Thursday, March 23, 2006

To those physicians who continue to remain silent ...4/25



To those physicians who continue to remain silent about what is going on at PRMC... I say shame on you! E$$ent and folks like J.R. may have a Teflon coating, but you are just as liable and responsible for tolerating what is going on inside these walls as they are... if not more so.

This is precisely the time one must remember taking the Hippocratic Oath:

I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.

…or were these just fleeting words, merely to suit the moment?

Do you think that E$$ent will support you when the walls come crashing down? When the lawsuits start? Will they even be here? Ask Wentzville, MO.

The doctors in this community MUST put aside their trivial North/South differences. They might have had some value prior to the merge, not unlike school spirit, but at this point the pathetic political tirade has gone on long enough! We all lost! Soon, none of us will have a place to practice medicine! Is that what you want..?


This is a pull from a comment, but is heartfelt. Years ago, I heard something about Pogo logic, and did some searching. Can't say if "the enemy of my enemy is my friend" quite fits, but this has to go to basic loyalties. The rape and plunder of the Paris healthcare system is all of our concerns, and I can't see that north or south means a lick of difference.

Would you let a loved one go through our system without monitoring? I wouldn't in any case, but now it is just plain scary. What if you are on vacation or out of town on business?

More and more of our patients' family members mount vigil over them. Transfers to Dallas facilities have skyrocketed for things that could well be treated here. They don't blame the staff, for the most part, only the administration. But that can change, given our tolerance for what has transpired.

There is a lot of griping, but little dedication to finding a solution. I challenge the physicians:
You enjoy the position of respect for what you have accomplished, and for the care you've given. Now it’s time for some leadership to appear, as well.

Do you enjoy the quality of medicine that is currently equated to the medical community as a whole? In your judgment, is this harm or an injustice?
Step up to the plate.

104 comments:

Anonymous said...

An earlier post, asked the question, with the poverty level here, why would someone invest for a hospital in this community.

STRATEGY---that's why.

We are in the middle between Tyler, Dallas, and Texarkana. We also take much of the Oklahoma population, because of location.

If we would step up to the plate on quality, we would have a much better situation. Nobody wants to drive that far for health care, they feel like they have to because of the horror stories.

A couple of years ago, I would have gone to the Christus facility in complete confidence of the services.

If we had a neurologist, or an endocrinologist, a good trauma program, we could set ourselves apart.

Some of the doctors are acting like there is nothing that we can do. I've seen posts that I believe are doctors, that act like there is no hope.

Well there is hope if you get off your duffs. You don't have to invest in a hospital. But you do have to do something if you want to continue practicing in Paris.

Collective bargaining comes to mind. A united stand. The same thing goes for the nurses. The only reason this north/south thing continues, is because there is some pride thing.

YOUR PRIDE IS KILLING OUR COMMUNITY. Its time to swallow it, and work together.

Anonymous said...

This post today points up a delimma that physicians in Paris face;to publically point out the deficiences that Essents policies have brought about is to further erode the already shakey confidence that the patients in the community feel.Most of us have already seen a 30 to 50% decrease in our practices and any further erosion could mean the departure of several M.D.sThe destruction of Essent would not neseserily mean they would be replaced by something better.The sad truth is that the 1998 budget amendment cut 5millon dollars from the medicare reimbursement to the two hospitals here. Since that time what you have seen happen here(the merger of Mc Cuistion and Presby and the merger f Christus with St. Jo , and the subsequent merger of both , and the 12 million loss in one year by the combined entity ;all that is the dynamics of trying to keep a hospital open in acommunity that has 65% of the hospitals revenue come from Medicare medicaid and Private pay.Essent paid upwards of 95 million for this "pig in apoke"they are now trying to show they can give a return on the investors $.Do any of you think that a white knight is out there to step in and save us?I have been a frequent critic of essent and will continue to be so when I think patient safety is at stake, but I think for now our best hope for this community is to help Essent suceed and not try to destroy them.A Physician.

Anonymous said...

Very well said! I have horror stories about a family member's stay in 8/2004,that I can't go into because too many people know about it.I agree that the docs are our best hope for change,IF they will as you put it"step up to the plate".They have the power/pull to change things.The hospital can bring in nurses,techs,ect,but without the doctors sending their patients there,there would be no hospital,hence change.I know the nurses and allied health pros would be more than happy to stand with the doctors if any of them ever decide to take a stand to force change.The doctors are the ones with the most power and the ones to lead this,the rest will follow.Every journey starts with one step,any doctors out there ready to lead the troops?

Anonymous said...

Regarding the 9:57AM quote by a "physician", I use the term loosely here folks, and it sounds more like an Admin post!

Do you think we are not aware of the percentages in this community? And the way you worded your comment, it seems its more of a "I can't be bothered with all this mess, am more concerned how it's affecting my pocketbook. So you Worker Bees out there, suck it up and make sure this devious entity succeeds." We are losing qualified people out of this community like an aortic bleed. Quick and deadly. When we do not have the capability to service our patients appropriately and effectively, we as a community have a very large problem. This issue can not be avoided anymore, it has to be directly addressed for what it is. We are at the point that fence straddling is no longer an option for you. Either face the issue, address, manage it, or you too like Essent will be history. The comfort zone is gone, and now that it's affecting YOUR pocketbook, you want US to ensure you don't have that concern anymore. Don't think so, human sacrifice went out of fashion a long time ago. Anonymity seems to be more your forte! With that in mind, perhaps Dallas would be better suited for YOUR needs, not Paris'!

Help Essent succeed MY FOOT, that is exactly what we DON'T need!

Anonymous said...

3/23/06

Dear fac_p,
I'm LMAO reading your blog. What a bunch of crying babies.
First, let me tell you that I'm Dr. Eliz and worked for over 12 years at PRMC.

What are you guys hidden from? Put your name where your mouth is!!!!!!

The problems of PRMC started way back when the sisters sold the Hospital and the appearance of Monty(what a guy!) who gang up with his "inner circle" of certain Adms. "employees", some providers of good Irish whisky,a few "respected" physicians, the Hospital Board members and few local "politicos". This gang, together, with the ongoing feud of North-South physicians and the extremely poor management of Christus, destroy the remaining of the good medical care present at the time the sisters were here.

In the mist of all this a few "big players" emerged with their own agendas, namely Advanced Heart Group, the Ortho Group, the Radiology Groups, the Urology Clinic and a few other "minor players" with great political influence at the Medical Staff level such as Dr. Love, the Primary Care groups from the North campus and very few others such as the previous Vascular surgeon.

The influence of all these people came to a boil when the medical care was so poor that the patients were fleeing to other Hospitals for care and in the brink of bankruptcy Christus decided to pull out and a "search Committee" was formed to look for another buyer.

I was present to most of those meetings and I was the only one opposed to the Essent acquisition due to the fact that I did a bit of research and found out most of the problems at their other owned Hospitals. Of course I was overridden by everyone(you know I was blacklisted for speaking up), including most of the crying babies now, as well as the Hospital Board, the local politicians, 99% of the medical staff.

I told them, but no one listened, that a better choice will be ETMC due to the proximity, their interest in the region medical care and their history of excellent patient loyalty at their institutions.

