A St. Thomas Hospital physician who acquiesced to a request that he keep a black hospital employee from entering an operating room during surgery has created a firestorm of controversy at the Catholic hospital.
The physician in question is Dr. Michael R. Petracek, a nationally known heart surgeonperhaps the best-known heart specialist at St. Thomas. The hospital itself is consistently rated one of the finest heart specialist hospitals in the nation.
For his part in the Oct. 9 incident, Petracek, who is described by other doctors as “brilliant” and “meticulous,” said he had made a bad mistake, one he wishes he had never made. “I made a very bad error in judgment,” he told the Scene. Petracek has not been disciplined by the hospital.
This is what is known about the situation, as has been told to the Scene by Petracek himself, numerous sources at the hospital, and others in the Nashville medical community:
Earlier this fall, a young woman and her husband walked into Petracek’s office at Cardiovascular Surgery Associates, which is located at St. Thomas. The woman had obvious heart problems and needed surgery. During that visit, the woman’s husband insisted that no African American males be present during her operation. (The identity of the patient, and her husband, have been kept private by both Petracek and the hospital, citing doctor-patient confidentiality.)
Petracek says he distinctly recalls from that first visit that the wife was taking directions from her strong-minded, apparently racist, spouse. The husband was simply adamant, Petracek remembers, that no black man see his wife naked. Petracek said he would agree to do his best to fulfill the man’s request, and he set in motion plans for the surgery.
On Oct. 9, the woman arrived at St. Thomas for surgery. And, as fate would have it, a male, African American technician was assigned to Petracek’s operating room. The African American was the perfusionist, a pump specialist who works under the anesthesiologist. After a quiet word from Petracek, however, the black technician left the surgery and went to work elsewhere. Another technician replaced him.
Word of the bizarre incident immediately spread throughout the hospital, and complaints were quickly forthcoming. The matter, according to numerous sources at St. Thomas, first was referred to the hospital’s medical ethics committee. But because it was so potentially explosive, it was bumped up to the hospital’s executive committee, where it was kept under tight wraps by the publicity-conscious hospital.
Nonetheless, a contrite Petracek explains his position. “I alone am responsible for the mistake,” he says. “My partners in the practice and the management at St. Thomas have both made it clear to me that they did not agree with my decision. If I had to do it over, I would not have handled the case the same way. I have apologized to everyone involved. This has become a nightmare for me. But understand I did what I did solely because I was trying to find a way to get the woman the medical care she needed.”
Petracek says top hospital management has expressed its displeasure, but no disciplinary actions have been taken against him. Colleagues speculate Petracek’s prolific medical practice, which brings significant business to St. Thomas, may have contributed to his lenient treatment. Meanwhile, in a brief statement through spokesman John L. Mays, St. Thomas officials introduce an altogether different explanation for Petracek’s behavior.
“Our non-discrimination policy is very clear,” the statement starts off. “Immediate action was taken in response to this situation.” But it continues, “An internal review concluded that the threatening statements from the patient’s family put undue pressure on Dr. Petracek. This was an internal matter and all parties involved are satisfied that it has been resolved.” Mays declined to elaborate on the idea that the doctor was threatened.
Meanwhile, the African American medical technician was also quoted by the hospital spokesman as saying that as far as the technician was concerned, the “situation has been resolved.”
At the heart of the issue is an age-old question of medical ethics: To what lengths should a doctor go to ensure that a patient gets requisite medical care? In retrospect, many say that Petracek went well beyond what is acceptable. “I don’t think that any institution would say the doctor’s actions were acceptable in a case like this,” says Stuart G. Finder, assistant professor of medical ethics at Vanderbilt Medical School.
Meanwhile, should the hospital have taken disciplinary action? “This is not a firing offense, but the doctor will probably need to make a public apology and explain why he did what he did,” says Owen School of Management associate professor Ray Friedman, who studies diversity in the workplace. That is precisely what Petracek has done.
If one wonders how other surgeons might have reacted in the same situation, it’s worth noting that Petracek was not the first heart surgeon the couple visited. Sources say they first visited Dr. John Austin, another Nashville heart surgeon who practices at Baptist Hospital. When the husband made the same controversial request of Austin, the couple apparently was shown the door.
In fairness to Petracek, who has a long and unblemished history of providing quality medical care at St. Thomas, members of the Nashville medical community give him high marks for working with patients with particular needs. He has, for example, found innovative ways to perform heart surgery on Jehovah’s Witnesses, who refuse blood transfusions for religious reasons. Numerous colleagues contend he simply doesn’t have a racist bone in his body. They say he truly thought he was trying to figure out a way to offer needed medical care to a patient.
Nonetheless, senior hospital managers are apparently aware that they have a potential public relations disaster on their hands. The hospital has tried to deal with the incident quietly, but the Nashville medical community has been abuzz with it for weeks. So public has the incident become that the episode was recently used, without reference to Petracek or St. Thomas by name, as a teaching tool in a Vanderbilt Medical School class examining medical ethics.
That’s the kind of attention no doctoror hospitalever wants.
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