Clinical Activity—Lauren’s Update Nov 2020
The short answer is that there is none right now. I haven’t completely closed the door to re-entry, I can’t ( and don’t want to) face again what I have faced repeatedly in the last few years, never more expensively or crushingly as in New York this fall.
Some of you know that I moved to Long Island in August to start a Mastery of Surgery Program at Stony Brook University Hospital as a re-entry pathway. The September 1 start date was postponed to October 1 to accommodate the credentialing timeline. In early September, the offer was retracted when the chairman of surgery was advised that a policy change from the new president of the university precluded credentialing physicians with a clinical gap, even though the reason I was accepted into the program was to remediate my gap. The chairman and other faculty were blindsided by this. I have been in conversation with American College of Surgery leadership about this and the American Board of Surgery for 4 reasons. First, this program is sponsored by the College, and the credentialing premise of its design is likely to become a bigger problem as credentialing is increasingly regulated and physicians are excluded from the qualification of physicians. Second, the trend that will grow toward surgeons taking time away from clinical practice for a variety of reasons needs to be accommodated in professionally credible ways. Third, the exclusion of physicians by risk-averse corporate medicine from a defining role in qualifying expertise undermines a defining feature of all professions: that the expertise acquired in education, training, and meeting discipline standards can only be evaluated by people who share the expertise. Finally, I need help with a path forward and have intended to be a contributor to solutions to these problems for over a decade.
I won’t recount them all here, but I have been at the threshold of a re-entry pathway in
Pennsylvania twice (2017 and 2019) working with my former fellowship director John Marks at the Main Line Health System where the (now-deceased) CMO had confused me with another surgeon and refused to support my engagement there,
Anne Arundel Hospital where the Acute Care Surgery Director and sponsor of my program abruptly accepted another job offer weeks before I was to begin work, and
the local health system community partner of the University of Maryland where I Iived on the Eastern Shore when the surgeon who herself had successfully re-entered practice more than a decade earlier, became an examiner for the ABS, was an invited speaker not he topic of re-entry, had been chair of the credentials committee in the community hospital system for 6 years, and who offered to sponsor me had her house burn down the weekend before the meeting at which my application was presented and then was bullied by the CMO at that institution.
I have had offers of support from my former fellowship program in Florida, but the re-licensure process was formidable, and without the financial base of my relationship, it was also a financially challenging option since there was no stipend. Over the years, I have also explored opportunities and/or had interviews at Christiana Medical Center, Beebe Hospital on Maryland’s Eastern Shore, Elkton Hospital, University of Maryland, Johns Hopkins, and the University of Washington. I have revisited possibilities in Milwaukee, which would be difficult on multiple levels but even harder during COVID. I also was considered for a very compelling advanced practice training opportunity in Hereditary Colorectal Cancer at the Cleveland Clinic in Ohio. Twice. They offered to the position to candidate who accepted then changed her mind. Through all of this, I have maintained both of my board certifications and licensure in Pennsylvania, New York, and Wisconsin.