Sunday, April 29, 2007

Seven things...5/8

I checked the new CEO's website, and if he implements all of his seven points, he's going to be following Andy's route, with an escort.

Patient first? When has Essent aspired to that??? Heck, one of the CEOs (can't remember which one...so many preceded ....) said they didn't really need Paris behind them.

The Golden Rule for Customers? From the description, he's been through "The Customer." Well, the employees are also the customers of the hospital, and a call to the Better Business Bureau on their behalf would be in order for this place.

Manditory fun. All the skipped raises put us in a great mood. Paste a smile on your kisser, or your keester is going to hit the bricks.

People are a hospital’s most important asset! We've been shedding assets for three years, now. LCDs are heading up the list of personnel replacements.

Employees need to take risk and challenge the status quo! Like that's going to happen...people even get fired for contributing to the blog. Suggestion boxes, anyone????

Practice Scottish spending! Actually, I agree. But, there needs to be a willingness and ability to pull out the wallet when it's necessary. Essent hasn't been terribly willing...and possibly not able....

I left this for last: Always try to exceed...expectations! I really think the blog has....

29 comments:

Anonymous said...

Friend of mine just went in for an emergency appendectomy. While filling out the paperwork, his wife noticed something she didn't understand on one of the forms. So she asked what it meant. She was informed it indicated her husband had been admitted for a cholecystectomy. She further inquired and was told he was there to have his gall bladder removed.

Keep in mind, he had already seen his surgeon who had ordered the appendectomy.

Appendectomy, cholecystectomy, yeah, I can see why they would get that confused. Seedless to say, they were not pleased. I probably would have been headed out the door at that point.

Anonymous said...

Just ANOTHER one of Hud's Healthtrust Yes Men.....

Anonymous said...

I came into the hospital for tests preceeding surgery. My first impression of the floor was a true bonding experience: I stuck to it! I walked out of my slippers. The floors looked as if they had been mopped over with dirty water amd were sticky.

The bed rail was so loose it seemed to be coming off, and the call button/speaker worked intermittantly.

It decided me. I'm having my surgery elsewhere. There is only one chance to make a first impression.

Anonymous said...

A 60-ish friend of mine began having chest pain/pressure yesterday afternoon, April 29th...radiating up her left neck and shoulder and low B/P (before they left for the ER it was 70/50's) and extreme weakness.

When they got there, they signed in at that cheesy "Triage" area, where the nurse did not look at the triage form for 20-30 minutes. (I also think it was an LVN doing the triage again.)

When they finally got in to be triaged, about an hour later, she was told that "there were a lot of people ahead of her, and it would be a while"...fortunately her B/P had come up to low normal and the C/P had subsided.

One guess as to my advice when she goes to the Cardiologist this week...Dallas, Dallas, Dallas!!

Anonymous said...

I have said it once and I will say it again.... P R M SH_T!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Anonymous said...

How about Hashmi for CEO??? He has the connections clear to Pakistan!!! Since they let him do whatever, seems he could be a candidate!!! HOLD ON.... I HAVE TO PUKE!!!!!!!!!!!

Anonymous said...

Wouldn't Hashmi be a great hospital CEO!!! He already has great skills at hiring a dumb@!# for a office manager. He would fit in fine with ESSENT's great hiring techniques.

Anonymous said...

Hey 8:55 PM Why are you attacking Hashmi. News flash he is just a doctor. Just who (specifically) lets him do "whatever" and what does he do that the other docs don't? Maybe you should be a little more specific with your accusations in the future. I have no more love for this place than you do but, damn attacking doctors is just stupid and counterproductive. Doctors have private practices genious. They don't work for the hospital. Like it or not Dr. Hashmi is the best cardiologist that we have and his patients get the best care that they can get in this crappy facility. You are obviously jealous. What other doctors are you jealous of. Maybe you should be CEO you may not have connections he does but you are obviously a petty little preson with plenty of ego and spite. You would fit right in in administration.

Anonymous said...

If Ducks (misspelling on purpose) puts the employee first then he either lied or he won't last long. At Essent employees are rank some place below pond scum!

Anonymous said...

11:07
While I agree attacking the physicians is counterproductive... Dick is famous for bashing our local physicians...

And to your statement, "Dr. Hashmi is the best cardiologist that we have and his patients get the best care that they can get in this crappy facility." PAH LEESE.

He is the last cardiologist in this town I would send my family member too, in full blown cardiac arrest...his method, go straight to bypass, and pay through the nose...if you make it.

There is more technology available prior to going the bypass route and much better for the patient. Read a Cardiovascular Journal....

Anonymous said...

RE: 8:55

NEWSFLASH!!! How do you think that the cath lab got a makeover when he came on board?? Why did he get his brother-in-law to come to this sh-t hole for an exam? To try to make PRM shi-t a name since it was going South!! What other DR.S park in the fire lane to come do whatever he takes his time at doing!! I have not seen any other Dr. pull this. Why do Dr's get suspended for not agreeing on Big Hashmi's so called of a plan!!! What other Dr's leave studies ceiling high b4 they get read. I only know of one and you got it... HASHMI!!!!!!!! There is many more to list, but I will not go there!!

Anonymous said...

what I find interesting about Hamshi , is that he was named "director of cardiovascular services"This office does not appear anywhere in the staff bylaws!Essentially he and the other paid creature of Essent , Bercher are usurping the staff organization which exists in every hospital in the country!It is bad enough that Dr. Shafique has been relagated to some sort of meaningless role,the board has been renamed THE HOSPITAL ADVISORY BOARD (not the board of governors as in the past)what all this means is that HUD has created a way around the medical staffs role as patient advocates; worse it gives him a free hand to discipline any wayward staff member who tries to blow the whistle on the superficial bullshit that Essent puts in place to placate the state boards and federal oversight modalities.I would challenge anyone who doubts this , to go to the north campus and see for themselves the way Essent implemented the JACO demand that the north campus had to have an ER.It consists of a TV camera hooked up to a 20 year old monitor and an intercom salvaged from the nursery.
If someone comes to the north campus "ER" after the day surgery closes; the person calls into the monitor , the ob nurse calls the house supervisor, the house supervisor goes to the back door and shows the patient into a room with a telephone.

she then dials "911";Assuming the patient's MI is not progressing too swiftly toward death ; the ambulance will arrive and transport him to the south campus!
This is the absolute truth!
I would suggest just putting a red phone in the parking lot and a sign saying (in spainish and english) "if you are real sick pick up this phone and dial 911!


How far we have fallen since we lost local control of our hospital!

Anonymous said...

Ok 12:46 PM
You say thay you agree that, "attacking the physicians is counterproductive... Dick is famous for bashing our local physicians..." Yet you attack local physicians in your own posts. Are you a hypocrite or just an idiot?

You go on with your bashing and hypocrisy with, "He is the last cardiologist in this town I would send my family member too, in full blown cardiac arrest...his method, go straight to bypass, and pay through the nose...if you make it."
Obviously you don't work in a critical care area. If you did you would know that's a bunch of BS. Any of the cardiologists in town will cath you, stent you, and stop your arrest if they can. If you blockage can't be stented what should they do? Let you die or send you to surgery?
If you know so much more than the cardiologists why aren't you one?

Your drivel and rantings continue with "There is more technology available prior to going the bypass route and much better for the patient. Read a Cardiovascular Journal...." I guess you have the luxury of sitting on your a$$ reading. Some people are too busy actually DOING and making a difference. You just spout off and put people down that you are obviously jealous of. With your ego, arrogance and, obvious lack of intellect you would be a shoe in adminstrator for any essent facility.

Anonymous said...

Ladies and gentlemen, another Hud-apologist has been identified- the poster of the 10:51 and 11:07 comments. Either that, or heor she is employed by Hamshi.

Sorry folks, but I hope I'm elsewhere should I ever have a heart attack. If Hamshi is now the designated Big Cheese among the physician staff, you folks are really in trouble. Even more so if Slipknot Lui is still on staff and allowed to do CABGs (two for the price of one- what a deal).

ANd just because a person is now a doctor does not make him or her immune to criticism. Pull your head out.

Let's get back to the subject at hand, which is Essent and their crap policies.

Anonymous said...

The first major dirty deal Essent pulled was PAYING the hospital board a salary. That effectively put them in Hud's pocket and by the gods it should be illegal if it isn't already!
So are you surprised that some docs are also in that same deep pocket? I'm not. Anyone can be bought. Hud knows that and that is his strongest weapon against us. All we can do is hope for a few folks with some integrity. Where the heck are y'all???? (Besides us poor employees struggling to maintain said integrity and still keep our jobs)

Anonymous said...

Well, I personally do not like PRMC, but I have had nothing but good experiences with Hasmi and Dick.

No lie, they have been good to my patients and stand up guys in my opinion.

You shouldn't blame them for trying to save the place. I really think they do have good intentions.

Anonymous said...

Recently, within this week, a patient was transfered to a Dallas facility after a full arrest and subsequent implantation of a stint due to sever blockage. The attending physician in the Dallas hospital expressed much disbelief at the level of care this patient got at PRMC ( Please Remove My Cash ).

Anonymous said...

Hey all you Whistleblowers...there are laws that protect you...

http://www.dol.gov/compliance/laws/comp-whistleblower.htm

http://www.whistleblowers.org/

http://employeeissues.com/whistleblower_laws.htm

SO BLOW THEM WHISTLES!
PS...the cath lab didn't get sh-t.. it is all the same equipt...
Pooch Smoocher

Anonymous said...

Hey 10:51am :
That's why they are called CE's Which stands for continuing education. Keeping up with technology is an important roll as a heathcare provider, from RN to DR.

Guess you are one of those that has been doing things this way for years and can't be bothered to read and go to training seminars to improve your skills (assuming you have any worth improving)into the next millennium. Technology is an amazing thing embrace it or get left behind..

So get some advanced interventional training (there is more available than stents)....read the literature and keep up...if you can...biliary stents in coronary..what percent is it again, in which stents are used off label? And some times fracture, what is the restenosis rate? these are things you should become familiar with

"Any of the cardiologists in town will cath you, stent you, and stop your arrest if they can." Or do you mean if they aren't to scared to.

I guess by assuming you know anything about me from a couple of lines in a blog post.. really makes an ass out of u

Anonymous said...

Board members are not to be paid that makes them employees on an Advisory Board.

Report this type of fraud to the texas state attorney general....

The Honorable Frank Madla
Chair, Senate Nominations Committee
Texas State Senate
P.O. Box 12068
Austin, Texas 78711

Letter Opinion No. 97-023
Re: Whether a person with an ownership interest in a utilization review agent is eligible to serve on the Texas Health Care Information Council as a member under Health and Safety Code section 108.003(c)(7) (ID# 39463)

Dear Senator Madla:

You ask whether a person with an ownership interest in a utilization review agent is eligible to serve on the Texas Health Care Information Council (the "council") as a member under Health and Safety Code section 108.003(c)(7). We conclude that a person with an ownership interest in a utilization review agent is ineligible to serve on the council as a member under that provision for the following reasons.

Chapter 108 of the Health and Safety Code creates the council to "develop a statewide health care data collection system to collect health care charges, utilization data, provider quality data, and outcome data to facilitate the promotion and accessibility of cost-effective, good quality health care." Health & Safety Code § 108.006(a). The council is composed of three nonvoting ex officio state agency members and fifteen members appointed by the governor. Id. § 108.003(a). Section 108.003(c)(7), the provision at issue in your request, requires the governor to appoint "two members who are not professionally involved in the purchase, provision, administration, or review of health care or health care insurance" and who have expertise in at least one of five areas.

You inform us that in January 1996, the governor appointed a person to the board, "John Doe," to fill a position under section 108.003(c)(7). Mr. Doe does business under the name "John Doe and Associates." A subsidiary of John Doe and Associates operates under four active assumed names, including Health Benefit Management. Health Benefit Management is certified as a "utilization review agent" under article 21.58A of the Insurance Code.

A utilization review agent is defined under article 21.58A as an entity that conducts utilization review for various types of entities, including an employer with employees who are covered under a health benefit plan, an insurer writing health insurance policies, and various types of health benefit plans. See Ins. Code art. 21.58A, § 2(2), (17), (21). Utilization review is defined as "a system for prospective or concurrent review of the medical necessity and appropriateness of health care services being provided or proposed to be provided to an individual within this state." Id. § 2(20). A utilization review agent may not conduct utilization review of health care provided in this state unless the commissioner of insurance has granted the utilization review agent a certificate. Id. § 3(a).

As noted above, a person appointed to the council under Health and Safety Code section 108.003(c)(7) may not be "professionally involved in the purchase, provision, administration, or review of health care or health care insurance." We believe it is clear from the definitions of utilization review and utilization review agent in article 21.58A of the Insurance Code that a utilization review agent reviews health care or health care insurance.

The more complicated question is whether this particular appointee is himself "professionally involved in the purchase, provision, administration, or review of health care or health care insurance." As stated above, the appointee, Doe, does business under the name John Doe and Associates. A subsidiary of John Doe and Associates, Health Benefit Management, is a certified utilization review agent. We assume, based on these facts, that Doe has at least some ownership interest in the certified utilization review agent. Chapter 108 of the Health and Safety Code does not define the phrase "professionally involved in." We believe, however, that this broad phrase is intended not only to embrace persons who are themselves directly involved in the review of health care or health care insurance for compensation but also those with an ownership interest in an entity that reviews health care or health care insurance. Therefore, we conclude that the appointee is ineligible to serve on the council as a member under Health and Safety Code section 108.003(c)(7).

S U M M A R Y
A person with an ownership interest in a utilization review agent is ineligible to serve on the Texas Health Care Information Council as a member under Health and Safety Code section 108.003(c)(7).

Yours very truly,

Mary R. Crouter
Assistant Attorney General
Opinion Committee

Probably set up as 'reimbursement of expenses incurred..." But, that's just a guess....frank

Anonymous said...

8:02 PM,

How much did Dick pay you to post this? I bet you still believe Elvis is alive, too.

Anonymous said...

Dick cares for himself and himself only..

I have heard him called the axe man, and that is exactly what he is. Remember the 10%.. only divulged the FTEs let go, not the parttimers. Interim CEO run Amuck..HUDDIES BUDDIE back under his wing and back home too I guess.

As the old saying goes..keep your friend close and your enemies CLOSER!

Smooch away butt Smoocher dickie.
Just remember what goes around comes around..you WILL reap what you sow... so if you aren't already...BEND OVER

Anonymous said...

Hey 12:50 AM

You ask, "biliary stents in coronary..what percent is it again"

Exactly what percent are you asking for? Try to get someone smarter than you to help with the questions next time OK. If it is the average percent the diameter of the stenosis is reduced when biliary stents are used in stenotic or occluded aortocoronary saphenous veins that would be 85.5 +/- 14.1%. Let me do the math for you, (since you probably can't), that would be 99.6 - 71.4%.

"which stents are used off label"

Technically any stent COULD be used off label as long as it would fit in the artery. May not be wise, but it is so. Once again you're not smart enough to form an intelligent question. I think you are looking for an answer of drug-eluting stents. Drug eluting stents are ony FDA approved for use in patients with simple artery blockages. However they are often, 60% of the time according to the FDA, used off label for things such as such as myocardial infarct, blockages in more than one branch of an artery, multiple blockages requiring more than one stent, etc...

Your idiotic rant goes on with
"Any of the cardiologists in town will cath you, stent you, and stop your arrest if they can." Or do you mean if they aren't to scared to."

You are the first one I've ever heard say this. I usually hear people bitch about the docs cathing too many cases. Of course generally the people I speak to have a clue and that would automatically exclude you now wouldn't it.

And your final bit of stupidity is, "I guess by assuming you know anything about me from a couple of lines in a blog post.. really makes an ass out of u"

Awwww, have I been hitting you a little too close to home? Does the truth hurt? All I have done in my responses to you is point out that you are jealous, a hypocrite, an idiot, and a pitiful little excuse for a person. You like to attack people but you can't handle it when someone blows holes in your posts and points out your true colors. Do us all a favor; have someone help you with your next post. Maybe you won't come across as an ignorant hypocrite in that one.

fac_p said...

