3 min read

A Thousand Cuts: the Lingchi within Dr. Velazquez vs. UMiami

Lingchi is the execution process of slowly removing body parts until death. Very few people have experienced it, and I can't say I'm one of them. However, I can assure you each cut fires off pain neurons. After all, I scream like a 4-year-old when my toe encounters a stray table leg.

Just like each cut builds up to death, each unhealthy interaction led to Dr. Velazquez suing University of Miami. The unfortunate truth is that each piece of evidence is probably not enough for a lawsuit. However, many individual parts of Dr. Velazquez's case are present everywhere.

I'll break them down into patterns where you can start recognizing each piece, acting on it, and potentially even building them in a story-worthy case.

Different Payment Structures

Dr. Velazquez was the Surgeon-in-Chief and reported directly to the Dean of UM and the CEO. That's as high as it gets.

Dr. Velazquez had quantifiable results due to her performance while Surgeon-in-Chief at UM.

  • she increased the rank of UM's Surgery Department from #27 to rank #11
  • she brought in copious amount of funding. For example, she played the chairperson role culminating in $7,000,000+ raised in 2022
  • she was inducted into the National Academy of Medicine

So, she should get compensated heavily. Right...? Unfortunately, her compensation was calculated differently:

  • her base salary was lower than her predecessor, peers, and some subordinates
  • her bonus was calculated on a portion of her overall compensation (opposed to 100% like her male peers)
  • she was unaware and misled of certain incentive programs that her peers were able to take advantage of

If a superstar Surgeon-in-Chief like Dr. Velazquez can be systemically underpaid, anyone can! Even though she had stellar results and accolades, her compensation (backed by hard evidence) was lower than that of her peers.

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If a superstar Surgeon-in-Chief like Dr. Velazquez can be systemically underpaid, anyone can!

Different Evaluation

Dr. Velazquez went into her 2022 review looking for a raise to squash any previous compensation inequities from previous years. She ended up with the complete opposite result – a performance improvement plan.

Dr. Velazquez had outlined her accomplishments according to UM's own templates and Faculty Manual. She had meticulously prepared her promotion packet and had supporting evidence for her pay raise.

The docket outlines that UM changed evaluations specifically for Dr. Velazquez. In particular, UM:

  • eliminated involvement from UM Faculty Affairs Office and Faculty Senate
  • excluded global input by eliminating the survey process
  • initiated her review one year earlier than the typical 4-year schedule

Same Action; Different Reaction

One component of the discrimination charges are towards Dr. Velazquez's protected activities. These protected activities are meant to allow reports of potential medical and legal violations to medical boards and reporting agencies.

Some protected conduct that Dr. Velazquez participated in:

  • escalating concern regarding 15+ improper Code 15 reports (a.k.a. "never events") involving Dr. Merchant. Some involved gross medical error, ethical violations, or procedural violations.
  • reporting an incident regarding Dr. Parekh trying to force a physician to open an understaffed clinic on a Sunday morning
  • reporting inequitable, protocol-breaking denial of medical recredentialing for Dr. Leon (a fellow Latino surgeon). Dr. Parekh co-lead the committee in charge.

The plaintiff believes UM retaliated against her due to these protected activities with PIP, recredentialing resistance (against her), and other aggression. For example, she was told that she "wouldn’t want to die on this hill" when defending Dr. Leon during his recredentialing.

What you can do

Dr. Velazquez has a case because she has data from publicly available Form 990 and the UM Faculty Handbook. Better yet, she has kept records of communication surrounding her compensation, protected activities, and promotional campaign.

I hope physicians will use this as a canary in the coal mine to start taking action in their own jobs. Again, even a Surgeon-in-Chief struggled getting "market rate" and proving their worth.

However, not every physician has access to evident data or how reviews are standardized within their institution. What can you do then?

  1. Ask your peers about their compensation. It is exceptionally hard to source data points regarding salaries (especially when scoping to location, patient volume, and specialty).
  2. Clarify bonus incentives in writing. Set goals, find exactly how you'll be compensated for your performance, and make sure your employer keeps their word. It's easy to not follow through with a deal that does not exist.
  3. Keep a record of your accomplishments. It's hard to remember them all when evaluations come around.
  4. Collect written record of anything pertaining to salary, bonuses, and activities that might rustle feathers.

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