On Jurisevic, Ross, Knight and Anonymous

I must say that I really have no idea what it is about my posts on this topic, or perhaps this whole issue in general, that has caused such a heated response.

I thought this was just an innocent comment on the activities of the ACCC and my own conjecture as to what might or might not have happened, and the wider implications of the ACCC's actions. I must make clear that I do not know Craig Jurisevic, Iain Ross, or John Knight, or anyone at the ACCC. I have never met them, have no inside information about what happened, and don't have any opinion on their character or skill.

Nevertheless, a series of anonymous posters seem to think that I am a dyed-in-the-wool Craig Jurisevic-hater when this is not the case. Why should some lowly general surgeon working in the middle of nowhere have anything to do with a high-flying, TV-appearing, book-writing, decorated cardiothoracic war surgeon? I don't know what his book is about - it could be about bird-watching for all that I care! What does that have to do with me? He could walk past me in the street and I would not know or care. I neither like nor dislike Craig Jurisevic - so Anonymous, please stop accusing me of being out to get him. I am not out to get Craig Jurisevic but I am not here to defend or promote him either.

In order for everyone to see clearly what I am being accused of, here are links to the two relevant blog posts and the amalgamated comment exchange on this topic.

ACCC Strikes Again, August 2007
Bleeding Hearts in Private Hospitals

Comments:

Milk & Two Sugars said...

Ah, but 'desirable' is not the same as 'required', is it? Do you think it's possible that the problem stemmed from Ross and Knight's inability to formally take action to prevent a surgeon they considered inexperienced and therefore dangerous from being allowed to take such a position? I'm not familiar enough with the College of Surgeons practices to know whether such an avenue was available.

6:18 PM, August 20, 2007 

Anonymous said...

The surgeon in question had several years as a trauma surgeon on top of his cardiothoracic training and had a Masters I Surgery in the field of cardiac surgery, so experience was never an issue, nor was patient safety.

9:39 PM, August 22, 2007 

Sheepish said...

You make a good point, M&TS. Ross and Knight may have felt that way for reasons apart from CJ's professional qualifications. There is no practicable means to limit someone's activity in private, as the whole point is that the market decides whether such qualities are a problem.

I have written a further post about my opinions on this.

Thanks for your insight, Anonymous. Please keep reading, and letting me know what you think.

2:20 AM, August 24, 2007 

Anonymous said...

Sheepish,
Why no response to posts that highlight the fact that CJ was more than qualified and competent??

9:53 PM, September 13, 2007 

Sheepish said...

Hi Anon - I assume you are the same Anon from the postACCC Strikes Again on this topic.

I don't claim to know CJ personally or professionally, so I can't really comment on his qualifications. My observations didn't relate to how skilled or competent he is, and I assume that he is appropriately trained to the level of an FRACS(CT). They were about the issues around the ACCC's actions and private hospital accreditation.

By the way, if you comment again it would be nice if you gave yourself a nickname or logged in to Blogger - it's a bit weird replying to "Anonymous".

10:31 PM, September 13, 2007 

Honest Doc said...

Dear Sheepish,
I am not the Anon from other posts referred to. This is my first time on this site. I have recently developed an interest in the case as I have worked in SA all my life, and I , and most other docs in the public and private hospital system know of the past behaviours of the two surgeons charged by the ACCC. The finding is of no surprise as these "Old Adelaide" exclusive practices have destroyed many a young medico in Adelaide.
Lets see what the Medical Board, our independent aribiter of professional conduct, has to sy about the actions of Messrs. Ross and Knight!

10:49 PM, September 13, 2007 

Anonymous said...

Hi to all- I have read enough peoples opinions and views of those who support Knight and Ross or try to make it seem that they were doing nothing wrong. I do personally and profesionally know Dr Craig Jurisevic, and in the past have worked under Dr Knight as a theatre nurse. Let me say that there are clear and distinct differences between these two individuals. While they are both immensly tallented and educated surgeons, the motivation behind Knights and Ross' actions were not in the interests of patients who might in future require the services of Dr Jurisevic. In my time working with Dr Knight, It was clear that money was a large motivator for him, while he is an excellent surgeon, and his patients are always the priority, money comes in at a very close second. This is not the case with Dr Jurisevic, while he may be earning a significant salary, and may be launching civil action as reported in the Australian, he has every right to do so. These men have attempted to tarnish this surgeons reputation in a decietful and pathetic manner, even making him believe that he was not qualified to work as a CT consultant surgeon. To Dr Knight and Ross, what you did was intentional, Dr Knight has at various times been very callous and decietful individual to get his way, and obviously has not changed since I have worked with him. While I do not directly work under Dr Jurisevic, I have assisted him in Surgery many times and saw first handedly what an experienced and caring individual he is. Money is not a motivator for him, nor is the position or titles. His main and only motivator is knowing that he is saving or greatly improving the life of another human being.

8:42 PM, October 31, 2007 

Anonymous said...

Why do you hate craig jurisevic so much? Have you read his book yet? now that you see he was MORE than qualified and Ross and Knight were being c**ts do you admit you are wrong?

2:41 PM, May 21, 2010 

Sheepish said...

Dear Anonymous:

I assume that you are referring to a series of posts that touch on news reports involving an ACCC finding regarding the failure to appoint Craig Jurisevic to an Adelaide private hospital. (Now I sound like Sir Humphrey!)

They are ACCC strikes again and Bleeding Hearts in Private Hospitals from August 2007.

Firstly it is helpful if you provide a name as many other commenters use the same pseudonym "Anonymous" and it makes it impossible to tell whether you are the same Anonymous as has commented on those posts.

Secondly, you may wish to post your comment on those posts rather than this one, as otherwise no-one has any idea what you are on about without me coming to your rescue.

