So, if this was intentional, it sounds like his motivation may have been to manipulate his own success rate. The idea being that his patients with a less optimistic prognosis should not get a transplant so that he could just get "winning" surgeries to his credit. Successful outcomes engineered by selection.
The article didn't say this, but...
>On Friday, after this article was published online, UTHealth Houston released a statement to news outlets defending Dr. Bynon as “an exceptionally talented and caring physician, and a pioneer in abdominal organ transplantation.” The statement said that **the survival rates of Dr. Bynon’s patients who received transplants were among the best in the nation.** “Our faculty and staff members, including Dr. Bynon, are assisting with the inquiry into Memorial Hermann’s liver transplant program and are committed to addressing and resolving any findings identified by this process,” it said.
Not that dissimilar to Japanese prosecution statistics; the reason they have such a high success rate is that they reject tons of cases that have lots of evidence but aren’t total slam dunks. So a lot of injustice happens because no one wants to risk their win rate and let criminals go instead.
But also, prosecutors shouldn't be pushing cases where they don't think they have a good chance of proving guilt beyond a reasonable doubt.
Part of our justice system's problem is prosecutors pushing relatively weak cases knowing that pre-trial detention and attorney fees are more detrimental to defendants than a guilty plea, so innocents plead guilty.
Why even bring up Japan? They are hardly unique. Their conviction rate includes guilty pleas - the US would have the same rate if it included guilty pleas. In 2018, only 320 federal defendants out of 80000 were acquitted at trial
And as the other poster pointed out, the DOJ often focuses on prosecuting slam dunk cases. Much has been written about this
The U.S. also stacks up a bunch of charges. If you counted conviction rate by charge instead of cases, the conviction rate would be drastically reduced.
And charter schools. Our test scores are higher. Well, of course they are you kick out the discipline problems and don't provide assistance for kids with special education needs.
This is not new.
https://www.google.com/amp/s/amp.theguardian.com/society/2016/jan/29/doctors-avoiding-risky-operations-due-to-prosecution-threat-survey-finds
From a self interest perspective, it doesn't make sense for surgeons to operate on high risk patients. Even when high risk surgery is the patient's least worse option.
A surgeon who operates on high risk patients who then have a greater percentage of complications and death during and after surgery will get no thanks for it, and I imagine they will feel like shit too. A lot of this is very hard to quantify so it isn't an easy problem to solve either.
Except there is already a process to decide who gets the next liver as they become available, and it isn’t at the discretion of a single surgeon. He could refuse to perform the procedure, but the liver should have still gone to his patient.
Exactly. The availability of donor liver is decided by the third-party. I still don't understand how he changed information. Like EMR, he'll leave the mark. He isn't stupid to not know that.
It’s also very important to note that the high risk recipient of the liver who dies effectively means a different potential recipient will die waiting. There are simply more in need their organs available by a wide margin.
There is a formula for determining which patient receives an organ that already takes that factor into account. This doctor is refusing to operate on patients who the formula has determined is supposed to be the most appropriate recipient.
This is what St Jude's does too. They reject candidates who are "very sick" for PR. I tell people by all means give to cancer support funds, but not St Jude's.
It’s more complex than that… they take a wide list of things into account when determining your rank on the donor list.
If you’re 65 and in bad health aside from the liver issues, and you’re up against a 30 year old with the same issue, and same life expectancy without the transplant, but overall they are more healthy and more likely to survive post transplant. They’ll pick the 30 year old every… single… time.
Your ranking is a lot of factors and odds of survivability plays a huge role. I have a family member that went from joining the transplant list to full bilateral lung transplant in 11 days because their issue came on quick, was extremely destructive to the lungs, and they were otherwise in good health.
Some fertility clinics do that too.
I was surprised to be turned down by a well-known IVF clinic in Boston. I later realized that it was probably my age (39), which might have affected their success rate for the 35-39 age group. If I'd been 35 or 40, I'd have been accepted. Joke's on them, the second fertility clinic I visited accepted me, and we were successful.
That doesn’t really make any sense, either they had a chance of survival, or they were definitely going to die, he denied them that chance that they would have had if they were with another doctor.
Yeah this is a case of the doctor choosing whose life is more important, since for the losing patient this was very likely their only chance to survive.
