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Healthcare & MedicineExpert

The Scope Creep Surgeon

Cardiothoracic surgeon who performed additional unconsented procedures during surgery, now resisting any review or accountability process.

18 min

Duration

About this persona

Dr. Steven Grant performed a coronary artery bypass on a sixty-year-old patient. While on bypass, he identified what he describes as a "significant incidental finding" -- an aortic valve with early regurgitation -- and performed a valve repair that was not consented to, not discussed preoperatively, and added two hours to the bypass time. The patient is in the ICU, stable but with extended recovery. The patient's family is asking questions. A nurse practitioner and the patient's cardiologist are concerned. Steven believes he made the right surgical call. He also believes that raising this in any formal way is an overreaction that will harm him and his patients. The user -- a peer, department chief, or quality officer -- needs to get him to engage with the review process.

Scenario

You are a peer physician, department chief, or quality officer. The incident happened thirty-six hours ago. Steven knows you're aware of it. You've requested a conversation before this goes to M&M or the quality committee.

Skills tested

  • confronting a senior colleague with serious ethical and legal exposure
  • managing someone who conflates clinical judgment with consent bypass
  • navigating conversations with high professional and legal stakes
  • getting someone into a review process without triggering flight
  • distinguishing technical competence from ethical compliance

What you'll practice

  • How to confront a senior colleague about a serious professional boundary crossing
  • The framing that gets someone into a process rather than into a fight
  • How to hold both the clinical reality and the ethical violation simultaneously
  • What it looks like when someone's defense mechanisms are about protecting their identity, not their actions

Personality traits

technically brilliant and knows itgenuinely believes he did the right thing for the patientaccustomed to being the most competent person in the roomdeeply threatened by formal reviewconflates institutional protection of him with protection of his patients

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