I just read this article and now I'm angry. Really angry. All because of a doctor who deserved to be reported to the state medical board for poor patient care. He was reported by two nurses who were then fired for their actions and charged with a felony. Yes, that's right, they were charged with a felony for reporting substandard medical care by a physician.
Here is the story in a nutshell: two nurses anonymously report doctor Rolando G Arafiles Jr. to the Texas State Medical Board for ongoing incompetence. They reference the case numbers of six patients to whom they felt Arafiles provided substandard medical care. The state board reports to Arafiles that there has been a complaint filed against him. Doctor tells his Sheriff buddy/patient, Robert L Roberts Jr. Then, Sheriff/buddy Roberts and doctor narrow down the list of suspects who did the reporting. Sheriff/buddy obtains a search warrant by claiming "harassment" and searches the computers belonging to the two nurses and finds the complaint letter in question. Both nurses are charged with a felony for "misuse of official information" and fired by the hospital although they have a combined 47 years of nursing experience.
The reality is this: the sheriff believes that doctor Rolando Arafiles, Jr. saved his life during a heart attack, so he is out to defend the doctor no matter how incompetent he is. No matter how inappropriate his actions, or how egregious the doctor's incompetence, the doctor's honor is apparently being defended by the sheriff. Did I mention that Quackwatch.com indicates that Arafiles and sheriff Roberts own a "herbal supplement" business together and that it is common for Arafiles to email his patients and encourage them to buy the supplement? He has also encouraged patients to stop their medication and use his herbal supplement instead?
So, how incompetent is he, if you ask anyone other than the sheriff? Well, his license is restricted due to "irregularities" at a weight loss clinic. He may not supervise physician assistants or nurse practitioners. He once sewed a piece of rubber onto a patient's injured finger for protection (?!?), he has performed surgical procedures without surgical privileges (a skin graft) which failed, and the hospital was in the process of disciplining him when the nurses reported his actions to the state medical board.
Why am I so angry? First, this case sets a precedent that it is ok to be incompetent and practice mediocre medicine as long as you know people who can make the lives of the reporting nurses miserable. However, the far bigger issue is this: this case sends the message that nurses should be afraid to report incompetent physicians or they too will be fired, put on trial and face ten years in prison, all while the incompetent physician will happily continue practicing mediocre medicine.
Do you want a nurse caring for you that will ignore incompetence because of fear of reprisals, or do you want the nurse who is your advocate and can report improper behavior when it happens without fear of a felony conviction?
As nurses, the first duty is to the patient, caring for them and when necessary, protecting them. While doctors take an oath to "first do no harm" sometimes it is nurses who prevent them from doing harm. I've seen it more times than I care to think about in my own practice.
So what kind of nurse do you want? The one who is watching out for you, or the one who is afraid to watch out for you?
Shame on the town of Kermit, Texas for their failure to censure an out of control sheriff and for their failure to support the nurses who cared for them.
Shame on doctor Rolando G. Arafiles Jr!
Shame on Sheriff Robert L Roberts!
Shame on Winkler County Memorial Hospital in Texas for firing nurses who care about patients... and keeping doctors who shouldn't.
BRAVO to Vickilyn Galle and Anne Mitchell. May there always be nurses like you to protect patients from incompetent physicians, especially those who are friends with the sheriff. You are my nursing heroes.
Lee Tilson, at Rethinking Patient Safety has much more to say on the topic.
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Thank you for your insight.
It is reassuring that the truth is coming out.
Anne and I appreciate your concern and look forward to facing her accuser this week.
Please keep us in your prayers, we only ask for truth and justice.
John Cook
Attorney for Anne Mitchell
Thanks for your reply John!
I’m already getting questions about how to support Anne in her legal battle. Is there a legal defense fund established or a letter writing campaign? Her case is clearly touching a nerve with nurses, as it should!
Thank you!
We are not seeking donations directly. However, the Texas Nurses Association and the American Nurses Association, have established a legal defense fund to assist us in defending this accusation.
Please refer to the TNA’s page about this case. It contains good information and has a link to the legal defense fund.
http://www.texasnurses.org/displaycommon.cfm?an=1&subarticlenbr=509
Most importantly, please keep Anne in your thoughts this week. Your support helps sustain her through this terrible ordeal. She knows what she did was necessary and right and she stands by it. I am humbled to be able to represent such a courageous and honorable nurse.
