Doctor Robert MacArthur Interview
On this particular day, we managed to have a conversation with Californian resident orthopedic surgeon, Doc Bobby Mac, in light of the inquiries about his experiences with wrong site surgery and surgical burn incidents, as well as a topic of "unexpected occurrences that must be avoided".
Who is Dr. MacArthur?
Doc Rob MacArthur graduated from the University of Cal Berkeley with a double major in Biochemistry and Physiology. In the course of his time at the Univ, Doc Robert Mac had been a renown player, engaging on both various box and rugby groups.
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Following that, Doc Rob MacArthur registered at the Columbia University College of Physicians and Surgeons, and was the chosen leader of the Columbia P&S School of Medicine (Now known as the Vagelos School of Medicine). Bobby MacArthur went on to conclude his orthopaedic residence at Harbor-UCLA Medical Center.
Dr. Robert MacArthur Addresses the Incidents
In statistical terms, the frequency of surgical errors usually falls within a once-in-a-career event for every single orthopedist, but this count surges to four per lifetime for sports, hand, and spine specialists. Regrettably, a lot of of these commonly do not document these cases, let alone, not discuss them publicly. Doc MacArthur carries a profound sense of pride and accomplishment about how he faced these unfortunate occurrences.
Instead of trying to conceal the incident, Dr. Mac reacted differently
Dr. MacArthur’s Robert MacArthur Handling of the Wrong Site Surgery
Doctor Rob MacArthur extensively looked into the underlying origins of his two incidents, and published numerous works describing how to prevent these occurrences
He eventually, became acknowledged as a published expert in the field of preventable accidents. He's written a couple of articles in the foremost orthopedic journal, The Journal of Orthopedic Surgery. To helping other doctors avert subsequent occurrences, his initial article guided the reader through the specific errors that occurred that caused the wrong site event.
The second paper, authored together with Dr. David Ring, who is also the Chairman of the AAOS, tackled the topic of the "tendency to shame and blame." Taking responsibility for these incidents is uncommon, as the common response is blaming third parties. He stressed that accusations not only discourages surgeons from disclosing their incidents but furthermore takes away from the crucial analysis of primary reasons that could potentially avert future incidents.
The Intraoperative Burn Incident with Dr. Robert MacArthur
In the context of discussing the intraoperative burn incident, Dr. MacArthur displayed the same thorough investigative mindset he applied to his wrong site event research. To illustrate, he contacted the manufacturer of the troublesome clamp to find out if similar burn events had happened. The producer advised him that the clamp in question had been "no longer in production." You can make your own inferences based on that what you wish.
And to prevent irregular heating in massive hinged clamps, Doctor Mac conducted a comprehensive investigation of what led to inconsistent heating in oversized clamps.
The results of his investigation showed that flash sterilization could cause inconsistent temperature distribution. He pointed out that nursing associations strongly advise against the use of flash sterilization unless an emergency situation arises such as sanitizing a fallen instrument. Additional investigation revealed that St. Joseph's Hospital regularly using rapid sterilization to ease back-to-back surgeries without the necessity to purchase additional equipment trays.
In a bid to stop further burns, Dr. MacArthur informed the hospital at St. Joseph's of potential dangers associated with ongoing utilization of this specific clamp as well as the regular use of rapid sterilization.
Rather than blaming the clamp, Dr. Robert MacArthur assumed accountability and made it obvious that he had made a surgical error. He was advised that the clamp was hot, but when he grasped it, he found the handles to be at a pleasant temperature. In contrast to some surgeons who may impatiently grab a towel to handle a too-hot clamp, he carried out the procedure the clamp without pain.
Shame and Blame, Dr. Robert MacArthur's Response
When discussing The perspective of Dr. MacArthur on response on the topic of the "culture of blame and shame," he emphasizes how the legal and general public communities often confuse the "in-command'' concept with identifying the underlying reasons. According to this "in-command" perspective, the surgeon is considered responsible for any unfavorable outcomes that take place to a patient under their care. This makes it enticing for many to exclusively blame the surgeon for any incorrect surgical procedure.
