Wednesday, January 03, 2007

Back to Rio Rojo...1/15

What are those big boxes being brought into Paris Imaging? Could it be a belated X-mas present...well, in a way. It's the new Gamma camera for their nuclear medicine addition! When hardly anything in PRMC x-ray is generating income except nuclear medicine studies, it's hard to ignore. This could cut heavily into the revenue stream.

So, let's lay it out, Paris Imaging has the newest and fastest equipment in town, including:

  1. ultrasound,

  2. digital mamography,

  3. diagnostic x-ray,

  4. CT,

  5. MRI,

  6. and now nuclear medicine.

    Guess the Boyz are back in town....


Anonymous said...

Oh yes, nothing like a heartwarming article like this to read and enjoy along with my morning coffee! Hats off to the Boyz, Paris should be thankful that SOMEONE had the cojones to stand up to Essent and progress with NEW technology for the Paris healthcare arena. Many times the phrase "bandaid station" has been bandied about regarding outlying healthcare facilites, now it's become the description of PRMC. Hud and Buds should be REAL proud of THEIR progress here, then again that's not what they came here for, is it?

Anonymous said...

...the boyz are back...
...the boyz are back...

Anonymous said...

Yeah the boyz are getting a gamma camera. But I don't think NEW is the word that should describe it. The word out is REFURBISHED.

Cool, is the software refurbished as well? Doubt it...frank

Anonymous said...

Regardless if it is refurbished, do ya really think the Boyz will get shabby with it? NOT........and the software, pul-lease they could have clay tablets and scribes and still be light years ahead of PRMC's equipment and technology. But that as we all know, is not the case.

Anonymous said...

In re: the 7:03 posting.....

It may be refurbished, but I'll bet you dollars to donuts that PRMC doesn't even have a PICTURE of such a device, much less an actual camera.

Score- da Boyz 1, Dud 0

For the record, I've operated refurbished analyzers in my career, and if the refurb is done right, the analyzer will run as well as a brand-new one.

The X-ray folks at PRMC have got to be sick at this sight.....

Anonymous said...

I understand that outpatient Nuc Med at PRMC has fallen off dramatically. Imagine that.

Anonymous said...

Well, word is they tried to get a nuc tech from the hospital... Guess their pockets weren't deep enough. Heard they settled for a tech that was brought out of retirement. You would think they would have supported the community with a local. Hope the guy doesn't mind the 100+ miles a day drive. Good luck to 'em.

Anonymous said...

In re: the 12:04 posting...

By the way; What is an analyzer? And yes PRMC has TWO NUC cameras AND a picture.

Anonymous said...

For the record, I'm in the clinical laboratory field. When I refer to analyzers, I mean the ones that do testing on blood & body fluids. Maybe not as visible to the public as, say, a CT scanner or MRI, but just as important to patient care.

PRMC may have 2 cameras and a picture, but do they now have the pt. census to keep 'em busy?

Don't say I can't chime in on this conversation. This thread seems to point out the lack of progress PRMC is making under E$$ent.

Anonymous said...

Hey 5:50,

It's like PRMC goes out of it's way to hire local...let's see, locums radiologists, temp techs, and all those agency nurses!

Retired, you mean he turned in his license?

Get a life!

Anonymous said...

I hope the new guy will understand that feedback means good and bad. If the plan is working or failing miserably.

Under Essent administration, if it was there plan--it was to be in place. If there was a problem with it, they didn't want to know about it---just do as I say, and I want to hear that everything is going great.

That is why things are failing so miserably now. Many of the people who gave honest feedback are gone. The others just learned how to play the game.

It kind of seemed like a mafia situation.

Anonymous said...


It isn't that we didn't understand the game, the facts are: the patients are more important to US than E$$ent and their politics. We know the E$$ent system is messed up, they don't care about that or the patient. Keep the morals and leave, or lose all morals, values and patient compassion and work as slaves for peanuts, knowing one day we all be free.

Anonymous said...

Hey 12:46,
I mean out of work and clinical hands on experience lacking. I got a Life.

The problem with the whole situation with the hospital is the people here are still in the mind set of good ol boys. You scratch my back and I'll scratch yours. And ESSENT has come in not playing those games. And that has wrecked everyones world!

Yeah Essnet has faults and EVERYONE does. Just because the physicians sends to RRR does not mean the dr in Paris will read the study, hell he may be in Rockwall, Longview, Greenville even Chile. Go Figure!!!

I don't think that the issue was of where, but of whom. The boyz are a good group, and certainly better (and more understandable) than most of what floats through PRMC. Transcription can probably attest to that. And consistancy does count!

As to good ole' boys, Essent is nothing but that in management. Look at who they're bringing in: Hud's houseguest. Who did Knizley recruit? His buds.

