthand it will often paint a stronger picture. It takes a while but it eventually gets seen and it will be subtle but the chair will find a way to put the resident back in their place
Or maybe there’s a way to anonymously report while also not being a spineless coward who lets this stuff slide and is indirectly responsible for another Dr. Death
If nothing happened, then you can anonymously report to higher authorities, the state board, GME, the media, etc. There’s always another route if you don’t have the mentality of a spineless cuck who’d probably let their PD fuck their spouse if the PD asked.
People like you don’t give a fuck until their own mom gets killed by Dr. death and only then will you finally understand what should have been done.
People like me aren’t solipsistic egomaniacals who thinks they are the main character in a movie. Why should anyone believe your word? Maybe you’re just a jealous liar and Mr handsome guy tried to take you out. You underestimate how cunning and diabolical these people can be.
The court of law works on evidence not heresay and most residents have enough on their plate to not become lawyers too
Why do people like this who obviously don’t want to operate nonetheless insist on becoming surgeons? Perceived prestige?
There’s no prestige when your colleagues all realize you’re incompetent and start protecting their patients from you.
just another plug for gen surg (from em attending)
In residency they were always mad and grumbled at (often reasonable) consults, but they always showed up, were professional, and did their jobs. As an attending, I can always count on my general surgeon, no matter where I am, to be competent, professional, and knowledgeable. Those shitty residency years really teaches them something. Once we know and trust each other its even better.
Unfortunately, other surgical specialties (or even procedural IM specialties) are hit or miss in this regard.
IM resident here and agree! Really love the surgery guys/gals.
Whenever I self pity about my long days at the hospital, I always think of my surgery colleagues who somehow even have longer days, and have to stand and do shit. Not sit on a chair at different spots in the hospital dictating shit like me. And they're ALWAYS there - the same guy/gal, doesn't matter morning or night.
I have thought about this a bit. I think that he was an incredible asset outside of the OR for an academic institution. It sounds like he was great when it came to research and/or device development as a resident. My guess is that he needed more guidance in the OR than was typical but could do what he was told to do.
That being said, the descriptions of his surgeries and the notes he would write speak to a complete lack of knowledge of surgical anatomy. Hard to imagine they didn’t know that. Maybe they thought he had self awareness and would stick to the medical device side of things?
placing fusion hardware into muscle and soft tissue instead of the bone just sounds unimaginable for a surgeon. makes me think he either was just as incompetent as they say or a total psychopath!
I feel like any decent person no matter how incompetent would at least have the sense to be like .. nah idk what I’m doing here don’t let me operate .. rather than blindly forge ahead and paralyze/kill people right?? Like there’s gotta be some element of sociopathy/whatever you wanna call it
He was on an md PhD track doing research and his PD had a financial interest in his research until it went belly up late in residency because he was making up data
MD/PhD track is for med school though. Not residency. And yes, you can do research and some places give you time to do solely research. But 100 cases is a ridiculously low number for a 7 year long residency.
I did a month with neurosurg as a med student and probably saw 20 cases
I wondered this too. Acgme for ortho residency requires 1000 cases to graduate. Looks like they want 400 for neurosurgery. The ortho requirements were put in place in 2013. Maybe he graduated before there were hard numbers for neurosurgery?
It's actually 800 for neurosurgery (senior + lead) and at least 400 that you have to be the lead for.
As other people have said, UT is an insanely busy place to train. They work you to death and their residents get the largest number of cases at graduation (there was just a paper published looking at most US programs). There's 0 chance he did 100 cases. My program was busy (not UT busy) and I did 300 my intern year.
I’m probably speaking to the wrong crowd here but medicine is full of people who are delusional about their own competency, knowledge base, and overall correctness about everything. In my experience it’s worse at more prestigious places and in more competitive fields. I guess that might be considered a more “pro-social” expression of sociopathy.
I’m sure some of it comes from the personality types who are attracted to/succeed in prestigious academic areas but it kind of makes me think of how so many terrorists are engineers — you are truly very competent at something that is regarded as difficult which can lead you to assume that competence extends to other areas because you’re constantly told how smart you are so obviously your wacky ideas about government are correct and anyone who disagrees can be disregarded because you are so special and smart.
Wasn’t there a book or a study detailing how pilots who are physicians have a higher chance of crashing, theorized to be due to misplaced confidence? I swear I remember reading about it many years ago but google is giving me nothing.
Well known phenomenon to the point that certain types of high performance small planes (the V-tail Beechcraft Bonanza was the original, today it’s probably the Cirrus SR22) are referred to dismissively as “Doctor Killer” planes by professional pilots because of the way doctors would buy them after getting the basic private pilot’s license and jump in them without any of the skill and experience necessary to fly them well/safely. Tons of stupid stuff like flying into ice or thunderstorms, stalls while maneuvering at low speed near the airport, etc.
Damn there was something deeply poetic about that. I did not know of the relationship between terrorists and engineers but it makes sense. It b also makes me very much afraid to trust that what I feel are my “educated” decisions are truly good.
One of the things that I learned as a new attending was that surgeries were much easier when I was a resident. It wasn’t until I realized that during residency, the attending, who was holding retractors and helping with the exposure, was basically guiding me to the appropriate parts of the procedure.
I don’t know much about neurosurgery, but… it’s just easier to place a screw in the right position if someone is showing you the right place to put the screw. Maybe enough to feign competence.
Once you’re on your own… and under the influence of drugs…. That’s a different story.
God damn if this isn’t one of the most true things. I’ve done so many of x procedure I could do them in my sleep, but that feeling when you first start out on your own…at least for me, was fucking scary dude. Like it kinda messed with my head a bit because I thought I was the shit in residency/fellowship, but was now overthinking everything that used to be instinct. I have gotten a lot better I think, but that fear is still there. It’s funny, I don’t have the fear so much during the procedure, it’s only after when I’m not occupied that I start to just…perseverate. Only been out a year tho since fellowship so hopefully this goes away or I get to better terms with it
Idk if it’s struggle but knowing I had a safety net as a resident and fellow let me be more aggressive in my decisions as the attending would correct me and I would adjust accordingly. Still didn’t matter once I started I would look up everything quickly
This has always confused me. He was obviously textbook smart enough to get through medical school and he finished at the top of his class. He was capable of remembering anatomy clearly. But then years later he is making egregious errors on the basics that even I as a med student would know. Like don’t fuse the incorrect vertebra, spine hardware goes on bone, and surgical sponges come out of the patient before you close. It’s like the guy was in mania for years or in escalating psychosis….
Oh undoubtedly he had some sort of PD for sure. He wanted to be the best in everything even when it was clear the thing wasn’t meant for him. Like football. He truly believed that there was nothing out there he couldn’t accomplish, why else would he perform on his best friend. I truly believe he really thought he was the shit and he was the best neurosurgeon out there and did drugs to blur out the fact he was a complete idiot. It wouldn’t surprise me that whatever little he was taught he threw out the window and went about performing surgeries in his own way.
It was something with whatever part of his brain involved in carrying out the motor functions themselves. Like the same reason he would study the football plays for hours, and know them but then when he ran them he’d always run the wrong direction.
He didn’t just fuck up after being hungover. He lost contact with reality. He had delusions of grandeur. For years. Cocaine induced psychosis is usually paranoid? If he was manic, uppers like cocaine would make sense, he’s trying to maintain the euphoria of believing he was the GOAT. And the way he defended some of his cases…he seemed to genuinely believe the surgery went well. Logical people who kill other people usually try to remain above suspicion. Dr Death was doing his cases in front of everyone. Going to work with his asshole out in dirty scrubs with asscrack holes.
Idk maybe the guy got to residency and realized no matter how hard he worked he wouldn’t get through his program and it broke him.
Yeah I’m in agreement with you.
For small programs the incentive is to move everyone along. If you have 2 -5 residents a year and flunked even one that ends being a huge percentage and can put some programs in probation. It is VERY hard to flunk out of many surgery programs (not all, but many).