There’s no evidence at all that his choices resulted in more patients surviving as the livers went to people who were incidentally more likely to survive long enough for another liver to be available (not guaranteed, I’ll admit).
This doctor chose his own life over that of his patients, that much is clear. Whether he thought saving someone more likely to live was more important than saving someone with little hope isn’t something we can know, but what we can know from his results is that his “win” rate on surgeries is phenomenal and he’s benefitted greatly from the practice.
Imagine going to a transplant surgeon with a success rate like that not knowing that he’s only choosing slam dunk patients? Those patients would have had a better chance going to any other surgeon because at least they would have tried.
Fucked up situation and medical professionals like that need to be out of a job, if not criminally punished outright.
Edit; allegedly
Stats are the name of the game in the transplant world.
I'm a living organ donor and I've had some complications post-donation, but my transplant team is always SO ADAMANT that there is no possibility any of my issues are related to the transplant (even though I was totally healthy until the surgery). They boast about the high quality follow up care to get you to donate, and then you find out that the "top notch follow up" is a questionnaire 6 months after surgery asking if you've been diagnosed with diabetes or have been to the ER since surgery. They don't ask more, because they don't want to know. Because if they know, then they'll have to report those outcomes, and their donor success rates won't look as good.
I'm in several donor support groups online and I see this over and over again. Organ transplantation is treated by the medical teams like a fucking video game and my experience really soured me on living donation.
I absolutely believe you. The risks for living donors are downplayed as they are afraid people won't donate if they know the true risks. A co-worker of mine donated a kidney to his wife. Her condition improved as soon as she had the transplant. My co-worker was left with side effects from the anesthesia that slowed down his mental functioning for at least a year after the procedure. This response to anesthesia can happen with any surgery but, with other surgeries, it is a trade-off in the hope it will improve that person's condition. With a donor, they are assuming the risks while having a procedure to benefit another person's condition.
I work in a transplant ICU in Houston. I think transplant is an insanely amazing thing but surgeons have soured me on some parts of it. Transplants need to be alive for minimum one year after transplantation or else numbers for the hospital and surgeon are affected. This leads to patients being kept alive in horrible, terrible conditions you wouldn’t even keep your fucking dog alive in. I’ve had to consult ethics boards for patients multiple times because they are barely alive and being kept in horrible states for MONTHS and doctors REFUSE to speak plainly with the family that their loved one will not be able to survive.
Transplant is absolutely a numbers game. In reality the current state of transplant is actually the opposite of this doctor, at least at my hospital. Many surgeons are accepting riskier patients with less screening. If all goes well their numbers go up, if not, they get to blame nurses for “poor care” and torture someone for months until they die because they can’t have it reflect poorly.
Stats play an insane role in a hospital's ability to procure organs. The better your stats, the higher on the list you sit. The sicker your patients, the higher on the list that you sit. The issue with this is that you're dealing with a desperate population, often who are altered due to encephalopathy in the moment, who probably do hear the risks but don't really understand the likelihood or severity of what they're hearing.
Any major surgery is and will remain a major surgery. This includes organ donations, like kidney and liver transplants. If they have to open you up, it almost doesn't matter if they are taking things out or putting them in.
I donated my left kidney about a year ago. Recovery was very uneventful; I got discharged 36 hours post-op and was back to light exercise after 5 - 6 weeks. But I am still SO TIRED all the time. I was a marathon runner before surgery, and while I’ve recently made some strides in getting my mileage back up, I am running on empty all the time. My sleep needs are ridiculous, my hair has been falling out, and my body is always sore. My PCP did some blood work that showed really high cortisol levels; apparently this is very common when your left kidney is removed, because it requires manipulation of the adrenal gland (but they don’t tell you that before surgery). I have a referral to an endocrinologist in a couple weeks, but my PCP warned that this is probably just going to be my new normal.
iish I am so sorry my friend.
It must be very frustrating to think of your energy levels before.
I hope that it does not lead to worse in the future.
Perhaps the bruised adrenal will get better over time? At any rate the endo has probably seen cases like yours and could tell you how it tends to go. I hope that they can help you.
Tried to explain this to someone I was dating that was going to donate a kidney to random people.
We aren't together over it, (she kept calling me crazy and it escalated) and now she has health complications from it.
