Which Path Will You Take?

On February 6, 2005, the New York Times reported that Paul Kornak pled guilty to fraud and criminally negligent homicide a month earlier.[1] Kornak was a nonphysician employee at the Stratton Veterans Affairs Medical Center (SVAMC) in Albany, New York. On November 21, 2005, a federal judge sentenced Kornak to the maximum prison term of six years. According to a local report, "At least one veteran died and 64 others suffered unduly or were harmed by the forgeries, which involved manipulating their medical backgrounds so they would qualify to participate in lucrative drug studies ...."[2] A decade earlier, two pharmacists had warned that patients were placed at risk or had died because of similar unethical experimentation.[2]

This is the first paragraph excerpted from Jeffrey Fudin's story, Blowing the Whistle: A Pharmacist's Vexing Experience Unraveled (pdf) published in Am J Health-Syst Pharm. 2006;63(22):2262-2265. ©2006 American Society of Health-System Pharmacists. Posted on Medscape.com 01/03/2007

I thought I would mention pharmacist Fudin's story because of three reasons.

Firstly, because it isn't often that you'll hear or read stories of heroic pharmacists, fighting against the multitude of apathetic supervisors, unethical leaders, or criminal operatives found throughout the healthcare system, and risking it all to do the right thing. Jeffrey Fudin is one of those heroes, and someone whose actions I truly admire. He's the kind of pharmacist we should all try to emulate.

Secondly, because most of the abusive, unethical, corrupt, or criminal stories pharmacists discuss with each other usually involve retail or community pharmacy practice. If you've read any pharmacist blogs or Twitter posts, you'll see that the they tend to focus on the abuses suffered at the hands of the chains, the PBMs, or even their patients. Many pharmacists mistakenly tend to think that such abusive situations don't happen as often in hospital pharmacy practice. They do.

I also wanted share pharmacist Fudin's story because, also having worked at VAMCs twice in my itinerant career, I've found the work environments to be THE MOST toxic of any I've experienced, and the hospitals staffed with some of THE MOST sociopathic people (including a few pharmacists) that I've come across in my life. So, I can understand how pharmacist Fudin would, almost unbelievably, have to fight so hard, and against so many, when just trying to the right thing for his patients.

And thirdly, here's the worst part -

One veteran reportedly died because of these intentional crimes. Yet, only one of the perpetrators or enablers was held criminally-liable, and served (minimal) time in prison.

I can't help but wonder - were any of the supervisors whom dismissed pharmacist Fudin's efforts ever even reprimanded for their apathetic or unethical behaviors, are they still working at that one VAMC, or have they retired or moved on to other positions?

If you happen to run into such a supervisor, how will you react? Have you decided beforehand which path will you take when something similar happens to you?