Cowardice. Why Physicians do not Report Misconduct by Other Physicians. Chapter 4.

We have just now been able to witness what happened, what didn't happen, with police in the Uwalde school. The sickening vision of police hiding some distance away from a classroom while small children were slaughtered by a lone gunman. How could this happen, Very simple: cowardice. Cowardice is the most common impulse of most humans when confronted with a terrible challenge. It is however horrifying when one sees it in regards to police doing nothing when small children are being slaughtered by gun fire. For small scale horror of what some humans are capable of, terrible misconduct, most people's response is to do nothing, because they are cowards.

We also see in the current hearings in Congress why when most people bear witness to acts of serious and dangerous political misconduct, they do nothing. They are cowards. One level more egregious above the cowards are the benefitters, above that the sycophants, and above those the enablers. Stacking of misconduct like Dante's description of the 9 circles of Hell. The first circle of bystanders are the cowards, which is the discussion in this blog.

Why did no one report misconduct by the alleged sexual misconducts of many in the media and entertainment fields: Harvey Weinstein, Matt Lauer, Bill Cosby, Charlie Rose, Jeffrey Epstein, Most were cowards, some benefitters, fewer sycophants, and the smallest number enablers. This formula explains also the most famous horrific misconduct of the last 2 centuries: Hitler and the Nazis.

I estimate a minimum of 20 individuals were aware of the misconduct of Larry Nassar. Also true of Jerry Sandusky, George Tyndall, James Heaps, Robert Hadden, Robert Anderson, Richard Strauss, and Reginald Archibald. For those who practice longer in the misconduct, like Archibald, the silent onlookers, the cowards, likely number over 100.

The difference of course between the cowards in these medical misconduct cases, and the Uwalde school, there was no risk of death for action in the medical misconduct cases.

So why are physicians too cowardly to report misconduct: the fear of retaliation and the adverse effect on their careers. This imbalance of the risk/benefit of whistle blowing must be corrected otherwise this silence of the cowards will only continue.

The only well recognized cases of incompetence or impairment medical misconduct are Robert Levy (pathologist, alcohol impaired) and Chae Hyun Moon (interventional cardiologist, incompetence and greed). There was no level of victim compensation for these victims compared to the sexual molestation cases. This ofcourse is absurd.

What is most disconcerting to me, is that all of the well recognized cases of medical misconduct involve non- penis in vagina (PIV) sexual molestation. None of these cases are of the worst forms of medical misconduct: incompetence or alcohol or drug-impairment. These serious forms of misconduct, especially when performed by physicians engaged in immediate life-and-death activities: surgery, interventional cardiology and interventional radiology. These are the cases where very large settlements seem appropriate, as misconduct in these setting can result in permanent injury and death. The worst by far is when senior administration is aware that the misconduct is ongoing. This immediacy of medical misconduct in surgery, and interventional cardiology and radiology most closely match the tragic level of cowardice by police in Uwalde school.

I am no coward,

Richard Semelka, MD