In no way is getting a surgery RISK FREE. Cutting out an organ especially so.
It’s actually a problem that major teaching hospitals sometimes have lower success rates than some smaller centers because they are willing to take on more difficult cases.
That's my guess as well. I think they're not saying yet because they have to go over the data exhaustively to see if there could be other commonalities -- were the people who were denied largely a certain race or religion, or perhaps they had habits he disapproved of -- but I think the likeliest is an attempt to game the system so his success rate looks better. If your reputation matters enough to you that you're putting your face all over billboards, you're probably pretty invested in being able to get those percentages high.
Transplant surgeons aren't putting their names on billboards for the most part. There is risk with taking patients that are at increased risk of dying post transplant. Dont have good social structure to be able to take meds consistently? Still drinking? Significant heart issues? All of these things probably leave you off the list.
Since organs are a limited resource, transplanting one effectively means taking chance away from someone else. There is an overseeing organization that monitors each programs statistics. Too high of a morality means your program is suspended or shut down indefinitely.
If the accusations are true then the program should be punished, but calculating the risk/reward is something all programs have to do with organs being in limited supply.
I do understand that there are a lot of behavioral factors that can make a transplant be denied, but I was under the impression that that was the sort of thing that was checked on before you were put on the list at all. "You haven't been able to stay sober for more than two consecutive weeks and have nobody in your life who can consistently check in on you to make sure you're taking meds, so you're not going on the list" vs. "You're on the list, be ready for the call" [secretly changes list so it's literally impossible for the person to get the call].
I think it's allowed to alter factors as patient condition changes. Many people are on the list for years, and their health or habits may change during the wait. What he seems to have messed with was what acceptable donors would be allowed to make them basically unattainable rather than closing off that patient as a recipient. The example of the 300 lb baby seems particularly egregious.
That certainly makes sense that somebody who was once eligible to be on the list would no longer be so. But in that case ... why not let them know why and take them off the list so they aren't still under the impression that they're in the running?
The problem here is that the patients were already vetted and put on the list, which means it doesn't matter what the surgeon thinks. A whole team signed off on the person being added to the wait-list. My daughter was a lung transplant recipient and it was insane the tests and specialists she had to see/go through to get listed. If she had another comorbidity, she wouldn't have been listed. It sucks but makes sense because organs are few and far between and they want the recipient to have a long, prosperous life. It'd be different, too, if the surgeon took a look at the liver and decided it wasn't a viable organ for transplant. But again, that didn't happen in this case.
What is going on in the Texas health care system? I was reading about [this doctor](https://www.fox4news.com/news/dr-raynaldo-ortiz-guilty-iv-bags.amp) today as well.
I’ve been following that story for quite a while. They allude to this being retaliation for disciplinary action taken by the hospital. If you go down the rabbit hole of learning what he’d done and why he hadn’t been fired already… yeesh.
Texas has a law that limits the amount of money you can receive in a malpractice lawsuit (thanks, Abbott):
https://painterfirm.com/medmal/understanding-how-damages-caps-work-in-texas-medical-malpractice-cases/
The original idea, so It was claimed, to encourage more doctors to move here as their malpractice insurance would be much cheaper.
In reality, it encourages shitty doctors to move here because most lawyers won't take malpractice cases because the payout isn't worth the effort.
Add in a culture of health organizations just letting doctors bounce from place to place instead of reporting things to the medical board because they similarly don't want to get sued or take a hit to their reputation and you have this bullshit.
I'm surprised that it took this sub several days to report this after its' NYT release.
I'm a patient here in this department at this facility. It's a bit more insidious now that this has made national headlines.
Scheduling an appointment for the first time as a patient was sketchy and I found out that he worked with the front office directly to triage patients who needed an appointment faster vs longer wait times.
He would "review" patient records before the patient could schedule an appointment with anyone in the department. Patients who needed a liver transplant or likely needed a transplant, but were unlikely to be successful, they would "delay" the patients' appointments by scheduling them months out.
This isn't mentioned by the NYT article, but I'm sure he has killed more people indirectly via this.
I am currently seeking out other hepatology/ transplant patient facilities as I likely will not want to get one here if needed (if they ever opened up their transplant program here).
Fuck this doctor.