In terms of J.R. who the hell is he? A glorified resp. tech. that has become a high class "puta" and will jump into any bed as long that he's in spotlight. HE IS A NOBODY!!!!!.

Anyway, you probably knew most of this, but I'm surprised that no one has the guts to face reality and put your names up front and do not blame the wrong people for the Hospital's problems. You CAN NOT FIX THE ACTUAL PROBLEM AT THE HOSPITAL WHILE THE SAME PLAYERS ARE HERE, NAMELY MOST OF THE "BIG PLAYERS", PHYSICIANS AND HOSPITAL BOARD.

Good luck with your blog and if there is anything I can do, please let me know and I will do my best.


Sincerely,

Julian S. Eliz,MD

Anonymous said...

9:57 post,

Doc, I empathize--really I do. I just think there is hope, but not unless some positive changes occur.

There are so many positive changes that could take place, that don't cost money. There is money to be had out there, that with cooperation, could generate more money.

It is cheaper in the long run to keep experienced, qualified staff, then to pay for agency and the cost of training. It makes the public feel safer as well.

That is easy an effective, and cheap. Start somewhere. Help somebody out, who will in turn, repay you with their loyalty.

Step up to the plate for the trauma designation. It will generate more funding. It's more work, but I think it's worth fighting for. It's also stratigically necessary.

Help the hospital out---give them leadership and direction doc. A defeatist attitude, and keeping quiet, is making the public more scared of the hospital.

Make changes, let the ANA, and the AMA help. Make these changes public. Empower the nurses, and they will empower you. I guarentee it!

Anonymous said...

Hi Dr Eliz,

You generated another thought with me. I too was blacklisted after standing up for what I thought was right. I was harassed into quitting--but I think it was the way I stood.

Like Dr. Eliz, when I think something is wrong--I just say it. I don't sugar coat it. I'm not a politician by any means. Most medical proffessionals are direct. I think its a good thing, but others don't see it that way.

Some people see it as just a way to give them a problem, to make waves. It puts them in the defence mode, and the fight is on.

I don't play the little mind games, and I don't expect anyone to have to, but there are ways to point out problems and generate ideas without them becoming a power struggle, and ego's getting stepped on.

Anonymous said...

Hi, Dr Eliz I miss you!
A nurse

Anonymous said...

Well, hon, you just don't worry your head over that. We've got that handled.....

Yeah, r..i..g..h..t!!

Anonymous said...

What does the 12:58 post mean?

Anonymous said...

That 12:58 post, with the condesending "hon" attatched to it sounds like the Hannible Lector,who tried to chew my face off before.

Well "hon" if your trying to silence this lamb, your gonna have a harder time than you did before.

If your ego is damaged, why not talk about it instead of playing the passive agressive game. That game is for girls and sissy's.

Uh oh----I still haven't learned how to practice what I've preached. I'm the 5:48 post.

Anonymous said...

HA! No, the 12:58 post was a quotation of the illustrious Director of Radiology's pat answer to anything asked of her!!
Usually along with the pat (knife) on (in) the back, coupled with that slurpy, overly sweet heavily effected southern accent thingie she does. Scarlett at least was noticeably more practiced at it then she is!! She's got a long way to go for that "Trust Me" routine to work!

Anonymous said...

If the Advanced Heart group, would use our facilities as a hospital,instead of middle ground for getting their patients to Dallas, our heart program could be a great success.


What about the ortho docs--you know I have great respect for most of you, and you do have pull---what are using that pull for, huh. Was it you that veto'd the trauma designation--or the general surgeon? Whoever that was, reconsider please. This hospital needs the money. If the hospital is making money, you will too. If it goes under---what will happen to you.

fac_p said...

The previous post sounds like an Admin post. I think that the continuation of the E$$ent presence is an affront to healthcare professionals on all levels. And, I would say, that apparently it is as much of a threat to the physicians as it is to lower levels. Why else would the talk of moving practices be coming up?

In effect, they would win, because they are playing for all the marbles. They have to have the staff cowed and dependent. They are accomplishing the salary compressions: driving off the more experienced staff and replacing them with new grads.

They can tolerate the temp costs, if in the long run, they can hire a large portion of the nursing grads and the rad class. The new grads won't have the experience, but they come cheap...as will you, with nickel raises....

Anonymous said...

I'm not administration. I swear. I honestly believe in the trauma designation, and the heart program. I know they can't run these 2 programs with new grads. They will be in alot of trouble if they try it.

It is kind of funny the paranoia though. I thought the hon remark was someone I had made up with, and they were trying to let me know the gloves were off.

No, I'm not administration. I just know those 2 programs could bring the hospital money. The heart program is a big money maker. The trauma designation is stratigic.

I don't think administration was pulling for the trauma designation, or we would have had it.

Anonymous said...

ANONYNOUS 9:37
IF THE HOSPITAL MAKES MONEY, WHAT A LINE. FACTS ARE YOU HAVE BEEN SHOWN WAYS TO SAVE, NURSES AND TECHS HAVE EXPLAINED IN DETAIL HOW TO SAVE MILLIONS OF DOLLARS A YEAR WITHOUT ANY SACRIFICE, JUST CHANGING PRODUCTS. WE DID IT ,YET THE SAVING WERE THERE,ALL ADMIN DID WAS DELAY THE RAISE BY 1 YEAR WAS THAT THE THANK YOU?
EVERY TIME I HELPED I GOT BURNED,
BUT YOU THINK I SHOULD DO IT AGAIN?
NOT EVEN AN ATTABOY, (THIS IS WHAT YOU THINK THEN WHY WOULD WE DO IT AGAIN ?
OUR COLLECTIVE KNOWLEDGE DOES NOT START AT PRMC,(EX, JR'S) IT ENDS HERE.
THERE HAVE BEEN EMPLOYEES THAT OFFERED TIME AND AGAIN TO HELP WITH PURCHASES AND EQUIPTMENT
THAT COUNL HAVE SAVED $$$, OF COURSE JR KNOWS ALL AND REFUSED TO LISTEN, RADIOLOGY DIRECTOR REFUSED TO LISTEN YET THE HIRED THESE PEOPLE KNOWING OF THERE KNOWLEDGE.

Anonymous said...

There are many agenda's with this blog site.

1. Problem issues
2. What can be done to fix these issues.
3. Who can fix these issues.
4. Venting to keep from explosion


Someone said that ex-employees should make the public aware of what is going on.

There is a problem with that. We look like scorned ex-employees, making waves. Most of us are scorned ex-employees if the truth be known and we would love to tell all, but we've already lost credibility because we aren't there any more---so what real good does that do?

Next, it's a double edge sword if we still live in the community, because my husband and I both have family heart histories, and it's a matter of time before we are going to need services. With heart being muscle, and not wanting to have CHF after a heart attack, we don't want to have to drive 2 hours with AMI in progress.

Essent management is screwing up. There is no doubt about it. It is affecting care 1st and foremost. They are loosing money, loosing nurses, and it won't be long until the doctors follow.

You can say why try and give up. Why help essent---they have screwed me over. I don't want to help Essent either. Who I want to help is the doctors, and nurses who can save people who need saving.

If the doctors, the ones with the most to loose, and the most to gain, will join together for the benefit of the community, one way or another--it is the only hope. They have to lay personal agenda's aside, and that is hard to do. If the nurses will call or write the ANA they could get some guidance as to what to do.