Yes, Essent did make some positive changes, especially in attention to detail as far as reimbursements (I know that they wouldn't have forgotten to bill for an entire year of services for a minor care clinic), but that isn't what started this blog nor caused the furor. Your people can be your greatest resource, or your worst nightmare. You set the tone...or to phrase it a bit differently: You brought the band, we dance to the music....frank

Anonymous said...

How can you say the "boyz" are better than what has been floating around. In my opinion, the docs that have been around here consistently for the past 3-4 months are just as good and have a better personality than the RRR staff. Granted, at first it was BAD! But we have improved greatly and trust our docs that we have now. Its just a shame that the physicians at PRMC, a place that provides these physicians a place to care for their pts and make a living, send their pts elsewhere. Why dont the physicians here at PRMC grow some NUTS and speak up to administration and make things right!!!!

Let me count the ways....
Lower cost
Understandable (english as a first language)
Multi-modality (remember what was pulled from the PRMC list of procedures when they left)
and lastly, but probably most important, they are responsive to their customers-both physicians and patients....frank

Anonymous said...

I dont remember them being very "PROMPT" in signing reports when they were here!

Anonymous said...

Let's be clear on one thing:

Prior to the boyz walking, Dud (Andy) was warned, "you push these guys and they will walk." Dud didn't believe it and continued to push. So Dud (and Hud) are responsible for our current radiology situation in Paris, and it will NEVER change.

PRMC will lose millions of dollars yearly in outpatient imaging. E$$ent only has themselves to blame for that "minor" miscalculation in judgement.

Regarding the 6:11 post: I "speak" to managment every time I send one of my patients to Paris Imaging. It's the only language they seem to understand.

Anonymous said...

I received a comment and decided to put it out for discussion. It seems like this was the 6:11 poster. The original and additional comments are included. Since it was put out late, additional submissions will be added, or you can just comment in:

Anonymous in the 6:11 post; you got it right and Frank is just guessing.
English is now the first language.
PRMC pricing is higher, but if insurances are paying it; so be it.
Now consistant.
Now prompt: If the docs are not on auto fax with their reports they need to get that way!!
The docs are responsive to the patients and the physicians.
Half of the studies on the list the boyzs would cry about doing anyway or cancel once the patient arrived. Alot of times there would not be an interventional Dr onsite but the schedule would have one listed.
How about the boyz sitting in the reading room reading films from their clinics and not reading hospital films; thus making the hospital look bad. Come on area Dr's open your eyes.

1st comment:
Personally, I can't remember when I saw xrays left unread when the radiologist left for the day. I know that transcription has had issues in keeping up at times. I know RRR brought in their own equipment to read the studies, and that consultations were far clearer because of it. I can't remember a request for an interventional study turned down unless they had a patient health issue--and then they let me know the reason.

Next comment:
Having worked there in X-ray, I didn’t observe anything that would compromise patient care. Yeah, some of the signing was delayed, but we could always pull up an unsigned report and read it off. Later, even those were being sent to the floor, and pulled when the signed ones hit.

I have two insurances, yet I don’t like having to pay any deductible. For someone without insurance, or on limited income, the difference in pricing can be critical. Apparently admin is fairly cavalier with other people’s money.

There were times when docs switched days, but the schedule usually reflected it (revision f). And I can remember calling Billy in even when he wasn’t on call to do a procedure.

I’m not there now, but from what I saw while I was, even the ones that could speak intelligible English had issues (not reading plain films, or not reading CTs, or NM studies, or “I don’t do interventional”, or lack of a personality), but some are understandable: They were temps. But, my healthcare deserves more than a “temp”.

As far as I can see, the Dr.s have their eyes wide open! Where would you send your family?

Third comment:
I'm totally at a loss on this one. These problems just were not there when I worked at the hospital. I quit when things started going south. When I worked there radiology got it done, no problem.

Remember the Customer classes we had to take, and all of the yearly meetings with the Sisters before Essent took over? I wish Hud and the crew could take some of those classes. Everybody griped about having to go, but they showed us the direction Christus wanted us to take.

When I was working for PRMC, I was still working in the Customer mode, and I felt like Essent wasn't appreciative of that direction. I couldn't figure out what they wanted from me.

Anonymous said...

I've got a how to question for you.

If a Dr. orders a radiology test, and they don't specify where it be done, can the pt. or the home health agency send them to Paris Imaging?

Is there a requisition form at Paris Imaging, like there is for the hospital?

What about portables. Does Paris imaging do portable x-rays for home health?

Anonymous said...

Forms should be at most if not all Physicians offices, and are at Radiology Center of Paris for just a call. The same link gives a list of services.

A patient has the right to be treated where they want to be treated, if a choice exists.