Thirdly, I have never said, and can confirm that I do not, hate Craig Jurisevic nor bear him any ill will. I have not read his book nor do I have any immediate urge to go out and buy it as I don't have the faintest idea what it is about yet.

I have merely passed comment on the general issues raised in this ACCC case and theorised on what might possibly have happened. As I passed no judgement on Craig Jurisevic I really don't have the faintest idea what you are accusing me of, or what I could possibly be wrong about.

Next time I would appreciate it if you could write a comment that at least made sense, rather than a paranoid rant.

Sheepish.

11:56 PM, May 21, 2010 

Anonymous said...

Dear Sheepish,

I have read all those posts about the ACCC, and I am very close to the case of Mr Jurisevic and Mr Edwards. I know it well. Far better than you'd like to think you are - you are a nobody. You have no idea what you are talking about and you elude to the fact that Ross and Knight were shafted in some way. You need to go f*** (edited) yourself!

1:51 PM, June 10, 2010 

Sheepish said...

Dear "Anonymous":

I don't claim to know the case or any of the doctors involved well or at all, other that what I have read in the paper. I may well be nobody but I am entitled to pass comment and express an opinion. It is, after all, my blog.

I do not allude to anyone being shafted, but you are not doing your case any justice by your irrational, unjustified finger-pointing. I think it is fair to say that your attack on my comments is, to say the least, paranoid behaviour. If you have inside information then please feel free to share, as raving and ranting is clearly not doing much good for my education, nor your pent-up frustration (which may well be solved by the same action that you have asked me to perform).

8:40 PM, June 10, 2010 

What Waiting List? A followup.

I received an insightful comment from Anonymous in response to my post on Waiting Lists. My reply follows.

Anonymous said...
I disagree with the assumption that waiting list manipulation doesn't change how long patients wait for operations.

If we use a lie (using stats) to say there is no waiting list problem then additional resources will not be allocated and ignore attempts at increasing real efficiency. This means that real waiting times may increase along with losses in quality of life, patient productivity, increased complications and increased cost of care. It’s not just the usual cost of the operation but all the related costs before and after that don’t show up in the hospital stats.

Differences in the delay of processing of forms will change the order when patients are seen.

Dear Anonymous (why are there so many people called Anonymous???),

I would agree wholeheartedly with you if the statistics were actually used for resource planning - unfortunately as far as I can tell they are only used as a political football. I am not saying that sitting on waiting list forms is a great thing to do, just that we live and work in a pragmatic world and have to get on with things.

I remember clearly in a chat with a friend who was a government lackey a few years ago why we don't look at more useful KPIs - the response was that there was no interest in measuring a KPI unless it was a number that could be improved upon and promoted in a media release.

Efficiency is squeezed to its limit already - there is no efficiency gain to be realised. Our driver at the coalface is the desire to treat patients as best we can, not to meet arbitrary targets or make the Minister look good. The only thing that can be improved upon is more capacity by capital investment - and this will never happen because placing a chokehold on capacity is the only way to limit ongoing costs! Just like the logic that if we have fewer doctors the health budget will be smaller. Bugger the patients.

As for differences in delay of processing forms... all the forms for our specialty went through me. It didn't matter how long I sat on them, or when I put them on the list, or when I received them. I filled out the forms, I submitted the forms, I reviewed the waiting list, and I booked and scheduled patients into theatre where I then operated on them.

Patients were prioritised by me on the basis of firstly clinical need, secondly resource availability, and waiting time came a very distant third. The patients were more frustrated by delays and cancellations on the day of operation than an extra week after 2 years of waiting. This is what happens every day in every hospital I have worked at. How about yours?

Getting Blotto with Otto

At the risk of turning my blog into a "Dear Abby" column for disaffected medicos, I am replying to Anonymous who writes:

Dear Sheepish,

A question for you: I asked my HMO3 today why he thinks women are more likely to develop a femoral hernia. He said that it is because the process of childbirth weakens the posterior wall of the femoral canal. I asked him to tell me an examination feature that would distinguish an incarcerated femoral hernia from a tender groin lymph node. He said that a patient with an incarcerated femoral hernia would have signs of a bowel obstruction and that a hernia is reducible.

I am not on call tonight.

My question is: How many alcoholic beverages should I consume tonight?

Unfortunately for you, Anonymous, however many drinks you have tonight, your poor HMO will still be there on Monday, oblivious to his ignorance and not having learnt a thing. You, however, will be hung over and barely functioning, and very much the worse for wear for your alcohol-fuelled binge.

If you plan on pursuing your surgical career, you need to decide on one of two paths.

1. Work out how much you can drink on a regular basis without anyone knowing the difference. This may take a fair bit of trial and error.
2. Realise that one-in-two or one-in-one on-call, will make frequent Toga Parties or Bond Nights a near impossibility, so perhaps it is time to give up or cut down now.

Personally, I have made it a point that I don't drink when I'm on-call, and at other times I'm limited to one drink at night with dinner. If I'm on holiday, then no restrictions apply. In reality, though, not being in the habit of drinking regularly I often just go without. There is not much point opening a bottle of wine when I know I'll be unlikely to finish it before it goes off - but that is just me.

I don't think that I am any more authoritative on this issue than anyone else - is it OK to drink when you are on call? Given that sleep deprivation for 24 hours is said to be as bad as having a blood alcohol level of 0.05, perhaps it's OK to have a few drinks if you get plenty of sleep? Stories abound about surgeons who operate while inebriated. Is an impaired surgeon better than no surgeon at all? Is an incompetent surgeon better than no surgeon at all? The Bundaberg experience would say no, and so would my MDO.

Perhaps next time, you should ask your HMO3 if he knows what a torsion of the testicle feels like. Or intermittent claudication of the arm. If not, you can always provide a demonstration.