Friday, February 24, 2006

More Tapdancing 3/5 +

J.R. was there, we were there, where was Andrew? J.R. Lindsey, the current director of ???, made a pitch Tuesday night: Everything is better. Do you find it so?

Mr. Lindsey has two projects, E$$ENTially, PACS and voice transcription. Hopefully, at least one will make it to fruition.

One locum (temp)radiologist that is unable/unwilling to use their PACS, would prefer to have his CTs on film, and is unable/unwilling to do interventional studies. (At least he recognises his limitations and doesn't attempt it with liquid courage.) The other rad apparantly has an aversion to reading plain films...the rumor is he's already been fired...everything is meshungina.

Radiology is a diagnostic tool that we cannot afford to minimize, which the administration apparently has. Studies that we need and that are unable to be performed on in-patients require one of two things: transfer to a facility that can do them, or bring in a radiologist that is qualified.

Reports were processed within an hour...but, having spent a million dollars on a PACS, hiring two additional transcriptionists, and pulling overtime restrictions, would you expect less? Would the results have been any different with the Red River group, given those resources? And, how long before the emphasis returns to normal with staff levels and overtime? (Tokhis oyfn tish, bubbala.)

But, radiology wasn't the only subject raised. The hospital is contracting for some services that are out of network for some of the largest insurers in the area. In one case, the very same lab was used by the urology clinic and the hospital. With the clinic, it was in-network, with the hospital, it was out. Go figure. The billing for the Emergency Room physician is listed as out of network for BC/BS, another major carrier in the area.

But, what strikes at the heart of the matter wasn't even brought up as an issue: The hospital apparently files liens against its patients, insured or not, dropping them only when the bill is paid. They might lose cars, property, and bank accounts. Only homes are exempted, as this is a homestead state. The hospital with a heart ...pickled in a jar ....their pound of flesh.

31 comments:

Anonymous said...

JR LINDSEY?!?!?! Giving assurances that "everything is okay"?!?! OHMYGOD, way to go Andrew, sure shores up my FAITH in you-OH YEAH! Going after other insurers? Hmmm, do they have billing problems that they plan to fix by adding insult to injury? Radiologists that truly ARE PRIMA DONA'S? Serves the buggers right, and they thought they had it bad with RRR, yes higher end exams pay more when read, but also the plain films were read with the same diligence! DER! Fired the Long Island Doc, more like he let 'em know New York style what our Director could do with the poor stab at a professional PACS set-up. Liens, now does that REALLY, REALLLY surprise anyone with regards to Essent??? I think not, simply another perverse bend to their nature! And Andrew NOT at the meeting........that's not surprising either. Or maybe his Gen. Patton costume had to be picked up at the dry cleaners.

Anonymous said...

THIS ought to bring the Baylor folks/friends to their KNEES with laughter. Can anyone say Keystone Kops???? HA HA HA!!

Anonymous said...

You have got to give JR credit. He faced the masses. That takes guts.

He's also managed to wade through the corperate BS without getting a drop on himself.

He also managed to climb the corporate ladder, without climbing into bed with administration.(Purley a figure of speech there. No one would actually do that -would they?)

Anonymous said...

PRMC will have to look for a long time to find rads as good as RRR. Not only were they good, they were concerned with patients and bent over backwards to offer the best, most professional service you can find. I don't believe that I ever saw a pseudoaneurysm after RRR did an arteriogram or other intervention, but you can't say the same thing about the cardiologists, they've had more aneurysms than you can count because their time is too valuable to spend holding pressure on an artery. The hospital wasn't thinking about patient care when they allowed the cardiologists to do peripheral vascular interventions. I seem to recall the head cardiologist state "I only have so many years to work and I have to make all the money I can". That makes me want to lay down in the cath lab....NOT!!!!
granger

Anonymous said...

In my opinion, JR is all flash, no substance. He dodges any mud by being two-faced and telling people what they want to hear, then stabs them in the back. I couldn't wait to get away from him and his "management" style. He truly defines the Good Old Boys mentality.

Anonymous said...

Pursuing the liens, since they are public record, I think that wandering down to the courthouse might be in my future!
Having an attachment on my personal property isn't my idea of service to the community!
Does either Clarksville or Bonham do that?

Anonymous said...

Patton uniform---What do they go by, Andrew's Raiders, the Dirty Dozen, or the Lost Platoon?

They're teaching TEAM BUILDING????

Anonymous said...

I know you are bitter. Your right, RRR did a great job, and they cared about their patients, but you can't say that about the whole cath lab because of a cardiologist. I know some of them who are very good, and care a great deal about their patients.

The sheaths were sometimes pulled upstairs by nurses, after they had had blood thinners for hours, and sometimes they were pulled in the cath lab by techs. One of the big problems was then the patient had to go to the floor, and the nurse had too many patients, or a high acutity of patients, the site may be overlooked for a while.