It has to be a combined effort, but there is hope.

Anonymous said...

I am a new RN and there is no way in he** I will work @ PRMC. We may be new, but not stupid. Every spring it's the same thing-"We'll hire the new grads to fill the holes" It never happens

Anonymous said...

As a physician, in my judgement, it is harm, and it is injustice.

I have practiced here for a number of years, and it is my judgement that healthcare is on a downward spiral--not just due to Essent, but a number of factors.

This community is being harmed, by indifference, by the passion for the almighty dollar, and by a reduced sense of what all of us deserve in healthcare. Essent is not the cause, merely the symptom.

It is being harmed by people abusing the system from all sides of the issue: Physicians who schedule unnecessary procedures, tests, and re-checks to boost numbers, the hospital charging clearly excessive prices, and patients who use the emergency room as an outpatient clinic/drugstore--all driving up the already exorbitant costs of healthcare.

It is an injustice that everyone pays for it.

Anonymous said...

I support the doctors decisions. I support the decision to or not to buy a hospital.

I will support whole heartedly if they make the decision to take a stand with the hospital.

But, the personal agenda's from some of the docs, as Dr. Eliz pointed out are going to kill us.

Here is an example of a personal agenda that I'm talking about. I once saw a surgeon dog on a nurse in front of the patient and staff, because of personal agenda.

The nurse had made a split second decision to call out the surgeon on a sucking chest wound. The ER doc was not immediatly available, and the nurse thought it was best.

They had the pt. ready for surgery, inside 30 min. When the surgeon arrived, they got browbeaten for calling him before the ER doctor had evaluated, and test results were back, and a speech on the reasons we are too poor to be a trauma designated facility.

This all happened in front of the patient. The patient got scared and asked "am I going to die?"

The personal agenda for the surgeon was related to politics, that the patient or staff had no clue about. It was obviously something he felt passionate about, but it had nothing to do with that patient, or why that staff made that decision.

This incident forced the decision about the trauma designation, and as I see it, we all lost.

Was that a personal agenda decision? Was it a decision best for the community?

Anonymous 2:20, talk about not getting an attaboy---this person got flogged.

Anonymous said...

I'd like to see this hospital succeed by giving quality healthcare to the community and treating its staff with the respect and support they deserve. If Essent can do that--which they haven't so far--great! If not, we need to get someone else to run this show!

Anonymous said...

3:33
Agreed, if they are just going to take the money that we make them, and stuff it in their greedy pockets, and continue to short staff, and not pay what is due to the doctors, then we need to do something else.

When it comes right down to it, doctors can you afford to not take a stand?

Anonymous said...

By the way post 10:59, I know you know it, but we're not saying that we don't want you, We're just trying to keep you from loosing your license. I learn more from new grads than they probably learn from me.

Anonymous said...

To 6:57,
I would hope that's not true. I do learn from everyone I work with--sometimes only perserverence. But I hope that I impart that if not more.

This is a closed system: PJC grads go to work here, with very little cross-feed from other organizations. They finish their BSNs through a completion program, with still no outside exposure.

They then go and teach at PJC. Teaching within the limitations that they have learned.

The best thing would be to get some experience outside. Then bring back what you have learned. That goes for the community as well as for personal development. There is almost always an alternative method in procedures, but exposure to them is limited.

Anonymous said...

To 6:57 post Thankyou-the new RN

Anonymous said...

Maybe that is one of the things wrong with Paris we are killing ourselves with "in breeding" Essent thinks we are a bunch of dumb hicks and sometimes I wonder, this sh** has gone on way to long. This blog is a year old now looking @ the archives; I do not have enough power to be a leader, but sure will help. Someone please step up to the plate! I think PJC should also look @ motives when accepting nursing students instead of just GPA's. Nurses make pretty good money for an AD esp. for Paris. Altough I think Paris has many good nurses maybe too many are just in it for the $.

Anonymous said...

first of all I have a new t-shirt idea (front) e$$ent...(back)e$$entially stupid.
secondly I would like to agree w/ the new grad. I will be a new RN in may (god willing) and after doing clinicals at paris, and unfortunately having to work there. I want to say thank you essent for giving me that little push I needed to get the hell out of there. Any new grads that read this site lvn or rn please take my word for I know youve worked to hard and to long to loose you licence, so if your smart youll go else where or youll be looking for a new carrer.

Anonymous said...

The physicians that are silent now are the ones that selected E$$ent in the first place.

The hospital board is also a joke. They do not have any authority and they're on E$$ent's payroll.

Dr. Eliz is right. ETMC would have been a better fit. We're stuck now. You know who knows that more than anyone? Hud.

The physicians cannot really do anything.

There's only a few ways to make changes:
a. Competition
b. improved transportation to say Sulfur Springs, say a bus 3-4 times a day.
c. the courts (i.e. lawsuits)
d. by force (i.e. Andrew or Hud has an "accident.")

Hud doesn't care that everyone in Paris is upset. He's got everyone at all the other hospitals upset also and sleeps just fine at night. From his perspective everything is just fine. He's making money.

Anonymous said...

"they can hire a large portion of the nursing grads and the rad class. The new grads won't have the experience, but they come cheap...as will you, with nickel raises...."

"will hire new grads to fill the holes"

Can't speak for the rad students but a few weeks ago PRMC did a "recruitment" lunch at PJC for nursing students. I'd say a max of 20 or so students even came. Most of those from Greenville who didnt want to leave campus for lunch. I for one was in it for the free food. Through the grapevine I've heard a certain clinical supervisor was "very disappointed in the PJC turn out"

WELLL....the entire classes have now done clinicals at all 3 hospitals (PRMC, Greenville, & SS) And even a green new-grad can see the difference and smell the stench that prevails at PRMC.

As a students/employee I do thank PRMC for teaching me perserverance, humility, to watch my words, and I'm extremely good at charting now to COVER MY A$$!! All qualities that will continue to help me develop throughout my career.

Personally I would like to see a good hospital here in Paris. We have the good docs, good nurses, & good groups (AHC, RRR) to make it happen. I love Paris and will hate to leave it.

Anonymous said...

Why can't the physicians do anything? Without them the hospital will not make money and just like the new nurses, no new doc(or one w/ exp.)will want to come into this mess.I do like the "accident" comment

Anonymous said...

12:29 post

You know that is some great insite. I've never thought about it that way.

I didn't go to school here, and Paris was not the first place I worked as an RN. Everywhere else that I've been, the nurses pulled together more. The goal was the patient, and we took care of each other. If someone was burnt out, we recognized it, and tried to help them through it.

I thought it was the changing of the times. Maybe it is, or maybe its just too many people in the same place, with the same ideas, learned from the same people.

The monkey theory is coming to mind. Not that I don't think most of the teachers at PJC are great. They are. But what do you do to empower people out of the monkey theory?

Anonymous said...

8:20 post

Oh man, the doctors can do something. So can the nurses.

Sulpher Springs is not the answer, they don't have ortho, or cardiac ability, nor does any other small facility close to us.

We have the resources and the ability to do almost anything but neuro. They can take a stand to fix this.