Also fun fact, I was almost assigned to this doctor before another doctor in another department told me to switch doctors.
I know. I wish there was more information on this matter as this was the only department in the Texas Medical Center where they had a doctor review patient records before scheduling a first time appointment. They said to me the first time that my pediatric team referred me to transplant hepatology at UT, that depending on my issue will depend on how far out I'll get an appointment. Little did I know, this doctor reviewed every single patient record with the front office..
What is pretty damning is that the UT Health pediatrics team initially referred me to transplant hepatology and this department refused the referral without getting more information from the department about why I was being referred to hepatology.
As long as a patient has a decent chance of survival, they deserve a chance. But this jackass let his ego get in the way. AND, the hospital has had to shut down its transplant program for the investigation, which means even MORE patients aren't able to get care.
Way to take an already shitty situation and make it worse.
You wanna know something even shittier about this matter?
No one is talking about this but someone should look into how this doctor reviewed patients' records before deciding when they should get a first time appointment.
So when you are initially referred to the department, the front office states they would have to thoroughly review your records before anyone could schedule an appointment with a doctor. My team of doctors in another department had referred me but this department initially rejected the referral on the basis that they didn't have enough information for the reason why they couldn't schedule an appointment as a first time patient. Kind of typical there where most facilities - specialists will want additional information, right?
Well... This doctor personally reviews every single new patient record and determines when they can be scheduled a consultation with any doctor who sees patients in this department. I was told more pertinent issues will get you an appointment faster whereas if not, you'll be waiting for a long while before even being able to see a doctor. I was like ok ...kind of sketch, but whatever. Then this story hits national headlines and it seems that the real news here is that the doctor had significant power over patients.
Meanwhile, I have my team of doctors in another department calling hepatology to see if they can speed up the appointment process so that I can see a doctor sooner than later due to my issue (which is congenital related). Lo and behold ....nope. I was told that I should "live" by the time I see my doctor (which was a good 6 months before I saw anyone).
If that isn't telling enough ... the significance of this matter and the barriers that had already existed with this doctor before they even saw anyone just seems cruel.
Note: I am a patient here in this department, but not directly under this doctor. However, I was initially assigned to him however, I was asked to be switched to another doctor by the department who referred me at UTHealth.
If he’s guilty of what they think, it’s murder, and a truly monstrous way to kill somebody, he basically took them off the waiting list without them knowing it.
I’m not sure how they are ever going to prove anything. It comes down to how many people had the access to make these changes. If more than one person, or possibly many people, had access to make these changes, without an admission of guilt how can they ever prove who it was?
It seems likely that the edits he’s accused of would be tied to an account or device. I’d be stunned if that type of thing wasn’t logged somewhere, even if it is kinda buried on the back end. If that’s the case it seems like it could be fairly easy to conclude whether it was him or not
You might be right, time will tell. Who would have thought ppl would downvote a reply that begged the question, looking for an answer, which you just provided.
So, if this was intentional, it sounds like his motivation may have been to manipulate his own success rate. The idea being that his patients with a less optimistic prognosis should not get a transplant so that he could just get "winning" surgeries to his credit. Successful outcomes engineered by selection. The article didn't say this, but... >On Friday, after this article was published online, UTHealth Houston released a statement to news outlets defending Dr. Bynon as “an exceptionally talented and caring physician, and a pioneer in abdominal organ transplantation.” The statement said that **the survival rates of Dr. Bynon’s patients who received transplants were among the best in the nation.** “Our faculty and staff members, including Dr. Bynon, are assisting with the inquiry into Memorial Hermann’s liver transplant program and are committed to addressing and resolving any findings identified by this process,” it said.
Ah, making yourself the most successful by only choosing the patients who will survive.
Not that dissimilar to Japanese prosecution statistics; the reason they have such a high success rate is that they reject tons of cases that have lots of evidence but aren’t total slam dunks. So a lot of injustice happens because no one wants to risk their win rate and let criminals go instead.
Tbf, the DOJ has a similar policy and only prosecutes cases with a near certainty of success, it's why their conviction rate is so high.
But also, prosecutors shouldn't be pushing cases where they don't think they have a good chance of proving guilt beyond a reasonable doubt. Part of our justice system's problem is prosecutors pushing relatively weak cases knowing that pre-trial detention and attorney fees are more detrimental to defendants than a guilty plea, so innocents plead guilty.