I think the cath lab was based on good intentions, and many good things came from the cath lab.

PRMC is making a huge mistake for letting RRR go. They are making a huge mistake in ignoring retention efforts for their employees. Especially with the nursing shortage.

If you let quality go to get a buck, you are hurting yourself in the long run. The people of Texas don't take it too well either. They are shooting themselves in the foot.

Anonymous said...

All too often the cleaning up of pseudoaneurysms fell to the radiology folks, when the cardiologists faded off into the distance (spelled D-a-l-l-a-s.) Look at the charts.

Anonymous said...

I know what you are saying about the psudo-aneurysm. And I did look at those charts. I know who cleaned them up, but how can you blame a cardiologist for it, when he did not pull the sheath? I never saw a cardiologist around when a sheath was pulled.

Could anyone ever link these psudo aneurysms to one doctor? One nurse? One tech? I don't think so. It could have been caused by the cardiologist if it were his technique, such as selinger techniqe. ( I probably didn't spell that right but you know what I'm talking about)

It is a risk you take when having this procedure done. I'm not taking up for anybody, and I know as well if not better than anyone that there are good doctors, and then there are business men. Not many are both. Actually I can't think of any that are.

Yes dear, believe me, I'm mad too, at what Essent has done to me. I've been mad at cardiologist that don't care, but that doesn't include all of them.

It's kind of like saying that the whole ER staff is bad because of what happend to one patient.

It's just hurting people that could eventually pull together to make a good team later.

I do believe we will get that chance again.

Anonymous said...

this whole site is just alot of BS. I see your views, but only someone so pissed off, someone from th RRR personnel. The RRR would probably have been the answer to the Radiology problems, but they cant handle it all. Just go on with you businness!!!! Let the "Big Dogs" in charge dig their grave. This is just alot of heresay dogging everyone. Its just obvious that RRR is so pissed off at the hospitl administrtion that they have to do this. Yea..... it may be a mistake, but let them ride the wave and learn from their own mistakes. I have been here a while, and have seen so much BS that I have never, ever, or would want to ever see in my career. Backstabing and lying from administration is uncalled for, but what do they care... only about $$$$$$$$$$$$$$$$$$$$, which is the most important factor to them, Equipment breaking, personnel gone to ignore pts, lights going off for assistance just for some H2O. This is absolutely the biggest joke of a hospital that I have ever been involved with. The "Big Dogs" need to start having a taste of their own medicine... do you think they would come to PRMC for evaluations, checkups, or test????? They know better!!!! I am here to take care of pts. not listen to a bunch of BS about who is doing what. It will all show in the end what is best for the hospital... but until then.... SUCK IT UP.... let them do what they can do!!!!!

Anonymous said...

Excuse me for a second... Okay sorry, I'm back.. I just had to pause and laugh at what you guys think you know.

It's funny how one only sees one side of the story or how the author, who obviously has ties to RRV, can twist things around to suit his needs. I can't say that I blame them really. After all, we're all here to make money aren't we fac_p or should I say Dr. Haas?

Ich weiß, wem Sie sind!

Anonymous said...

JR, yep, climbing into bed with administration--a time honored tradition--with a financial motive?

Anonymous said...

I'd have to say that RRRA was there for the long haul, and yes, to make money. Can't see Essent for the distance. Lot of the players they have were from Healthtrust--if you notice--sold to Columbia/HCA.

Nothing on the signs even identifies the hospital as part of Essent (in any of them--look and see for yourselves.)

Slash and burn, turn and earn.

Anonymous said...

...if it looks like a duck, quacks like a duck, s#### like a duck, it must be E$$entially, a duck.

Anonymous said...

So is it Haas, and he wants you to think it's not, or is it someone else, wanting you to think it is? Or, is it Haas, wanting you to think that it wouldn't be Haas because he let the post go, or is it someone else, wanting you to think....this can get involved!

Anonymous said...

Oh! So it was the responsibility of the ICU nurse or tech to hold pressure on the artery? That makes me feel better. Someone is putting a 9Fr hole in my artery and walking away to allow someone else to take the responsibility if I bleed to death. Maybe they should pay the cardiologist to close the holes then I bet, they would stay.
granger

Anonymous said...

I just think there are ways to fix the issues instead of name calling and blaming others. This site could be useful instead of hurtful.

Yes, I am an ex-employee of PRMC. I didn't agree with staffing, and other things. Nurses would come to me with problems, but not back me up when I spoke out (sometimes in their behalf.) I was seen as a trouble maker. I finally quit.

I do think people were afraid to speak out against what was happening. I think they feared loosing their job, and I think their fears may have been founded.

But that is what I think. What I know is there are some cardiologist that are Pt. advocates, and good doctors here in Paris. I also know that J.R. was fair to me personally.

