How Not to Run an M&M Conference: Why I Don’t Watch Medical TV Shows | Guest Blog

Having been a surgical department chairman for over 23 years, I estimate that I have run about 1,000 M&M conferences. I feel well-qualified to comment.

On my personal blog, I wrote about an incredibly bad medical television show called “Do No Harm” that premiered on NBC last week. I won’t reiterate here but if you want to know just how bad it was, here is the link to my blog. Spoiler alert: The show did do harm—to my sensibilities.

Much to my dismay, there’s another show debuting this week called “Monday Mornings.” Its original title was “Chelsea Hospital,” but that must not have fared well in focus groups.

Unlike “Do No Harm,” which could not possibly have had input from any physicians, nurses or even hospital transport or custodial staffs, “Monday Mornings” is based on a novel written by Dr. Sanjay Gupta, who is a neurosurgeon and the chief medical correspondent for CNN.

The story revolves around events at the fictional Chelsea Hospital’s Monday morning surgical morbidity and mortality (M&M) conference. For those of you who aren’t familiar with it, M&M conference is where complications and deaths are candidly discussed by attending surgeons and residents. Medical students and others are usually present too.

Having been a surgical department chairman for over 23 years, I estimate that I have run about 1,000 M&M conferences. I feel well-qualified to comment.

Cases are presented and critiqued by the assembled participants. The idea is that every surgeon, not just the one who made it, can learn from mistakes. The premise is a good one, and I had high hopes. The five-minute preview that was posted online served to dash those hopes to bits.

So what’s wrong with the show?

The chairman of surgery is a crusty bastard, who might have survived in the 1960s and 70s, but he’s way out of place today.

The preview features a hapless orthopedic surgeon who presents a case of delayed diagnosis of a tumor of the hip that results in the tragic death of a young mother. It seems he didn’t order any diagnostic tests and simply prescribed Extra-Strength Tylenol for pain when he first saw her.

He apparently had made mistakes before. The chairman then asked him why his nickname was “Double-07.” The orthopedist said it was because they say he had license to kill.

As if that wasn’t humiliating enough, the chairman then threw him off the hospital staff right there in front of everyone.

The chief of trauma got all self-righteous, stood, shouted that it wasn’t enough to take away the orthopedist’s privileges because he would just go somewhere else to kill people and threw his newspaper at the front of the room. Then the chairman tells him he’s out of line!

OK. That stuff might have flown 40 years ago, but in 2013 … there is no way.

A doctor cannot be summarily dismissed from the medical staff of any hospital. The orthopedist is entitled to due process. A physician can be suspended, usually with at least two administrative officials (eg, department chairman, chief medical officer, hospital CEO) signing the suspension papers. Everyone lawyers up. There are bylaws, committees, appeals.

The truth is, if a suspension had been warranted, it should have taken place at the time the error was discovered. To wait 3 weeks until M&M conference means that other patients might needlessly have been put at risk.

I guess a suspension of privileges followed by numerous committee meetings isn’t dramatic enough.

Now you know why I don’t watch medical shows on TV.

Skeptical Scalpel is a recently retired surgeon and was a surgical department chairman and residency program director for many years. He is board-certified in general surgery and a surgical sub-specialty and has re-certified in both several times. For the last two years, he has been blogging at SkepticalScalpel.blogspot.com and tweeting as @SkepticScalpel. His blog averages 800 page views per day, and he has over 4,700 followers on Twitter.

 

 

 

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