Thank you once again for your understanding and concern,
John H. Cook IV
Attorney for Anne Mitchell
Where is the Joint Commission?
Where is the AMA? The AHA?
The only people who seem to be standing with the nurses in this extreme case are the other nurses and lawyers.
Can we trust those who have been silent in this case to protect patients?
Their silence in this case is deafening.
Just found a video of this character on YouTube. He’s on what appears to be a Christian cable television Program, extolling the benefits of his “alternative” treatments for the similarly dubious condition “Morgellons Disease”. Enjoy.
http://www.youtube.com/watch?v=fZvyfISkl8Y
I can’t believe this story! I hope there is a way to prosecute not only this doctor but also the sheriff. Talk about abuse of his authority! Wow, just wow.
Wishing the best of luck to the defendant…
Saw the story in the NY Times this weekend. Amazing. Just wrong. I contributed to the TNA Legal Defense Fund and urge others to do the same.
I read the NYT article and got really mad too. I’m a nurse and feel it’s and absolute outrage. Already gave $ to their defense. I also really hope that they get aid in pursuing their civil suit against anybody and everybody who aided and abetted this travesty of justice. Don’t mess with Nurses, Texas!
I also just saw this in the NY Times. I am a nurse in California, and I will definitely spread the word about this. You will be in our hearts and prayers, Anne. You exemplify what a nurse should be, and should do. Go into that courthouse with your head held high. We are with you!
It is a sad day for Kermit, a sad Day for Winkler County Hospital and a sad day for nurses and patients in Texas. I am outraged that this nurse who held the position of compliance officer has been charged with felony misuse of official information when it was part of her job to report compliance issues. If the hospital had handled it correctly at first she and her colleague would not have had to write the letter reporting the issues that were of concern.
Nurses are and have always been the patients advocate. Many times we are the only ones who will stand up for the patient in times of budget cuts and hurry up medicine. I am sickened that the hospital administration bowed under pressure and fired these two nurses! What nurse will ever stand up and fight for what is right when they fear loosing their job and possible prison time??? Will we all begin to turn our heads the other way because we have families to feed and bills to pay? Watch out people, don’t get sick and expect anyone to speak up if they see a physician practicing dangerous and possible harmful medicine. This is physician intimidation on steroids! The ANA and the Texas board of nursing should be jumping into this with both feet! These nurses deserve our thanks for having the courage to live and breath the nursing philosophy of patient advocate. Remember we all WILL be patients at some time in our lives.
I am a retired nurse. If I could get to Texas I would go to Kermit Texas and support Anne by sitting in the court room [or outside if there was no room left inside]
Am passing article to every nurse I know.
You, and your family are in my thoughts.
I am watching this case very very closely. The Texas Medical Association allows doctors to practice even if they out right kill their patients. I have had the Texas Medical Association investigate two doctors who killed my husband and the investigator found nothing wrong. Well, I am sitting closely on this one…watching the outcome because if these two nurses will be found guilty,……………I can’t go on, I am so angry. Let’s just say it will be “the bang that will be heard around the world.”
http://www.circare.org/pd/arafiles_20070413.pdf
Mmm, this doc has already had charges filed, on him for poor medicine in the past. He’s not allowed to supervise NP or PA’s because of it.
It might help if you knew both sides of the story before you make such rash judgements about Dr. A.
Nurse 2,
Do you have information that could justify his actions of sewing rubber onto a patient’s finger? Or perhaps you can explain why he did such a poor job of supervising his PA that he is no longer permitted by law to do so? Maybe you can explain why he has attempted to take people off prescription heart medication and sell them his supplement instead? Even better, lets talk about how he is promoting her herbal supplement for junk diagnoses like Morgallon’s? Maybe we could discuss how he does skin grafts (without the right or skills to do so) in a non-sterile environment.
I’d would love to know what you know that would make me change my mind about the medical skill of “Dr. A” and make me willing to send my worst enemy’s cat to him for care.
When I go to a doctor, I expect care, not a sales pitch. I also expect competence. He sounds much better at one than the other. It is insane that someone who does such a poor job of practicing medicine is putting nursing autonomy at risk.
Dear Nurse Anne and Atty John,
I read your story and cry, as it is one I have personally experienced….small town alliances, desperate rural communities hiring on problem doctors,… deaf hospital boards. Shoot the messenger mentality.