What I think I know, is if people would pick issues, such as staffing, and saftey, and what's best for the community, and back each other up on these issues. Stick together and fix it, we could actually have a decent hospital. Addressing burn out, and helping the employee through it, instead of helping them through the door, would help as well.

Anonymous said...

I'm slow here. Some of this reads like Nostradamas Quatrains, and since we don't know the identity of the posts,we can only speculate who they are.

I keep wondering why someone would go after the heart program, in such a negative way, and I think I've figured it out. The cath lab is a huge money maker for the hospital. If you attack it, divide and conquer, and destroy public confidence, you could basically destroy the hospital.

Interesting chess move.

But developing a distrust in the hospital staff and the public is a bad idea. For one reason we will mostly still be here when E$$ent is gone. And we all know its coming.

It's going to take a tremendous amount of undoing, to fix it with the public as it is.

Another reason why not to do this, is because when E$$ent does decide to sell us, nobody worth a s*** will buy us, because we are too much of a risk.

I think we really need to step up to the plate here, and start looking for answers instead of causing more problems.

givemeabreak74 said...

Yea lets not worry @ the standard of care we give these patients; but we need to line their pockets. The h**l with this...

Anonymous said...

"The people of Texas don't take it too well either. They are shooting themselves in the foot."

As long as these people who "shoot themselves in the foot" dont end up at PRMC ER they should be fine.

I dont believe that Clarksville or Bonham are into filing liens, as they are as far as I know not-for-profits.

As for this being a Pro-RRR site, not at all...its Pro-Community, Pro-patient, Pro-Paris, Pro-local nurses, Pro-local doctors, and Pro-good patient care....Just getting the info out there for others. I for one appreciate a greater insite in to the hospital workings as I don't have the time to worry about it while on shift. Those heavy nurse-to-patient ratios don't leave you too much time these days to worry about anything but patient safety. We even have to leave our charting until after report most days. But whatever it takes, we're just out there doing the best we can, hoping it will get better....it definately can't get much worse.

Anonymous said...

Well, the pot has certainly been stirred... and what a brew it is!

I’m sure the doctors of RRVR have better things to do with their time than orchestrate this blog site...

...since they are busy doing what they do best...

...providing the highest QUALITY of X-Ray interpretation

...IN THE COMMUNITY ...AND FOR THE COMMUNITY!

RRVR (and let’s be clear on this as there is some confusion... RRVR is the radiology doctor group, a Professional Association) is contracted by other companies to read radiology exams, including Radiology Center of Paris and Magnetic Imaging of Paris as well as formerly PRMC. Their business is to read MRI’s, CT’s, Ultrasounds, and Digital X-Rays, and ...Opps! They’ve done it again (a la Miss Spears)! Introducing new technology to Paris… DIGITAL Mammography! But obviously the ANONYMOUS person posting at 12:07 am does not have a clue!

It must be easy for E$$ENT to believe that RRVR has a hand in this blog... after all E$$ENT is certainly doing everything they can for.. or rather TO the community. Let’s see, how many nurses have they ran off to Dallas and other regional hospitals (50 job openings posted on their web site and counting)? What about Anesthesia, GI, Radiology (12 MD’s that have left)! Apparently the entire Cath lab also recently threatened to quit! ...Do ya think that “something may be rotten in PRMC"? Opps! ...I meant to say "Denmark!"

I’m sure Dr. Haas and the other members of RRVR are flattered to be considered as potential fac_p contributors, but once again you ASSume, and E$$ENTially draw a wrong conclusion based on incomplete information. This brings to mind other recent blunders by the E$$ENT administration including Powerscibe digital dictation, forced on the radiologist, Opps! It doesn’t work! And how about the new Amicas PACS, purchased by E$$ENT corporate without radiologists input.. the equivalent of buying a car without a drivers license! Well, at least E$$ENT is consistent...

...consistently wrong that is!

Do you think you could pull your head out of the sand long enought to look around and see what is happening to medical care in Paris???? It’s not “what we think we know” but what is obvious to everyone in this community except E$$ENT!

By the way, you should also check your other “facts”, as the correct phrase is “Ich weiss WER Sie sind” translated “I know who you are” which is E$$ENTially another incorrect ASSumption on your part!

Anonymous said...

My, my, my.....looks like some buttons were hit with this posting! But that is a good thing. And I believe that everyone that posts here knows, that whether the entities are whom we think they are or not.......it allows personnell AND the community to vent THEIR opinion. There are going to be sides taken, but I doubt much will be on the Essent side for sure. Yes, RRR is a business, but they sure have a heck of a lot more heart than Essent has shown! AND a valid interest in this community. When a group of individuals takes the end liability with the types of exams RRR dealt with, they ABSOLUTELY had and have the right to voice concerns to management, expect certain protocols to be adhered to, etc,etc. If the Techs were doing a sloppy job, they needed to be told so. AS well AS Management. But then again, with Essent the truth is NOT to be heard. We now are under unknown Rad's, with no recourse for the Techs OR Physicians to build a professional relationship with. Another hole in the "patient care" umbrella. So, personally, I don't care who fac_p is, I am very grateful that this blogsite is available for not only those of us suffering under the tyranny of Essent, but for the community to view and realize that they should seek health care in a more sound and safe environment.