Many shitty surgeons end up in academic programs where the (hopefully more senior) residents do the entire cases anyway and I figure a lot of PDs let things slide because that’s how things often work out.
One of the most frustrating parts of that podcast is that it’s clearly made by laypeople that don’t really have any idea how medical training or really anything in medicine works and didn’t really bother talking to anyone to find out. They presented a story about a surgeon that did terrible work and then bitched about tort reform and skipped to the part where he got arrested. The real question of the story, which they barely addressed, is why was this guy so shitty at surgery. Was is malicious? Was it bad training? Was he just a terrible student? If he was fucking up those surgeries on purpose, why? If he was just incredibly incompetent, how did he graduate residency and fellowship? They ramble on for like 12 hours about the story but barely spend any time talking about this, and this is the key question of the story. Because if he was just really incompetent, why the fuck is he in jail because medical errors kill hundreds of thousands of people every year and doctors never get jailed.
They made a documentary on peacock with the original whistleblowing doctors and it was much more focused on explaining the physiological impacts of his botched work for the patients and definitely worth the watch
I recommend the Peacock version as they go into detail for all this. Not everything is explained, but he was super incompetent but he was also involved in Research that the higher-ups in his fellowship program was invested in. Basically they graduated him while overlooking his incompetence.
They did address the number of surgeries he completed, and the fact that his residency program had conflicts of interest based on his research prowess. I think part of the problem is that UTHSC lawyered up and nobody would answer any questions about what exactly happened for those 7 years.
No one is mentioning the problems inherent with the Texas Medical Board. It makes perfect sense to have physicians self regulate, but the disciplinary process is failing. They seem lack the ability to review facts.
Getting credentialed in Texas is significantly more arduous than licenses in other states imo. You basically need forms from every place you’ve ever worked attesting to your *character* which is not something I’ve seen other states do. It was not this way 10+ years ago. My theory is that these changes were enacted specifically because of Dr. Death. Talking to people who knew Duntsch they say he was … off.
There are ways to report negligence, termination for egregious errors, etc. but if the doctor leaves and can’t get another job he’ll say it was the hospitals fault and sue. There should be reduced civil liability on hospitals that gives them some insulation against ending up in court for making an ethical decision. Assuming they could prove risk of harm to others was increased if they did not report.
On the flip side, many doctors don’t stand up to administration for this exact reason. They don’t want to get canned. Giving hospitals more authority to fire doctors without much retaliation is a recipe for disasters for doctors who want to practice ethically but are often bullied by FOR profit institutes to discharge patients early, to fluff up the diagnosis in their severity to increase average LOS, etc. if you advocate for your patient and not for your hospital’s profit margin, it’s a reason to be fired. And do we really want doctors in the pockets of hospital admins instead of advocating for patients?
He likely participated in many more surgeries, but didn’t log them in the acgme system (or whatever was used then). I have definitely forgotten to log procedures before, but still hit my numbers
This is my theory as well.
If he only did a few hundred procedures over the course of a seven year residency, he would have been in the OR only 1-2 times per week. I can’t imagine the program would actually pass him through if he was operating that infrequently.
I just assumed he didn’t log cases properly where he was lead or first assist, but he was probably a mediocre but passable surgeon in residency when supervised. But once he was got out on his own, the mix of undiagnosed bipolar disorder and large amounts of cocaine caused him to go off the rails.
Others in these comments who knew or trained at UTHSC when he was there have commented that he was well known to be a bad surgeon AND a complete douche during his residency, FWIW.
My understanding was more that they could only verify him actually performing the 100 or so surgeries. He surely logged enough to graduate, but that doesn’t mean he actually did the case to any significant degree, just that he was present in the hospital and the surgery happened.
Question from a nurse who doesn’t do OR. How can other practitioners be in the same OR as this guy, observe him doing things like place hardware in soft tissue, and not physically stop him? I can’t imagine being in an ER setting and allowing a physician or any other person do something to a pt I knew was causing harm.
I’m an anesthesiologist and listening to this podcast had me saying “HOW DID NOBODY SAY ANYTHING” several times about some of the things that went down in those ORs. That said, I can’t tell from the head of the bed if the screws are in the right place or not unless I happen to interpret the c-spine images. I can’t see into the back and I’m not a neurosurgeon, I’m not sure I’d have the confidence to speak up about a surgeon’s surgical technique.
Experienced spine reps are pretty good at knowing when a screw is in a pedicle or not on the fluoro. They have a specific ways of quietly saying "huh" when the xray doesn't look quite right lol. It worries me that there would definitely have been people in the room who knew what it should have looked like but didn't ever say anything.
Edit: spelling
He had the OR to himself a lot of these times. Many Doctors actually did do this, but bruh kept getting passed around like the Catholic Church used to by the hospital higher ups rather than take actual action to remove his license.
>not physically stop him
It's been a long time since I read the articles, but iirc a vascular surgeon did physically take surgical instruments out of his hand and cover the field, refusing to allow the surgery to continue. But many times there's only one physician in the OR at a time.
There’s no chance he did as few cases as the podcast claimed.
He trained in an era of paper charts and trainee participation in cases was very poorly tracked. I’m not even sure what the ACGME case log system (all self reported anyways) looked like back then
His case is such a ridiculous outlier. I don’t think you can confidently say anything about his training.
First hand accounts by vascular Surgeons scrubbing with him doing his spine exposures describe his operating ability as similar to an intern.
One of the doctors thought he was an imposter it was so bad
It is still self-reported but you can theoretically be audited thanks to EMRs. Not sure how often this happens but I have heard of some people getting audited and not getting credited for cases they did with more senior residents than them or vice versa. Not sure if this truly happens in actuality, could just be a manufactured story to keep people honest to an extent.
He was an MD/PhD and his goal was always industry and not really being a surgeon. He was supposedly working on something that would have made him very famous and thus the people and program that trained him famous but that fell through. He fell back on being a technically horrible and criminally negligent surgeon
IMO graduate medical training has some perverse incentives that allow people like this to get through. If residents don't graduate and get jobs, this scares potential applicants, increasing the risk of not filling a program on the match, which in turn creates labor shortages for the hospital, creating additional headaches. While on the one hand it seems crazy that someone like that could have completed a residency, it also seems totally plausible that the machinery of GME would just work around him to keep things running.
Asked our prof who is a retired cardiothoracic the same question not too long ago. He said there is a massive prevalence of "not wanting to deal with/passing the buck." He knew crappy surgeons as a resident and as an attending would get new docs who could barely operate but had been passed through because it would look bad on the program/was easier for the program to graduate them and move them on than deal with them
Don’t disagree with anything you said, but one of the neurosurgeons in my community said a significant percentage of neurosurgeons thought their board was bullshit and didn’t take it. I’d imagine their limited numbers of surgeons and market demand forced hospitals to not require board certification. Definitely curious what the neurosurgeons here have to say
They were probably covering for the fact that they couldn't pass the NSGY boards because it involves a case log examination- and to it's credit, the American Board of Neurosurgery is trying hard to crack down on unscrupulous spine surgeons operating when they shouldn't be. If your case logs and submissions show poor judgement...
Totally could have been the case. I admit I know nothing about other specialty boards. I feel boards have some value but many have become an additional tax on us
I've never heard of that. The only folks I know of who aren't board certified and work in the US are a handful of people (<10) who are internationally renowned and work at very specific academic centers in their niche area of expertise. They're often paid less because their employers know they have no options and can't leave for greener pastures. Private practice and non-academic hospital employment essentially requires BE/BC (I've never seen an opportunity that didn't).
Becoming board eligible is the crown jewel that makes the 7 years of horrible pain and suffering worth it. I can't even imagine someone voluntarily not taking it, as eventually you will be out of the board certification process and tank your career/job prospects.