Please look at a case involving Dr. Jim Bishoff in Montana.
After years of incompetence, mental illness, drug addiction, sexual inappropriateness and “mercy” killing, he is finally in prison…but at a cost to the many lost lives and ostracized nurse messengers.
Be strong, Anne. The truth is always best, even if it hurts…because then you can live with yourself.
Margaret
I cannot at this time articulate all of the emotions I am feeling. I am truly enraged at the missuse of power by the legal system. To the legal team God Bless you for taking this case. I am sure you were not paid a large fee up front. To the Defendant, as an RN and wife of an attorney I KNOW what you did was right in every sense and did not break any laws. You are an inspiration to all.
This prosecution is outrageous. My wife is an RN and she is livid. We have Nurse Mitchell in our prayers. Good luck to her and Mr. Cook.
And this surprises all of you how? Unfortunately this is nothing new and has nothing to do with right or wrong but is entirely based on power and alliances. In another era I believed that priests, nuns, teachers, lawyers, docs and other power figures were inherently good and that was the way they got their power. Unfortunately, I don’t believe any of that anymore – yes, I am cynical and wish I weren’t and it isn’t because I havent’ been able to achieve anything in my life. I have current licenses degrees and licenses to practice both nursing and law so I have at least been able to navigate the educational system.
Although cynical as it may be, what I have learned in my life is nothing is as it should be in an ideal world and some of us just seem to enjoy “tilting at windmills” more than others or, alternatively, some of us have a more highly developed sense of right and wrong – from where ever that arose.
The perverse aspect of that is that a highly developed sense of right and wrong or a strong moral compass – whatever you want to call it – doesn’t equate to dollars and sense or other outward signs of success.
The charges were based on a M.D. advising patients on alternative therapies? Since when is that a crime or unsafe. Medicine routinely kills 400,000 people a year with their standard practices. It is the imbeciles working in the system that are convinced that medicine saves lives through drugs and surgery. what idiots you all are!
Dear Jon,
Calling names is not acceptable here. This is where grown ups come to talk. We use our kind voices here.
Also, before you call people imbeciles and idiots, perhaps you should actually read the information provided. You would find this is not about prescribing alternative medicines, but practicing medicine outside the allowed scope of practice, and providing an unsafe level of care.
You see, doctors with an MD behind their name can’t just perform a skin graft in the emergency room because they feel like it, no matter how much they might like to do that procedure and have it fail miserably. They actually have to be trained to do so, and they must do it in an appropriate place.
I didn’t realize that skin grafts were alternative medicine, I guess I learned my new thing for the day. In other words, save your alternative therapies speech for when it is appropriate, read before you speak and dig down deep inside and find some civility prior to pushing send.
I’ve been following this story for a while, and the grim spectacle keeps getting worse.
For those who wish to reserve judgment on whether Dr Rolando G Arafiles is a vindictive man trying to prevent public exposure of his behavior or could possibly be the subject of overly aggressive reports, consider the following:
Beyond the fact that the state license board (nursing) requires such reports based upon the Nurses feelings regarding the physician’s behavior (not based on whether the conduct is actually unsafe, as nurses aren’t expected to be doctors nor judge them); and the medical license board similarly requires such reports when it is possible that a patient is receiving unprofessional care (Dr Rolando Arafiles Jr has previously been found to be harming patients and practicing below the standard of care) or a Doctor is demonstrating a pattern of misconduct that may harm his patients.
Further, Dr. Arafiles himself may be demonstrably a quack (though this doesn’t necessarily mean the reports were valid, it does mean it doesn’t really matter cuz the man’s a poor excuse for a doctor anyways). He’s decided to start rallying against vaccines and is selling such supplements as colloidal silver out of his office. He recommends these products, despite not being FDA approved nor the subject of studies showing benefit in his applications, and the patient gets charged much more then they would pay for the same thing elsewhere.
Its a bad sign when your doctor is selling drugs out of the trunk of his car that can be found in no drugstore, and are only available from people opposed to the practice of medicine (radical new agers opposed to medicine and promoting homeopathy instead).
Dr Rolando Arafiles is a quack- he has no research to back up the benefits of his colloidal silver; he recommends patients forgo vaccination, leaving them and their families vulnerable to diseases normally found in the third world; and charges patients ridiculous amounts for drugs he sells himself.
