Anesthesiologist accused of sexting in surgery -- Take steps to prevent now

Anesthesiologist accused of sexting in surgery -- Take steps to prevent now

Electronic communications are often a headache for managers in healthcare, but sometimes the issue extends beyond staff members constantly checking their cell phones. Consider this recent example: The Washington State Medical Board suspended a Seattle anesthesiologist after investigating allegations that he "sexted" during surgery, at one point sending 45 sexually explicit messages during a single operation.

The board suspended Arthur Zilberstein’s license for a "lack of focus" and putting patients at risk during an appendectomy and other procedures, according to a Washington state medical board’s statement of charges.

The board also investigated claims that Zilberstein sent X-rated selfies, wearing his hospital scrubs and badge with his genitals exposed. "Oh. And my partner walked in as I was pulling up my scrubs. I’m pretty sure he caught me," Zilberstein wrote in one text message, according to the board. The statement of charges included claims that the doctor sent multiple sex-related messages to the same woman, a patient, and invited her to visit the hospital for sex. He told her she could park in the doctor’s lot instead of paying for parking, according to the claims, and the pair allegedly arranged to meet in the doctor’s lounge or hospital call room for sexual encounters.

In addition, the statement of charges says Zilberstein obtained the unnamed woman’s medical records "not for medical purposes, but in order to view images of the patient for his own sexual gratification."

The state health department investigated after receiving two complaints, one from a patient and another from a healthcare professional, the report notes. Zilberstein is appealing the suspension.

While this situation appears to be an unusual case, the issues of privacy and protected health information are growing in this social media age, say sources interviewed by Same-Day Surgery.

"You won’t believe how many stories you hear about people taking inappropriate photos and sending it out," says Marcus M. Crider, JD, partner at the Waller law firm in Nashville, TN. Crider recently spoke on "Social media from a legal perspective" at the annual meeting of the Ambulatory Surgery Center Association.

Address patient contact

Another issue is inappropriate patient contact, says Neal R. Reisman, MD, JD, FACS, chief of plastic surgery at Baylor — St. Luke’s Hospital, director of aesthetic surgery, Division of Plastic Surgery, at Baylor College of Medicine, professor of plastic surgery, Baylor College of Medicine, and attorney at law, all in Houston, TX. Reisman also is president-elect of The Aesthetic Surgery Education and Research Foundation.

"It is important to have a communication agreement as to how the patient may be contacted, and to follow it and update it," he says. Also, electronic communication might take away time from necessary duties, and thus it is a "distraction that must be controlled," Reisman says. "There should be a communications policy in the office manual restricting contact with a patient unless approved, and then only for business."

Reisman chairs a Committee on Practitioner Health that addresses physician issues that conflict with patient care and hospital bylaws. Based on his experience, he says managers should be proactive in educating staff about privacy issues, including the Health Insurance Portability and Accountability Act (HIPAA). Specific topics should include accessing medical records, releasing confidential information, violating the duty accepted with patient care, along with general risk management issues. Encourage members of your staff to "function as a team and watch each other, not necessarily to `turn one in,’ but to approach to see if there are any added stresses not addressed, and to see if there is anything you can do to help."

For example, in the case of the sexting allegation, the anesthetists might have better explored what was happening and taken prompt action to avoid such issues, Reisman says. Members of the surgical team might have recognized distractions in patient care and brought it to the attention of managers, he says. "We all have a responsibility to protect the patient and should work together toward that end," Reisman says. "When one link is recognized as a problem, all team members should rally to identify and resolve issues."

When a members of the staff is accused of inappropriate behavior such as sexting patients, it "reflects on the entire institution and negatively affects outcomes of all," Reisman says.

Protecting confidential and sensitive information is critical for healthcare facilities, Crider says.

"Remind employees they shouldn’t be speaking in a way that could identify them, or make it look as if they’re speaking on behalf of the surgery center, when stating their own personal views," he says.

Members of your staff must be taught to separate the professional from the social, Crider says. He says the easiest approach is to simply say, "We don’t have time for that. If we’re an efficient ASC, you can get on Facebook and Twitter during lunch, but while in our facility, you need to be focused on work." Tell employees not to take work home with them and not to bring their social lives into work, Crider says. "Keep them separated," he says.

Your staff will underestimate the power of an inappropriate tweet or post, Crider says. "It spreads like nothing before. It’s remarkable," he says.

Addictions, including addiction to electronic communication, are prevalent, Crider says. "But social media can be a dangerous environment where something like that [accusations of texting during surgery] can flourish." (For more information on this topic, see these Same-Day Surgery stories: "Patient info on Facebook traced to temp staff," May 2012, p. 54, and "All it takes is a few keystrokes, and your facility’s reputation is ruined," April 2012, p. 37. The April 2012 issue also includes "How to create a social media policy," "Components of a Social Media Policy" and "Components of Social Media Policy on Employees’ Personal Posts," as well as an example of a social media policy.)

Resource

A position paper by the American College of Physicians and the Federation of State Medical Boards provides guidance on the use of social networking, blogging, online forums, cell phone photography, electronic searching, texting, and emailing. To view the guidelines, go to http://bit.ly/ZR5Xvt.