It would take a risk. Do this or I will ship everything from a cold to a corn to somewhere else. It might take some dollars out of their pocket book for a little while, and it would definatly take a united front. If every doctor don't stand together and do this, it won't work.

They know it could work. I've seen a group of doctors (just one small group) doing it for selfish reasons and they got their way.

Pull this one for the staffing docs. Pull it for your patients. Get Paris back where it needs to be. Don't let them tell you about the money. They are paying the same money out on agency. Look at CEO wages. He's probably making more than some of you, especially with the some of the patients leaving.

Anonymous said...

10:59 post:
It is true that the new grads do not want to work at E$$ent. They do clinicals here and see how bad it really is not only on the nurses but on everyone else as well. These people have no respect for anyone except themselves. Congrats to the new grads who see this place for what it really is and choose to go elsewhere. In fact I would say all nurses beware for your license will be on the line with no one to back you up if you happen to make a mistake or stand up for how you feel or believe.

Anonymous said...

I think you have to have respect for yourself, before you can treat others with respect.

Some of the disrespect seems to be rolling downhill doesn't it?

Trying to make others feel dumb, is a poor attempt at making yourself look smarter. Everybody can see through that. Disrespect works the same way---its just a little harder to see through.

Anonymous said...

10:57 post,

Ok, I've got a great idea, how about a hands across Paris, walk with doctors and nurses. Or maybe a big group hug. Yeah that'll get their attention,A BIG GROUP HUG. Or MAYBE, we could all get those ribbons, you know, like the ones you wear, or put on your car, yeah, that'll get their attention, we'll ALL WEAR RIBBONS.

LOOK, these guys don't CARE.

Everyone wants the doctors to do something. Well, guess what, they DID. They SELECTED E$$ent as the new owners. Now, I wansn't one of them that wanted E$$ent. The radiologists have already bailed. Some of us just simply dont't have that option.

I've outlined the only REAL strategies a, b, c, or d, but if you think, the ribbons, ok yeah maybe we can get Hud to wear one.

Anonymous said...

Personally, I like option "d", but, being in healthcare, I suppose we'd have to treat him--in our ER, after going through triage...how long can that take???? Hopefully, on a day they floated ER nurses....

Anonymous said...

5:12 post

OK, there is nothing you can do. Do nothing then. See where that gets you. Big nothing. We will all go to hell in a handbasket, and I guess you'll lead the way?

I'm so sick of hearing there is nothing we can do. I swear its a ploy from administration trying to beat us down more.

It's just like the battered wife who says my husband will find me and kill me if I leave him.

I will stay away from those stairs because the other monkeys will beat me. Grow a male part, and stand up will ya?

Anonymous said...

If the docs boycotted together, (they can't get along well enough to do it) it would either force compliance with Essent, or force them out of business.

Either way sounds good to me.

Anonymous said...

5:03--

The disrespect started from E$$ent management. They have no respect for the employees. So why should the employees respect them?

Anonymous said...

6:34 post,

Ok, that's the response, I need. You need to understand that these are not NICE people. They don't have the good of Paris or patients as a priority. They're priority is MONEY. So as much as you would like to play on YOUR terms, you cannot. You have to play on their therms. I.e. you have to affect their MONEY, or bottomline.

The idea of a BOYCOTT by the doctors is the same thing as the ridiculous options that I outlined, i.e. a GROUP WALK, or GROUP HUG, or WEARING RIBBONS.

jse said...

to a Nurse anonymus 11:33PM

THANK YOU and keep doing a GOOD JOB.
At the of the day THE GOOD NURSES AND THE GOOD DOCS WILL PREVAILED.
And if not at least you can sleep at night unlike the "others".
Good luck and keep fighting for YOUR PATIENTS!!!!!!!

Dr.Eliz

Anonymous said...

5:12

Patronizing. A great form of disrespect. Another perfect example of where the disrespect is coming from.

Do you respect yourself?

Anonymous said...

Okay, let's figure what would hit hardest that is controlable. Outpatient tests? Obviously RR for x-rays, Digital Mammo, and for lab, LabCor and Quest.

Anonymous said...

so you post what you want eh fac_p?

The 6:34 poster insults my masculinity and you don't post my response. You're as bad as E$$ent if you don't allow free speech. I can think of not posting some things that could result in libel, and end up having the site shut down from a law suit. But you've proven to me that you're as bad as they are!

Anonymous said...

yeah fac_p,

you bail and now expect the rest of us to go to battle?

Anonymous said...

I already send outpatient xrays to RRR and lab to another lab service. So any "mass Boycott" of outpatient services may be less effective than you think.

fac_p said...

8:19

Comments come in and are stacked, most recent on top. I go top down and I had apparently had some time lapse when my link was down.

I think the only comment that I have totally censured has been a slur on Dr. Eliz which I felt was uncalled for. Maybe one other, and not today.

That being said, "as bad as they are"?? I think not. I can accept criticism, while they can't.

I am proposing, while you are throwing rocks. If those ideas don't seem appropriate, find a better one, and then comment it.

E$$ent picked up 47 properties in the purchase. All of those are taxed at an unrealistic rate. Each dollar that they don't get hurts them where they live...and they don't live in Paris.

So, outpatient revenues do affect the bottom line.

All the temps that they have affect the bottom line.

Paying radiologists for exams that they don't get reimbursed for hurts the bottom line, no matter that you can write it off.

...and all they are is bottom line.

Anonymous said...

I apologize to you fac_p.

I felt personally insulted by the 6:34 post and responded at 7:22. Your 7:50 comment got posted and my 7:22 post din't. I looked to me as if you had censored my response.

Thanks,

Anonymous said...

9:46 post,

I felt patronized by the group hug thing, so I felt I had to respond. Nobody comments in meetings for fear of Essent.

Nobody is going to put out ideas in brainstorms if you patronize. I didn't want to make a come back like that, and I am ashamed of myself for doing so. Old habits die hard.

I apologize.

Anonymous said...

And 7:22,

If you think that I don't know these are not nice people, you are wrong. There aren't many people out there, who knows this as well as I do.

Anonymous said...

If I may, I will offer an excerpt from another blog dealing with problems with the City of Paris. It seems very appropriate.

"George Orwell, in his book "1984", told the story of a untopian society where those in power painted a picture of a perfect world, a world that they (Big Brother) would have you believe existed. The citizens of Orwell's utopia knew better, but could not say so because of fear of reprisal. In truth, that world was seedy and oppressive and benefitted only those who made up all the rules."

My, that sounds vaguely familiar.

Anonymous said...

Ok, 9:46, I'm expecting an apology from you too for treating my response like one from a dumb blonde.

Can you dish it out and not take it?

Or do masculine people just not have to say they are sorry when their behavior is bad?

Or do you not recognize it as bad behavior?

Or, are you one of the ones that thinks they only have to apologize to doctors, and that everyone else is poo on your shoe?

fac_p said...

Now that everyone has made-up, back to business.

Thoughts:

Whistle-blower laws protect those who report violations to state/federal regulatory agencies. And, most will work with anonymous tips.... The rules are there to protect your loved ones when they are patients....

Public opinion is a big force. If facilities aren't used, they can't bill.

Letting friends know about the $8 Tylenols, $350 chest x-rays, and the other various overcharges.

