English: Facial Plastic Surgeon Vishal Kapoor,...

Facial Plastic Surgeon Vishal Kapoor, MD placing cartilage graft during rhinoplasty procedure. (Photo credit: Wikipedia)

She came into the hospital with her three year old child. Her child had a one inch laceration on the left side of her face. The child had fallen and cut her face. And her tetanus vaccination status was up to date.

As I cleaned the wound with peroxide, the mother stated that her husband was on the board of directors of the hospital and that the family had contributed over $1,000,000 to the hospital.

I said that is admirable. She then said that she wished a plastic surgeon to tend her child.

I said that I would ask the plastic surgeon on call to tend her. What would you have done?


The options are:

  1. Refuse to call the plastic surgeon?
  2. Call the plastic surgeon and not mention the high profile of this family in the community?
  3. Or call the plastic surgeon and  mention the high profile of this family in the community?


When the plastic surgeon called back I explained the mother had asked for a plastic surgeon to treat her child’s superficial laceration. I did not mention the name of the family, because of patient-doctor confidentiality I would never do this for other patients either.

The surgeon refused stating that this was a routine problem and that I was competent to care for the patient.

I informed the patient that the surgeon did not see the reason for her expertise for this routine problem.

I sutured the laceration and discharged the child with follow-up care for the mother.

The mother was not pleased and told me that they would go to another city to see her plastic surgeon.

I never heard any more about the case.

What was the ethical response? I don’t know.  What do you think?


Striving for aequanimitas,


John Mary Meagher


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