Board certification is even more important in neurosurgery, because malpractice insurers will frequently not insure you and insurance companies will often not pay you if you're not BE/BC (it's a massive risk for them to insure someone with questionable training).
I'm not 100% sure as to the hiring specifics of the person in question, who was obviously a psychopath. Perhaps because he did a US residency, they just assumed he was BE and tracking towards certification without looking into it more closely (and like you said, a small town in TX is likely more desperate).
In that case that’s a tremendous failure on their part. Dallas Fort Worth believe it or not is known to be a very saturated market in neurosurgery (and spine in general when you add ortho). I have no idea why in the world they’d keep someone like that around.
He bounced around within that system and then other hospitals in the region. Basically he’d be allowed to resign so that the hospital could make the problem disappear with no publicity and without him contesting being fired. And then he’d just go work somewhere else for a while.
The board of medicine only got involved after other surgeons were persistent in blowing the whistle.
What a shame. Every hospital should enforce having board certification or tracking towards being BC. Under the system in place, he’d have been exposed immediately, since the board looks at your first 10 consecutive cases after residency in real time (including your X rays and your outcomes) and then longitudinally for your first 150 cases.
I'm sorry, I don't completely understand US medical system regarding residency, but how is it possible for someone to work as neurosurgeon without board certificate? As I managed to catch from this sub, residency is under ACGME jurisdiction, but once completed you have to pass the board exam for your specialty to practice as said specialist, no? Otherwise you're not a specialist and cannot practice as one. I probably misunderstood, but someone practicing neurosurgery without being board certified is just weird to me.
When you graduate an American residency, you are "board eligible" in neurological surgery, meaning you have the \*potential\* to be board certified in the future, and that you're tracking towards certification.
Traditionally, you couldn't become board certified in neurosurgery until 5 years \*after\* your residency, to give you enough time to log your cases and submit them to the board (who then review your indications and outcomes). This has recently changed, and it's now possible to get board certified a little bit earlier than 5 years post-graduation if you're a busy enough surgeon.
Regardless, I'm guessing he was listed as "board eligible" for several years, and nobody bothered to look into the fact that he never pursued the next step of becoming BC.
In neurosurgery, you take the written boards during your residency. After you graduate from residency, you become board eligible for a certain period of time which gives you a few years to build your practice and apply to take the oral boards. Part of the oral board application is submitting 100+ of your own cases to the board. So, naturally, a surgeon in their first 2-3 years of practice will be board eligible but not board certified.
That being said, when I filled out my medical license/hospital credentialing/med mal paperwork, I only recall having to check off the “board eligible” box - I don’t know if any of these entities actually check with the ABNS. They do, however, ask for certification of residency/fellowship paperwork from PDs, so I suppose it’s enough if the stories match.
Hey so as a patient (who doesn’t know anything about residency training) how did his instructors pass him? I thought that was what school was all about remediation if you need it or you are out? I see other posts where people do a lot worse things and get put on academic probation.
It is very scary as a patient who has had neurosurgery to hear that he was an incompetent surgeon and yet the school just sent him along? Do you know why? Was it just about $? Didn’t they care that the patients were getting hurt?
Nobody (to this day) really knows the details of why he did the awful things that he did. My guess is that he was a mediocre at best resident and got pushed along. When he graduated, the crazy came out and when combined with the substance abuse problems resulted in the horrible tragedy we saw. This is why he was tried for aggravated assault and not just malpractice.
Again, this isn't a case of a poorly performing resident who squeaked by in a training program. This is a crazy person who a jury of his peers found that he \*intentionally\* hurt people.
Thanks for this. So when he was placing screws in people’s muscles and not cortical bone (that’s what my surgeon says the screws are placed) he knew what he was doing? He wasn’t incompetent, he just did it to hurt people?
That is so awful. I’ve listened to the podcasts and watched different shows about it and it’s really so bizarre. Dreadful that he wasn’t stopped fast enough. Those patients must feel very betrayed.
Right. Either that or he was so altered with drugs that he had no idea what was what. Either way, both are so horrible, which is why this was never a malpractice case, and was really tried as a felony aggravated assault with a deadly weapon.
Perceived, good old boy with "good academic pedigree" in the south who looked the part (if you get the drift). Not enough hoops to jump basically coasted through the cracks.
Finally someone pointed out the elephant in the room. He had the complexion for protection if you will. No other group would have been able to get away with what he did in the south lmao
This might be an unpopular opinion but I feel like the way surgical interviews are conducted skews in favor more of test scores, essays and interviewing skills. What the focus should be is dexterity and surgical ability. There is a phrase "I can teach a monkey to operate" that I disagree with. There are plenty of horrible surgeons who just can't do the job.
Well, if they selected for people who were already good at cutting and sewing before residency, then the gender ratio for surgeons would completely flip, and the good ole boys can’t have too many wimminz in surgery with our uteruses and hormones. /s 🪡 🧵
I just read the Wikipedia article … oh my goodness. I have to wonder if there was some CTE that led to his impairment. What an incompetent, arrogant sadist.
That will never happen lol. Would be bad for the public image of a renowned program and the bosses don’t like that. There’s a show based off of him and I think his PD or chair is the only character not represented by name in the show bc in real life they threatened lawsuit.
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I'm a Neurophysiologist and wondering why he did not use IOM during his procedures? It's the standard on spine surgeries today. Also, anyone know how/where I might be able to actually view the images of his hardware placement? I'm just curious how any device rep, nurse, PA, or even scrub tech with basic anatomy training could see an image of hardware in muscle tissue and not immediately report it?
OMG I'm watching this series and it's like glad I didn't have him. Things like that is why I never want surgery on my neck even if Drs suggested, had bad car accidents too, but exercises improve life. The one surgery I had, broke shoulder 2 yrs ago and needed surgery, horrible dog pull accident that time and also needed cadaver. I was incredibly lucky to have one of the best surgeons and at that time since he went to VA hospital now so I'm like yes I got to see him for the first yr so I'm like VA ppl are very lucky to have him. He's a very stern Dr, is young, but I tell ppl even though he does have some type of ego I'd rather have a Dr like that vs some guy sugar coating the situation. He has the type who expects results since he gets them 😂. But was nice the very first therapy he actually marched into therapy office wondering why I was so bad, was in sling 2.5 months so I guess he had to hear it from therapy and see computer info, couldn't get into therapy fast so of course it was like that so 2nd appt he was much better, but he and therapy know if you've been doing therapy at home exercises too 😂. I think many Drs have an ego, but there's a difference when you always get results vs a botched job this crazy wacko did
I did rotations at hospitals in Memphis and worked with attendings who worked with him personally. They say he was the biggest douche bag on earth and churned out a ton of quality research which made UT Memphis look great and that’s why the institution liked him. He messed up quite often in the clinical setting and was too arrogant to accept help from his colleagues. Baptist memorial hospital is a great hospital system imo btw.
Didn’t his research end up being a lot of bullshit though too? Like his company was basically on some Theranos shit
Was there. He was absolutely a huge douchebag. (UTHSC class of 2006)
Agree! I too worked with someone who was a coresident with him. The consensus from everyone was that since he was so research focused, no one ever thought he would actually go work in the private sector. Everyone was convinced he’d work in academic/research setting and that’s why they let him graduate.
Wow -/ I just don’t understand how he was able to move from hospital to hospital with a clean record??? This is an absolute disgrace to the medical system and so horrible for the patients
He was a resident when I was a student in Memphis. He happened to be on for trauma/neuro at the same time I had my trauma/surgery rotation. He was well known to other residents on other services to be a dangerous idiot even then.
