Well, the Snooze has announced the arrival of two new radiologists. Emphasis on 'new'. The first, LUCHO LOISEAU ROSSMAN has 
been practicing for three years, after an eleven month fellowship. You wonder how much of that was as an assistant professor?
MICHAEL SCOTT ALLEN, the second radiologist, has practiced for 18 years, with only a small misunderstanding on his renewal--delinquent/non-payment--and an 'active-not-in-practice' during 2002. Maybe it was during his mini-fellowships....(the information on Hopkins and Emory has mini-fellowships listed from less than a week to three months....) Worldwide Imaging sounds like a radiologist reading from his home in a bathrobe...with little to no patient contact.
One good thing, he ought to be able to keep up with dictation! Hopefully he can get past the generalization trap of the on-call services and make definitive statements.
But, here is the story, you be the judge:
A (64) slice of life
Staff reports
Special to The Paris News
Published April 23, 2008
Two board-certified, fellowship-trained radiologists — Michael Scott Allen, M.D. and Lucho Rossman, M.D — are new additions to the Paris medical center.
Their arrival in the community coincides with the arrival of a Toshiba Aquilion 64 Slice CT Scanner on the North Campus where work continues on new cardiology facilities.
The Toshiba Aquilion can perform a whole body trauma in ten seconds, more than twice as fast as conventional multi-slice CT scanners. This speed is especially helpful in shortening breath holds for geriatric patients, patients who are on ventilators and pediatric patients.
In a single rotation, the scanner creates 64 high-resolution anatomical image “slices” as thin as a credit card. These images are combined to form a three-dimensional view of the patient's anatomy for the physicians at Paris Regional Medical Center to analyze. From these images, physicians can view such things as blockages in the coronary arteries, as well as the motion and pumping action of a patient's heart.
Both Allen and Rossman bring extensive experience and knowledge to the hospital’s radiology department, Paris Regional Medical Center CEO Chris Dux said.
“We are thrilled to have them here,” Dux said.
Allen, who is to serve as Medical Director of Radiology, specializes in neuroradiology, muscle skeletal radiology, virtual colonoscopies, magnetic resonance imaging (MRI) and Coronary Computed Tomography Angiograms (Coronary CTA). He joins the staff from a private practice at Worldwide Imaging Technologies in the Dallas area.
Allen received his Doctor of Medicine from the University of Texas Southwestern Medical Center at Dallas and fulfilled his residency at the University of Missouri Medical Center. He has completed mini-fellowships at Emory University, New York University, University of California at San Francisco and Johns Hopkins University.
“Paris Regional Medical Center made me feel at home right away. It has a great group of physicians and the best radiology department that I’ve ever worked in,” Allen said. “I am honored to be part of such a top-notch organization.”
Rossman, the area’s only fellowship-trained interventional radiologist, joins the staff after most recently serving as assistant professor of Vascular Interventional Radiology at the University of Texas at Houston and as a clinical interventional radiologist at Memorial Hermann Hospital and Lyndon Baines Johnson Hospital in Houston.
He graduated from the Baylor College of Medicine in Houston and performed his residency and internship at the University of Texas at Houston. He completed a fellowship in vascular interventional radiology at MD Anderson Cancer Center.
“I have been impressed with the significant investment Paris Regional Medical Center has made in the latest diagnostic and interventional radiology equipment,” Rossman said.
“What we have here compares favorably to what is available in most major cities — like Dallas and Houston — and far beyond what you would normally find in a community this size,” he said.
What is a Radiologist?
Nearly all physicians examine patients, obtain medical histories, diagnose illnesses or prescribe and administer treatment for people suffering from injury or disease.
Generally, a radiologist is different from other physicians because he or she diagnoses diseases by obtaining and interpreting medical images. Some images are obtained by using X-rays or radioactive substances, others by means of sound waves or the body’s natural magnetism.
A radiologist correlates medical image findings with other examinations and tests, recommends further examinations or treatments and confers with the referring physician. Radiologists also treat some diseases by means of radiation (radiation oncology) or minimally invasive, image-guided surgery (interventional radiology).
It's back in the hands of the judge, again. Arguments have been made, answered, and now it's under consideration.
My contention is that it is a SLAPP suit, but Texas has no provisions against such suits. What is a SLAPP?
