Monday, January 22, 2007

An Open Letter...3/1


Dear Ladies and Gentlemen,

As a native Parisian, I am intrigued with the ongoing debate about healthcare in my hometown. I am a physician and have been in practice for 20 years in a neighboring part of the state of Texas. I have been following your plight with great interest, as my family remains there.

First, let me say that unfortunately, you as a community are caught in a rough spot. You are no longer a not-for-profit health care community. In this setting, bottom line will always be profit. There is only ONE solution, RETURN TO NOT-FOR-PROFIT status. As you can imagine, this would require someone buying the for profit people out. The community would have to become united behind a central process to root the for profit folks out.

If you are interested in pursuing this, I can organize the folks that can begin these discussions. However, please understand that this would promote a serious debate and would require a high level of sincerity on the part of both sides. Feel free to contact me.


Gary D. Boyd, M.D.

I have the contact telephone numbers, should people want to contact Dr. Boyd (just email me.) Here is the rub: A direct negotiation would be more expensive monetarily for the investors. Buying it on the Chapter 11 block would be more expensive for the community as a whole. In such a situation, we probably would be close to that '10%' left of employees. The hospital would be broken, both financially and in spirit.

Should it be on the auction block as court directed sale, the assets would probably be split. Through an Essent sale, it would probably be as a whole package...far from what I would care for, and far dearer than I would like, but talking never hurt.

I have my doubts that Paris will recover its former glory in healthcare: Too much water under the bridge, and our perceptions of 'what was' might be a little glorified with time. But it certainly could be better than what it has descended to....frank

23 comments:

Anonymous said...

Andrew K. was alway quick to tell you that PRMC in size and money was half of Essent Corporation. I would be shocked if Hud would let this one go.... As long as he has credit (300 million for 2006) my guess is they will be entertaining us for a long time with their ineptitudes. In traditional american style management you keep throwing money and people at a problem. Essent appears to be doing this very well. The only way Essent will leave town is if their investors loose confidence in Essent Corporation's ability to manage their perceptions of what is happening with all their millions (the name Enron comes to mind). I hope I am wrong, but my guess is they are here to stay for a long time. Sorry....

Anonymous said...

I would love to see us go back to being a not for profit.

At this point, I'm not sure how much good it would do. There is so much learned helplessness, and distrust in this community.

It's not just in the hospital either. Everything has come down to money. People are no longer an issue. It seems like the people who care about people, have gotten squashed by the people who care about profit.

Anonymous said...

Why not pursue the hospital that was proposed a few years ago north of Paris. SUrely a hospital owned by doctors would be better for all than what we have now.

fac_p said...

7:09--It would probably be cheaper than buying the assets, and would be NEW! But, what they wanted to put in was a specialty hospital, not full service....

6:50--Yes, but even RR was willing to give Essent a chance--for over a year. I think the community would support the effort if the majority interest was local, or they had a good track record.

6:36--Hud can't afford another Arcon. This would let him off.

But I see it more like Crossroads. Again, the cost to buy would be prohibitive, unless someone else has a different viewpoint.

Anonymous said...

Hey Frank:

Make no mistake, 'cause th boyz at RR only stayed at the hospital while they were making a profit, and bailed when the margin got too tight. Can't say I blame them. Everyone has to make a living. Just don't think they're any more nobel than their competition.

Few people in Paris will do anything without the potential for profit, and doctors building a specialty hospital is no different. Unfortunately, the people in Paris are stuck with E$$ent. Given the reputation this town has across the state and nation (not just in healthcare but look at the cities leadership... or lack there of... again greed driven) nobody will invest millions in a sinking ship. I would really be concerned about anyone that would want to buy, even at a fire sale ... look at what we got the last time! The devil you know is still far better than the devil you don't!

Paris needs to wake up! Clean up the community. Restore Paris to it's former pride. I sincerely hope the new interim city manager gets the support he needs. But the community needs to vote for improvement. You have a chance for change during the next city council elections... make your voice heard! Status quo will not do the job for Paris.