Tell everyone you know about the blog. (I hate that in e-mails. Say, “you really ought to see this.”) A great deal of Paris has no clue that it is here.

Anonymous said...

What is the blog site for the city of paris?

Anonymous said...

anonymous 12:33,

The city issues site is citizensforparistexas.blogspot.com . Be aware however, this is NOT sponsored, endorsed, moderated, or anything else by the city. It is read, however by some of the council and former council and their resulting posts do not conceal their identities very well.

You will see the strange similarities. Rules (charter)violations, employees who point out problems in the city and varioius city departments and the people who call them crybabies for it, the loss of staffing and experience and the reduced service as the result. All in pursuit of that elusive bottom line.

There are even monkeys, hosers, and those who would defend both.

The moderator is Hopeful Citizen. He/she has done a great job. Currenly, the issues posted for comment are;

Paris News Article March 24, 2006
City Council Agenda March 27, 2006
ISO PROGRAM
Charter
To City of Paris Employees
Citizen Advisory Committee
City Council Canidates
Guidelines for Council Canidates
Opinions on the Paris Historic Preservation Committee
City of Paris, Texas Opinion Survey
Archives
Thursday, March 09, 2006
Saturday, March 11, 2006
Monday, March 13, 2006
Tuesday, March 14, 2006
Thursday, March 16, 2006
Tuesday, March 21, 2006
Friday, March 24, 2006
Saturday, March 25, 2006

Pass this link on. Enjoy.

Anonymous said...

I don't understand why 7:22 thinks that not admitting, on a mass level would be ineffective.

I know that there are certain areas where that would not work. Maternity, and ER for example would violate EMTALA, and I know that there would be other situations where you would have to admit, but........

If a mass of doctors worked together on this, it wouldn't be like the RRR, or lab. It would effect the bottom line.

Anonymous said...

Thanks for the information 6:38.

I wonder if we have players that are both city council and hospital board members?

It would be nice to find a common denominator other than greed alone.

Anonymous said...

Regarding the original post and comments 9:22am, 10:51am, 10:35am, 10:57am, 6:34pm, 6:51pm, and 11:900 am post:

What seems to be proposed is a Boycott, i.e. not to admit patients to the hospital. Let me share a few comments with you regarding this approach.

Let's say I have a patient that needs to be in the hospital. They have congestive heart failure, or Diabetes Ketoacidosis, or Pneumonia. They need to be in the hospital TODAY. Now lets say I simply don't put them in the hospital because I'm boycotting it. Well they could die and I'm liable. I expose myself to lawsuits and I do not do the right thing for the patient.

Next option. I don't admit to PRMC. Ok, now this is somewhat workable. Let's say the patient needs to go into the hospital, but the patient says "I'm not going to PRMC." Then arrangements could be made at another hospital. Let's say the patient had adequate transportation and wanted to go to say Greenville, or you pick a hospital.

Now PRMC can't just be replaced like the 10:57 comment said, another facility doesn't "have ortho or cardiac ability." So where would these boycotted patients go?

So a "boycott" or not admitting is not (in my opinion) a real option.

BUT, hang on please...

How about if we don't discharge. Now, I'm serious and not patronizing or condescending. Please hear me out. We get told on a daily basis how we have to discharge patients. But if we took a stand and decided not to discharge patients on a particular day that would somewhat get their attention. Now this can only last for at most a day or two. The hospital would fill up and we would then be potentially harming patients by not having a bed for them if needed. So, in my opinion not discharging is much better because the potential harm to the patient is much less and it still gets their attention.

I for one will not do anything unethical, or that could harm my patient, and I think most physicians feel the same way.

If your goal is to work with E$$ent and to get some cooperation a "no discharge day." by the doctors might be helpful.

If your goal is to get rid of E$$ent, then I still think your options are:
a. Competition
b. improved transportation to say Sulfur Springs, say a bus 3-4 times a day.
c. the courts (i.e. lawsuits)
d. by force (i.e. Andrew or Hud has an "accident.")

Now a final comment on option "d." I'm not suggesting that anything truly deadly happent to a CEO, but pressure from investors, or public humiliation may be the answer.

Anonymous said...

To 4:19:

I have tried to make that connection and have been unsuccessful so far. But there is no doubt, the common denominator is indeed the bottom line.

The symptoms of both of these problems appear to be almost identical; A board (council) telling us that they have to cut costs to make ends meet. Even though poor management got them into the situations in which they find themselves, it is taken out on the backs of the employees.

Experienced employees are run off in favor of less expensive "FNG's". As a result, service suffers because the FNG's haven't been doing the job long enough to know what they're doing, much less how to do it. Thus the patient (taxpayer) suffers.

Both entities have a responsibility to their customers, to provide for their safety and well-being. Yet neither entity is willing to do what it takes to fulfill said responsibility.

And let me assure you, the muzzle is tight on the city employees also.

Here is one connection; The more patients that insist on being tranferred to Dallas because of their fear of what might happen to them here, the more money the city makes. Transfers to Metroplex hospitals by Paris EMS are VERY expensive. Poor care here translates into big $$$ for the city. An earlier post said that those transfers had skyrocketed. Don't misunderstand, I am not insinuating the city has anything to do with the woes at PRMC, but they are certainly capitalizing on them.

Anonymous said...

I say more power to EMS. At least somebody is getting something out of it. That is if the EMS employees get the benifit of it.

Anonymous said...

I don't think anyone has indicated any action that would put patients at risk. However, referring out to other hospitals is not putting them at risk.

There are several local physicians who have obtained privileges at Clarksville because of the lack of call.

What would be ironic is if the cardiologists were by-passed. Since they have been doing that to the cardiovascular surgeons for years...that would be one of the heaviest hits Essent would take…and they’re a big part of why Essent is here now.

As someone mentioned earlier, AHC's referrals make a big difference, and that's one of the reasons that Christus lost the battle. But, it isn't the main reason. Inefficiency on all levels is.

However, Essent's major flaw is their inability to treat people like people, not pawns. That's what is costing them, and I really don't think they could rectify their position. And that, in combination with going around AHC, and thereby the Cath Lab, would hurt them. Greatly.

Anonymous said...

Ok, competition and law suits take too long.

Shuttle service, no discharge day, looks like an alternative.

If we are waiting on humiliation--history shows that ain't happening.

Shuttle service, along with no scheduling of outpatient services--how long would that take?

Have to watch out for staffing on the no discharge day---may be more harm than good due to med errors.

I wonder how many no discharge days it would take? Could combine the effort, no discharge, and shuttle excess patients.

Anonymous said...

Well I would like to say right off hand, hello to everyone that I have not spoken with in a long, long time.

Now for those of you who don't know or remember me, my name is Cary Scott and I work as a pharmacy tech there at PRMC from Sept. 2000 through Sept. 2004 until I was fired for what my b**ch of a director Susie Glover and that buck tooth b**ch from HR Cheryl Perry saying that I wasn't an asset to the company nor was I a team player..

Ok, for those who know me, they will step up to bat for me. I was the only pharmacy tech in that hospital that any nurse, doctor or anyone in general could depend on. Many of times, the phone would ring and that person on the other end of the phone would specifically ask to speak with me because they knew they would see results in a matter of minutes; whether it was entering in a medication into Meditech so they could retrieve it from the pyxis or hand deliver an IV piggyback or large volume IV. No matter the situation, they had results in a matter of minutes.

