Confutata

Dr. Robert Biter (about whom I blogged on May 22 and May 30) has given an interview regarding his suspension, reinstatement and subsequent resignation from Scripps Memorial Hospital, Encinitas.

It appears he gave the interview to refute criticisms leveled by skeptics, but the article raises more questions than it answers.

1. Why did Biter wait until his relations with Scripps reached a crisis point to resign and seek privileges elsewhere?

In the interview, Biter describes a longstanding pattern of disagreements and mistrust between himself and “the old boy’s [sic] club” at Scripps—a situation that makes his decision to leave understandable, if belated.

There have been rumors of his unhappiness at Scripps, and speculations about his imminent departure for at least a year. In an interview given last November to SignOn San Diego, Biter himself proclaimed his intention to leave Scripps to open his own  birth center because “women shouldn’t have to fight for their choices or protect themselves from intervention.”

In the recent San Diego News Network interview, Biter says:

“I knew that I just could not deliver the care that my patients deserve and that I myself needed to provide for these women who have trusted me…”

However, far from ensuring he could provide for his patients, Biter’s sudden resignation after having his privileges reinstated accomplished only two things:

1) It ensured his near-term patients, as well as those needing in-hospital procedures, would suddenly have to make other arrangements for care from other providers;

2) It eliminated a source of income at a time when he is trying to finance the establishment of his own birth center.

2. What’s the truth about the  lawsuits?

According to the article, Biter states that “in his eight years of practice at Scripps, he has never had an obstetrical malpractice case filed against him and has won every gynecological malpractice case filed against him.”

While the first half of the statement may be true, the second is demonstrably false.

Of the five cases filed against him since 2009^[1] , one was recently dismissed at the plaintiffs’ request^[2]. The remaining four are still pending, according to the San Diego Superior Court website, and one is two are currently scheduled for a jury trial, one this fall and another early next year.

Perhaps Biter meant to say that of the closed cases against him, all were resolved in his favor.

Biter might be forgiven for the imprecision of his language, however the reporter evidently neglected to verify his easily-refuted claim.

UPDATE: On July 17, the reporter responded to my comment on this, noting that “Dr. Biter was referring to closed gynecological malpractice suits.”  The San Diego Superior Court website notes two earlier cases, but has no additional information on their disposition. I assume these are the cases Biter claims to have won.

The most interesting question raised by the interview, though, is the one it ostensibly intends to answer:

3. Why was Biter suspended in the first place, and what were the reasons for his reinstatement?

Throughout the interview Biter implies Scripps was pursuing a vendetta against him, and that their actions were motivated by greed.

He says that he was informed of the suspension via a terse phone call from Scripps chief of staff Dr. Ronald MacCormick, who provided no rationale for the action. Notice of Biter’s reinstatement came via a letter circulated to Scripps staff rather than to Biter in person.

If this was the case, it was certainly a shameful way to treat a colleague, and MacCormick and other involved parties deserve censure for such poor handling of a sensitive personnel matter.

However, Biter adds that he received a letter detailing the reasons for the suspension several days after the phone call.

What did the letter say?

We don’t know because either the reporter didn’t ask, or Biter declined to discuss it.

Scripps, of course, cannot comment on the case other than to reaffirm its “long-standing commitment of providing women many childbirth options,” which reporter Jennifer Reed acknowledges, but rather snidely characterizes as “playing defense.”

Of course, patient confidentiality dictates that Biter can’t provide names or details of any specific case(s) that may have prompted the suspension, but he could certainly have spoken of the hospital’s concerns in general terms.

Moreover, when asked about the last birth he attended prior to the suspension, he rightly declines to comment, out of respect for the family in question, but the reporter adds that the family has “been openly supportive of Dr. Biter.” If that is the case, it is curious that the reporter did not seek their comments, or state that they declined to comment.^[3]

And it is more than curious—in fact, it is rather astounding—that the reporter allows Biter to claim in print that Scripps was “on a mission to destroy” him and that childbirth at the hospital is “a political game,” apparently without pressing him for examples, much less proof of his assertions.

In the interview, Dr. Biter was given the opportunity (complete with You-Tube video) to tell supporters and critics alike why Scripps suspended him, why he was reinstated, and what, specifically, he feels is so wrong at Scripps Encinitas that he could not stay on long enough to care for his patients with the most urgent needs.

He didn’t. Instead, he lodged vague and unsubstantiated accusations against Scripps to a reporter who appears either credulous or incompetent.