Generally, a "SLAPP" is a (1) civil complaint or counterclaim;What is the harm in a SLAPP? Again, it curtails free speech, unless you have the money and time to fight it. While there should be an accountability factor, it shouldn't be dependent on one's bank account...and how much justice you can buy.(2) filed against individuals or organizations; (3) arising from their communications to government or speech on an issue of public interest or concern. SLAPPs are often brought by corporations, real estate developers, government officials and others against individuals and community groups who oppose them on issues of public concern. SLAPP filers frequently use lawsuits based on ordinary civil claims such as defamation, conspiracy, malicious prosecution, nuisance, interference with contract and/or economic advantage, as a means of transforming public debate into lawsuits.
Most SLAPPs are ultimately legally unsuccessful. While most SLAPPs lose in court, they "succeed" in the public arena. This is because defending a SLAPP, even when the legal defense is strong, requires a substantial investment of money, time, and resources. The resulting effect is a "chill" on public participation in, and open debate on, important public issues. This "chilling" effect is not limited to the SLAPP target(s): fearful of being the target of future litigation, others refrain from speaking on, or participating in, issues of public concern.
Essent confirmed Mike Browder as the permanent CEO. He had been the interim top dog since November when Hud Connery stepped down (or was stepped on...!)
One could wonder if the long and hard search they made uncovered any other possibilities, but Browder had the advantage of being current in the corporation. Another thought is, most of those about, in the various companies are like Hud--products of HCA/Columbia--with very little difference in style.
Had a comment that I had filed away for future use that might put things in context. Remember Muskogee? Essent bid on it and withdrew when Hud was invited to a question-and-answer session?
Apparently, the new owners (Capella) waited a bit and then drug-tested all the 
employees...using hair. Hair is a record farther into the past...3-6 months...and 200 of the staff were terminated. I can imagine a new look here...bald nurses and techs! (Remember, scalp hair isn't the only source! Eyebrows might not grow back!) (This is uncomfirmed, but an interesting contrast. How much would it cost to test everyone at that level, anyway???)
The employment pool is larger there, and they're relying on agency personnel heavily. Same story, different company and town.
Essent has stated that I defamed them. That since the blog came out, I have been mis-representing them to the public. But, have you noticed the changes in their operation?
Let's take this election year. Actually, please take it. I'm not wild about the choices, and it certainly looks like the Democrats are trying to eat their young--okay, Hillary isn't quite in that category, but you get the picture....
In election years 2000 and 2004, Essent employees contributed $13,250 and $16,250, respectively. Even in off-year elections 2002 and 2004, they gave $11,250 and $9,800 (mostly Hud). So far this election, the total is Zero!
Now, I don't mean to say that contributions have stopped, but large contributions have been turned off. 
Raises are back in vogue. Several other programs have been changed. Cameras were pulled from the smoke alarms. And Essent has plowed bucks back into the local economy--(how much do TV ads cost, anyway?)
Remember when the hospital was being bought, and everyone thought that the change would be good? Change can be for the better or worse. When someone's campaign's mantra is 'change', be careful what you wish for....
From the Boston Globe:Emerson Hospital misstated financials
Investigation finds senior executives created documents
By Jeffrey Krasner, Globe Staff March 21, 2008
Two senior executives of Emerson Hospital in Concord created documents that misstated the hospital's financial condition over parts of its last three fiscal years, the hospital found after an investigation and audit that concluded last week.
The misstatements made the hospital's performance appear
better than it actually was, at a time when it was seeking donations for a major expansion that is now nearing completion.
As a result, Emerson violated some promises it made to lenders. That, in turn, forced the hospital to reclassify some of its borrowing as short-term debt, a technical measure that could limit its borrowing ability.
Emerson has not missed any payments and officials said it is not in danger of defaulting on its bonds. The audit completes an inquiry that began last August when a midlevel manager noticed billing irregularities and told a supervisor, said chief executive Christine Schuster.
In all, the hospital had to wipe out $7.1 million in improperly recorded revenue. Because of accounting rules, however, it only had to formally restate its books for fiscal 2006.
The two senior executives - Dana P. Diggins, Emerson's chief financial officer, and Michael Collins, its controller - left Emerson last year. Officials declined to say whether they resigned or were fired. A third financial executive, who the hospital would not name, was let go.
The matter has been referred to the office of Attorney General Martha Coakley, said John M. Lowe III, chairman of the hospital's board of directors.
John O. Wilhelm Jr., interim chief financial officer, said the misstatements were accidental.
"They weren't aware they were misstating it - they thought they were correctly stating it, but they were wrong," said Wilhelm. "People make mistakes and they move on. That's life. They were big mistakes."
Diggins is now chief financial officer at Harrington Memorial Hospital in Southbridge. Collins is chief executive at Merrimack Valley Hospital in Haverhill. Neither responded to calls seeking comment.
Schuster said the former employees manipulated the hospital's earnings by misusing contractual allowances - a term that describes the discounts hospitals give to insurance companies on the "official" prices they charge for services and procedures. Each month, the hospital must adjust the amount of money it expects to receive to account for such discounts.
"The controller at the time overrode the estimates that the contractual allowance model was generating," said Schuster. "That resulted in an overstatement of revenue."
The restatement is particularly sensitive because the hospital is required to keep its lenders and bondholders informed of any changes in its financial condition. A failure to file audited statements can constitute a technical violation of the many promises and ongoing commitments lenders require of borrowers.
Footnotes to the restated financial results, by the accounting firm PricewaterhouseCoopers, state Emerson was "not in compliance with certain debt covenants" for a $3.9 million loan from Bank of America.
In addition, the footnotes state Emerson was not in compliance with covenants for a $63 million bond offering conducted in 2005 by the Massachusetts Health and Educational Facilities Authority, a quasi-public agency that facilitates borrowing for smaller institutions.
Wilhelm said that after the audit was completed, the hospital was able to forge a new agreement with Bank of America that waives the violations. He said that contrary to what PricewaterhouseCoopers reported, there was no violation of loan agreements with the Massachusetts authority.
"This was a fluid issue going back and forth with the auditors," said Wilhelm. "There were a lot of rewrites (to the footnote) and there was a little hurry-up at the end. We are not, and have not, been in violation of any of our bond covenants."
The facilities authority, which arranged the bond offering, declined to comment.
The restatement also comes at a difficult time for Emerson. The hospital made a small profit, $1.7 million, on its healthcare operations in fiscal year 2006. But in fiscal year 2007, it lost $8.1 million on healthcare operations. Some of the losses were offset by investment income, yielding a loss of $4.7 million for the most recent year.
For the first four months of the current fiscal year, the hospital has broken even. But officials said the results were dragged down by a series of one-time charges, some associated with the accounting problems.
In particular, the hospital paid $490,000 to FTI Consulting Inc. - a healthcare consulting firm hired to improve the hospital's financial operations - and about $100,000 to the law firm of Wilmer Cutler Pickering Hale and Dorr LLP, which conducted the investigation.
"The board was concerned when this came to light, but because Chris (Schuster) had kept us informed all along, we were comfortable we were taking the right steps," said Lowe, the chairman. "We're now focusing on regaining our financial strength."
Jeffrey Krasner can be reached at krasner@globe.com.
This might be a non-story, except for two names that we're familiar with: FTI Consulting, and Michael Collins. Wonder if the GE Capital mortgage will be the next subject for Mr. Krasner's reporting skills?
A new form of outsourcing is hitting the medical field. Radiology has been one of the first, but surgical procedures are now being targeted by the insurance companies. The hospital has been quick to use the over-night readings from Austrailia, wonder if TN BC/BS will be buying the tickets if the hospital can't meet the prices in Thailand? Or Costa Rica, India, or Ireland?
Business Week
Outsourcing the Patients
More U.S. health insurers are slashing costs by sending policyholders overseas for pricey procedures
by Bruce Einhorn
For years, Americans have been traveling abroad to save money on elective procedures or dental work. David Boucher, 49, doesn't fit the usual profile for such medical tourists. An assistant vice-president of health-care services at Blue Cross & Blue Shield of South Carolina, he has ample health benefits. But Boucher recently chose to have a colonoscopy at Bumrungrad International Hospital in Bangkok, mainly to make a point about the expanding options available to Blue Cross customers. And his company happily picked up the $640 tab—a bargain by U.S. standards.Blue Cross and other insurers would like to see more policyholders traveling abroad for medical care. Since the start of the year, Boucher has signed alliances with seven overseas hospitals and hopes to add five more by yearend, including them all in coverage for his company's 1.5 million members. As health-care costs continue to rise in the U.S., "medical travel is going to be part of the solution," he says.