Now, how in the h**l do they get off saying that I'm not an asset to the company nor am I a team player? Can someone please explain that?

Another thing... Your so called "administration".... What a d**n JOKE!! I recall 6 of the pharmacy staff including myself going to them ( Andrew and David ) and having a meeting with the two of them letting them know of some of the problems we had been having with our department and the leadership we had. I recall the exact words from Andrew and he said, "Things are about to change. I am going to let the Marine (David) handle this task since he is hard nosed and gets enjoyment of making someone's life h**l".

Well, let's just say that the only thing he did was fire the best pharmacist who worked there (Joe Ginn) for something that was Susie Glover’s responsibility; payroll.. I made the comment after I learned that Joe had been fired that I would be the next to get canned and I said it would take about a month.

Well, it was 3 weeks to the date of Joe's termination that I too was terminated and all because I wasn't an asset to the company or a team player. All which is Bull S**t!!!

Let me just say that there are A LOT of good Nurses and Doctors that work at this hospital. Don't let this company drag you down like those have tried with many others.

There is light at the end of the tunnel, you may just have to walk a little closer to get to the light. Don't give up on your career or dreams. Fight hard for what you believe in. Remember what the Standard of Care is and should be and everything will be alright.

I hope everyone is doing fine. Email me if you would like so I can catch up on everything that is going on.. My address is caryscott@hotmail.com. Talk to everyone soon….
Cary Scott


Hope things are going well, Cary, hope you don't mind the edits....***

Anonymous said...

11:52

I like your style. And I like what your saying. It is just so hard to get everyone on the same page.

How can you get everyone on the same page? I know they all have to be feeling the crunch here. If everybody would just work together on it.

Cary Scott---Hi. If you take a complaint to administration--you are gone. If you liked your boss that got fired or quit--you were soon to be fired if you voiced it.

If you asked for leadership from your new boss---big mistake. If you questioned rationals behind our new plan--big mistake.--If you asked what the big plan was--big mistake.

Rules were changing by the second, and no one would let you in on the changes---they would just lash out for breaking the new rule, that no one knew about.

Communication is out the door. There is no way to communicate with these people. Even if you think you are having a friendly conversation--it ends up being a backlash.

It's like one big dysfunctional family, with limited min. on the cell phone, and a bad connection anyway.

Anonymous said...

11:52

How many referals from AHC do they get from their Oklahoma office? I wonder how many caths they are getting from that, and bringing over here?

Anonymous said...

I agree with Cary, we always had the stuff we needed when he was here. I have waited over 4hrs for a k+ bolus before, and don't you just love Cheryl's lisp "Theryl Perry"

Anonymous said...

Theryl and JR. What a combo.

fac_p said...

If you happen to run across a site that has applicable information, shoot it in as an email and I'll link to it. I just dropped in a link section which could get very long....

If you don't have a blind email account and are just commenting to me, put "no post" on the first line. Sometimes 'assuming' gets a lot of people in trouble.

Anonymous said...

Not to mention wrong meds, in the wrong slots in the pyxis after you left.

At least 3 of us that went to orientaion together left within a few months of each other.

I don't know what you looked like when you left--but two of us looked like walking heart attacks. I feel 100% better--how bout you?

Cary said...

You asked how I feel now that I left the hospital?? I couldn't be happier. I am actually able to sleep the entire night, not near as stressed as I once was for the fear of not knowing if you were still going to have a job the next day when the sun arose. But things happen for a reason. I was fired on Thursday September 16,2004 ( 2 days before my 4 year anniversary) and the very next day I recieved a phone call from a former pharmacist that I worked for at one time asking me if I would like to return to working for him again. Don't get me wrong.. I miss some of the people there at PRMC, but I don't miss my job nor the politics and Bull S**t that went on there.
Cary Scott

Anonymous said...

Pretty much the same tune from ANYONE who "bit" on the "open door" policy that General Putton advertised so loudly. Ya know, kind of like a modified "fire side chat" crap. Oh yeah, go to Andrew and crew with facts, hard and true, about anything from poor management, problems that affect care of the patient, and also with solutions for these problems. You leave (the first time) feeling as though you just might have accomplished something. How wrong could you be, Andrew's intensive concentration to your presentation, the quiet manner and promises of "it will be looked into or taken care of, or even better, I had no idea that was happening. Guess I'd better start clearing out some of the management/supervisory staff." was merely con artist hooey. We were the people Andrew wanted out. He wanted the sly, covert, incapable, brown nosers to stay. THIS is how Essent expects this organization to be run. If you start something with the intention of bleeding it for every buck you can squeeze out, why in the world would you have a care for, of all things, the patient, or even funnier, the employee. You are merely a means by which their pockets become more stuffed!

Anonymous said...

I too have left the hospital, and it is like coming out of a dark closet. I sleep better at night, and now have a wonderful job. The first week was like something out of a sci-fi show, I kept wondering why everyone was so happy, and what was the deal with the "Good Morning"......from everyone! AND it was meant from their heart and soul! What a novel concept!!

As I've discovered, that is the way it is supposed to be. Not a mind numbing, spirit robbing dread when you walk through the doors. And guess what, it shows when you deal with your patients. THEY arrive happy, and leave happier. Going that extra mile with your patient doesn't rob you of what little you have left to give. If you have to work over, SO WHAT, you are more than happy to do so, as the team effort put forward by this group, is done with a team effort frame of mind. NOBODY minds, or cares....it's for the benefit (first and foremost) of the patient, and get this folks, for the group you work with!! The leaders in this group (namely the physicians) have the very SAME attitude. It is why they are SO successful. They lead by example. No one is talked down to, threatened or coerced. Now what in these last sentences, is so difficult to do or maintain. Where I work, power is not the issue, patient care, pride in your work and effective teamwork is. Something to be proud of when someone asks where you work.

I can only say in closing that in being forced to leave PRMC, it was truly the best thing that has happened in my life. I dreaded the fact that I would not get another job, guess what, the news is out on Essent from here to Dallas and probably points beyond as well. I didn't have to explain anything about my situation, it was already old news, and was NOT held against me as a prospective employee. My work history, prior to this pitiful interlude with Essent, was merely ignored. Many other professionals, as I've discovered, have gone through this same situation. And in doing so, realize that they are not the scum here, it is Essent, plain and simple.

Anonymous said...

7:11

Amen brother. I couldn't believe it either. It floored me.

Anonymous said...

I can't believe how many people had the same experience I had--almost verbatim.

I can't wait to return to the original self I was prior to the Essent experience.

I hope its not PTSD. I sure have some symptoms of it.

Anonymous said...

I agree, I hated working at a place I would not let my family or friends go to. I love not having to constantly have to deal with unhappy family members standing at the nurses station complaining about things beyond my control that administration doesn't care about.

Anonymous said...

Amen brother, with positive attitudes and management wanting to know (from the heart)what they can do to make it better for you the employee, you know your home.
Did I tell you I love Baylor.
Thanks for asking.

Anonymous said...

