DR. RON VIRMANI
Peer-Review Enters Tenth Year at Presbyterian Hospital, Charlotte
When I attended the New Jersey Medical School from 1981 to 1985 and finished my ob-gyn residency from Temple University in 1989, I had no idea how my career was going to turn out to be. I had not even heard of peer-review!
I started practicing at Presbyterian Hospital, Charlotte in 1990. On December 1, 1994, I was performing laparoscopy on a patient and the trocar inadvertently injured the external iliac artery. I opened up her abdomen, called general and vascular surgeons and took care of her. She went home.
On September 1, 1995, I was summoned to the imposing large Board Room of the Presbyterian hospital in downtown Charlotte. Mr. Paul Betzold, the CEO and Dr. Ronald Brown, head of ob-gyn department were present to break the news to me. The ambience was ominous.
They told me that the hospital was summarily suspending me as of 4PM that day because of a "peer-review" of my 102 patient charts out of which 24 were found to be "problematic". I was stunned by this revelation. I had been vaguely told that a peer review had been afoot for the last several months but I had assumed that the hospital would give me a chance to defend and explain anything that they considered "problematic". This is how things are always done in the hospitals.
"No" said Mr. Betzold, "We do not have to tell you what charts are problematic or what the problems are."
Suspended from the hospital, I sought legal help. Two and a quarter months of wrangling made the hospital finally give us a list of the specific problems with the 24 charts. Turned out that the problems were everyday things that happen to all ob-gyn's. Nothing special. It did include the laparoscopic injury case. Such things do happen, unfortunately. But I had never been called to explain anything. My lawyer knew a couple of senior ob-gyn's in the community. I did not know these gentlemen. They reviewed my charts without any compensation and said the charts met the standard of care.
It became clear to me that I was treated harshly because I was born in India. It was a case of egregious discrimination. Doctors, under the control of white power elite of administration, were eager to find faults where there was none. And of course, they did not have the courage to sit me face to face and simply ask me questions about the cases, because they knew how foolish they would appear.
Even the North Carolina Medical Board reviewed these charts. They took no action against me based on a review of these charts.
Nine years of my life have wasted away right in front of my eyes. I have vague memory of happy pregnant women coming to my office for their care. I faintly remember the last pink baby I delivered. I have spent these years in court rooms and lawyers' offices. Thousands of hours and a million dollars later, the case is still going. The hospital has not budged from its clearly discriminatory and unconscionable position.
After an unprecedented victory in the Fourth Circuit Court of Appeals in Richmond, VA, we have obtained records of peer-reviews of other ob-gyn's from the hospital, to compare with mine. We now have strong evidence that I was indeed treated very differently from others. Many other ob-gyn's who had incidents of adverse nature at the hospital were reviewed in a very collegial and understanding manner. They were not disciplined, let alone suspended. I was the first physician to be suspended from the hospital in 20 years!
The trial is scheduled for March 2005. I hope to have my day in court of honest public opinion in front of an unbiased people - the jury. We shall ask them to decide if the hospital indeed treated me far differently from how they treat other physicians at the same hospital. I hope that there will be justice in this land of opportunity and fairness.
Until then, I wait.
RON A. VIRMANI, M.D.
Board Certified Obstetrician and Gynecologist
4626 Charlestown Manor Drive
Charlotte NC 28211