Doctors Behaving Badly: Cornered doctor turns on nurses, with the help of a friendly sheriff

Nurses have one of the toughest jobs in health care.

Anyone who has delivered a baby in a hospital knows how much work they do, only to see all the credit go to the doctor who comes in for the final few minutes. How many photos have you seen of a nurse holding a brand new baby?

When things go badly awry, the nurses are often the first to get fingered (sometimes rightly so, as expertly described by Tracy Weber, Charles Ornstein and Maloy Moore in their series "When Caregivers Harm.") It is nearly a "never event" to find a nurse with enough confidence to actually accuse a doctor of doing something wrong.

Dr. Rolando Arafiles in the tiny town of Kermit, Texas, found himself the rare target of a nurse whistleblower. Two nurses, in fact, filed an anonymous complaint with the Texas Medical Board accusing Arafiles of using his medical office as a sales office for his herbal remedy business and of stealing hospital supplies. Arafiles was no stranger to the medical board. In 2007, the board issued the following:

On April 13, 2007, the board and Dr. Arafiles entered into an agreed order requiring that he complete additional continuing medical education in the areas of ethics, medical records and treatment of obesity; prohibiting him from supervising physician assistants or advanced nurse practitioners; and assessing an administrative penalty of $1,000. The action was based on allegations that Dr. Arafiles failed to adequately supervise a physician assistant and failed to make an independent medical professional decision about the protocol developed by the owner of the clinic.

Arafiles didn't take this latest complaint lightly. In explaining to the board what Arafiles allegedly had done, the nurses used anonymous identifiers for six patients. The hospital, being a very small operation, did not have many nurses who would have had access to this information, and it did not take Arafiles long to discover the nurses' names: Anne Mitchell and Vicki Galle.

Arafiles called the Winkler County sheriff, who happened to be a patient of his. Soon, the nurses found themselves fired by the hospital and indicted by the Winkler County Attorney for allegedly breaking Texas Penal Code 39.06, the misuse of official information.

Sound innocuous? It's a third degree felony that carries a maximum 10-year prison term.

The nurses aren't giving up, though. They have filed a lawsuit against Arafiles, the hospital and the county. Perhaps somewhere in all of these proceedings the truth about Arafiles, good or bad, will come out.

Even if he was intending nothing more than to protect his name, Arafiles has performed an invaluable service for dastardly doctors everywhere. Nurses now know their place. If they don't shut up and do as they are told, they might be hauled off to the pokey.

Watch for my interview with Clair Jordan, the executive director of the Texas Nurses Association, on Friday.