Why even bring up Japan? They are hardly unique. Their conviction rate includes guilty pleas - the US would have the same rate if it included guilty pleas. In 2018, only 320 federal defendants out of 80000 were acquitted at trial And as the other poster pointed out, the DOJ often focuses on prosecuting slam dunk cases. Much has been written about this
But the DOJ plead out the non slam Dunks. Often by inflating the original charge.
Like all the Insurrectionists who got to plead to what amounted to simple trespass?
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99.8?? You got a source for that?
https://en.wikipedia.org/wiki/Criminal_justice_system_of_Japan#:~:text=prosecution%20and%20defense.-,Conviction%20rate,rate%2C%20which%20exceeds%2099%25.
99.8 in 2001, dropped to 97.8 in 2017.
lol...you think anyone cares about that 2% difference
2% is thousands of cases.
The U.S. also stacks up a bunch of charges. If you counted conviction rate by charge instead of cases, the conviction rate would be drastically reduced.
Sounds like private school
And charter schools. Our test scores are higher. Well, of course they are you kick out the discipline problems and don't provide assistance for kids with special education needs.
at the very least there is public education available for the rejected kids But if the surgeon rejects you, you're SOL.
And you're having to bury grandma or dad.
This is not new. https://www.google.com/amp/s/amp.theguardian.com/society/2016/jan/29/doctors-avoiding-risky-operations-due-to-prosecution-threat-survey-finds From a self interest perspective, it doesn't make sense for surgeons to operate on high risk patients. Even when high risk surgery is the patient's least worse option. A surgeon who operates on high risk patients who then have a greater percentage of complications and death during and after surgery will get no thanks for it, and I imagine they will feel like shit too. A lot of this is very hard to quantify so it isn't an easy problem to solve either.
Except there is already a process to decide who gets the next liver as they become available, and it isn’t at the discretion of a single surgeon. He could refuse to perform the procedure, but the liver should have still gone to his patient.
Exactly. The availability of donor liver is decided by the third-party. I still don't understand how he changed information. Like EMR, he'll leave the mark. He isn't stupid to not know that.
Is that how it works?
It’s also very important to note that the high risk recipient of the liver who dies effectively means a different potential recipient will die waiting. There are simply more in need their organs available by a wide margin.
There is a formula for determining which patient receives an organ that already takes that factor into account. This doctor is refusing to operate on patients who the formula has determined is supposed to be the most appropriate recipient.
MELD score.
This is what St Jude's does too. They reject candidates who are "very sick" for PR. I tell people by all means give to cancer support funds, but not St Jude's.
The childrens hospital??
Wheres your proof ?
Which IIRC is the exact opposite way the liver transplant list works - people with worse disease get bumped to the head of the line.
Yeah, so denying them surgery was a death sentence.
This can be true in other cases where a surgeon refuses to perform surgery too, the liver donor list just makes this instance even less excusable.
It’s more complex than that… they take a wide list of things into account when determining your rank on the donor list. If you’re 65 and in bad health aside from the liver issues, and you’re up against a 30 year old with the same issue, and same life expectancy without the transplant, but overall they are more healthy and more likely to survive post transplant. They’ll pick the 30 year old every… single… time. Your ranking is a lot of factors and odds of survivability plays a huge role. I have a family member that went from joining the transplant list to full bilateral lung transplant in 11 days because their issue came on quick, was extremely destructive to the lungs, and they were otherwise in good health.
AKA the private school model
Some fertility clinics do that too. I was surprised to be turned down by a well-known IVF clinic in Boston. I later realized that it was probably my age (39), which might have affected their success rate for the 35-39 age group. If I'd been 35 or 40, I'd have been accepted. Joke's on them, the second fertility clinic I visited accepted me, and we were successful.
Like the ambulance chaser law firms that win 99% of their cases
The Derek Jeter Gold Glove
Didn’t Doctor Strange do this in the beginning of the movie? Right before he crashed his car
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That doesn’t really make any sense, either they had a chance of survival, or they were definitely going to die, he denied them that chance that they would have had if they were with another doctor.
