ASHRM stands behind fired risk manager

Retaliatory firing of a risk manager for reporting regulatory infractions is outrageous but not unheard of, says Dan Groszkruger, JD, MPH, CPHRM, DFASHRM, risk manager at Stanford (CA) University Medical Center and a board member of the American Society for Healthcare Risk Management (ASHRM) in Chicago.

Speaking on behalf of ASHRM, Groszkruger says the case of Margaret O'Connor, the risk manager suing her former employer for what she says was retribution after reporting an EMTALA violation, is troubling. Groszkruger acknowledges that O'Connor's complaint is only one side of the story, and Jordan Hospital has not been proven to have fired her for whistleblowing. Nevertheless, he says the scenario outlined in O'Connor's complaint is believable, and she wouldn't be the first risk manager punished for doing her job.

"I can verify based on my own personal experience that this is not exactly unusual," Groszkruger says. "One task of the risk manager is to protect the organization's resources and finances, and the mandatory reporting scenario is almost bound to do harm to that. It's a potential conflict, because the risk manager has to wonder if they're going to shoot the messenger."

Groszkruger notes that once the EMTALA violation occurred, it appears O'Connor did all the right things and even went further than strictly necessary to confirm that the case was reportable, he says.

"If her allegations are all provable and factual, she really got the shaft for doing the right thing," he says. "Reading the complaint and assuming this to be an accurate description, we would find someone who was terminated for doing this to be appalling, just about as troubling and worrisome as anything you could imagine. If indeed the decision to terminate was based on going ahead and reporting this, it's wrong. It's absolutely wrong."

Groszkruger says the description of the patient provided by O'Connor suggests she was right in concluding that the incident was a reportable EMTALA violation.

"I certainly couldn't see anything based on these allegations that would lead you in a different direction," he says. "It's almost an obvious violation."

ASHRM has been focusing more on professional intimidation, Groszkruger says, trying to offer its members support or advice when placed in these difficult situations. Much of the intimidation is less direct than firing or any overt punishment, he says.

"A lot of it is along the lines of 'I'm going to make your life miserable if you report me on this,'" he says. "It interferes with transparency and disclosure to the patient and family, let alone turning yourself in to regulators."

Groszkruger urges risk managers to turn to their colleagues in the field when faced with professional intimidation, partly to realize that they are not alone in facing such a dilemma and partly to seek advice on how to respond. ASHRM encourages risk managers to take the high road even when pressured, he says.

"I don't think this kind of conflict is something on which you can waver," Groszkruger says. "We're talking about what's right and wrong, what is honest or dishonest, what is the truth or a lie. When you get into that category, you're talking about integrity and self-respect."


• Dan Groszkruger, JD, MPH, CPHRM, DFASHRM, Risk Manager, Stanford (CA) University Medical Center. Telephone: (650) 725-4061. E-mail: