Tuesday, July 31, 2007

Burke's Law....8/4

No one could make a greater mistake than he who did nothing because he could do only a little. Edmund Burke
A Burke quote was used in a comment in Holly's thread, and I remembered the name of an old TV show that was on late at night when I was on the coast a while back, hence the title. I like the thumbnail philosophy, it makes everything seem black and white (like a 1963 cop show?)

My case is kind of like Holly's, wanting to help, but having no available avenue. Then digging into the situation and finding deeper problems.

All that is necessary for the triumph of evil is that good men do nothing.

If the blog is squashed by a lawsuit, does that really reassure the public? All it shows is that a large corporation can step on an individual.

There actually have been positive changes, merit raises coming back, bonuses(!!!?), and the like. Would that have happened without outside influence?

Would you like to know what I would really like to have happen?

A sliding ceiling for pay(based on inflation)--so that you can have a
possiblility of a cost-of-living raise, no matter if you're topped out.

A suggestion review committee comprised of staff and administration...50/50.

An inscentive program for the suggestions. If it saves money, a percentage goes to the person that suggested the idea.

More PRN staff hired. There is a slight hike in overhead, but it would allow the phase down the agency and temp personnel.

Maybe that ought to be on the next survey.....

Monday, July 30, 2007


Could it be that the Holly-Dick problem played into corporate policy?

ev3 Inks Deal for FoxHollow

By Elizabeth Trotta
Staff Reporter
7/23/2007 12:23 PM EDT

Medical device companies ev3 (EVVV - Cramer's Take - Stockpickr) and FoxHollow Technologies (FOXH - Cramer's Take - Stockpickr) climbed Monday after announcing a merger that will create a $1.7 billion company.

Under the $780 million deal, FoxHollow stockholders will receive 1.45 shares of ev3 common stock in addition to $2.75 in cash for each share. That represents total consideration of $25.92 a share, based on the July 20 closing prices. The price represents a premium of more than 20% premium to the 30-day average trading price for FoxHollow's shares.

Redwood City, Calif.-based FoxHollow specializes in medical devices primarily for peripheral artery disease (PAD) and other cardiovascular disease, while ev3, of Plymouth, Minn., focuses on minimally invasive technologies for vascular diseases and disorders.

"The combined company will enhance our aggressive market building activities and accelerate our clinical and research and development initiatives in this market," said John Simpson, chief executive of FoxHollow.

The merged company will be owned 59% by ev3 shareholders and 41% by FoxHollow shareholders. Jim Corbett, chief executive of ev3, will serve as chairman and chief executive of the merged company, and Simpson will serve as vice chairman and chief scientist.

Looking ahead, the companies project annual cost savings of more than $40 million from the merger. They anticipate net sales in the range of $585 million to $615 million in 2008, and adjusted earnings of 60 cents to 70 cents a share in 2008 and 90 cents to $1.10 a share in 2009.

When a company is setting up for a merger/IPO/sale, they try to make the best possible impression on the books. Holly's plight might have happened during "sweeps" week. Most people are aware of media "sweeps"--the period in which the popularity of shows/stations/networks is rated. Well, prior to a merger, they have their own version. You maximize your balance sheet to get the best rate in a stock exchange. Dick's push might have coincided with their downsizing of employees to optimize the ledger.

Might be interesting to look into, but that's for Cramer, or Business Week, rather than here.

Tuesday, July 24, 2007

Deliberate Negligent Understaffing?....7/31


...all too often the blame for errors targets individual Medical staff while facilities indulge in perpetrating a systemically dangerous treatment environment with “Deliberate Negligent Understaffing.” Fewer staff mean fewer overheads and capping malpractice payout will just make this policy more financially viable. Hospitals are very rarely held accountable for creating unsafe conditions with exhausted, overstretched Nursing staff and poor hygiene from minimal, poorly trained cleaning staff.

Anyone we know?????

Monday, July 16, 2007

When Fear Takes Over.....7/21

I don't know what happened to "Paris Needs A Super Hero"...it might have been the author just getting tired of moderation, keeping things moving, or whatever. Or, it might be fear....

I commented on his blog that the effect of this lawsuit, and a possible disclosure of IPs, could affect those that thought they were relatively anonymous. It shut down soon there after.

He might have been in the city employment, or a close associate, which means he was in effect silenced by what Essent is doing, and what the judge did. Interesting that this could be a precedent-setting case, and that the effects can be felt so soon.

While we all have something to lose, fear cannot run your life. Maybe Paris does need a Super Hero.... It certainly needs a loyal opposition, which is what I thought he provided....frank
You heard it here first (OKAY, maybe second or third): Paris Needs a Super Hero is back. Guess Batman couldn't hang up his cape, after all. (Wrong again, new moderator)
I'll take the hospital, you have everything else.....frank

Thursday, July 12, 2007

More Hazards.....7/15

PRMC CEO, Christopher Dux (pronounced Dukes), announced no staffing increases, no mention of raises, but he did say:

"Also, I don't believe that the way to improve employee satisfaction is to hire more staff to reduce individual responsibility, accountability or work load. Rather, I believe higher satisfaction will be achieved through providing employees with greater responsibility, accountability and authority to perform meaningful and purposeful work that makes a positive difference in the lives of both the patients and employees".

Something like: Work makes you free

Survey Says.....7/19

Hard to say what the current survey results say....only 43% of employees filled it out. Could it be that they are worried about the PRMC concept of anonymous? It doesn't really help that now they want to badger us in person... Right out of Cheech Marin and Tommy Chong's routine:

Sign the papers, old man!
I cannot sign the papers (whimper)....
And why can you not sign the papers?!?!
I cannot sign the papers because you have broken all my fingers.....

So now we come face to face with administration. Do they or have they ever really cared what we think? As long as we still keep coming to work and patients come through the doors...about as much as pit bull cares for the thoughts of a postman....

So what questions are they going to ask...guaranteeing them the answers that they want to hear? "Do you want to stay employed?...."

Probably the one that should lead off the survey: "Does the hospital create a workplace atmosphere that is conducive to work and hospitable to employees ?" What do you think?

Wednesday, July 11, 2007

When Good People.........9/20

HIPAA is really not the issue. Essent used that to force the action of the judge. When the deputy director for health privacy issues which is charged with enforcement says the following, we must look carefully at motivation:

"Either innocently or purposefully, entities often use this as an excuse," she said. "They say 'HIPAA made me do it' when, in fact, they chose for other reasons not to make the permitted disclosures."

Defamation? By its actions, Essent has defamed itself. It doesn't take myself or the commenters to do anything but show examples. Defamation is a 'false statement of fact.' Has the hospital stalled evaluations of its employees? Has it employed what would be considered in the industry large numbers of temporary nurses and technologists? Has it put out that they will suspend employees that state that we are running short staffed?

The hospital has offered to 'possibly' mitigate punishment for those who turn themselves in prior to the start of legal proceedings...and everyone is waiting with baited breath. Is that the reason for the 'delay' in action? Are people lining up for strokes of a paddle? "Thank you sir, may I have another one?"

One other thing occurs to me: If the court can compel Suddenlink to forgo their confidentiality agreement, why can't they do that with the non-disclosure agreements with former Essent employees???? They are as germaine to the respondent case as the Suddenlink records are to the complainant.

Parading a string of witnesses such as Hal, Mal, Anna, Essent hospital CFOs, and the like might give us all a different perspective....

Sunday, July 08, 2007

The Trouble With Holly.....8/4

Holly has been brought up a few times, and I would say the damage is done. For the folks that think that I have been excessive in what I've published, let me review the story for you in sequence:
The Initial Post:
I kind of wondered if the "we're really interested in your opinion" held true. Here is a copy of the emails to Dick from a (now, less than ardent) supporter....frank

-----Original Message-----From: HOLLY PETERS [mailto:_______@msn.com]
Sent: Friday, March 02, 2007 3:07 PM
To: Salerno, Richard
Subject: Welcome to Paris
Hello Mr. Salerno,

My name is Holly Peters and I worked with you on occasion, at the Austin Diagnostic Clinic and Medical Center under Jim Thomas. I was a Team Leader in the Clinic and my husband actually worked in the Radiology Department and the Nephro-vascular Lab.

I have to say that I have been very troubled with what has been going on, at the hospital you are now managing, since we moved here four years ago. Because my husband did at one time, work there in the cardiovascular lab, I am all too familiar with the problems you face.

My concern is, of course, for the community as a whole and my family's need for future medical care. I want to see you achieve the greatness, I believe the medical community of this area is capable of and deserves.

I will tell you, that based on my experience, I believe management, insurance contract negotiations, as well as improper coding for services are ultimately the cause of the dilemma the hospital is in.

I would be happy to help, in any way I can and provide you with my honest opinion regarding a number of challenges you face, if you are interested. I am sure my husband would also gladly provide you with any knowledge he may have too.


Holly N. Peters

I am sorry but I do not recall you. If I saw you, I may recognize your face. What kind of help are you referring to? Do you work as a consultant or have a business.

I am reading something between the lines but I am not sure of your motive.

Richard E. Salerno Interim CEO
To: Salerno, Richard
Subject: Re: Welcome to Paris

I really did not expect you to remember me, we only met a few times and it has been a while. I used to work for Dr. George Handley, if that helps any.

I really have no, between the lines, motives. I would like some genuine improvements in the healthcare available in this area and see additional services offered. I do not own a business or anything of the kind, in fact, I just completed Paramedic School and am currently taking Biology.
I am just concerned by the negative viewpoints and lack of teamwork, that seems to permeate the majority of the staff at PRMC. It is like everyone has forgotten what being in healthcare is all about, Caring.

I am not sure when all this began or why, I only know that, the longer it continues, the more patients are willing to drive a little further to receive medical care. I try to live by the moral principle of, do no harm and whenever possible, achieve the greatest good.

I honestly, do not know if there is anything I could really do, I am sure you have very capable people to assist you. However, I do know when a person’s livelihood is involved, people tend not to bite the hand that feeds them. I just wanted to offer to help in any way that I can, my candor and input are not contingent on fear of retribution or loss of income.

I guess it is weird to offer something for nothing, but in the long run we all benefit.


From: ______@msn.com
To: richard.slaerno@ftihealthcare.com; Richard.Salerno@prmc.com; Charles.fletcher@essenthealthcare.com
Subject: FTI Professionals Richard Salerno
Date: Sat, 10 Mar 2007 14:59:46 -0600

Does Interim CEO really mean that you are a part time CEO? Now, I am concerned about your intentions Mr Salerno. Perhaps, you are not the man of integrity I thought you were and are nothing more than a company "yes" man.

Since you are listed as an employee of two companies, I do not see how you could possibly give PRMC the attention it requires and deserves. Thus, an explanation for your frequent absences and lack of preparation for meetings you request.

I am beginning to understand the many references to you around town....maybe they suit you

Holly Peters
From: Frank Pasquale To: HOLLY PETERS ______@msn.com
Subject: RE: FTI Professionals Richard Salerno
Date: Sun, 11 Mar 2007 00:57:48 -0600


Thought I'd use your letter as a comment, but considering a short post. Any reservations?
HOLLY PETERS (______@msn.com)
To: fac_p@hotmail.com
Subject: RE: FTI Professionals

Richard Salerno he wrote me back and said he is not part time and that he no longer works for FTI.

I believe, he was hired by Essent, through his consulting firm, to serve as the axe man, in a manner of speaking. I do not get the sense that he is here to really fix anything other than the hospitals finances, on paper.

Whether it is to sell off some of their assets (Aerofit and the professional building) or sell the hospital outright, I am not sure. But he is definitely not here to save the day.

He also asked me not to send him anymore emails. I did not respond. I am hoping to hear something within the next week, so you can post the letter.

My opinion differs, somewhat, from Holly's, but we concur on one thing: Dick is not our (the hospital's, nor the community's) friend. He's here to put it back on Essent's track, take no prisoners, and cut losses. No exceptions.

I think that he's not in a consultant mode, but doing Hud a favor, like he did previously. He's one of the few that has fallen on his sword for Hud, and that rates him house guest privledges.

Sounds like Holly has a good heart, but had faith misplaced---no longer.
A follow-up:

From: Frank Pasquale
To: HOLLY PETERS (______@msn.com)
Date: Fri, 23 Mar 2007 00:37:31 -0500

A comment:

Not only that, but follow the link and you'll see what Dick is trying to ban. Already in use in PRMC's cath lab, it has already saved lives.

So, Dick is playing games with the Kerberos (Foxhollow.) But here's their dilemma:

    • If they agree to fire Holly's husband to keep a client, does she get the residuals? After all, PRMC would almost have to give Kerberos a lock on the cath lab to have them do so.
    • PRMC already pushed the publicity from the 'save', showing that it was a worthy product, are they showing the belief that we don't deserve the best?
    • As long as the community continues to crave favorites like biscuits and gravy, fried whatever, and have a high incidence of diabetes (and smoking), the procedure will be in the necessity column for plaque and thrombus removal.
    • Kerberos just got free publicity targeted to physicians, hospitals, cath labs, and healthcare workers about a product that works.
    • Will Kerberos be publicly bullied by PRMC?

    • --------------------------------------------------------------------------------

      From: (______@msn.com)

      To: fac_p@hotmail.com
      Subject: NO MORE

      Yes seriously. I feel horrible that all of this has happened to my husband and it cannot go on, despite my honest intentions.

      From: (______@msn.com)

      To: fac_p@hotmail.com
      Subject: NO MORE
      Date: Fri, 23 Mar 2007 12:29:51 -0500

      I got a phone call from my husband and he just got off a call with his bosses. You cannot print/post anything more about me or my huband on your blog, or he will loose his job. Salerno accused me (to my husbands bosses) of posting on the blog this am and I did not, nor do I know how he would even know such a thing.

      My husband said this has to stop now. So please do not use my name or any emails in your blog again, as it has already had dire consequences for me and my family. I am not sure what I said at any time, that would explain this fiasco other than it's appearance on you site.


      From: Frank Pasquale
      To: HOLLY PETERS (______@msn.com)
      Subject: RE: NO MORE
      Date: Fri, 23 Mar 2007 12:43:29 -0500

      No more posts, no email clips. Seriously.

      It is a shame that they can generate so much fear in someone that wants to do the right thing.... But, we don't live in a vacuum, and every one counts on hubby's check.

      Just remember that what you tried to do was noble: you were trying to help him, the hospital, and the community. He's the one who rejected the help and tried to hurt your family. I inadvertently did so, but also tried to make up for it in the only way I could.

      I'm glad your husband's company stood behind him. Hopefully there won't be any future repercussions.


      I actually pulled the first part of this post. Her husband was still let go. Supposedly in a reduction in salesforce for the area, but they re-defined the areas and actually put in another salesperson. I guess they caved to the buying group.

      I asked what her husband was interested in pursuing. Right about this time I put in the Cluster maps, a Holly suggestion:

      RE: I love the DOTS
      From: Holly Peters (______@msn.com)
      Add contact
      Sent:Sun 4/22/07 5:49 PM
      To: Frank Pasquale (fac_p@hotmail.com)

      oh...he is really looking at anything. he wants to stay in sales and loves interventional cardiology/radiology, but has not ruled out pharm or capital equipt. He started in special procedures and then helped a nephrologist perfect the procedure to clean out dialysis grafts and started a business doing that and then went on to cardiovascular work. He still wants to do cases when he can, his true love.

      Kinda scary, but he has seperation pay and insurance thru the end of may. I am a momma of three and in school myself, but I did just pass the registry. So i can earn $ 11.00 an hour as a paramedic.....


      The Short Version:

      So, what happened: A young mother, just finishing paramedic training wants to help the community she lives in. She sees a problem in the hospital perception and recognizes a name of the interm CEO. She emails him, offering help. He verifies that she has no 'connections' in the community and gives her the brush. Had he done so with tact, this probably would have resolved itself, but he steps on her. She finds the blog.

      Still wanting to help, but with a changed direction, she emails me the sum of the emails. I put together a post, sending a copy to her and misinterpreted a response, publishing it.

      She gets grilled by Salerno, accused of knowing 'the blogger', he threatened that hud would go after her husband's company(Foxhollow) if she did not give him my info and that if she did not appologize to him (Salerno) on the blog her husband would not be allowed into the hospital to do cases. (Blackmail or intimidation?) He is then let go from his company.

      All this, from wanting to help. Is there any wonder that good people turn a blind eye to problems in the community? "I don't want to get involved" might have been wisest, but how do you tolerate conditions which could be changed?

      Now, Suddenlink is being asked to turn over the addresses and names of IP addresses...one of which may be the blogger. The lever being used is HIPAA violations, of which several sources have said there are none.

      We are creating a population that is uninvolved, because compassion and caring are costly traits.

      Saturday, July 07, 2007


      It was suggested that I frame these into a post. I feel that they speak for themselves.

      Anonymous said...

      I was taken into surgery from ICU with my blood pressure so low that I could have died already. Obviously, they had to send me back to ICU with the plug still in my groin (without doing the surgery) that never stays in very long but they kept it in me for over 24 hours. I have photos of the bruises it caused. Two dinner plates wouldn't cover them up.

      They would give NO information to anyone here in Paris about my condition because my family is all in Houston. The one contact I had here to notify my family was not allowed any knowledge execpt that I was "stable" At one point she was not even allowed into ICU to see me even during visiting hours. We could see why later.

      She has since become my 'sister' in the event I am unlucky enough to have to go back to that hospital. I am telling you that it was a nightmare. Sue me if you want to but stop trying to kill me.

      Anonymous said...

      I just sent an email to the "Electronic Frontier Foundation" to find out why they haven't involved themselves and their counsel in this bogus litigation.
      Hopefully you will receive help from them.

      It seems that Essent Healthcare bringing this to court is only focusing attention to your cause. Had they just left "well enough" alone I would never had heard of this situation but now the whole IT world knows about it.
      Congratulations Essent you just stepped in your own "puddle".

      Anonymous said...
      Doctor Rowland,

      I understand your concern, and perspective. When you practiced medicine at PRMC, it was St. Joseph's, the sisters were still here, and it was a more gentele climate. We could make suggestions, and they were considered. One had the feeling that there was a heart beating in administration.

      That has changed.

      I'm glad your procedure went well and that your experience was good. A lot of staff were made aware of who you are. That's not to say that someone else wouldn't experience the same level of consideration...or is it?

      Hopefully they would.

      Friday, July 06, 2007

      National News.....7/6

      The likening to the Scopes Monkey trial in Trusted MD was kind of interesting, always liked the play, Inherit the Wind...just not the ending.

      "Now about the HIPAA and breach of contract claims:

      These of course could be more serious - if they were real. As far as HIPAA goes I have not seen what the real breach of patient confidentiality is here. HIPAA is always bandied around as an excuse for just about anything, but only a handful of cases (really flagrant ones) went anywhere. Regarding business confidentiality, maybe there is a legal case here, but leaks occur in every large organization every day and as Hewlett-Packard boardroom saga has shown trying to fight them too hard could really boomerang back at you. "

      Healthcare providers over zealous in HIPAA interpretation. A problem we seem to have. It's a bit paranoid, but no one wants the fines, so says the New York Times:

      "Experts say many providers do not understand the law, have not trained their staff members to apply it judiciously, or are fearful of the threat of fines and jail terms — although no penalty has been levied in four years. "

      In a related article in the Times, Susan McAndrew, deputy director for health information privacy in the Office of Civil Rights at the Department of Health and Human Services, was interviewed on the subject of sharing information under the Hipaa law.

      And, of course, the Computerworld article that seems to have frozen their server (a temporary thing.) A comment:

      "HIPAA Horsepucky
      Submitted by Not a Friend of Bill
      & Hill on July 5, 2007 - 13:23.
      report this comment
      Rated: 10
      They are hiding behind the skirts of HIPAA as many health care idiots do. The sad thing is the judge didn't appear to understand, and worse didn't get anyone to help him understand what HIPAA exactly means."

      I'd like to thank the News for breaking the story, the count was over 5000 hits in the two days following.

      Wednesday, July 04, 2007

      The Price They Paid.....7/6

      Marietta PA Editorial July 4th, 1999

      July 4th, 1999

      The Price They Paid

      "For the support of this declaration, with a firm reliance on the protection of the Divine Providence, we mutually pledge to each other, our lives, our fortunes, and our sacred honor."

      Just take a moment . . . Have you ever wondered what happened to the 56 men who signed the Declaration of Independence?

      Five signers were captured by the British and brutally tortured as traitors. Nine fought in the War for Independence and died from wounds or from hardships they suffered. Two lost their sons in the Continental Army. Another two had sons captured. At least a dozen of the fifty-six had their homes pillaged and burned.

      What kind of men were they? Twenty-five were lawyers or jurists. Eleven were merchants. Nine were farmers or large plantation owners. One was a teacher, one a musician, and one a printer. These were men of means and education, yet they signed the Declaration of Independence, knowing full well that the penalty could be death if they were captured.

      In the face of the advancing British Army, the Continental Congress fled from Philadelphia to Baltimore on December 12, 1776. It was an especially anxious time for John Hancock, the President, as his wife had just given birth to a baby girl. Due to the complications stemming from the trip to Baltimore, the child lived only a few months.

      William Ellery's signing at the risk of his fortune proved only too realistic. In December 1776, during three days of British occupation of Newport, Rhode Island, Ellery's house was burned, and all his property destroyed.

      Richard Stockton, a New Jersey State Supreme Court Justice, had rushed back to his estate near Princeton after signing the Declaration of Independence to find that his wife and children were living like refugees with friends. They had been betrayed by a Tory sympathizer who also revealed Stockton's own whereabouts. British troops pulled him from his bed one night, beat him and threw him in jail where he almost starved to death. When he was finally released, he went home to find his estate had been looted, his possessions burned, and his horses stolen. Judge Stockton had been so badly treated in prison that his health was ruined and he died before the war's end. His surviving family had to live the remainder of their lives off charity.

      Carter Braxton was a wealthy planter and trader. One by one his ships were captured by the British navy. He loaned a large sum of money to the American cause; it was never paid back. He was forced to sell his plantations and mortgage his other properties to pay his debts.

      Thomas McKean was so hounded by the British that he had to move his family almost constantly. He served in the Continental Congress without pay, and kept his family in hiding.

      Vandals or soldiers or both looted the properties of Clymer, Hall, Harrison, Hopkinson and Livingston. Seventeen lost everything they owned.

      Thomas Heyward, Jr., Edward Rutledge and Arthur Middleton, all of South Carolina, were captured by the British during the Charleston Campaign in 1780. They were kept in dungeons at the St. Augustine Prison until exchanged a year later.

      At the Battle of Yorktown, Thomas Nelson, Jr. noted that the British General Cornwallis had taken over the family home for his headquarters. Nelson urged General George Washington to open fire on his own home. This was done, and the home was destroyed. Nelson later died bankrupt.

      Francis Lewis also had his home and properties destroyed. The enemy jailed his wife for two months, and that and other hardships from the war so affected her health that she died only two years later.

      "Honest John" Hart, a New Jersey farmer, was driven from his wife's bedside when she was near death. Their thirteen children fled for their lives. Hart's fields and his grist mill were laid waste. For over a year he eluded capture by hiding in nearby forests. He never knew where his bed would be the next night and often slept in caves.

      When he finally returned home, he found that his wife had died, his children disappeared, and his farm and stock were completely destroyed. Hart himself died in 1779 without ever seeing any of his family again.

      Such were the stories and sacrifices typical of those who risked everything to sign the Declaration of Independence. These men were not wild-eyed, rabble-rousing ruffians. They were soft-spoken men of means and education. They had security, but they valued liberty more. Standing tall, straight, and unwavering, they pledged:

      "For the support of this declaration, with a firm reliance on the protection of the Divine Providence, we mutually pledge to each other, our lives, our fortunes, and our sacred honor."

      Are there any among us who would do likewise?

      There is no comparison--the blog, and the Declaration of Independence. But, the priciples have a similar bent to them. And the persecution by the British has a similarity to that of Essent.

      From the same period, a famous quote comes to mind: "I offer nothing more than simple facts, plain arguments, and common sense . . ."

      A Patient Response.....7/8

      Wow, sounds like a Hud's bud talking there. I mean, that sounds just like what they are trying to allege in a suit- that the hospital has been defamed. This "Anonymous" physician chose not to put his name, from all appearances. Who knows where it really came from. Funny, though, there appears to be a NASHVILLE connection.

      Its kinda hard to have the proverbial sh_t scared out of someone when there are no violations of the law that have taken place. If PRMC was smart, they would realize that they can not initiate a HIPAA action in State or FEDERAL court. The only ones who can are CMS (Centers for Medicare and Medicaid services) and HHS (Health and Human Services).

      A physician in Nashville..... hmmm.....Isn't that where Essent is based?

      First of all, isn't it illegal to retaliate against a person who has reported a crime, or who is a potential witness against a corporation in a state or federal criminal case? Not saying Essent has done such, but should they retaliate (and if a blogger or bloggers, or employee or employees, or a patient) has reported an alleged crime, I believe retaliation is an offense.

      ETMC and several others were in discussion for this hospital, but the Christus board bought Hud's dog and pony show, and went with them.

      Maybe this town is better without this so called doctor from Nashville (hud's back yard) assuming that it isn't Nashville, Arkansas. Hell, who knows, Hud and this doc may be members of the same Country Club. Wonder if he will pay Hud's legal defense bills????