1. 1. Since my initial posts on this topic, an additional malpractice case has been filed against Dr. Biter. Sarah Holder v. San Diego Fertility Center was filed in San Diego Superior Court on June 29, 2010, naming San Diego Fertility Center as the primary defendant, with Drs. Biter and William P. Hummel, and Robert M. Biter MD, Inc. as co-defendants.
2. 2. Jamie N. Wiest v. Robert Biter, M.D. was dismissed with prejudice (meaning it can’t be refiled) on June 2, 2010 at the request of the plaintiffs. This may mean either that the plaintiffs decided to drop the case entirely (perhaps because they realized it was unwinnable) or that the parties reached a settlement stipulating the action.
3. 3. In fact, in a May 14, 2010 San Diego News Network article, the same reporter (Jennifer Reed) had already detailed some of the specifics of this birth, as related to her by Biter supporter Carol Yeh-Garner, including the facts that it was a cesarean section, and that the baby had suffered meconium aspiration, requiring a stay in the NICU. She also wrote that that the baby was doing well, and that the parents, who, although they could not “could not be reached for comment,” were said by Ms. Yeh-Garner to be “shocked and distraught” over Dr. Biter’s suspension.

Img. adapted from "Do you find my brain" by alles-schlumpf & "Music-dissonance" by Denelson83, under CC-BY-NC-SA

Looking at the stats for this blog, I noticed that the top Google searches for the past week all involve Dr. Robert Biter, about whom I blogged on May 22 and May 30.

I’m not surprised, as it seems the Biter story is still going strong. A supporter has written two blog posts for HuffPo, and fundraisers for his birth center are being listed almost weekly on the “I Love Dr. Biter” Facebook fan page.

In all the discussion, I’ve  noticed some commentary that very neatly exemplifies the kind of cognitive dissonance that seems to occur whenever people rely too heavily on personal anecdote to form opinions or prove a point.

Many of Dr. Biter’s supporters talk a great deal about  empowerment in making choices about childbirth, however their unwavering support for him–and especially their excoriation of Scripps–is anything but empowered given the lack of much factual information about Dr. Biter’s problems with the hospital.

Quite a few of his fans have very nice stories of their experiences with him, which seem to form the basis for their noisy condemnation of his initial suspension from Scripps and demands to have him reinstated. Perhaps this is why some supporters seem more interested in the personal  motivations prompting skeptics and critics to comment on his saga than in the few verifiable facts surrounding the case.

Abi Cotler O’Roarty, the author of a glowing HuffPo blog post on how Dr. Biter helped her overcome trauma from a previous childbirth, wrote on the “I Love Dr. Biter” Facebook fan page:

“Ok, couldn’t resist finally calling out insiders and haters on the Huffington Post comments. Don’t they realize how funn yit [sic] looks that they, who’ve never even had a bad experience with Dr. Biter (or any, so far’s we can tell) are soooo interested in maligning him? Ach, money can be a big motivator. I’m glad we are suc…h a strong community now to drown out the lower vibes:)” ~ (posted June 10, 2010)

But wait… look at what she said a few days earlier to a commenter from Canada who wrote that she had been following the story from afar, and that Dr. Biter “appears to be…’Dr. Wonderful’”:

“Thanks Pam, we feel you all the way from here! If you have a second to pop up on the HuffPo I think it would really help people to see that this is not just a local issue by any means. I can not believe how many women our Dr, [sic] Biter stories resonate with!” ~ Abi Cotler O’Roarty (June 5, 2010)

So if someone who has never had any experience with Dr. Biter comments positively, it’s okay because it “resonates,”  but if someone comments critically it’s “funny,” and possibly motivated by money?

Moreover, the “lower vibes”  Ms. O’Roarty claims to be “drowning out” are actually questions and criticisms–some valid, some not–of Dr. Biter or his supporters. The only “vibe” I get from this is fear of dissent. That doesn’t line up so well with the empowerment Ms. O’Roarty claims to care about.

Here’s another supporter’s comment on the HuffPo piece:

“Why I personally am 100% on Dr Biters [sic] side even though I don’t know details are this:
I did alot [sic] of research on labor and delivery and wrote out a 1 page Birth Plan. I had to actually FIGHT (during my unmedicated labor) my first OBGYN to deliver my first child the way I wanted to. . . . That is why I logically & intelligently (and not blindly) support Dr Biter.” ~ mybabysmommy (June 11, 2010)

Sorry, but taking such a firm position without knowing “the details” (read: the facts) is indeed blind support.

Yet another commenter’s riposte to critics sums it up nicely:

“It’s amazing the time and energy you two have put into researching and commenting about Dr Biter. What are you getting out of it? Your opinions have not changed anyones [sic] minds with the people who believe in him. You two- men or women really need to get a handle on your lives and get over Dr Biter.” ~ amazedfor all (June 11, 2010)

Opinions may not change minds, but facts should, when they contradict beliefs. The notion that the facts presented by critics wouldn’t change the minds of “people who believe in [Dr. Biter]” says little about the preoccupations of critics, but much about the critical thinking faculties of the commenter and those he/she claims to represent.

Dr. Biter himself, rather than address questions,  elects instead to attack his critics in the HuffPo comments with ad hominems and ham-fisted insinuations about critics’ motives.

Dr. Biter claims that he “would welcome a more extensive investigation” (although he has yet to provide either critics or supporters with any substantive information about the reasons for his or Scripps’ actions, except to talk in vague terms about Scripps’ alleged persecution of him.) It seems, however, that he and some of his supporters just want critics to shut up.

How empowering is that?