I agree that there are some mighty powers out there that can stand up and make a difference. I do not see that the North/South doctor's from the past really hold any truth anymore. I think there are those who are worried about the hospitals (not Essent) and their future of staying in Paris is at stake here and fall on the side of Essent just to make the hospital work here. Some physicians cannot see but what is in front of them at the time. Sometimes you have to empty your pockets and take a step back to see where you can go be further ahead that when you started.

The biggest problem with the system and physicians here is the "good ole boy system". For example, how can a less than mediocre cardiac surgeon with high mortality rate come back to Paris and get the other cardiac surgeon suspended? The mortality rate of the other surgeon is about 10% better than the "good ole boy". The surgeon got his ducks in a row and presented some very compelling information and got to come back to work. Now you have to believe that he has the admistration over the barrel if they ever try to get rid of him.

Next, why attack AHC for giving the patient what they want. Not to knock any of the nurses or allied health which majority are very good. If you were a patient and had the choice of going to Dallas or staying here where the admin is more worried about how quick you can get them out and at the cheapest route where would you go?
This is where the ortho group, RRR, and AHC need to join forces and make Essent pay.

P.S. Kudos to RRR for standing up to the bullies.

Anonymous said...

4:44

You know there are many times, I would be in an area, say ER for example, and we would have a patient that no matter what we did, we knew was going to die--and we would try to get it to ICU before they did. We didn't want the paper work, and it would make our mortality rate look higher.

I've seen the same thing from the cath lab. Actually there have been a few times that I knew of that we brought dead patients to the cath lab-pumping their chest-thinking that we were going to fix them. The result wasn't good, and it actually effected cath lab mortality rate--making it look worse than it actually was.

I'm not taking up for this surgeon in any way, but I am curious about the mortality rate. I mean when you have nothing to work with in the first place, should you be penalized for trying?

This is a question, not any type of accusation, I promise. Are the mortality rates figured by actual numbers, or probability of survival?

I agree with the way to go RRR!

I also would prefer, at this point to go to Dallas, but I do want the choice offered to me. My opinions have changed, and may change again depending on the circumstances.

Anonymous said...

I can tell you what the patients want. They want to be able to have it done here with the reasonable confidence they are not going to die with a nocoscomial infection, or a medication error.

Patients want to be here, with their family, their support system.
Doctors that they know, trust and love, and nurses that actually have the time to take care of them.

They don't want a 2 hour drive over there feeling like crap, and they don't want the 2 hour drive back home. They don't want the expence of hotels and gas for their family members.

That's what we want. I don't think its asking too much either. Get Essent out of there and get the staff back.

Anonymous said...

AHC and Dr. L have been fighting for years. It's no big secret they don't cooperate. Both are wrong and both are right.

Mortality rates are really not a fair assessment, as one would want you to believe. Take 2 nurses in the ER. One takes the trauma, and cardiac beds routinly, and the other takes ortho, and vag beds for example. Is it fair to compare those nurses mortality rates against each other?

If there is something that person is doing that routinly causes harm to the pt. Infection for example--may or not be the doctors fault. Test things out. Find out the problem.

But if its the luck or unluck of the draw--or the acuity of the patient you take, then its not a fair assessment.

Anonymous said...

Mortality rates are deceptive, and we all know several reasons. Here's one of the biggest: Insurance.

The ones that are done here have a higher mortality rate because of the other factors that come along with lower incomes--they are in worse shape. They are your emergency caths, the folks that never had the check-ups, higher propensity of smoking, high carb and fat intake, little to no preventative care.

AHC refers out their insured patients, skewing the stats.

A better figure would be post-op infection rates. Ortho complications here have a lot of the same skew.

When they cut the number of respiratory techs, the mortality rate took a jump. Look at the state stats...and that was a Christus move.

A large concern of mine is family of those in isolation. I rarely see any precautions taken, and they have the run of the hospital.

How often are the pieces of portable equipment wiped down that are used in isolation rooms--and are they used on post-CABG patients??? Since the isolation carts do not have the supplies to clean them....

I find that the direct fault of infection control, along with other factors that have new isolation patients springing up in rooms next to old ones....

Anonymous said...

Very good points there, and I have had some of the same concerns on infections.

Also staffing a nurse with infection patients vs. not infection patients--huge issue. When you have the number of patients some of the nurses are having, you are bound to cross contaminate, not to mention respiratory and non licensed personell.

Anonymous said...

The conflict may not be north/south anymore, but there is still conflict.

I wish I knew how many millions of dollars, these conflicts have cost the hospital, and the community.

One of the problems I have with AHC, is that the majority of them don't live here. Yes they own a house that they share when they are in town, but their families do not live here except one.

They aren't as commited to this location, so their stake here is minimal, and they may get their bread buttered better if they send the patients to Dallas.

The one problem that I noticed was continuity of care was in jepardy.

One doctor would be there Monday, another Tuesday, another Wed, another Thursday, and another Friday. Communication wasn't that great either.

Now things may have changed since I was dealing with this on a day to day basis. Correct me if I'm wrong. I don't want to give people the wrong idea about it if I am. They may have worked out some of those kinks now.

I am all for the heart program. I want it to be a huge success. I have all the confidence in the world of their abilities.

I just think that motives and promoting what is best for this community should be looked into. Also I think whatever is impeding cooperation between the cardiologist and the cardiac surgon, needs to not just be addressed---it needs to be fixed.

Anonymous said...

This is nothing new--it drove off an extremely good cardiac surgeon before--remember Casey?

Anonymous said...

I know it's old news. Maybe it will be new to somebody that can do something about it.

You know its a catch 22 and they know it. You can't afford to lose the group, but we could be so much better off if they would help us instead of Dallas.

I don't mean Essent. I mean the next group up and coming.

Anonymous said...

You are true that the majority of the AHC docs do not live here but the hospital and AHC and others have been searching for a quality cardiologist besides the one already here for years to live in Paris. With the shortages of cardiologist and the high demand of $$$$ it is hard to get one to commit to Paris alone.

You are wrong with saying that AHC does not care about the community. The support the schools, sports teams, and community events. But again that is someone looking from the side that they are evil and just here to take our money. They are providing a service here. They have tried for years to work with Christus and now PRMC but because they were the North side cardiologis they were the evil ones so PRMC just followed suit lead by JR.

As far as a different doc everyday. You are getting what everyone desires - more that one opinion.

The heart program lacks and AHC takes thier patients to Dallas if they wish or it is a high risk case. If the patient needs bypass they give the patient the option with the stress on Dallas. The same as Dr Shafiq does with his high risk cases and Baylor. With the hospital talking about a new surgeon coming to Paris that may change the minds of everyone if he is a quality surgeon. That will also answer some questions whether it is a surgeon issue or a hosptial issue with increased mortality and infections.

Everyone in the community wants to see the heart program succeed. But if you are having increased infections and mortality you cannot put the patients at risk. Would you want that for yourself or family?

Anonymous said...

I have never seen AHC give the option of staying here or going to Dallas, and I have had patients ask me, why can't I just have it done here.

At this point, I would opt to go to Dallas, because of the nursing situation. Increased infections are directly related to the nursing shortage, and respiratory shortage at PRMC.

There is a pi$$ing contest between the doctors, that started way before this nursing shortage. You know it and so do I.

Anonymous said...

I don't think AHC is evil, I just think they and the surgon got off on the wrong foot during the merger, and it escalated.