      After all, Enron's officials were criminally prosecuted. If a crime has been committed by Essent (who knows if it has or not).

      I am going to put some numbers up here to report alleged Medicare fraud by Essent/PRMC or other illegal acts, below of when to "Contact the FBI" (Health Care Fraud, Corporate Fraud, etc).

      FYI, the FBI office that handles Lamar (and other counties where Essent has assets) is FBI- Sherman.
      Suite 506 1800 Teague Drive
      Sherman, Texas 75090
      Phone: 903-892-8764

      Here is there address and contact information. Ask to speak to a Special Agent regarding possible crimes committed by Essent, which hypothetically could involve fraud. It is not illegal to report something to the feds, even if it is only a suspicion. If you have knowledge which may prove a crime is or has been committed.

      Mr. Dux, go ahead and sue the blog, request the identities of the people who have said things here. That will only go to further the belief that this is being done as retaliation by Essent. The best thing you can "Dux" is let this thing play out however it does, and not interfere. If people think a crime has been committed, let the feds investigate. If an investigation is underway, all you are "Dux-ing" is making it look bad on the company.

      I am a patient- not an employee, nor have I ever been employed by Essent PRMC. The community knows something is wrong, we know how we are treated.

      I was diagnosed with severe problems that were not detected during testing with PRMC (misdiagnosed), now I am going to undergo multiple operations to correct the miss-diagnosis of PRMC's physicians and the hospital, and other local doctors. I was prescribed medications, which when combined can cause seizures. I have had seizures ever since visiting your hospital. I had no family history of seizures. When I was treated elsewhere, and after giving them my list of meds, (which were prescribed in the ER), the combination alone can cause seizures.

      I think the best thing that can happen is that if fraud is alleged to have occurred, that the person or persons, or employee or employees know that they can be protected for reporting criminal offenses which may be occurring, or may have occurred, if in fact one has occurred.

      When Should You Contact the FBI?

      If you have an emergency situation that requires an immediate law enforcement response, you should always call 911 or otherwise contact your local Police Department or Sheriff's Department first.

      The FBI is a federal investigative and intelligence agency that has jurisdiction in a wide range of federal crimes; all national security matters such as terrorism and espionage; cyber/computer crimes and intrusions; and intelligence activities that relate to those missions. Below are some examples of when you should contact the your local FBI office or the main office in Dallas:

      You have information about organized crime activities

      You have information about or have been the victim of financial crimes that involve fraud, especially Corporate fraud, Mortgage fraud, or other investment fraud schemes where significant dollar losses have occurred

      You have information about fraud in the Health Care industry.

      -From FBI Dallas website http://dallas.fbi.gov/

      Everyone needs to know that Medicare fraud is a serious offense, and if there have been up-coding, over-billing, etc, it only hurts those who are recipients of Medicare, and the honest providers out there (not saying Essent isn't honest), but there seems to be some allegations of fraud. Report them and see what happens. The FBI is not going to "out you for reporting a crime". They keep everything quiet, and will work to secure your identity. Hell, they may even pay you as an informant!

      -Former PRMC patient considering a lawsuit!

      It's kind of like talk-radio. I put on the "Nashville Doc from McKinney", and then folks can comment...and they do.

      Essent pays a lot for their side of the discussion--websites like what they put together aren't cheap. But, they allow no discussion of the issues, and suggestions? ...we know where they go.... And if you actually contribute...you end up like Holly.

      Every process needs feedback for control...when it isn't incorporated into the planning, the un-planned makes its appearance....frank

      Monday, July 02, 2007

      Paris MD Response.....7/4

      Thank you Dr. "Mc Kinney-native-now-living-in-Nashville". I don't know what gives you the idea that you have any credentials whatsoever that would make anyone take you seriously!

      I have practiced in Paris for over 25 years, and had offers to practice in Houston, Dallas, and New Orleans. I am not from here, so my reasons for locating here were not due to any family ties, etc. I came here because of the remarkable quality of the medical staff that I found here and the presence of two medical centers that provided over 60 years of superb medical care.(I might add that, at the time, I looked at your home town and found a Quack-run birthing center and a marginal- pass hospital that was controlled by a single physician and his cronies.) That might be behind your decision to look to Tennessee to settle, instead of coming home.