Yes, just like manufacturing facilities and call centers, health care is moving offshore. "All of the largest U.S. insurers are starting to educate themselves or are putting [offshore] programs in place," says Jonathan Edelheit, president of the Medical Tourism Assn., an industry group formed just last year. Companies that self-insure are also bombarding Edelheit's group with requests for information.
Getting covered employees to leave the U.S. won't be that hard, says Edelheit. An insurance company could waive all deductibles and co-pays, offer to cover travel costs for the patient and family members, even throw in a cash incentive, and still save tens of thousands of dollars. After all, a heart procedure that costs $100,000 in the U.S. runs only $10,000 to $20,000 at some of the best private hospitals in Asia. And the quality of care? Foreign hospitals in such arrangements are typically approved by Joint Commission International, part of the same nonprofit organization that accredits American hospitals.
Blue Cross took the lead in medical offshoring when it formed its first partnership, with Bumrungrad Hospital, in February. Since then the insurer has signed similar pacts with the Parkway Group Healthcare, owner of three hospitals in Singapore, and hospitals in Turkey, Ireland, and Costa Rica. Three members of India's Apollo Hospitals Group are also joining the network. And another large Indian chain, Wockhardt Hospitals, is talking with U.S. insurers as well. "Americans haven't come to grips with having their heart surgery in Thailand," says Curtis Schroeder, the American CEO of Bumrungrad. "But that will change."
The shift is sure to leave some policyholders disgruntled, of course. Offering international coverage might make it easier for employers to limit benefits at home, for instance, by raising the deductibles on U.S.-based procedures. It's also extremely difficult for patients to sue for malpractice in most Asian countries. Bumrungrad has offices for marketing and promotion in 20 countries, but not the U.S.—in part because having a U.S. office would open the door to potential liability, hospital officials say. So it will take a while for the trickle of insured U.S. patients in Asia to become a torrent. But over time, for policyholders and payers alike, the price may be hard to resist.
With Catherine Arnst
Sign the paper, old man.... Let me preface, when I read the comment, all I could think of was Marty Feldman....
A lot of the problems stem from poor employee morale. The bully tactics used by administration do little to empower or encourage the staff. The forced signing of the "Nursing Standards of Excellence" if not signed by 3/10 it was considered termination (or voluntary resignation). A lot over a signature on something that some people may or may not have agreed with.
Especially with an already understaffed facility that is doing nothing to correct thiscritical problem - travelers, agency, etc.... Personally some of it was so trivial and more of it was just plain common sense/courtesy (let people off the elevator before boarding) or my favorite will make eye contact within 15 feet and again within 10 feet smile and speak...how creepy can this get...eyeballing me walking down the hallway.
Does it mean that someone will be fired for running down the hallway in an urgent situation and failing to speak the the other people in the hallway? If going on prmc history...that very well may be the case... you'vevoluntarily resigned by "not meeting the standards of excellence...see you signed the paper...." blow me prmc
"Profit oriented focusAhh yes, shareholder value. Tangible results? Enhance customer satisfaction? Anyone with a subscription to American Hospital Directory can verify the 'tangible results' that Andy created for PRMC during his tenure. But, resumes are selling tools, and should be taken with a grain (or shaker) of salt.
We help rebuild core businesses with a focus on the bottom line. We work with clients to develop new product lines and cull unprofitable product lines. We have multiple awards for enhancing shareholder value.
Analytics
Our team has a high-level ability to conceptualize and prioritize. We have a track record of transferring ideas into tangible results.
Quality centered management
We help our clients to achieve lasting, long-term results through intense focus on quality improvement. We have earned multiple national quality awards achieved in short time frames at turn-around facilities. We are fluent in the use of “best practices” and quality improvement methods to enhance performance and customer satisfaction."
What makes it more of a disconnect is the current bastardization of TQM (TotalQuality Management for those of you from Rio Linda). About the only characteristic that has emerged is the evaluation by peers. Which, by itself, has the tendancy to homogenize the workforce. It recognizes both ends of the bell curve: Those that do a poor job, those that make the others look bad...and those that make them feel uncomfortable. Performace is irrelevant, it's a Survivor or Big Brother social club. Who's next to be voted off the island?
not looking at a hanging, but the other side probably has a different hope and expectation. Speaking of expectation, I've heard, over the months, many that said should the case go against me, they were dropping Suddenlink like a hot potato. Something about an expectation of their privacy. Could be (might be just talk,) but I'm going to explore the Suddenlink involvement in the case in later posts, so don't drop that 'tater just yet.Remember how Essent was going to build a new hospital in Ayer, 
MA? They said the current one was unable to be renovated and they would have to build new, instead? Ennnnnh, wrong again. The Lowell Sun had an article recently:
Hospital abandons new-facility plans, to renovate instead
By Jack Minch, jminch@lowellsun.com
Article Last Updated: 02/29/2008 11:32:12 AM EST
AYER -- Nashoba Valley Medical Center announced yesterday it is abandoning plans to build a new hospital at a cost of $50 million to $60 million, and will instead renovate the existing facility.