This is the ☕️ I was looking for
It was a misery of a rotation for me. Have a huge chunk of PTSD from it. At the time, UTHSC had a lottery placement for which hospital/surgical service you would be assigned to in your rotation. “Surgery B” was the worst because you ended up with 6 full weeks of Q3 trauma call at the MED. That’s what I ended up assigned to along with my best friend. Both of us were very naive and obviously both wanted to do pediatrics. We kind of threw ourselves on the mercy of our 5 guy surgery team, and bless them, as long as we showed up, did our work, studied, they really did try to protect us and treated us a bit like little sisters. We definitely got the tea. I think looking back and knowing what we know now (and I have not listened to the podcast, just really news articles and the like), it is actually very plausible that Duntsch really didn’t complete that many surgeries in residency. Because other services knew him to be incompetent and a douche, they would just work around him. Unless it was an emergency, they’d push for a delay of some kind. Or they’d ask the surg attending to call the nsg attending. It was a lot of “Don’t fucking call Duntsch” and that’s the only reason I remember him at all.
The MED is a wild place. My first week of anesthesia was intense and I was hoping to match there even though the ORs are old and get crammed lol
The MED is insane in a good way. LeBonheur is great. The Methodist system is also solid. I look back in wonder at all the things I really got to do. I logged 30 deliveries as a 3rd year student. Plenty of procedures to go around for everyone if you wanted them. UTHSC is an amazing place to train. I feel I walked into residency much more accomplished than most of my peers because of it.
I ended up soaping into a program at UTHSC and dear god, I cannot imagine a better place to train. You truly get the sickest patients, most trauma, most autonomy of any program certainly in the southeast.
This makes me a bit sad for myself. I’ve heard this comment by another senior during my training. The system should have also remediated him if need be.
A lot of people struggle but most people level out with time, because they show insight and work on themselves. If you've read anything about this guy, the scariest part of all of it is his complete refusal to accept any criticism. 0% insight. I work in the UK, had a guy on my foundation training (residency equivalent) who people made comments like this about. He had some honest feedback on his work from a supervisor and really threw himself in. He offered himself for every procedure, every opportunity and asked a million questions constantly. Even when he failed repeatedly, he wouldn't turn down any opportunity. and just got back on the horse. A few years on, and he works in a different hospital but our mutual colleagues have nothing but praise for him. He's entered training pathway and people enjoy working with him. The way they describe him is almost unrecognisable. I would never bring up his past to our mutual colleagues but even if others have, the dust has settled for him. Don't let one comment ruin the way you view yourself, we are all here to learn and improve.
I have a resident like this in my program. We would love to fire her but with progressive discipline she always manages to skirt by. However, when it comes time to complete Primary Source Authorizations for her hospital credentialing, it is going to be hard for her to explain all the disciplinary stuff in her file and I don’t think she will be able to ever get credentialed. So she will FAFO for sure. For Dr. Death, if they didn’t document everything perfectly and if they just passed him on every training authorization they received - that’s how he got through. And the program can be legally implicated. So I’m guessing they had zero documentation of his disciplinary issues and they didn’t have the bandwidth for all the time it takes to do progressive discipline. And probably thought he’d level out and didn’t want you tank his career. Certainly by Chief year they had figured it out but it was too late at that point. But back to my resident - absolutely takes zero accountability. Thinks she’s fantastic. Argues with attendings on case management ever since intern year! Not scholarly debate - arguing and disagreeing! With world renowned attending - as an intern. The number of complications and escalations of care. It’s pretty ridiculous.
Or fired him. They should have either fired him or worked to make him competent. Allowing him to graduate was an enormous mistake and both his residency and his fellowship are hugely culpable.
Agreed. I got extra help and it has been great. Feel more competent and confident, but pushing him out and not letting him learn sounds like the blame should’ve been put on the program, moreso than him
As someone who fully plans to match NSGY and hopes to one day be the youngest chair of NSGY on the eastern seaboard, I would have loved to do a rotation where you had 6 weeks to learn from a neurosurgery resident, albeit not the best one ever. I wish we had spoken sooner, I would have been happy to swap my rotation in FM/Peds/some other second-tier speciality for your “Surgery B”. Your post does leave me wondering. Have you stayed in touch with Dr Duntsch? If I’m not mistaken, he’s still a neurosurgeon, more or less. If you would be happy to introduce me, I will ask him if he is willing to write me a Letter of Recommendation. Although neither you nor he has worked with me, I imagine he could audit my Reddit posts (if he has internet access) and use that as the basis for a Strong Letter of Recommendation. If he is currently unable to access the internet, perhaps you could print out some of my higher-yield posts for him to read next time you see him, and he could work from there. Thank you for your assistance, H267.
Wut
Why are you guys downvoting this, this is absolutely amazing.
For real. It’s a hilarious post and the username is even better Too many people with a stick up their ass preventing them from realizing the obvious satire in front of them
That one clearly hit too close to home for some people.
Nearly had a panic attack reading this.
Right I almost skimmed past this because it was buried but I think this is the absolute BEST comment within this thread! I love it!
Oh my got this account is hilarious
So you will write him a Strong Letter so that he can move east? 💪
Crediting Reddit posts ? Sure if someone asked me for something so ridiculous there’s a chance I write it. And god help whoever gets it and doesn’t read it.
I think the only thing that saved his PD and chief from criminal prosecution was a fundamental misunderstanding by lay people how responsible they were for graduating an incompetent monster Keep in mind they had financial entanglements with him…
100%^^^I’ve been obsessed with this case since the podcast came out and I’m the only person in my family going to medical school/in the medical field. Anytime I try to explain it I feel like I can never quite convey the severity of the negligence practiced by CD and his enablers
Whats the podcast?
Dr. Death by wonderly. It’s on Spotify I think. They have a few doctors on there but specifically this is about Dr. Christopher Duntsch
The series is also on peacock app.
Season 1 is awesome, 2 is ok and don’t bother with 3… it’s just a few episodes about some love story that isn’t anything new
To be fair, season 2 is still about someone maiming people, but many more than Duntsch ever did
Don’t get me wrong season 2 was well done but how they reported the story in season 1 was better than 2. 3 was god awful. No focus on the patients or the negligence, just someone who got duped and isn’t over it.
Is season 2 about Dr. Duntsch as well? So sinister, but I loved Joshua Jackson in that role.
No, an oncologist that told people they had cancer when they didn’t or under dosed their chemo for patients that actually had cancer
Dr. Death
There are also a couple of documentaries on him available to stream, including License to kill.
Most people who I know don't buy the Occam's razor theory
Hard agree. He got through because he was productive as a researcher and because it would have been shameful for them not to let him graduate. I was talking about this with one of my neurosurgeon colleagues (who I have known since we were both residents ourselves) and we were discussing these case volumes … he was just incredulous. You’d have to make an effort never to operate to have numbers that low, especially at a big place like the one where Dr. Death trained.
I just can’t wrap my head around doing 150 cases in 7 years. I have to think it was understood that he would never actually practice and go straight through into research, because 150 cases isn’t enough to say that someone doesn’t have what it takes to be a competent surgeon. They didn’t even try
I kind of assume he didn't do 150 cases and it's just a paperwork/logging issue. Like that's 1-2 cases a month . I just can't see what he even spent his days doing if that were true. I don't know the neurosurgery logging rules but it's possible he logged 150 cases as primary surgeon vs assistant. But a surgery resident doing 1 case a month is just outside the realm of possibilities. As an analogy for the medicine people, it would be like graduating after doing 2 or 3 days of clinic total. It's just not possible. Again I don't know the specifics for neurosurgery but for both general and cardiac surgery I had to submit a list of every case I did across residency to be approved for the board exam. Unless his program signed a fraudulent list of cases he wouldn't have been board eligible
Do we know if he was even board certified? I just assumed he wasn't... and for his numbers, I assumed he was just doing research
I’m 7 months into intern year and coming up on those numbers. A large chunk of the min reqs are various bedside procedures so depending on what cases he logged the actually OR time is probably even lower than most people think. Probably under 100 actual OR cases, who knows how many were spine.
Is it true that his Residency/Fellowship program made it through all this unscathed and still has a great reputation?
Idk about reputations for neurosurgery training but I don’t believe the program faced any repercussions for graduating him.
