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Beth Israel Deaconess fires plastic surgeon after 'impairment'

Posted by Elizabeth Cooney July 21, 2008 10:54 AM

A Boston hospital fired a plastic surgeon last week after he showed signs of an "impairment" during surgery, the Boston Herald reports.

Dr. Loren J. Borud, 44, a graduate of Harvard Medical School and head of Loren J. Borud Plastic Surgery, was suspended after a June 27 incident at the hospital and fired on Friday, Dr. Kenneth Sands, senior vice president of health care quality, told the Herald.

Sands did not explain what the impairment was, but said the hospital sought help from Physician Health Services, a program of the Massachusetts Medical Society through which doctors deal with alcohol problems, substance abuse, or other mental health issues.

Today Beth Israel Deaconess confirmed that Borud is no longer employed at the hospital or conducting surgery there. Citing patient and physician confidentiality, it offered no other details. That contrasts with a very public discussion of a wrong-site surgery that occurred on June 30, three days after the operation for which Borud was suspended.

Yesterday, Beth Israel Deaconess CEO Paul Levy continued the conversation on his blog, musing about comments on whether to discipline the surgeon involved in the medical error, which he weighed against the value of encouraging people to come forward when something goes wrong.

"It ... occurred to me that the easy path for a hospital administrator in this kind of environment would be to punish the wrong-doer, bolt on a new process, protocol, procedure, or requirement, and declare the problem solved. After all, that shows decisive and timely leadership," he writes. "There's only one problem. That doesn't work. Or if does, only for a short time or until a new glitch is uncovered."

6 comments so far...
  1. This is why people don't trust the media and your circulation's in a free-fall. You're trying to make up a conflict where there is none. Firing a physician for being impaired and intentionally putting patient safety at risk is completely different from taking no action when a well-intentioned physician makes a mistake - humans are fallible, after all, except maybe you, Cooney - because disciplinary action would create an environment hostile to surfacing and reporting medical errors, and thus, creating an opportunity to learn from them.

    You need a license to practice medicine, but not to practice journalism. How interesting.

    Posted by Rachel July 21, 08 06:41 PM
  1. Why hasn't this story appeared in your newspaper????

    Posted by marty sloan July 22, 08 09:23 AM
  1. Rachel makes some important distinctions between the two cases. Our purpose in publicizing the wrong-side surgery case to our entire staff (and then, necessarily, to an external audience) was to help bring attention to an important quality control issue to everyone in the hospital and, through my blog, to other hospital people around the world interested in lessons that could be drawn from that case. And, of course, we held the patient's name and specific medical information confidential.

    We did not initially choose to make the Borud case public; rather we responded to a reporter's inquiry. The termination is a matter of public record. Nonetheless, Dr. Borud has certain rights of confidentiality with regard to details of the case, and we will not violate those rights. Ditto, of course, with regard to his patient.

    Posted by Paul Levy July 22, 08 09:45 PM
  1. I would like to know what the Dr. was impaired with, is he stealing drugs from his practice or writing out his own prescriptions

    Posted by hdixie July 23, 08 08:48 AM
  1. Rachel, it seems like quite an extrapolation to claim mistrust of the media and declining circulation from this rather neutral, small article that points out the contrasts between media coverage of a loaded subject like the hospital's handling of an intoxicated surgeon with the way it handled a less loaded, unfortunate quality control related measure such as the wrong-side misstep, which presents more of an opportunity for correcting future errors than does the impaired surgeon case.

    Kudos to Paul for approaching this—albeit unfortunate—learning opportunity as such.

    Posted by Hunter July 26, 08 12:13 PM
  1. Hi Dr. Borud,

    I tried to call your office many times without any success. Drop me a line or a note to let me know how you are doing!

    I hope you are doing well!

    I am a bit worried about you. So please keep your chin up and keep going through this tough time and you will do fine. You are the best. You are a strong man and stay resilient to a tough media.


    You will get through this!

    OPC (the smallest onion not)

    Posted by OPC August 31, 08 01:25 AM
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Elizabeth Cooney covers health for the Worcester Telegram & Gazette. She previously reported on business and was an editor at the paper. Earlier in her career, she edited medical books and journals at Little, Brown, and worked for Boston magazine.

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