Not a healthcare background here, but here is my take on it.I remain deeply curious about the role Dr. Flores did or did not play when Justina was admitted to BCH.
Dr Flores is a well-respected physician and a full professor at Harvard Medical School. At BCH, he is not the GI Department head, nor is he the director of the Motility Service. He is the director of Ambulatory Community Services, and an associate in GI and Motility disorders.
Since Justinas symptoms, as reported to the Boston Globe, were largely neurological, it is likely she was initially admitted under the neurology service. The Globe article mentions a large number of doctors were in and out of her room the first few days, so it is likely that GI, Cardiology, the Metabolism service, Psych, and others examined her. I am sure that Flores was not called in the middle of the night when Justina arrived as he was not on call. It is likely that he was contacted to ask about the cecostomy during the day on Sunday. If he had volunteered to take on her case, he likely could have done so at that point. A couple of things could have prevented that:
1) If the hospital administration already suspected abuse and believed he was too close to the case to be objective
2) His primary location is Boston Childrens Waltham about 30 minutes from the main hospital. He appears to spend the majority of his time in Waltham, not on Longwood Avenue.
3) He may not have been on service that week. My childs GI issue is secondary, so GI has never admitted my kid directly. However, if they operate the way at least some of the other departments do, the doctors are on an on service rotation where they take on responsibility for all the GI hospitalized patients for that week. Depending on the size of the department, and the details of the rotation, they may be on service 1 week every 1 to 3 months.
4) If the other physicians, including the on call GI, has already concluded that her primary issue was not GI, there would be no reason to insist that he be allowed to join the case.