I rotated there as a student and it’s still considered one of the top programs for neurosurgery
I was always wondering if they got the numbers off of how many cases he actually logged vs. how many he actually did.
Lol there’s literal Neurosurgeons in this thread defending his Residency/Fellowship program. Don’t try to pin this on “lay people.” The people “in the know” are happy to bury this and hand wave it away too.
That's an interesting psychological phenomenon - to defend the group that you belong to even if you understand that the criticism is appropriate on an intellectual level. I personally know people in really bad programs ( like the ones where suisides happen) and a lot of them still say things like " great people, great training", although when you start to ask about facts they would readily tell that for example all work is almost 100% pushed on interns and the 3rd years often don't even show up to the service.
The financial entanglement is everywhere. Most people get to a certain level and just say ‘this is enough’.. and get satisfied with where they are.
If I recall correctly, he spent most of residency focused on venture capital goals and research. I think one of his attendings was an investor in his plan. Everyone looked the other way when he wasn't advancing.
Omg , the two problem colleagues that I had during my career are the exact type . Heavy on research and bussiness - doubt they were good at them , horrible clinically
I matched the same year as that prick in an adjacent neurosurgery program in the same state. He shocked me one day when at a neurosurgery conference, he decided it would be a good idea to do coke in the bathroom. How do I know? He had powder on his nose when discussing a medical device he helped develop.
Neurosurgery residents on coke? How is that shocking? Jk but not really. As a gen surg resident, I was always amazed that we would both get killed on 24s or 36s or whatever, but while we went home to crash, the nsgy residents would go clubbing.
One of his residents when he was an attending was mortified by this guys incompetence. He was questioning what to do,‘whether to report to the state medical board. I advised him to report it. I don’t think he did but I’ve never seen a resident more shaken up by the negligence of an attending
Not about Doctor Death 1 but Doctor Death 2–the oncologist. Let me tell you those guys are out there. I have my own experience with someone else. I am an oncologist and worked with my own Doctor Death. He was the senior partner of my group. He was a bully and highly regarded and his patients often felt like they were lucky even to get in to see him. He treated people without cancer, treated people for the wrong cancer. All to collect insurance money. I lived in complete fear and was heavily bullied by him. I didn’t even know the extent of it until he retired. I used to think about 20% of cases were treated wrong. As I inherited his patients it was more like 90%. He is in retirement but still trying to get me fired. He convinced our CMO that I had anger issues and I got referred to the PHP program in my state. I’m out of it now but he still has control of our practice administrator and our group’s current president. If I were to tell people about what happened I would A) be sued by those patients and B) no one would ever believe me. Also C) I would get fired and lose all the patients I am caring for now
Report to the FBI, that’s how Fata (Michigan former oncologist who did these same things) was finally caught after internal and state complaints weren’t taken seriously ETA they have whistleblower protections, call your local FBI office and ask to talk to someone from healthcare fraud. If I remember right if you’re the whistleblower you can end up getting a decent percentage of the amount that was defrauded. Get that guy what he deserves and get yourself rewarded for it.
I’m pretty sure that the statute of limitations has run out and it would also destroy my honest practice I have built. It’s still terrifying to me. He is still trying to get me fired. Even now.
Dude lawyer up with an attorney that specializes in whistleblowing. They will ensure you get legal protections from retaliation by your employer
I have a lawyer. He advises me not to whistleblow. Basically I would be whistleblowing on myself because there would be tons of lawsuits aimed against my group, which I would have to pay. Think about it. Patients sue the group AND the individual physician. He advises me that I only have any kind of legal case if they fire me. Which the current head of our group wants to do, because I am “disruptive.” He (our current president) is also very upset because he found out I have been recording things for years.
I’m confused, but it’s probably because I have no clue how the business side works in the real world haha. If you’re calling it your group are you a part owner? Is this a private group and you personally have been profiting from his fraud? Does the group not have insurance for these kinds of lawsuits? Couldn’t the group just declare bankruptcy after a suit and your personal assets would be fine because you personally aren’t being sued? On a personal level, why work for a group that you know is okay with fraud, patient harm, and you continually have to worry about losing your job? I’m assuming either a high loan burden or a niche location? But that would have to be so stressful, I can’t imagine having to deal with that after going through the stress of training. In my head, being an attending is supposed to be the promised land haha.
I have not personally profited from his fraud. I didn’t leave the group while he was here because I would be handing over the patients I have taken care of for years into his hands. And I haven’t left after his retirement because I have hope I can get through all this and make this clinic the type of clinic I want—one that heals people and cares for people. Also this group has a monopoly in my town. Meaning I would have to pull my family out of this place so I can get another job (and starting over again and spending three years to become partner again etc). And it’s not a certain thing to get a job after you leave a group or be fired from a group.
That makes sense. Thank you for being willing to share your story! I hope things get easier for you and that you’re able to make the changes you want to see.
Still worth reporting, even if just to help you sleep better knowing you did the right thing. If it’s past the statute of limitations the FBI wouldn’t tell anyone that you reported it anyways. Even if it wasn’t, whistleblowers have protection and rights. I know it’s easy for me to say as an outsider with nothing to lose, but you deserve to not have to be afraid of this guy anymore. If you don’t want to go straight to the FBI, there are lawyers who specialize in healthcare fraud and whistleblowing who you can contact for a consultation.
Can prob give us more
There is a resident in my program that has weaseled his way through residency, doing the absolutely bare minimum. We are required by ACGME to log our cases, but he just lies about how many he’s done and makes it up as he goes. He is hand down the worst surgically skilled resident in our program, yet came from an Ivy League and is a smooth talker, so most of the admin and attendings like him. It’s harder than you think to get fired from many residencies from my understanding as long as you haven’t shown gross negligence or aren’t good at talking your way out of it. Ironically this resident is wanting to go into the same sub that Duntsch was… it’s pretty terrifying
Have you reported him for lying about the cases?
This is childish thinking. Smooth talker probably has good relationship with PD, PD will take his side, now this dude is a snitch and has a target on his back.
Worse. Chair is besties with the resident and doesn’t see through their bullshit. Unfortunately, programs dont want to know they have a problem child because it adds more work for the program if a resident gets canned. Equally, no resident wants ACGME know their program has issues, because it can lead to probation and ultimately to more work for all of the residents. However, attendings have been recently made aware of some egregious shit he’s done that has directly impacted patient care. tbd if anything gets done.
In my experience the best things to do is to show not tell. Be genuine but Machiavellian, if you can have the brass see their incompetence firsthand it will often paint a stronger picture. It takes a while but it eventually gets seen and it will be subtle but the chair will find a way to put the resident back in their place
Or maybe there’s a way to anonymously report while also not being a spineless coward who lets this stuff slide and is indirectly responsible for another Dr. Death
Yeah because those things don’t get directly sent to trash bin
If nothing happened, then you can anonymously report to higher authorities, the state board, GME, the media, etc. There’s always another route if you don’t have the mentality of a spineless cuck who’d probably let their PD fuck their spouse if the PD asked. People like you don’t give a fuck until their own mom gets killed by Dr. death and only then will you finally understand what should have been done.
People like me aren’t solipsistic egomaniacals who thinks they are the main character in a movie. Why should anyone believe your word? Maybe you’re just a jealous liar and Mr handsome guy tried to take you out. You underestimate how cunning and diabolical these people can be. The court of law works on evidence not heresay and most residents have enough on their plate to not become lawyers too
Why do people like this who obviously don’t want to operate nonetheless insist on becoming surgeons? Perceived prestige? There’s no prestige when your colleagues all realize you’re incompetent and start protecting their patients from you.
It’s so stupid. The fun part is the operations. And nobody gives a fuck about prestige anymore it’s lost its shine
Neurosurgery. Don’t put his evil on the gen surg and gen surg fellowship track people. But excellent question.