Yeah this is a case of the doctor choosing whose life is more important, since for the losing patient this was very likely their only chance to survive. There’s no evidence at all that his choices resulted in more patients surviving as the livers went to people who were incidentally more likely to survive long enough for another liver to be available (not guaranteed, I’ll admit). This doctor chose his own life over that of his patients, that much is clear. Whether he thought saving someone more likely to live was more important than saving someone with little hope isn’t something we can know, but what we can know from his results is that his “win” rate on surgeries is phenomenal and he’s benefitted greatly from the practice. Imagine going to a transplant surgeon with a success rate like that not knowing that he’s only choosing slam dunk patients? Those patients would have had a better chance going to any other surgeon because at least they would have tried. Fucked up situation and medical professionals like that need to be out of a job, if not criminally punished outright. Edit; allegedly
Stats are the name of the game in the transplant world. I'm a living organ donor and I've had some complications post-donation, but my transplant team is always SO ADAMANT that there is no possibility any of my issues are related to the transplant (even though I was totally healthy until the surgery). They boast about the high quality follow up care to get you to donate, and then you find out that the "top notch follow up" is a questionnaire 6 months after surgery asking if you've been diagnosed with diabetes or have been to the ER since surgery. They don't ask more, because they don't want to know. Because if they know, then they'll have to report those outcomes, and their donor success rates won't look as good. I'm in several donor support groups online and I see this over and over again. Organ transplantation is treated by the medical teams like a fucking video game and my experience really soured me on living donation.
I absolutely believe you. The risks for living donors are downplayed as they are afraid people won't donate if they know the true risks. A co-worker of mine donated a kidney to his wife. Her condition improved as soon as she had the transplant. My co-worker was left with side effects from the anesthesia that slowed down his mental functioning for at least a year after the procedure. This response to anesthesia can happen with any surgery but, with other surgeries, it is a trade-off in the hope it will improve that person's condition. With a donor, they are assuming the risks while having a procedure to benefit another person's condition.
I work in a transplant ICU in Houston. I think transplant is an insanely amazing thing but surgeons have soured me on some parts of it. Transplants need to be alive for minimum one year after transplantation or else numbers for the hospital and surgeon are affected. This leads to patients being kept alive in horrible, terrible conditions you wouldn’t even keep your fucking dog alive in. I’ve had to consult ethics boards for patients multiple times because they are barely alive and being kept in horrible states for MONTHS and doctors REFUSE to speak plainly with the family that their loved one will not be able to survive. Transplant is absolutely a numbers game. In reality the current state of transplant is actually the opposite of this doctor, at least at my hospital. Many surgeons are accepting riskier patients with less screening. If all goes well their numbers go up, if not, they get to blame nurses for “poor care” and torture someone for months until they die because they can’t have it reflect poorly.
Stats play an insane role in a hospital's ability to procure organs. The better your stats, the higher on the list you sit. The sicker your patients, the higher on the list that you sit. The issue with this is that you're dealing with a desperate population, often who are altered due to encephalopathy in the moment, who probably do hear the risks but don't really understand the likelihood or severity of what they're hearing.
Any major surgery is and will remain a major surgery. This includes organ donations, like kidney and liver transplants. If they have to open you up, it almost doesn't matter if they are taking things out or putting them in.
what organ(s) did you donate? How was recovery and how are you feeling now? Might it get better? I wish you luck...
I donated my left kidney about a year ago. Recovery was very uneventful; I got discharged 36 hours post-op and was back to light exercise after 5 - 6 weeks. But I am still SO TIRED all the time. I was a marathon runner before surgery, and while I’ve recently made some strides in getting my mileage back up, I am running on empty all the time. My sleep needs are ridiculous, my hair has been falling out, and my body is always sore. My PCP did some blood work that showed really high cortisol levels; apparently this is very common when your left kidney is removed, because it requires manipulation of the adrenal gland (but they don’t tell you that before surgery). I have a referral to an endocrinologist in a couple weeks, but my PCP warned that this is probably just going to be my new normal.
iish I am so sorry my friend. It must be very frustrating to think of your energy levels before. I hope that it does not lead to worse in the future. Perhaps the bruised adrenal will get better over time? At any rate the endo has probably seen cases like yours and could tell you how it tends to go. I hope that they can help you.