Chief Executive Officer Steve Roach said he'll meet with town officials to determine if the change affects a tax-increment financing agreement approved at Town Meeting last May. However, the hospital still plans to add 30 new jobs to its staff as agreed to under the deal.
"The commitment to 30 jobs is still there," Roach said. "We have to grow the staff. You can't do it without staff."
The cost savings for renovations can be used to pay for new equipment, which benefits patient care and also works as a recruiting tool for new doctors, Roach said.
Officials say the decision to renovate reflects a trend in the medical industry that places emphasis on more outpatient care and shorter inpatient stays when hospitalization is required.
"Most of what we used to keep people in the hospital for three, four days or a week we do in a day now," said Dr. Kenneth Janes, a surgeon at the hospital for 30 years.
The hospital was built in the late 1960s and early 1970s as a 100-bed facility with little outpatient capacity, Roach said. Now, with clinical work, about 85 percent of the care is on an outpatient level.
The cost of the renovation hasn't been set, but it will be less than $50 million, Roach said.
The timeline for work won't be determined until the scope of renovations is decided. The work isn't expected to shut down the hospital.The hospital originally planned to start construction in 2009 on a facility with 60 private rooms.
Instead, hospital doctors and staff members will work with a design-build team to determine what renovation work needs to be done, Roach said.
"We would get what we call a new hospital within a hospital," Roach said.
Town Administrator Shaun Suhoski and Planning and Development Director Christopher Ryan met Wednesday with Roach and Richard Salerno, the senior vice president of operations for Nashoba Valley's parent company, Essent Healthcare LLC of Nashville, Tenn. The meeting didn't delve deeply into details.
"From what I can gather, it would still represent substantial growth and investment at the facility," Suhoski said.
The current hospital has about 104,000 square feet, and renovation plans could include some new construction, Roach said.
The hospital is licensed for 57 beds but effectively uses about 35, Roach said.
There are about 116 doctors on staff, but only about 65 or 70 are active.
Now, take Paris. Should they build a new facility on the North Campus? What's going to happen to the old one? What about the property values around the South Campus? What about all the property that Essent owns around that facility? You wonder if Essent announced that 'exploration' to drop property values and get a tax-break on all the properties they hold.This is just an observation from a person who has used both hospitals recently, for pre op and then op I saw such things as unsanitary conditions in both places, inconsiderate staff, and what appears as inept or untrained personal.
Maybe it is the attitude of the staff "I will do what I have to do to keep the job but not one thing more," “patients don’t matter,” and “it is not my job” attitudes prevail. If my Aunt was still there and was head nurse again, I assure you those nurses would take care of the patients or they would be gone. Should she have caught one looking at a surgery wound without gloves on that nurse would be gone right then. There would not be trash left on the floor, patients would be made as comfortable as possible, and the staff would use a pleasant tone of voice at all times.
In the three days that I spent in the hospital I can say that there were only 2 nurses who showed me that they were true nurses. The rest were there for the pay check and did nothing more than what was required by the chart. On the third day I told the Doctor to release me I could get better care at home.
I have no knowledge of the Quint Studer group or what they really do, however, if it is that patients should be treated with respect, dignity, and compassion I am all for it.
When nurses and staff dictate to the Doctors and patients what will be done and how it is to be done or ignore doctors orders you don’t have a hospital, you have a first aid station. A poor one at that. This is why patients go else where to go to a hospital. Patients have rights, and the first one is where to spend the money for health care. If I have to have someone in the room taking care of me while sick I don’t need a hospital or their nurse.
I see a bunch of passing the buck and no one taking the responsibility of making changes. I guess if you cover it up deep enough with layers of management the problem will go away. And this is why most people go elsewhere for their Medical care.