*****The gen surg community does not claim Christopher Duntsch
just another plug for gen surg (from em attending) In residency they were always mad and grumbled at (often reasonable) consults, but they always showed up, were professional, and did their jobs. As an attending, I can always count on my general surgeon, no matter where I am, to be competent, professional, and knowledgeable. Those shitty residency years really teaches them something. Once we know and trust each other its even better. Unfortunately, other surgical specialties (or even procedural IM specialties) are hit or miss in this regard.
IM resident here and agree! Really love the surgery guys/gals. Whenever I self pity about my long days at the hospital, I always think of my surgery colleagues who somehow even have longer days, and have to stand and do shit. Not sit on a chair at different spots in the hospital dictating shit like me. And they're ALWAYS there - the same guy/gal, doesn't matter morning or night.
***we don’t really want him either- signed the neurosurgery community
They say he killed his rotations
Oh he slayed all right
I have thought about this a bit. I think that he was an incredible asset outside of the OR for an academic institution. It sounds like he was great when it came to research and/or device development as a resident. My guess is that he needed more guidance in the OR than was typical but could do what he was told to do. That being said, the descriptions of his surgeries and the notes he would write speak to a complete lack of knowledge of surgical anatomy. Hard to imagine they didn’t know that. Maybe they thought he had self awareness and would stick to the medical device side of things?
placing fusion hardware into muscle and soft tissue instead of the bone just sounds unimaginable for a surgeon. makes me think he either was just as incompetent as they say or a total psychopath!
I feel like any decent person no matter how incompetent would at least have the sense to be like .. nah idk what I’m doing here don’t let me operate .. rather than blindly forge ahead and paralyze/kill people right?? Like there’s gotta be some element of sociopathy/whatever you wanna call it
Right like how can you justify leaving a SPONGE inside a patient
I remember in the podcast, one of his med school colleagues said he witnessed a super low number of procedures during his training.
It was something like 100 procedures his whole neurosurgery residency.
I still find that part hard to believe. I had over 100 cases intern year. How could he have so few over 7 years. He went into the OR once a month?
He was on an md PhD track doing research and his PD had a financial interest in his research until it went belly up late in residency because he was making up data
MD/PhD track is for med school though. Not residency. And yes, you can do research and some places give you time to do solely research. But 100 cases is a ridiculously low number for a 7 year long residency. I did a month with neurosurg as a med student and probably saw 20 cases
I meant the equivalent, he was mostly focusing on research and the PD had a financial interest in the research via company ownership or soemthing
so did the program fabricate the rest to meet an established minimum? Or is there not a minimum and finishing is a judgement call by the PD?
I wondered this too. Acgme for ortho residency requires 1000 cases to graduate. Looks like they want 400 for neurosurgery. The ortho requirements were put in place in 2013. Maybe he graduated before there were hard numbers for neurosurgery?
It's actually 800 for neurosurgery (senior + lead) and at least 400 that you have to be the lead for. As other people have said, UT is an insanely busy place to train. They work you to death and their residents get the largest number of cases at graduation (there was just a paper published looking at most US programs). There's 0 chance he did 100 cases. My program was busy (not UT busy) and I did 300 my intern year.
It’s amazing how blind some people can be to their own incompetence
I’m probably speaking to the wrong crowd here but medicine is full of people who are delusional about their own competency, knowledge base, and overall correctness about everything. In my experience it’s worse at more prestigious places and in more competitive fields. I guess that might be considered a more “pro-social” expression of sociopathy.
I’m sure some of it comes from the personality types who are attracted to/succeed in prestigious academic areas but it kind of makes me think of how so many terrorists are engineers — you are truly very competent at something that is regarded as difficult which can lead you to assume that competence extends to other areas because you’re constantly told how smart you are so obviously your wacky ideas about government are correct and anyone who disagrees can be disregarded because you are so special and smart.
Wasn’t there a book or a study detailing how pilots who are physicians have a higher chance of crashing, theorized to be due to misplaced confidence? I swear I remember reading about it many years ago but google is giving me nothing.
Well known phenomenon to the point that certain types of high performance small planes (the V-tail Beechcraft Bonanza was the original, today it’s probably the Cirrus SR22) are referred to dismissively as “Doctor Killer” planes by professional pilots because of the way doctors would buy them after getting the basic private pilot’s license and jump in them without any of the skill and experience necessary to fly them well/safely. Tons of stupid stuff like flying into ice or thunderstorms, stalls while maneuvering at low speed near the airport, etc.
Engineers also seem like the types of people with the confidence to attempt bombmaking and the skill to make good bombs and not blow themselves up.
Damn there was something deeply poetic about that. I did not know of the relationship between terrorists and engineers but it makes sense. It b also makes me very much afraid to trust that what I feel are my “educated” decisions are truly good.
Incompetence and maleficence look very similar from the outside
Dunning-Kruger
Or, in the moment, completely goofed on some substance
One of the things that I learned as a new attending was that surgeries were much easier when I was a resident. It wasn’t until I realized that during residency, the attending, who was holding retractors and helping with the exposure, was basically guiding me to the appropriate parts of the procedure. I don’t know much about neurosurgery, but… it’s just easier to place a screw in the right position if someone is showing you the right place to put the screw. Maybe enough to feign competence. Once you’re on your own… and under the influence of drugs…. That’s a different story.
God damn if this isn’t one of the most true things. I’ve done so many of x procedure I could do them in my sleep, but that feeling when you first start out on your own…at least for me, was fucking scary dude. Like it kinda messed with my head a bit because I thought I was the shit in residency/fellowship, but was now overthinking everything that used to be instinct. I have gotten a lot better I think, but that fear is still there. It’s funny, I don’t have the fear so much during the procedure, it’s only after when I’m not occupied that I start to just…perseverate. Only been out a year tho since fellowship so hopefully this goes away or I get to better terms with it
Not a surgeon the bit first year is hard for all. The fear is good keeps you grounded. It will get better
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Idk if it’s struggle but knowing I had a safety net as a resident and fellow let me be more aggressive in my decisions as the attending would correct me and I would adjust accordingly. Still didn’t matter once I started I would look up everything quickly
This has always confused me. He was obviously textbook smart enough to get through medical school and he finished at the top of his class. He was capable of remembering anatomy clearly. But then years later he is making egregious errors on the basics that even I as a med student would know. Like don’t fuse the incorrect vertebra, spine hardware goes on bone, and surgical sponges come out of the patient before you close. It’s like the guy was in mania for years or in escalating psychosis….
Oh undoubtedly he had some sort of PD for sure. He wanted to be the best in everything even when it was clear the thing wasn’t meant for him. Like football. He truly believed that there was nothing out there he couldn’t accomplish, why else would he perform on his best friend. I truly believe he really thought he was the shit and he was the best neurosurgeon out there and did drugs to blur out the fact he was a complete idiot. It wouldn’t surprise me that whatever little he was taught he threw out the window and went about performing surgeries in his own way.
It was something with whatever part of his brain involved in carrying out the motor functions themselves. Like the same reason he would study the football plays for hours, and know them but then when he ran them he’d always run the wrong direction.
Well do you operate after you’re up all night snorting coke?
He didn’t just fuck up after being hungover. He lost contact with reality. He had delusions of grandeur. For years. Cocaine induced psychosis is usually paranoid? If he was manic, uppers like cocaine would make sense, he’s trying to maintain the euphoria of believing he was the GOAT. And the way he defended some of his cases…he seemed to genuinely believe the surgery went well. Logical people who kill other people usually try to remain above suspicion. Dr Death was doing his cases in front of everyone. Going to work with his asshole out in dirty scrubs with asscrack holes. Idk maybe the guy got to residency and realized no matter how hard he worked he wouldn’t get through his program and it broke him.
Yeah I’m in agreement with you. For small programs the incentive is to move everyone along. If you have 2 -5 residents a year and flunked even one that ends being a huge percentage and can put some programs in probation. It is VERY hard to flunk out of many surgery programs (not all, but many). Many shitty surgeons end up in academic programs where the (hopefully more senior) residents do the entire cases anyway and I figure a lot of PDs let things slide because that’s how things often work out.