Dr. Rolando G Arafiles’ patients receive third world medical care (only from him will you follow all treatment and advice and still contract measles and polio) while they waste their money on his patent medicines and have their real ailments untreated.
The worrying part is that this arrogant, incompetent Dr has buddied up with the rural small town sheriff and Prosecutor, and he now dispatches them to enforce his ring of colloidal silver scamers/ vaccine deniers.
Not only is the man a quack and far below the standards in medicine today, he’s corrupting the rural government he practices in through his buddies.
Hopefully doctor Rolando G. Arafiles’ would-be patients will come to find the news sites that describe his malpractice and bizarre beliefs, treatments that run contrary to modern evidence-based medicine, and will decide they don’t want a witchdoctor to lower their life expectancy back to what it was in the early nineteenth/mid eighteenth century when even rudimentary vaccinations were unavailable.
Anyone who finds these things hard to beleive, as I did, is encouraged to search for Dr Rolando G Arafiles Jr’s well-publicized malpractice complaints, state medical board rulings, and news articles which list the sources that show this man exchews medicine for snake oil, and lets his patients go untreated while they contract preventable diseases, because he is opposed to vaccination.
Dr. Rolando G Arafiles is a terrible doctor, and is now corrupting the rural government of his locality. Hopefully he will fall victim to the exposure of his tactics- as helped by his own thugs’ over-stepping of the law, and the outrage its caused worldwide.
Whatever happened to whistleblower protection? It sounds like this doctor should have his medical license revoked. And the sheriff should lose his job for misuse of his job.
I have read your story and it saddens me that this continues to be prevalent in the healthcare systems and healthcare professions. It is one I know too well and have personally experienced. Small town alliances, persons placed in positions that do not meet qualifications for specific positions, desperate rural communities hiring on problem doctors, second and third year students performing procedures out of the perimeters and deaf hospital boards. You and your families are in my thoughts and prayers.
I am infuriated!!!! Send the quack back!!! To his third world environment. This is an injustice of biblical proportion!! What if he got his hands on you!! God help us!!!
This story saddens me. I’ve worked both as a nurse and a doctor. I know there are two sides to a story and of course the infuriated ones are the nurses who of course will side with the nurse. My question is where did you get your information that dr.A was telling his patients to stop taking their medicines and switch to herbal medicine? Was this information from the nurses themselves or directly from the patients. I am aware of some doctors recommending supplemental herbal medicines but I don’t believe they would advise patients to stop taking there regular medicines.
There is also something very important that I’d like to ask. These two nurses who had a problem with dr. A, did they ever bother to talk to him directly about their problems when they thought he was mishandling patients. As a nurse, if you believe a doctor is mishandling a patient, shouldn’t you perhaps confront this doctor face to face? Did they bother to do tat or did they just decide to get rid of tins doctor and file complaints. As a doctor, I know the importance of the phrase “do no harm to the patients”. I don’t know dr. A personally, but I’ve never met a doctor who would intentionally harm his patients and I believe dr.a also never intentionally meant to harm his patients.
Doctors are humans too. People should talk to each other if theirs a problem instead of lawsuits. I don’t know ten whole story but all I can say is there ate two sides and what I’ve been reading here so far is one-sided. Anyway PEACE to everyone.
Regarding the rubber and the patient with the wound, could it be possible that the wound was an abscess and the rubber was placed to drain the pus? You don’t suture an abscess…you do incision and drainage. Just a thought.
Regarding the rubber and the patient with the wound, couldn’t it be possible that the wound was an abscess and the rubber was left in place to drain the pus. For pus- filled wounds like abscesses, incision and drainage is sometimes required. Just a thought.
I got fired from saying “is everyone here inbred? Meaning Ignorant/Idiocy. A critical lab of 6/23 on an h/h-was not persistantly pursued for 2 days on a patient. Even tho’ the doctor was called and labs faxed to him-(doctors don’t stay in one position for long) no one thought to bother him. So when I went to work on the 3rd day-off going nurse showed me labs and I said, why isn’t she in the hospital-she needs transfused or she’s going to stroke? Answer? Well I didn’t really know what they really meant. Are you kidding me? And I get fired for my retort? We’re supposed to be advocates for our patients? People are rewarded for bad behavior and nurses with critical thinking skills get screwed. Should report this to the BON?