The Ayer is getting a bit thin.... Browder signed a mortgage
agreement with GE Capital for $115M, and an agreed revolving credit of $15M plus $3M swing. What's the difference between that and the investors (which GE has been at a different time)? The hospital secures the loan.
When maintenance money is tight, but capital improvements are available, that's when you know investors are tightening in the moneybelt. Maintenance can't secure a loan...real property and assets can.
What they fail to realize is this: A hospital is more (or less!) than the sum of it's assets. Management can drive down the intrinsic worth faster than you can say "cutbacks". Actually, they may well be aware. GE probably figured having your hand out at the beginning of the line is better than at the end.
Actually, the mortgage was signed on Dec 20, but not recorded until about a month later. It was, in fact, the day after the saga of Dr. Rimas Maurukas came to an ignoble ending with revocation of his medical license in the Commonwealth of Massachusetts.
The fourth of next month will be interesting in the national arena, but it will also be worth a look here. I was going to let things slide, but then someone pointed out that Essent has a PAC (Political Action Committee), and hasn't been shy in the past as to who they support and what contributions they will make to their campaigns.
Sharon Hospital tried to host a fund raising breakfast for one Senator a few years back, and was promptly slapped down as being in violation of campaign contribution rules. That's when they formed the PAC.
So, who are the contributors, and who are the recipients? It will certainly be interesting, and possibly telling.
I'm fac_p, and I endorsed this ad.....
I received this promo from Dell and Microsoft:
Your choice of a PC can dramatically improve the lives of people living with AIDS in Africa. Windows® is proud to partner with Dell™ and (RED)™ to give you an opportunity to buy (PRODUCT) RED next time you buy a PC.
For every purchase of a Dell (PRODUCT) RED PC, Windows and Dell will make a contribution of $50 to $80, depending on the product purchased, to The Global Fund to help improve the lives of people in Africa affected by AIDS. $50 is enough to pay for almost four months of life-saving antiretroviral treatment for one person suffering from AIDS.
It's simple. You choose Windows Vista Ultimate (PRODUCT) RED, we give to The Global Fund, and people in Africa benefit.
It is a beautiful choice with a powerful impact.
Where lies the future of Paris’ hospital?
Staff reports
The Paris News
Published January 27, 2008
It’s been a long time coming — and it may very well be quite some time before we actually see it happen — but Paris Regional Medical Center recently announced that it was another step closer to what it calls “campus consolidation.”
Chris Dux, the hospital’s CEO, told employees a couple of weeks ago that the hospital had purchased two new heart catheterization labs and a 64-slice CT scanner. One of the labs and the CT scanner were destined to be installed within two months at the hospital’s North Campus, the former McCuistion Regional Medical Center. The new equipment is to be part of the hospital’s planned Cardiac Center of Excellence, a facility dedicated to the prevention, diagnosis and treatment of heart disease, providing a level of care previously only available in larger metropolitan hospitals.
As exciting as news of the advancement of the cardiac center is, the announcement that the hospital was another step further along in its long-range plans for the North Campus was just as exciting to the community at large.
As far back as the merger of Christus St. Joseph’s and McCuistion, Paris’ two long-time independent hospitals, into a single provider, hospital officials began to formulate long-range plans to make greater use of the facilities on the North Loop, expanding services offered there and building new structures on the open ground surrounding the main structure.
“Our long-term goal remains for Christus St. Joseph’s to relocate all services to the North Campus," said Monty McLaurin, chief executive officer of CSJ, as reported in an Aug. 8, 2002, story in The Paris News. The remark was part of a report on short-term relocation of services to the South Campus, a move designed to improve cash flow for the hospital.
When Essent Healthcare bought the hospital soon after, Essent officials went on record that they, too, saw the wisdom in eventually making greater use of the North Campus, with its open acreage and fewer busy city streets cutting through the grounds.
Dux told hospital staff at the meeting recently that the new equipment was “the first step in our campus consolidation.” He also announced that Essent had hired the nation’s largest designer and builder of healthcare facilities to assist the hospital with “a clear long-term plan for future expansion and growth of the North Campus.”
Such an announcement can’t help but make the people of Paris optimistic that Essent is prepared to do what it takes to make PRMC a first-rate medical facility. The hospital’s willingness to go forward with plans that will make best use of all available facilities should be encouraging to those of us who have watched the hospitals with a wary eye these past few years. We hope we are witnessing the first steps in returning Paris to its standing as a strong, stable center of regional medicine for Northeast Texas and Southeast Oklahoma.