Looks like Dr. Hashmi has made his response...wouldn't you say? Welcome to the blog.

So far, we've had comments from a Florida physician, local cardiologists, an ER physician, and probably a radiologist or two. Some of the Essent corporate staff have jumped in when they couldn't take it any longer, a local board member, and, a couple local administrators. We've even had comments from administrators from other hospitals. (Not on this post, but others....)

But, the staff that works around the physicians, in a lot of cases, sees far more than is credited.

They see the procedures, they see the lab and path results, they see the slips, the personal problems, and the end results. Most of the posts are from those people, and some from patients and relatives.

What we should be concerned about is one of the last mentioned: The Patients.

As far as Cardiovascular, we are results based. Mortality/ Complications/ Recovery. And to some of those there is some justification. I've known some that kicked the high risk because they didn't want to drop their stats. Cherry-picking as it were.

And then there were those that took everything that was billable, and didn't really care as long as the check was in the mail.

Finally, there are some, that when they have the chance of making a difference, do so.

Which are you? ...frank

Anonymous said...

I posted last week (7:44pm)about my friend going to PRMC's ER with chest pain and pretty much being run off by an incompetent and uncaring triage nurse...now, after speaking to her again today, guess what??

She DID have a heart attack and has residual damage that has left her extremely weak.

She is such a nice person, I haven't been able to convince her yet to follow up on what happened to her, but fortunately her husband is totally pissed...I can see them retiring in comfort!

Unfortunately, my point is that this could have been any of YOU or your FAMILY in this same situation...! If you have to go to PRMC, better bring along a family member that doesn't mind being your advocate...don't be afraid to be loud and assertive to get what you need to.

On a plus note, she had a traveling nurse on the day she came in for her cath that was really a fantastic caregiver...kudos to that one anyway!

Anonymous said...

Sorry Frank in response to your 10:32 post. That was me at 8:07PM not Dr. Hashmi. However you do, as usual, bring up some good points that I would like to address.

I agree that, "the staff that works around the physicians, in a lot of cases, sees far more than is credited." They (the staff) see the procedures, they see the lab and path results, they see the slips, the personal problems, and the end results."

Very well put.So if anyone really wants to know if Hashmi is worth a crap they should ask the ones that would know. That would be CCU, ICU, ER, and cath lab. So if you don't work with him in one of these areas why don't you ask someone that does? See what they think of the man, or any other cardiologist/cardiovascular surgeon for that matter.

"As far as Cardiovascular, we are results based. Mortality/ Complications/ Recovery. And to some of those there is some justification." True story, nuff said.


"I've known some that kicked the high risk because they didn't want to drop their stats. Cherry-picking as it were."
"And then there were those that took everything that was billable, and didn't really care as long as the check was in the mail."

I have never seen Hasmi "cherry pick" I have ,however, known him to take patients with all types of problems, including active MI's, reguardless even if they were self pays.

"Finally, there are some, that when they have the chance of making a difference, do so."

You hit the nail on the head, and that is one of the reasons I have stood up for Dr. Hashmi in this post. Think about it for a minute does this guy need the money or influence that dr's get? Hell no. He had more money and influence when he was born than he will ever be able to make as a cardiologist & alot of people are obviously jealous of that. Want to know why he does it. Ask him, I did. His response was that he likes helping people.

fac_p said...

9:44
Assumption.... The other listings are pretty well on target.

Two things, I hadn't attacked Dr. H, seems he's better than several. I do ask the staff for their input--you gave it. I published it.

People can use the "Other" option with posts to claim a name--it can keep things straight--and interesting....frank

Anonymous said...

Wasn't saying you had attacked Hasmi, Frank. Was saying that some others were. Actually I have never seen you attack anyone on here that didn't deserve it ie. dick, perry, krye, hud, etc... Keep the pressure on those a$$es.

Anonymous said...

I'm a recent patient of Dr. Hashmi
I was through the Cath. lab and I found the staff of the lab along with Dr.Hashmi very kind and professional
And my condition has improved through medication since no blockage was found. I'm also a patient of Dr. Bercher and have always found him to be caring and professional to me as well.