Anonymous said...

I don't care who fac_p is. At least here we can say what we want without fear.
By the way, I checked with my German friend and you said it wrong: "It's incorrect.
They wanted to say: "I know who you are"
Which would mean: "Ich weiß, wer Sie sind"
That being the nominative (or first) grammatical case.

They used the dativ ( or third) grammatical case, which most likely comes from a bad habit that quite a number of Americans have, namely over-using the word 'whom' when they actually want to say 'who'."

Stick to English, Andrew.

Anonymous said...

SOMEONE obviously really has a yen for Haas, don't you think. And obviously, again, RRR is the root of all evil..........I think not folks, get a clue, wouldya???

Anonymous said...

Apparently the highest bidder for this hospital, originally, was HCA, not E$$ent. One reason they did not succeed was the board.

HCA wanted to dissolve it, E$$ent indicated that they would leave it intact. How much of the selection was left to the board?

Kind of like the welfare system. A candidate says he will discontinue welfare and the welfare recipients are voters. The analogy might be apt as well.

Anonymous said...

There are plenty of nurses in Lamar County to staff the hospital. Many are certified in their area of Nursing.

Have you seen the Ad in the paper. The heart of healthcare begins with nurses? They want the nurses to come home to a special reception.

Recruit all you want. Give sign on bonuses all you want. If you aren't interested in retention, it is putting a band-aid on the problem.

Are you going to float these nurses that sign on to places out of their comfort, and saftey zone?

Are you going to listen to these nurses about saftey issues, legal issues, staffing issues? The way I have seen administration dealing with these issues is deal with it and do the best you can. If nusing directors of thier department bring questions or concerns, they seem to be gone.

So we have new nursing leadership. Are they in a position where they can speak out on saftey, legal and staffing issues. Or are they so new to the position, they are just happy to have finally climbed the ladder, and keep their mouth shut. Do they advocate for thier patients?

Do they advocate for their staff?

Are they burned out and just so happy their names won't be on the charts anymore? Are they yes men, and just go along with any said?

CEO's are concerned with money. It is up to nursing leaders, and directors of departments to educate them on saftey and legal and staffing issues. Otherwise, they don't have a clue.

They think a nurse is a nurse is a nurse, and they should be able to handle 10 pt's with q15 min visual checks, and aortic balloon pumps, and triage, and delivering babies, and float to each place without diffaculty.

If the leadership and directors can't speak up---if they are browbeaten and seen as troublemakers--if they themselves don't know--don't care, or are just happy with their new paycheck and don't want to rock the boat, where is the good in recruitment.

You won't keep your staff if they are afraid for their license. You won't keep your staff if they are so burned out from short staffing. You won't keep your staff if you don't listen to them.

PRMC---WAKE UP!!!!!!!!!!!!!!!!!!
Sign on bonuses, and increase in pay may get the nurses. But it won't keep them.

Anonymous said...

So much for RADIOLOGY this weekend! Getting a report was a real joy. We had three nurses listening and couldn't make out heads or tails. Couldn't even understand the patient's name! The doctor was asking for a written report, and if a transcription will ever be available, it will be a miracle. No wonder they sent flowers! Should have been chocolate, and a lot of it!

fac_p said...

Had a good emailed suggestion, and am going to try to implement it: If you see a red date (2/27) beside an older post, that means there has been a comment posted on Feb27. Since I can email posts in, rather than actually 'get on' the site, it may have some lag, but will try to keep up. (now they'll try to block the email sites!)

Anonymous said...

Thanks for the "New posts" date thingy. That helps a lot. Three cheers for fac_p for making this great site for freedom of expression!
All I can say is Essent would do well to study American history. Americans just don't do well under opression--we resist it...very very strongly!

bob said...

Ok I was there at the doc's meeting with administration (i.e. J.R.) A few comments:

J.R. has been in a tough spot, and has been the number one "fall guy" for Essent. He's had his own set of personal/career challenges.

The only way that ESSENT is going to listen to the community is throught the courts. The nurse who lost her job due to a HIPPA violation should find an attorney. The husband and son who recently lost their wife/mother due to neglegence and refusal of care should find an attorney. The husband said "All they cared about is how much money I had." As I understand she was in the ER for chest pain, sent home and came back a day or so later DOA. These two lawsuits would be a "good start."