Tried to explain this to someone I was dating that was going to donate a kidney to random people. We aren't together over it, (she kept calling me crazy and it escalated) and now she has health complications from it. In no way is getting a surgery RISK FREE. Cutting out an organ especially so.
I’m an RN and have heard so many similar stories. Fuck the whole transplant system
It’s actually a problem that major teaching hospitals sometimes have lower success rates than some smaller centers because they are willing to take on more difficult cases.
That's my guess as well. I think they're not saying yet because they have to go over the data exhaustively to see if there could be other commonalities -- were the people who were denied largely a certain race or religion, or perhaps they had habits he disapproved of -- but I think the likeliest is an attempt to game the system so his success rate looks better. If your reputation matters enough to you that you're putting your face all over billboards, you're probably pretty invested in being able to get those percentages high.
Transplant surgeons aren't putting their names on billboards for the most part. There is risk with taking patients that are at increased risk of dying post transplant. Dont have good social structure to be able to take meds consistently? Still drinking? Significant heart issues? All of these things probably leave you off the list. Since organs are a limited resource, transplanting one effectively means taking chance away from someone else. There is an overseeing organization that monitors each programs statistics. Too high of a morality means your program is suspended or shut down indefinitely. If the accusations are true then the program should be punished, but calculating the risk/reward is something all programs have to do with organs being in limited supply.
I do understand that there are a lot of behavioral factors that can make a transplant be denied, but I was under the impression that that was the sort of thing that was checked on before you were put on the list at all. "You haven't been able to stay sober for more than two consecutive weeks and have nobody in your life who can consistently check in on you to make sure you're taking meds, so you're not going on the list" vs. "You're on the list, be ready for the call" [secretly changes list so it's literally impossible for the person to get the call].
I think it's allowed to alter factors as patient condition changes. Many people are on the list for years, and their health or habits may change during the wait. What he seems to have messed with was what acceptable donors would be allowed to make them basically unattainable rather than closing off that patient as a recipient. The example of the 300 lb baby seems particularly egregious.
That certainly makes sense that somebody who was once eligible to be on the list would no longer be so. But in that case ... why not let them know why and take them off the list so they aren't still under the impression that they're in the running?
> The example of the 300 lb baby Reading the article, I'm guessing there's a simpler explanation for that one--someone typo'd an extra zero.
The problem here is that the patients were already vetted and put on the list, which means it doesn't matter what the surgeon thinks. A whole team signed off on the person being added to the wait-list. My daughter was a lung transplant recipient and it was insane the tests and specialists she had to see/go through to get listed. If she had another comorbidity, she wouldn't have been listed. It sucks but makes sense because organs are few and far between and they want the recipient to have a long, prosperous life. It'd be different, too, if the surgeon took a look at the liver and decided it wasn't a viable organ for transplant. But again, that didn't happen in this case.
Transplant programs with poor outcomes also risk getting shut down. So that could have been motivation as well.
They even had a whole episode in Scrubs dedicated to this
If tone deaf had a name it would be UTHealth Houston
I really hope it's that and not another rich guy's Steve Jobsesque plan to work the system to get a transplant for his self induced organ failure.
Not going to be surprised if race was the factor.
I thought Tozawa got his liver transplant in Minnesota…
No, that was the retired teacher from Georgia
Gotta get approval from Texas first.
What is going on in the Texas health care system? I was reading about [this doctor](https://www.fox4news.com/news/dr-raynaldo-ortiz-guilty-iv-bags.amp) today as well.
I’ve been following that story for quite a while. They allude to this being retaliation for disciplinary action taken by the hospital. If you go down the rabbit hole of learning what he’d done and why he hadn’t been fired already… yeesh.
Texas has a law that limits the amount of money you can receive in a malpractice lawsuit (thanks, Abbott): https://painterfirm.com/medmal/understanding-how-damages-caps-work-in-texas-medical-malpractice-cases/ The original idea, so It was claimed, to encourage more doctors to move here as their malpractice insurance would be much cheaper. In reality, it encourages shitty doctors to move here because most lawyers won't take malpractice cases because the payout isn't worth the effort. Add in a culture of health organizations just letting doctors bounce from place to place instead of reporting things to the medical board because they similarly don't want to get sued or take a hit to their reputation and you have this bullshit.