The clock is ticking folks!! It is bad to have lost a strong medical community... and this will likely never reverse. But make no mistake, as it could get worse. It would be devastating to loose Campbell's Soup, Sara Lee or Kimberly Clark... and if one goes they all go!

Anonymous said...

Our two hospitals were destroyed by the same people who have destroyed our city government in the past two or three years and for the same reasons - greed and stupidity. Bad decisions were made that destroyed the major industry in Paris - healthcare. I don't think it can make a comeback now. After they screwed up both hospitals they made a comeback onto the city council. Sweetheart deals for themselves and their clique prevail - they got some city management they could manipulate and decimated the city services by destroying the morale of the city employees. The rich boys are running amok in Paris and the Daily Snooze writes the articles just (lie) like they want it written. Notice you didn't see anything about a certain councilmember's tremendous financial loss after he invested his money in Sherman. Thanks for your concern Mr. Councilman. I have the same concern for you that you have for Paris.

Anonymous said...

I earnestly hope that some of our healthcare professionals take this gentleman's suggestion to heart and inquire! Sometimes through small steps, answers to problems reveal themselves. We all know the monetary pitfalls involved, but unless we try, what do we gain or learn? Granted, it might not come to fruition, however, if we don't try we won't know, will we? Change is inevitable, but perhaps with a little effort we can control that change so it's beneficial to our community. At this point, what do we have to lose, E$$ent?!?!
We'll never recoup what we had, not for a long time, but we CAN rebuild...........if we do NOTHING, E$$ent has e$$entially won. Now isn't that a comforting thought.

fac_p said...

By the way, I don't think that I'm going to fold my tent and go away, just because we would be under new management....

But, if the management communicates and engages in what would be considered fair labor practices in other states, I might swing my beady eyes to something else--like trash privatization--Oh, Yeah, done that already!

Heck, we could even change it around to a Paris promotion site if things go well....frank

Anonymous said...

9:04

Would the councilman's color be pink?

Anonymous said...

While we are on the subject of city council, does anyone know the real reason that Jim Bell was angry about the city manager being let go. He is in realestate you know. He had a housing contract or rental agreement of sorts with the city manager and it hurt him financially to see him go, but you didn't see this mentioned in the Paris Snooze did ya. You see, it's all about money people.

Anonymous said...

Frank,
Rumor control has picked up a whiff that PRMC has been sold! Announcement pending. You need to tap some sources.

Whups, guess I should.... More to follow....frank

Anonymous said...

ETMC--ETMC---ETMC--ETMC---ETMC

Wouldn't that be great! We would finally get our trauma designation, networks with support, educational opportunities,etc....

Oh who am I kidding. We aren't that lucky.

Anonymous said...

Ok, everyone is talking about the big "dog" or "god" should I say since that's what CP thinks of herself. If Cheryl is next, which I don't think we could get that lucky, what would she do??? Does she make that much money and is a smart saver that she could actually retire? NO! She would move before she ended up working at a local restraunt or grocery store bagging our groceries! Wouldn't that be a sight!!! Anyway, look at ALL DEPARTMENTS at PRMC? And what do you have?? UNSTABLENESS! Look at pharmacy for a moment, WHAT hospital in their right mind has gone WITHOUT a Pharmacy Director for WELL over a year now? Every healthcare facility needs access to prescription medication am I right? Well who is running the show on our meds? NO ONE! Nurses can't get meds on time or accurate or (the favorite saying) "not on formulary" Who is in charge of the formulary without a Pharmacy Director OR a CEO? There are so many issues at this hospital, we don't know where to begin, but it has gone down to even the smallest pill.... If someone in Pharmacy would speak up and give us a little insight on what's going on on EITHER 2nd floor hospitals it would be great of you! I don't think there's that many of you on the Pharmacy payroll to begin with. Between both hospitals, something is going on there also! WHAT IS IT??? Don't be shy.... 15 months later and NO director? Who's running the show down there?? Plus, anyone not aware, or that hasn't called pharmacy on the weekends, the EX director ms glover is still working for the hospital i am guessing part time on weekends, so she stepped down but who stepped up??? A dept head steps down...no one steps up?? What is the deal??????