It's hard to refer to someone that you just don't like.....It's like giving buiness to the enemy.

It's easier to see the errors of people that you don't like, and its much easier to attack their skills.

I think they have both been doing that since day one.

fac_p said...

The split happened when Mallick separated from the other cardiologists, and he referred to HML. Casey was inbound, and was affiliated with the group--but Mallick's practice was overwhelming--Casey didn't have a chance. Why would Mallick refer to someone associated with the group that was suing him?

Anyway, the cardiology group kept referring out, not because of HML's skill, but because their roots are in Dallas. When Mallick left, the patients started disappearing for HML, and the ones he was getting were higher risk.

He probably had good memories of Ohio... med school, I believe, but things have changed. It didn't take long for him to return, merely the time to realize what he had here. But, Lui is now here, and the referrals are still going out...and Andrew's buddy (cardiologist) and his brother(?), a cardiovascular cutter, are inbound.

It gets better and better. I'd say that in order to keep three cardiovascular surgeons employed, and the surgical suite busy, they're going to have to bring in their own cardiologists--and subsidize them to break the hold…with their finances??? Ha!

Anonymous said...

That's what I think. You would have to bring in more cardiologist to get business to surgery.

AHC has never refered here, and I don't think they ever will, and I don't think their reasons are as much for the concern of the patient, as for their loyalty to Dallas.

If this had been a recent turn of events---I would say that it was--but this has been going on for a long time.

I miss Dr. Mallick.

Anonymous said...

It is readily apparent, that the hospital is not interested in quality.

What is more significant, is that they are also not interested in the quality or number of physician they are trying to bring into the community.

The docs already here need to wake up! E$$ent is not your friend! What do you think will happen if they are successful in recruiting their own cardiologist/cardiothoracic surgeon, maybe and FP or two, OB/GYN, General surgery....

With the current exodus to Dallas, the docs currently practicing are already fighting over the few patients willing to stay... There's not enough for everyone to stay busy. The hospital, on the other hand, doesn't care, as long as they have as many docs as possible IN THEIR POCKET to send to them!!!

This should scare the h*$l out of physicians in Paris. You guy's and gal's really need to see this for what it is!

What incentive would a Tampa (Florida not Texas) based cardiologist with a successful practice have to move to Paris?????? Stock options!!!!!!!!!!

Anonymous said...

Christus tried the same with the Lamar Medical fiasco (how many lawsuits?), but it was to balance the referrals that 'Big Mac' was getting from PCA. Somebody better tell the new guys where that went.

“Those who do not learn from history are doomed to repeat it."

Anonymous said...

I don't want a different doc everyday, and I don't want a second opinion from the same group.

My father and mother have great insurance. I am finding this to be as bad as not having it.

I have brought them to Paris--to the doctors I trust to get second opinions and have so far saved them bilateral knee surgery and a cardiac cath.

Had they have went to somebody from the same group of doctors for a second opinion, I think the outcome would have been different.

Nobody from the same group is going to speak out and say that they don't need a surgery against one of their own guys.

Anonymous said...

Truth is, I just didn't want the most commented on post to die.

What I don't understand is that this is a conservative town, right?

The city leaders refused a budweiser bottling plant from locating to this area is that true?

This place is so conservative that we can't have a beer bottling plant? Yet.... We have E$$ent as the healthcare provider for the community?

I just don't get it.

Anonymous said...

Can you imagine how much money that could have brought to the town if we had a beer plant.

Think of the insurance= jobs, how many people it might get off the drugs, and into work.

What do they think a plant like that is going to do to the community? Get us out of the poverty level= Give someone a job, and a reason to keep their pee clean to keep their job? Maybe.

Anonymous said...

Everyone is looking to the physicians for change and I think the physicians are doing what they can. i.e. Red River Radiology moving to the loop, Dr. Salas for minor emergencies, etc.

We know E$$ent is not good for our community, yet our community leaders don't seem to know or be taking any action to change this.

So by comparison which is worse Paris, a beer bottling facility or E$$ent?

Anonymous said...

I read the Blog but have not posted before. However, I feel I must address a post.

8:16 PM anonymous said:
"This is a closed system: PJC grads go to work here, with very little cross-feed from other organizations. They finish their BSNs through a completion program, with still no outside exposure.

They then go and teach at PJC. Teaching within the limitations that they have learned."

This person obviously is not well acquainted with the PJC nursing instructors. Only 2 of the 14 fit that description.

Anonymous said...

How much have the lesson plans changed with the influx of the new people? What curriculum changes have been made over that period?

I once worked for a company in which the CEO would call in the new employees at the end of their probationary period and ask them what changes they would make. Otherwise, as he was aware, it comes back to "Company Policy” and the phrase "that's the way it's always been...."

Anonymous said...

12:24 asked:
"How much have the lesson plans changed with the influx of the new people? What curriculum changes have been made over that period?"

Nursing curriculum is based more on state board requirements than "company policy" or "that's the way it's always been".

Anonymous said...

OK, I couldn't resist to push this one over the top… 100 comments!

From an earlier post "YOUR PRIDE IS KILLING OUR COMMUNITY. Its time to swallow it, and work together"

We can not let this go, and need to continue to inform the community of what is going on at PRMC...

Patients being stroked out by cavalier cardiologists… locums radiologists sticking 14 French Perm Caths into carotids and killing patients. This is malpractice, even if you cover it up.... Burt!

Anonymous said...

Hi, I was out blogging and found your site. It certainly got my attention and interest. I was looking for health information and even though this isn't a perfect match I enjoyed your site. Thanks for the read!

Anonymous said...

Did anyone look at the Paris Survey for improvement? Most people were more interested in making Paris beautiful. Everyone seemed happy with emergency services--and seemed oblivious to the problems they were facing.

Yes they are good--yes we will loose them if we don't face their issues. We are loosing experienced staff. If anyone has ever lived through a fire, they know the importance of what firemen do, and how experience comes into play with their jobs.

I guess what I am saying is--Why is making Paris beautiful, more important than keeping us safe?

There are major priority problems here in Paris. Maybe the survey should be more problem oriented to get the word out.

Something like Are you aware that we have lost X amount of experienced firemen? Would you rather spend are tax dollars on tearing down old houses, or fixing the problems with our fire department.

Because if we don't spend money fixing the fire department problems, we will be tearing down more houses due to fire, not to mention loosing young firemen in fires because of their inexperience, and lack of leadership.

It's the exact same problems with our hospital. We are loosing experience daily---I guess people won't see it until it bites them in the butt.

Anonymous said...

Can you just imagine what we look like, from the outside looking in?

I don't know--I guess some of these same problems are everywhere. I think many people can't relate unless they are in healthcare, or find themselves unfortunate enough to be a patient these days.

I think many people don't step up to the plate because they don't think they know enough about it to say anything or do anything.

It doesn't stop administration or board members though.

Anonymous said...

So what are the remaining docs at the hospital doing?

Are they tolerating these obsured problems in radiology?

...radiologists not showing up for work (last weekend) with no departmental coverage, abismal reports with poor turn around, poor PACS, even poorer oncall coverage (6 hrs for that chest CT with blood clots), etc...

It sure helped the radiology department to run off those RRVR guys!!!??? Didn't it Andrew?