Personally, I'll believe it when I see it- but if it happens, it can't be soon enough. The south campus is landlocked, and I don't believe Brookshire's is going to close its doors any time soon, so expansion there is out of the question. --anonymous
My take is: status quo. There are some minimum upgrades needed for the cath lab...minimum to staying open. Putting in a 64-slice CT at the North campus might be just to appease Dr Hashmi...it becomes as unwieldy as the MRI when needed for a South Campus patient. By the time it would start to be utilized fully, it will be as outdated as the one it replaces....frank
While not confirmed online, I received notice of another PRMC lawsuit, but this time with them as the defendent:
What makes this interesting is Dr Gunder's pending departure from Paris. That and why a hospitalist is being sued based on an ER turnaway. I imagine we'll see in the months to come...frankJerry Dean, individually and on behalf of the estate of Wanda Dean v. Adam Gunder M.D.; Paris Regional Medical Center LP; EHC PRMC GP, LLC; EHC PRMC LP, LLC; Essent PRMC LP; Essent Healthcare - Paris Inc.
1/25/2008 208cv027(It is a medical malpractice suit, alleging the person died from a heart attack after she was turned away from Paris Regional Medical Center's emergency center. )
Ours, of course, the gang of 10 (John Does 1-10, Happy Hour meeting at Applebees on Fridays)
NONA HARRIS VS. KHALID SHAFIQ, M. D., RAPHAEL LUI, M. D., AND ESSENT PRMC, L. P., D/B/A PARIS REGIONAL MEDICAL CENTER
WORLDWIDE IMAGING TECHNOLOGIES-TEXAS, LLC VS. ESSENT PRMC, L. P. D/B/A PARIS REGIONAL MEDICAL CENTER
DEBRA BROWN AND IN THE INTEREST OF BRITTANY BROWN VS. PARIS REGIONAL MEDICAL CENTER
This one has a default judgement, but 01/17/2008 lists an "ORDER GRANTING MOTION FOR NEW TRIAL."
Enough traffic has come back on the ER/CT issue that it gets its own post. One video tracker lists the 'reports' that are on the news channels. I solicited the following from some of those in the field:
Years ago, it was often said that radiology and lab was used to "rule out" this or that ailment because the doctor's didn't know how to make a clinical diagnosis. As a kid, I had right lower stomach pain and the family doctor did a simple blood test, pressed on the area that was hurting and told my parents to get me to the hospital ASAP and the surgeon would be waiting to take my appendix out. Today, it's lot's of lab work, plus a CT and then surgery. I think we can thank in large part of this particular dog and pony show to trial lawyers for driving up the price of a simple diagnosis. That's a whole different topic for another time!And:
On the plus side, CT has eliminated so many x-ray studies I couldn't count them. The numbers must be huge. Plus, the difference in radiation dose in a minimally invasive CT versus an angiogram (name your study) has to be significantly lower. And, many of these exams are performed on an outpatient basis eliminating lengthy hospital stays while recovering from such procedures. The diagnostic results are far, far superior to the "old" methods and techniques once touted as leading edge technology.
In a nutshell, CT may be over used by some physicians as a CYA defense, but on the whole, it's such a valuable tool that it has become the standard of care in medicine.
CT is a great thing. It lets us see into areas of the body that "the sun don't shine". And that's good. However, the over-use of radiation in any form is not. If you go into the ER, and I mean virtually any ER, and you have a cold, headache, miscellaneous pain, or trouble with your bowels (too active, or not enough), you will have an X-ray, and/or a CT. And, if you go there the next day, or a week later, the likelihood is that you will get the exact same treatment.
It doesn't mean that the treatment you will receive is bad, it just means that an emergency room is for EMERGENCIES. So, that's why you are directed to follow-up with your family physician. Without knowing you, the ER performs the same general screening time after time.
All xrays and lab tests are overused in the ER. I know this because I have a good friend who is a board certified ER doc and he would tell you: ER docs are the whores of the hospital. They are hired to do the dirty job that staff physcians don't want to do (ER coverage) but when the fecal matter hits the rotating blades, the staff docs won't hesitate to let the ER docs hang in the wind. So to cover their bottoms, they order more lab and xray, CT, etc than they really need, because it all comes down to our lawsuit happy society. CT is a great tool and it is over used, but it's either that or lawsuits every day and no more ER docs to cover.