Nonetheless, Dr. Robert MacArthur stresses that this method goes against the fundamental principles of investigating root causes. This form of analysis intends to comprehensively grasp what caused a incorrect surgical procedure to then preferably avert similar incidents in the future. By resorting to blaming and shaming, not it not just hamper proper analysis of the root causes, but it also prevents other surgeons from disclosing their individual wrong site events, fearing the repercussions.
He didn't recognize that the sizeable, walnut-sized hinge of the clamp was considerably hotter. When he positioned the clamp against the shin area of the patient's leg, it caused a burn. At the time, he was proctored for procedural privileges at the CHOC Hospital during the incident, and none of the proctor nor Dr. Robert MacArthur were promptly aware of the burn.
It wasn't only after he had dictated the operative report that an attending nurse in the recovery room drew attention to a small patch of redness on the anterior aspect of the patient's leg. Even then, he did not at the outset fully grasp the severity of the burn.
Dr. MacArthur references the aviation sector as an exemplary case of effective root cause analysis. From its inception, aviation sector has aimed to deeply understand the reasons behind each negative aviation occurrence rather than simply attributing blame to the pilot. Because of this focus on understanding root causes, aviation sector boasts notable safety records.
However, Doctor MacArthur laments that healthcare field hasn't been successful in fully implementing root cause analysis due to prevailing legal and public perceptions surrounding the "in-command" concept. The regrettable result of this is that the incidence of preventable healthcare errors remains unchanged, and the professional careers and reputations of many doctors and healthcare providers are unfairly tarnished.
The frequency of incorrect surgical procedures persists at an disturbing rate of one event per surgeon per career, and as many as four incidents per surgeon's career for specialists in hand, spine, and sports.
Dr. Robert MacArthur “Sexual Harassment” Allegations
In 2023, it is possible to raise false accusations against someone, defame their name and reputation, and experience no negative repercussions for the accuser. Regardless of whether the person facing accusations is innocent or guilty, just making an allegation is enough to bring about long-lasting damage to a professional's reputation.
Doctor Bobby Mac disclosed that he elected to leave a workers compensation clinic because of possible unlawful practices on the clinic's management. In retaliation, the manager of the clinic allegedly worked with a client to fabricate a claim, accusing him of "undressing in the clinic and soliciting sexual favors in return for a positive workers' compensation report.
He was informed of this claim over a year after his departure from the clinic, at which point he asserted on undergoing a polygraph examination. The accuser, however, opted not to take such a test.
Dr. Rob Mac was later informed that both his polygraph examination results and the claimant's refusal to participate would be deemed inadmissible in court.
The lawyer acting as mediator cautioned him that the jury would likely be composed of "individuals similar to her" and not his, meaning a court loss could be highly damaging. Despite the ludicrousness of the claim, he was counseled to settle for $29,000
Conclusion
The Medical Board of California examined the accuser's claims and found them to be "not trustworthy," hinting at an ongoing investigation into the clinic. When we spoke to Dr. MacArthur, he suggested that the clinic was indicted, but he did not verify this.
Regardless of the facts presented above, Doctor MacArthur found no means to eliminate the allegations made by the accuser from Internet search results. Consequently, despite his lack of guilt, the campaign to tarnish his reputation was achieving its goal.
Since the claim does not state that Dr. MacArthur was found guilty, it merely acts as a condensed version of a complaint, which continues to be available to the public
Dr. Robert MacArthur strongly believes that those who make baseless allegations should face penalties equivalent to the consequences of the falsely claimed event. To illustrate, he thinks that his false accuser should be treated as a predator of a sexual nature and felon.
Doctor MacArthur concluded by contemplating the existence of both good and evil in the world, hoping that those who read his account