Dallas Has a Real-Life Dr. Gregory House in Dr. Richard Buch

Through his attorneys, Buch declined an interview request by the Dallas Observer. Many doctors associated with him and physicians who have treated his former patients refused to talk about him, referring requests to their lawyers.

But voluminous court records and interviews with former patients paint a picture of a highly skilled physician trained at some of the best hospitals in the United States.

And a jerk.

A former co-worker describes him as "Archie Bunker": blunt, condescending, prone to cursing and making sexist or racist comments. When things go wrong he's known for screaming and calling nurses "idiot" or "fucking stupid."

Buch's bedside manner can be atrocious—labeling a patient "candy ass," for example—and his follow-up has been called poor by hospital administrators. When he loses his temper in the operating room, Buch often hits people with his hands or instruments, a move he calls "Buch caning," the former nurse claims.

"He has the patience of Job when he is trying to put something together in somebody," says his former nursing colleague. "But he has no patience for people. If you hand him the wrong thing, he'll flip out."

And he'd disappear.

"There were a lot of times he was unreachable," says the nurse. "He liked the surgery part but not the post-op."

Few nurses, however, will file complaints against powerful surgeons who use a hospital's operating rooms and bring in revenue.

Three patients who filed unsuccessful lawsuits against Buch wish they had known that physicians at the hospitals where they were treated had serious qualms about Buch's behavior.

If a committee of doctors deems that a physician isn't fit to practice in their hospital, shouldn't consumers be informed?

Plump, blonde and vivacious, Bajadali pulls up a leg of her athletic pants.

"This thing really screwed up my whole life," she says, showing the deep scar that snakes from her left ankle up her thigh.

After her first surgery, performed at Medical City in 2002, Buch explained that he had removed bone chips, but Bajadali's injury was more extensive than he had first thought and her leg was too swollen to operate again. He sent her home in a full plaster cast from her hips down, saying he'd do follow-up surgery after the swelling went down.

As the swelling subsided, the cast started irritating her skin. A woman at Buch's office recommended pain pills. After several weeks, Bajadali demanded to see the doctor.

"It was like it was a bother," her husband says.

When Buch removed the cast, Bajadali was shocked to see it had rubbed against her skin and destroyed a hunk of tissue on her knee.

Buch ordered another cast, advising Bajadali to use padding and Vaseline to soothe the wound. Four or five days later, he operated again.

"When I came out of surgery, there was a huge hole in my leg," she says. Three days later she left the surgical floor; during her remaining nine days in the hospital, Buch did not check up on her in person.

After Bajadali returned home, the gaping wound, which she describes as the size of a golf ball, became infected. In terrible pain, she twice went back to Buch, who insisted it would heal.

Two weeks later, Bajadali sought another doctor. He referred her to a wound doctor in hopes it would heal. Finally, after 28 weeks, the second surgeon took a calf muscle and pulled it up over her knee, then grafted skin over the wound.

No longer able to sit for extended periods, Bajadali lost her job and health insurance. She filed a lawsuit against Buch in 2004 but discovered the X-rays taken at Medical City had disappeared. And Buch's neatly typed medical record—produced for her lawyer and identified by a note as a "clean copy"—said very little.

Eventually her lawsuit was dismissed by a judge because her lawyer could not find an expert witness who was willing to testify—based on the "clean" medical records—that Buch had done anything wrong.

"He didn't keep good medical records at all, period," says his former nurse. "There were times he'd ask me, 'Do you remember this one?' We would have dozens of charts sitting there, and they didn't get done until several days, a week or more. When he dictates it two weeks later, he'll do it the way he wants to remember it."

Buch's lawyer Kelly Reddell says that Buch "categorically denies that he would wait days or weeks to write up charts."

In 1999, when Mary Mote saw Buch for a consultation about a hip replacement, she saw lots of pictures of family and diplomas on the walls of his office. One of Buch's patients, a nurse, had recommended Mote go to him for the procedure.