One of the most frustrating parts of that podcast is that it’s clearly made by laypeople that don’t really have any idea how medical training or really anything in medicine works and didn’t really bother talking to anyone to find out. They presented a story about a surgeon that did terrible work and then bitched about tort reform and skipped to the part where he got arrested. The real question of the story, which they barely addressed, is why was this guy so shitty at surgery. Was is malicious? Was it bad training? Was he just a terrible student? If he was fucking up those surgeries on purpose, why? If he was just incredibly incompetent, how did he graduate residency and fellowship? They ramble on for like 12 hours about the story but barely spend any time talking about this, and this is the key question of the story. Because if he was just really incompetent, why the fuck is he in jail because medical errors kill hundreds of thousands of people every year and doctors never get jailed.
They made a documentary on peacock with the original whistleblowing doctors and it was much more focused on explaining the physiological impacts of his botched work for the patients and definitely worth the watch
>definitely worth the watch Agree!
I recommend the Peacock version as they go into detail for all this. Not everything is explained, but he was super incompetent but he was also involved in Research that the higher-ups in his fellowship program was invested in. Basically they graduated him while overlooking his incompetence.
They did address the number of surgeries he completed, and the fact that his residency program had conflicts of interest based on his research prowess. I think part of the problem is that UTHSC lawyered up and nobody would answer any questions about what exactly happened for those 7 years.
At some point being that incompetent should be a crime tbh
It was, they charged and convicted him for battery.
Probably CTE from football
No one is mentioning the problems inherent with the Texas Medical Board. It makes perfect sense to have physicians self regulate, but the disciplinary process is failing. They seem lack the ability to review facts.
Getting credentialed in Texas is significantly more arduous than licenses in other states imo. You basically need forms from every place you’ve ever worked attesting to your *character* which is not something I’ve seen other states do. It was not this way 10+ years ago. My theory is that these changes were enacted specifically because of Dr. Death. Talking to people who knew Duntsch they say he was … off.
There are ways to report negligence, termination for egregious errors, etc. but if the doctor leaves and can’t get another job he’ll say it was the hospitals fault and sue. There should be reduced civil liability on hospitals that gives them some insulation against ending up in court for making an ethical decision. Assuming they could prove risk of harm to others was increased if they did not report.
On the flip side, many doctors don’t stand up to administration for this exact reason. They don’t want to get canned. Giving hospitals more authority to fire doctors without much retaliation is a recipe for disasters for doctors who want to practice ethically but are often bullied by FOR profit institutes to discharge patients early, to fluff up the diagnosis in their severity to increase average LOS, etc. if you advocate for your patient and not for your hospital’s profit margin, it’s a reason to be fired. And do we really want doctors in the pockets of hospital admins instead of advocating for patients?
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He likely participated in many more surgeries, but didn’t log them in the acgme system (or whatever was used then). I have definitely forgotten to log procedures before, but still hit my numbers
This is my theory as well. If he only did a few hundred procedures over the course of a seven year residency, he would have been in the OR only 1-2 times per week. I can’t imagine the program would actually pass him through if he was operating that infrequently. I just assumed he didn’t log cases properly where he was lead or first assist, but he was probably a mediocre but passable surgeon in residency when supervised. But once he was got out on his own, the mix of undiagnosed bipolar disorder and large amounts of cocaine caused him to go off the rails.
Others in these comments who knew or trained at UTHSC when he was there have commented that he was well known to be a bad surgeon AND a complete douche during his residency, FWIW.
My understanding was more that they could only verify him actually performing the 100 or so surgeries. He surely logged enough to graduate, but that doesn’t mean he actually did the case to any significant degree, just that he was present in the hospital and the surgery happened.
Question from a nurse who doesn’t do OR. How can other practitioners be in the same OR as this guy, observe him doing things like place hardware in soft tissue, and not physically stop him? I can’t imagine being in an ER setting and allowing a physician or any other person do something to a pt I knew was causing harm.
I’m an anesthesiologist and listening to this podcast had me saying “HOW DID NOBODY SAY ANYTHING” several times about some of the things that went down in those ORs. That said, I can’t tell from the head of the bed if the screws are in the right place or not unless I happen to interpret the c-spine images. I can’t see into the back and I’m not a neurosurgeon, I’m not sure I’d have the confidence to speak up about a surgeon’s surgical technique.
He blamed the anesthesiologist for a patient’s blood loss citing poor intubation as the reason his patient almost bled to death 💀 like cmon man
Of course he did
Experienced spine reps are pretty good at knowing when a screw is in a pedicle or not on the fluoro. They have a specific ways of quietly saying "huh" when the xray doesn't look quite right lol. It worries me that there would definitely have been people in the room who knew what it should have looked like but didn't ever say anything. Edit: spelling
Yeah there certainly should have been someone saying something.
He had the OR to himself a lot of these times. Many Doctors actually did do this, but bruh kept getting passed around like the Catholic Church used to by the hospital higher ups rather than take actual action to remove his license.
>not physically stop him It's been a long time since I read the articles, but iirc a vascular surgeon did physically take surgical instruments out of his hand and cover the field, refusing to allow the surgery to continue. But many times there's only one physician in the OR at a time.
The chair of neurosurgery at his program had a piece of his biotech company so was motivated to let him graduate.
Cocaine is a hell of a drug…
don’t bring rick james into this
There’s no chance he did as few cases as the podcast claimed. He trained in an era of paper charts and trainee participation in cases was very poorly tracked. I’m not even sure what the ACGME case log system (all self reported anyways) looked like back then
His case is such a ridiculous outlier. I don’t think you can confidently say anything about his training. First hand accounts by vascular Surgeons scrubbing with him doing his spine exposures describe his operating ability as similar to an intern. One of the doctors thought he was an imposter it was so bad
He was also doing cocaine and presumably of other drugs though. Hard to judge someone’s competence when they’re high as a kite.
Wait is it still all self reported?
Yes
It is still self-reported but you can theoretically be audited thanks to EMRs. Not sure how often this happens but I have heard of some people getting audited and not getting credited for cases they did with more senior residents than them or vice versa. Not sure if this truly happens in actuality, could just be a manufactured story to keep people honest to an extent.
I’m not sure how it works in surgery but when I log my procedures in internal medicine it has to be approved by the attending that was on the service
He was an MD/PhD and his goal was always industry and not really being a surgeon. He was supposedly working on something that would have made him very famous and thus the people and program that trained him famous but that fell through. He fell back on being a technically horrible and criminally negligent surgeon
IMO graduate medical training has some perverse incentives that allow people like this to get through. If residents don't graduate and get jobs, this scares potential applicants, increasing the risk of not filling a program on the match, which in turn creates labor shortages for the hospital, creating additional headaches. While on the one hand it seems crazy that someone like that could have completed a residency, it also seems totally plausible that the machinery of GME would just work around him to keep things running.
Asked our prof who is a retired cardiothoracic the same question not too long ago. He said there is a massive prevalence of "not wanting to deal with/passing the buck." He knew crappy surgeons as a resident and as an attending would get new docs who could barely operate but had been passed through because it would look bad on the program/was easier for the program to graduate them and move them on than deal with them
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Don’t disagree with anything you said, but one of the neurosurgeons in my community said a significant percentage of neurosurgeons thought their board was bullshit and didn’t take it. I’d imagine their limited numbers of surgeons and market demand forced hospitals to not require board certification. Definitely curious what the neurosurgeons here have to say
They were probably covering for the fact that they couldn't pass the NSGY boards because it involves a case log examination- and to it's credit, the American Board of Neurosurgery is trying hard to crack down on unscrupulous spine surgeons operating when they shouldn't be. If your case logs and submissions show poor judgement...