      As for your assertion that Paris is dying, the demographic statistics do not support your contention. The medical drawing area is over 90,000; when I came it was 48,000 (See "Bugatti Stevenson medical demographics report august 1980, available upon request.)

      What has actually happened here, my good sir, is that the Federal Balanced budget amendment of 1998 cut almost 5 million dollars of funding to the two hospitals. This set in motion a series of events that resulted first in McCuistion allying itself with Texas Health Resources(ne, Presby Dallas plus Harris Methodist Ft Worth) and then, after the Harris Methodist HMO melt down made it no longer feasible to keep McCuistion, The THR group decided to sell their interest to Christus. About the same time the out patient DRGs were implemented which further cut revenues another 3 million per year. All this together resulted in a staggering 12 million loss in one year!

      You don't have the slightest idea of what you are talking about! The chicken here is the loss of federal funding in a poor rural county whose payer mix is 62% medicare/ medicaid / no pay. The egg is the drastic results: Namely a tragic loss of services and a dismal track record of attempts by various parties to live with those funding cuts.

      Certainly you would not come here to practice! You are interested in being close to the $ and services that are available in Nashville and the other places that you mentioned practicing in.

      Finally: How dare you call anyone an "also-Ran"? We have Drs here who trained at Mayo Clinic, Cleveland Clinic, Baylor Houston, MD Anderson, Vanderbilt (I could go on...but won't)

      I don't give a fig if you write your opinions on the blog; they are like a$$holes; everybody has one.

      From frank:
      Note: Proposed CMS changes for 2008 :

      Medicare payments to physicians in 2008 will drop nearly 10% under a proposed rule issued today by the CMS, which projects it will pay $58.9 billion to 900,000 physicians and other healthcare professionals next year.

      ...from Modernhealthcare.com

      ...and the good news just keeps on coming....frank

      Hospital blog suit worth watching.....7/6

      Staff reports
      The Paris News

      Published July 1, 2007

      In what may prove to be a very interesting and perhaps precedent-setting case, Essent Healthcare has filed suit in 62nd District Court against unknown bloggers contending a blog — http:the-paris-site.blogspot.com — has defamed Paris Regional Medical Center. The suit also alleges bloggers are breaking the law by releasing patient confidential information.

      One of the aspects of this case that make it so interesting is that Essent, the hospital's parent company, doesn't know exactly who they are suing. Thus, they have asked 62nd District Judge Scott McDowell to compel cable Internet service provider Suddenlink to disclose known mailing addresses of 10 bloggers. The clock is ticking on the 20-day deadline the judge gave the ISP to provide the information.

      We offer no opinion on the merits of the case nor the judge's order, but express interest in several aspects of each. First, we take interest in whether a media provider such as an ISP should be compelled to reveal the names of subscribers who have obviously sought to be anonymous. Second, we are interested in the responsibility of third parties with regard to the release of patient confidential information.

      While we watch these aspects of the case with interest, we express our opinion about responsible blogging without taking a position on material published on http:the-paris-site.blogspot.com .

      Everyone has a First Amendment right to free speech, whether that speech is published in traditional media — like this newspaper or a radio broadcast — or new media — like a Web site or blog. However, free speech is not unbridled. With free speech comes responsibility. As the old example goes, you can't yell fire in a crowded theater unless there really is a fire.

      Essent argues bloggers published "false and misleading statements with malice, with reckless disregard for truth or falsity and with negligence in failing to ascertain the truth of the statement."

      We do not suggest whether those allegations are true or false, but we do believe those who operate blogs have a responsibility to ensure that published material is not false, misleading with malice or recklessly disregards truth. Free speech standards must the same for all material published or broadcast, regardless of the media.

      One thing about blogs that concerns us is the use of pseudonyms. With rare exception, we believe speech should be tied to a real name. When expressing an opinion, not just stating facts, we find no exception. That's why we don't publish anonymous letters in this newspaper.

      There are a number of Paris-related blogs on the Internet, where opinions about everything from the hospital to city hall and local nightlife are expressed. Our hope is that the suit filed by Essent does not have a chilling effect on these blogs. It is important to have such forums in our techno-savvy world. However, it also is our hope that those who operate these blogs will do so in a responsible manner where the goal is truth without malice.

      By the way, we hit world wide web status a while ago. Blogspot registred us. So www.the-paris-site.blogspot.com is appropriate....frank