I guess I was too harsh on the bean counters, since I did get several replies defending their honor. A few observations were made that need the light of day, as to why Essent and Paris weren't the right mix:
1. Essent didn't have the assets to be able to swing this large an endeavor. They were very exposed coming into this deal, partially because of a poor evaluation during the 'due diligence' period. They had no idea of the magnitude of what really needed fixing.
2. Short term goaling. Corporate put them on a fast-track schedule, with milestones in the monthly/quarterly timeframe, rather than planning for the long haul. Sort of the difference between Japanese and American corporations: Japanese take a longer approach, while American corporations are more instant gratification driven.
3. Lack of real understanding of the politics of the situation.
They had no real concept of the animosity between the "Holy House" and "Big Mac" crowds, and how it actually impacted Paris healthcare. (Note: the quoted descriptors were not mine, but they seemed to illustrate the point....) Additionally, the dynamics of the physician groups that had formed were foriegn as well.
4. Inability to adjust to the situation. Despite descrepancies in their conceptualize viewpoint and reality, they insisted on staying with the original plan and milestones, forgetting that feedback, adjustment, and re-evaluation are important steps in a project.
5. Mis-evaluation of the area's labor pool. In metro areas, there is always a supply of staff, due to the population base. But, in the Paris area, there are a couple of fallacies in that equation: There is a smaller population and limited draw to the area. The metroplex pays far better. Why drive the same distance to one and get paid less? It's like what put some of the nails in McCuistion's coffin: A Dallas-based management team that assumed the business climate was the same as the metroplex, and implemented policies that drove away their physician tenants.
And the result? Patients are leaving in droves. Shuttle bus services to Texarkana, Tyler/Longview, and Dallas are having to buy more vans. (Maybe Essent invested in those!) Services and procedures that we could previously count on are here no longer.
All we get in return is a visit from a military dictator, who meets with the hospital CEO--probably sharing tips....