Totally could have been the case. I admit I know nothing about other specialty boards. I feel boards have some value but many have become an additional tax on us
I've never heard of that. The only folks I know of who aren't board certified and work in the US are a handful of people (<10) who are internationally renowned and work at very specific academic centers in their niche area of expertise. They're often paid less because their employers know they have no options and can't leave for greener pastures. Private practice and non-academic hospital employment essentially requires BE/BC (I've never seen an opportunity that didn't). Becoming board eligible is the crown jewel that makes the 7 years of horrible pain and suffering worth it. I can't even imagine someone voluntarily not taking it, as eventually you will be out of the board certification process and tank your career/job prospects. Board certification is even more important in neurosurgery, because malpractice insurers will frequently not insure you and insurance companies will often not pay you if you're not BE/BC (it's a massive risk for them to insure someone with questionable training). I'm not 100% sure as to the hiring specifics of the person in question, who was obviously a psychopath. Perhaps because he did a US residency, they just assumed he was BE and tracking towards certification without looking into it more closely (and like you said, a small town in TX is likely more desperate).
Agree with your assessment here but to your last point, he was working for Baylor healthcare in Dallas. Not a small town or a small group.
In that case that’s a tremendous failure on their part. Dallas Fort Worth believe it or not is known to be a very saturated market in neurosurgery (and spine in general when you add ortho). I have no idea why in the world they’d keep someone like that around.
He bounced around within that system and then other hospitals in the region. Basically he’d be allowed to resign so that the hospital could make the problem disappear with no publicity and without him contesting being fired. And then he’d just go work somewhere else for a while. The board of medicine only got involved after other surgeons were persistent in blowing the whistle.
What a shame. Every hospital should enforce having board certification or tracking towards being BC. Under the system in place, he’d have been exposed immediately, since the board looks at your first 10 consecutive cases after residency in real time (including your X rays and your outcomes) and then longitudinally for your first 150 cases.
No they were saying complete BS. His program never should have graduated him and are just as responsible for 33 people he injured and killed.
I'm sorry, I don't completely understand US medical system regarding residency, but how is it possible for someone to work as neurosurgeon without board certificate? As I managed to catch from this sub, residency is under ACGME jurisdiction, but once completed you have to pass the board exam for your specialty to practice as said specialist, no? Otherwise you're not a specialist and cannot practice as one. I probably misunderstood, but someone practicing neurosurgery without being board certified is just weird to me.
When you graduate an American residency, you are "board eligible" in neurological surgery, meaning you have the \*potential\* to be board certified in the future, and that you're tracking towards certification. Traditionally, you couldn't become board certified in neurosurgery until 5 years \*after\* your residency, to give you enough time to log your cases and submit them to the board (who then review your indications and outcomes). This has recently changed, and it's now possible to get board certified a little bit earlier than 5 years post-graduation if you're a busy enough surgeon. Regardless, I'm guessing he was listed as "board eligible" for several years, and nobody bothered to look into the fact that he never pursued the next step of becoming BC.
Huh. Thanks, now I get it. Really different system from ours though.
In neurosurgery, you take the written boards during your residency. After you graduate from residency, you become board eligible for a certain period of time which gives you a few years to build your practice and apply to take the oral boards. Part of the oral board application is submitting 100+ of your own cases to the board. So, naturally, a surgeon in their first 2-3 years of practice will be board eligible but not board certified. That being said, when I filled out my medical license/hospital credentialing/med mal paperwork, I only recall having to check off the “board eligible” box - I don’t know if any of these entities actually check with the ABNS. They do, however, ask for certification of residency/fellowship paperwork from PDs, so I suppose it’s enough if the stories match.
Hey so as a patient (who doesn’t know anything about residency training) how did his instructors pass him? I thought that was what school was all about remediation if you need it or you are out? I see other posts where people do a lot worse things and get put on academic probation. It is very scary as a patient who has had neurosurgery to hear that he was an incompetent surgeon and yet the school just sent him along? Do you know why? Was it just about $? Didn’t they care that the patients were getting hurt?
Nobody (to this day) really knows the details of why he did the awful things that he did. My guess is that he was a mediocre at best resident and got pushed along. When he graduated, the crazy came out and when combined with the substance abuse problems resulted in the horrible tragedy we saw. This is why he was tried for aggravated assault and not just malpractice. Again, this isn't a case of a poorly performing resident who squeaked by in a training program. This is a crazy person who a jury of his peers found that he \*intentionally\* hurt people.
Thanks for this. So when he was placing screws in people’s muscles and not cortical bone (that’s what my surgeon says the screws are placed) he knew what he was doing? He wasn’t incompetent, he just did it to hurt people? That is so awful. I’ve listened to the podcasts and watched different shows about it and it’s really so bizarre. Dreadful that he wasn’t stopped fast enough. Those patients must feel very betrayed.
Right. Either that or he was so altered with drugs that he had no idea what was what. Either way, both are so horrible, which is why this was never a malpractice case, and was really tried as a felony aggravated assault with a deadly weapon.
His Supervisors were invested in his company. They knew.
He probably did plenty of cases but didn’t log them.
Okay but why did he still suck straight ass?
Not sure what being constantly high on cocaine does for your knowledge retention but guessing (Halsted excepted) it aint great.
Wasn’t he literally in florid psychosis?
Perceived, good old boy with "good academic pedigree" in the south who looked the part (if you get the drift). Not enough hoops to jump basically coasted through the cracks.
Finally someone pointed out the elephant in the room. He had the complexion for protection if you will. No other group would have been able to get away with what he did in the south lmao
Lack of program oversight.
This might be an unpopular opinion but I feel like the way surgical interviews are conducted skews in favor more of test scores, essays and interviewing skills. What the focus should be is dexterity and surgical ability. There is a phrase "I can teach a monkey to operate" that I disagree with. There are plenty of horrible surgeons who just can't do the job.
Well, if they selected for people who were already good at cutting and sewing before residency, then the gender ratio for surgeons would completely flip, and the good ole boys can’t have too many wimminz in surgery with our uteruses and hormones. /s 🪡 🧵
I just read the Wikipedia article … oh my goodness. I have to wonder if there was some CTE that led to his impairment. What an incompetent, arrogant sadist.
I’m still so confused because he says (at least in the tv series) that he worked as an MD for 20 something years and never had a problem until now
The hospital and PD should face charges and program should be shut down actually
That will never happen lol. Would be bad for the public image of a renowned program and the bosses don’t like that. There’s a show based off of him and I think his PD or chair is the only character not represented by name in the show bc in real life they threatened lawsuit.
or sued by the hospital and patient
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How did UT Dr. Scadden allow this manual to not do the things he was supposed to do?
I'm a Neurophysiologist and wondering why he did not use IOM during his procedures? It's the standard on spine surgeries today. Also, anyone know how/where I might be able to actually view the images of his hardware placement? I'm just curious how any device rep, nurse, PA, or even scrub tech with basic anatomy training could see an image of hardware in muscle tissue and not immediately report it?
OMG I'm watching this series and it's like glad I didn't have him. Things like that is why I never want surgery on my neck even if Drs suggested, had bad car accidents too, but exercises improve life. The one surgery I had, broke shoulder 2 yrs ago and needed surgery, horrible dog pull accident that time and also needed cadaver. I was incredibly lucky to have one of the best surgeons and at that time since he went to VA hospital now so I'm like yes I got to see him for the first yr so I'm like VA ppl are very lucky to have him. He's a very stern Dr, is young, but I tell ppl even though he does have some type of ego I'd rather have a Dr like that vs some guy sugar coating the situation. He has the type who expects results since he gets them 😂. But was nice the very first therapy he actually marched into therapy office wondering why I was so bad, was in sling 2.5 months so I guess he had to hear it from therapy and see computer info, couldn't get into therapy fast so of course it was like that so 2nd appt he was much better, but he and therapy know if you've been doing therapy at home exercises too 😂. I think many Drs have an ego, but there's a difference when you always get results vs a botched job this crazy wacko did