Anonymous said...

Fourth comment:
Having dealt with the Boyz on a consistent basis in Radiology, I found them to be spot on with their reading. Sure, some reports might not have been "signed off" on, but there was always a report to refer to and forward. Usually, it was a technical problem with the system at the hospital, period! In unusual circumstances when something hadn't been read, it was because the films had never been put in front of the Doc's.

And the comment about "reading their own films", pretty shabby comment if you ask me, especially when they had their own equipment in the Rad room to do their jobs.

Regarding the cancellations and whining, cancellations were usually done for good reason, many times patient health issues and Xray was ALWAYS notified as to why-get it right folks! And whining, who in the medical arena hasn't whined about their job?

Invariably, when asked to cover a situation that arose in Xray, RRR was there to step up to bat. A situation comes to mind regarding a thoro that was needed, I specifically remember Dr. Parkhill (even tho' not scheduled at the time) coming in to attend to the patient. And this has occurred on many occassions. It was all in how the Boyz were handled. Yes they could be a tough lot, but I personally respected and admired the hell out of them. How many locums can you say have this accessibility? None, I would say.

Anytime I had a question,concern or problem, the Boyz may not have been gracious about it, but they were reliable , dependable and took care of the issue at hand. And just exactly who expects sugarcoating from a Doc when dealing with patient care or other issues?

Ultimately, it filters down to this: reliability, definitely understandable (language-wise) expertise in their field, and am sure the area Docs were left floundering with no one reliable enough to call and confer with, regarding patients. I know Xray was.

It's been a fiasco since they left, whether some in Xray would admit it or not. Early on in my association with RRR there were some ground rules that evidenced themselves pretty your job, know your job, perform it correctly, give them what they need and you were good to go.

Too bad these guidelines weren't followed by many, including Essent!

Anonymous said...

Yes, RRV are excellent doctors but they have a temper. Remember the equipment, I believe it was a computer, that was thrown out into the hallway and came close to hitting a coworker. What about when they screamed down your throat for a problem that you are trying to fix that was caused by someone else on a different shift or wasn't really caused by anyone but just happened. They were extremely good at shooting the messenger. Very few coworkers would even walk into the reading room because of the tempers which caused problems not to be corrected. That wasn't working together. What about talking nasty about the hospital while walking down the hall following a coworker with patients around. That was respectful and it happened constantly. I also wonder if the hospital was reimbursed for the time spent and electricity used while they read their own reports. Both sides of this story have their faults. The RRV boys should be called the good/bad 'ol boys. They are far from perfect. I've dealt with them at various locations. And, as far as reports not being signed, some still aren't, and a specific doctor would leave them go for 3 months or longer, now that is patient care. The only way a doctor can get a report, unless they call the department, is after it is signed.

After checking up a bit, I deferred to a former employee:

Unsigned reports were being posted in patient charts, so obviously they were available. But signed reports sitting in baskets for a week before being distributed to the floors impedes the process a bit more, wouldn't one think?

Losing hours of dictation because of a cobbled together system would drive any physician to distraction.

Bringing films to be read that were weeks old because of poor fileroom control was ludicrous.

Reimbursement for electricity? What about reimbursement for the resources that were utilized by the hospital? As for time, they weren't hospital employees, so that doesn't fly.

And having to put up with the slipshod departmental management (or lack of management in so many instances) should qualify them for sainthood. Tantrums probably are a disqualification, however.

The Rads had their moments, but they were far less tempermental than some I've worked with, and far more competant than most.

Anonymous said...

Frankly it sounds like sour grapes from the original poster. Probably an Essent-er.

Patients were never turned down for a study because the rad didn't want to do it. Usually it was for reason such as: patient had not been properly prepped [which means study = useless], patient had elevated creatinine [use of contrast media a major health risk for patient] or wrong the study ordered [dr ordered a CT when MRI would be more diagnostic].

The Boyz are not just docs. They are businessmen who know what side their bread is buttered on. Not giving good service means poor returns. Which is why their outpatient radiology centers are doing very well.

Face it Essent. You screwed up by pushing the Boyz out. They made money not just for themselves but for the hospital too.

More than likely, it was that the hospital felt like they were prima donnas, and the corporation has only room for one of those....

As was explained to me: Before, the rads absorbed the cost of the no-pays (self-pays that don't) since they billed for the professional services. They also provided a cross-check for billing and coding errors.

Now, PRMC's billing has to catch their own coding errors--the ones they made themselves--and pay the nighthawk service, and pay the locums whether they collect anything or not. Plus they lost out because of the reduced services, and the more visable competition.

Good thing Knizley was handy, because explaining that to investors isn't Hud's favorite pastime...but it is mine....frank