Fired Resident Sues DHMC Claiming Whistleblower Retaliation

Lebanon — A former resident physician who was fired from Dartmouth-Hitchcock Medical Center in June is now suing the hospital, saying that she was improperly dismissed for reporting concerns about a colleague and that she was acting according to professional ethical standards.



The resident, Thersia Knapik, of White River Junction, spent five years in the Lebanon hospital’s surgery department, first as an intern and later in the residency program before being fired in June, according to a lawsuit filed in Vermont District Court in August.



She has been unable to find work as a doctor and says she was only trying to warn others against another resident whose sloppy practices had garnered scoldings from supervisors.



Knapik declined through her attorney, Norman Watts, of Woodstock, to be interviewed for this story. Dartmouth-Hitchcock also declined to comment on the case.



“As an academic medical center, we do not comment on individual academic decisions, and out of respect for the judicial process and all parties involved, we will have no comment while that process is ongoing,” hospital spokesman Rick Adams said Tuesday in a statement.



However, court documents point to the ethical dilemmas that physicians, even those who are in training, encounter while working with each other as well as caring for patients.



According to Knapik’s lawsuit, the issue stemmed from a disagreement she had with another resident who would be entering a fellowship program after her residency training at DHMC. The other resident had been chided by the DHMC residency program director over “serious concerns” he and other faculty had about her attention to detail, medical knowledge, including “not being aware of ‘the steps of the operations you are performing,’ ” and the resident’s professionalism, according to the lawsuit.



The program director wrote the resident a letter that effectively resulted in probation — DHMC denies this, calling the letter instead a “privileged quality assurance document” — yet the resident didn’t mention the letter to the fellowship program to which she had applied or to the corresponding state’s licensing authority, according to Knapik’s lawsuit.



The resident allegedly showed the letter to Knapik during a debate they were having about the ethics of revealing the letter to the fellowship program. Fearing that she could be complicit if she failed to report the matter and feeling ethically obliged to do so, Knapik sent the letter to the fellowship program and also to the state’s licensing authority, according to the lawsuit. Court records don’t reveal which state.



Though some technical details over her firing are disputed, both sides agree that DHMC’s reason for dismissing Knapik was because “she engaged in ‘behavior incompatible with the role of a physician’ ” and violated the hospital’s code of conduct.



DHMC said Knapik sent the letter anonymously and without permission. DHMC also refuted Knapik’s claims that she was motivated by her own ethical standards.



In her lawsuit, Knapik justified her actions by pointing to standards of accreditation bodies for graduate medical education programs. DHMC’s residency programs are accredited by the Accreditation Council for Graduate Medical Education, which includes the American Medical Association among its five member organizations.



AMA’s code of ethics says that physicians must “report impaired, incompetent, and/or unethical colleagues” and that “when the inappropriate conduct of a physician continues despite the initial report(s), the reporting physician should report to a higher or additional authority.” It also says “unethical conduct that violates state licensing provisions should be reported to the state licensing board.”



A spokesperson for the AMA and medical ethicist reached Tuesday declined to comment for this story because it involved ongoing litigation. Several other medical ethicists did not return calls and emails seeking comment.



Chris Fleisher can be reached at 603-727-3229 or cfleisher@vnews.com.