Anonymous said...

4:26 PM,

I may not be from Missouri, but you'll have to show me (lol). I've been in tha area for a lot of years, and know all too well the Red River Rumor Mill.

Now if it's true, I'll happily stand corrected....lol

Anonymous said...

Well I was sure hoping that one was going to pan out.

I would like to go back to the hospital, but not under Essent.

Anonymous said...

5:56,

As would I, brother.....as would I.

Anonymous said...

11:22

Gee, they must be wanting more fines: Thankyousir, may I have another....

Anonymous said...

11:22

It's probably cheaper to pay the fines than it is to pay someone to do that job.

And if they get sued for malpractice due to a med error because the right saftey measures were not in place--it will just fall to the nurse that made the error, unless a good paralegal understands how the process works
and understands that it was an administrative problem that no pharmacy director was in place.

Unless these people get hit in the pocket--they will continue to do this kind of thing to save money--because it is more money in their pocket.

Anonymous said...

I hope that the nurses understand how important it is to have their own malpractice insurance, and not rely on that of the hospitals.

I know what some of the nurses say--having your own malpractice insurance makes you a target. That is not true--I can't stress that enough. Get it and don't tell anyone you have it.

If you rely on the hospital's malpractice insurance, and something goes wrong--you will have to take council from the hospital's attorney, and you will be the fall guy. They will be protecting the hospital and the top people.

They will leave you hanging to save their own butts. I've heard of administration changing documentation of nurses to save their own rears. You have to have your own council, because if not, there will be no one to look out for you--they will be looking out for the company.

Anonymous said...

Is anyone able to step back and look at the big picture and really see what is going on? This for-profit group has destroyed in two short years what took a lifetime to build. Remember how we use to be a "family"? All the 'old hands'that made this hospital known for its CARING AND COMPASSIONATE CARE are just about all gone. Time was when the community really loved the care they received here. What ever happened to all the elderly folks and their families that used to come up here and eat breakfast and lunch on Sundays? And for the ones of us left...remember the TREE OF LIFE? A gold figure of a tree whose leaves of solid gold that bore the names of our family of employees that had died and whose memory was honored by purchasing a leaf with his/her name on it. What ever came of it? Those leaves were solid gold and not cheap. Did Essent care about our family here...on the contrary,they have done everything they could to destroy it! No,it was never a utopia here, but at least the employees had some semblance of respect/credibility. Now, we have nothing. Remember when the employee of the month meant something? How about the suggestion boxes? And how about receiving a raise whenever you received your evaluation? Does anyone remember all the LIES that Essent promised us at the big meeting whenever they took over? Soon,there will be none of the old guard left and then it will be complete. Essent will have taken a once well respected and well staffed healthcare facility and reduced it to SHIT!

fac_p said...

I usually screen out profanity, however, putting a collection of ??!#% would have taken away from the emphasis....frank

Besides, I agree.....

Anonymous said...

To the author of the comment on stepping back and looking at the big picture...Here,Here!! Its about time the truth was told. And by the way,the TREE OF LIFE is in a Catholic church. Which one I don't know. It needs to be put back in the lobby on the 2nd floor! E$$ENT,if you were a man,we would go out back and I would treat you to a good ole' country ass whippin'!

fac_p said...

An Internal Revenue Service inquiry into not-for-profits' executive compensation found widespread disclosure errors and raised "considerable concern" about loans to directors, officers and key employees, according to a summary of the findings. Of the 1,200 not-for-profits reviewed by the agency, including hospitals and health systems, more than 30% were required to amend annual IRS filings, resulting in additional excise taxes totaling $21 million against 40 individuals or subsidiaries of not-for-profits.

Wonder how Royer faired???

frank