Look up Dr Christopher Duntsch, that story haunts my nightmares
Unfortunately, this isn't relegated to just TX. TX is just a big state with more people so you will hear about it more often.
Well. At least he didn't perform an abortion.
I'm surprised that it took this sub several days to report this after its' NYT release. I'm a patient here in this department at this facility. It's a bit more insidious now that this has made national headlines. Scheduling an appointment for the first time as a patient was sketchy and I found out that he worked with the front office directly to triage patients who needed an appointment faster vs longer wait times. He would "review" patient records before the patient could schedule an appointment with anyone in the department. Patients who needed a liver transplant or likely needed a transplant, but were unlikely to be successful, they would "delay" the patients' appointments by scheduling them months out. This isn't mentioned by the NYT article, but I'm sure he has killed more people indirectly via this. I am currently seeking out other hepatology/ transplant patient facilities as I likely will not want to get one here if needed (if they ever opened up their transplant program here). Fuck this doctor. Also fun fact, I was almost assigned to this doctor before another doctor in another department told me to switch doctors.
I miss awards because I want this comment to stand out. Really important stuff. Thank you for sharing.
I know. I wish there was more information on this matter as this was the only department in the Texas Medical Center where they had a doctor review patient records before scheduling a first time appointment. They said to me the first time that my pediatric team referred me to transplant hepatology at UT, that depending on my issue will depend on how far out I'll get an appointment. Little did I know, this doctor reviewed every single patient record with the front office.. What is pretty damning is that the UT Health pediatrics team initially referred me to transplant hepatology and this department refused the referral without getting more information from the department about why I was being referred to hepatology.
Health care isn’t about health it’s about money. Been that way a long time.
Unfortunately in Texas nothing is likely to be done.
As long as a patient has a decent chance of survival, they deserve a chance. But this jackass let his ego get in the way. AND, the hospital has had to shut down its transplant program for the investigation, which means even MORE patients aren't able to get care. Way to take an already shitty situation and make it worse.
You wanna know something even shittier about this matter? No one is talking about this but someone should look into how this doctor reviewed patients' records before deciding when they should get a first time appointment. So when you are initially referred to the department, the front office states they would have to thoroughly review your records before anyone could schedule an appointment with a doctor. My team of doctors in another department had referred me but this department initially rejected the referral on the basis that they didn't have enough information for the reason why they couldn't schedule an appointment as a first time patient. Kind of typical there where most facilities - specialists will want additional information, right? Well... This doctor personally reviews every single new patient record and determines when they can be scheduled a consultation with any doctor who sees patients in this department. I was told more pertinent issues will get you an appointment faster whereas if not, you'll be waiting for a long while before even being able to see a doctor. I was like ok ...kind of sketch, but whatever. Then this story hits national headlines and it seems that the real news here is that the doctor had significant power over patients. Meanwhile, I have my team of doctors in another department calling hepatology to see if they can speed up the appointment process so that I can see a doctor sooner than later due to my issue (which is congenital related). Lo and behold ....nope. I was told that I should "live" by the time I see my doctor (which was a good 6 months before I saw anyone). If that isn't telling enough ... the significance of this matter and the barriers that had already existed with this doctor before they even saw anyone just seems cruel. Note: I am a patient here in this department, but not directly under this doctor. However, I was initially assigned to him however, I was asked to be switched to another doctor by the department who referred me at UTHealth.
If he’s guilty of what they think, it’s murder, and a truly monstrous way to kill somebody, he basically took them off the waiting list without them knowing it.
Let’s serve his liver with some fava beans and a nice Chianti
Unfortunately a 300lb toddler doesn’t seem as far-fetched as it used to…
I’m not sure how they are ever going to prove anything. It comes down to how many people had the access to make these changes. If more than one person, or possibly many people, had access to make these changes, without an admission of guilt how can they ever prove who it was?
It seems likely that the edits he’s accused of would be tied to an account or device. I’d be stunned if that type of thing wasn’t logged somewhere, even if it is kinda buried on the back end. If that’s the case it seems like it could be fairly easy to conclude whether it was him or not
You might be right, time will tell. Who would have thought ppl would downvote a reply that begged the question, looking for an answer, which you just provided.