BREAKING NEWS
The decision from Indianapolis is in and the Judge has ruled against the Floyd County Moratorium placed against the competing hospital. This is a big win for the new hospital and a huge loss for the County and the Hospital. The judge reportedly wrote a 38 page ruling and I am in the process of obtaining a copy.
I was asked to give a short opinion on the current members of the Board and how they vote related to most issues and how they voted supporting the financing of the legal defense for the moratorium. The vote related to the defense of the moratorium was 6 voting for and 1 opposed. I was the lone dissenter on this particular issue.
The following is a list of the Board Members I had the pleasure of working with. I also am giving my opinion of how they voted based on my experience. I disagreed with some of them often, but I consider them all friends and respect their opinions. I did feel that at times, some of them overlooked obvious issues related to administration. The reason for this was never clear.
Kay Garry—a truly great lady. Full of knowledge, dedicated, brilliant in oversight and finances and has become a good friend. It has been a pleasure working with her and getting to know her. She votes based on principles and the facts and always in what she felt was the best interest of the hospital.
Von Marshall—a true gentleman. Always concerned about etiquette and has been a very strong Chairman. He held each of us accountable for statements and decisions and I also have enjoyed his company and friendship. He votes on issues relative to their merit and in the best interest of the community and hospital.
Darrell Mills—always cares about the employees and is easily approachable to listen to problems and concerns. Not afraid of controversy and has some political aspirations. This has been manipulated by some commissioners but Darrell was a stand-up guy and willing to work around the issue for the betterment of the hospital. Again, he is a friend whom I will continue to work closely with. He votes on issues based on what he feels is best for the hospital and the employees.
Bob Kleehammer—intelligent and very mild mannered. Never seems to get frustrated. He is in the banking business and brings that expertise to the Board. He usually votes and sides with administration.
David Atkins—retired from a large business in Louisville. Has experience in blue collar and white collar careers as well as union issues. He is very personable. Usually votes with the CEO's recommendation.
Mary Garner—retired nurse. Widow of Dr. Garner and mother of Dr. Bill Garner and the Mayor. She is very outgoing. She nearly always votes based on the CEO's recommendation.
Newest appointee is Keith Megraw. His wife was the CEO's secretary in the past. He is in the insurance business and has been a member of the commissioner-appointed task force to look at the competing hospital issue. From what I've been told, he will likely vote based on the CEO's direction.
This is the view from my seat. We can certainly disagree on this as well.
I was asked to give a short opinion on the current members of the Board and how they vote related to most issues and how they voted supporting the financing of the legal defense for the moratorium. The vote related to the defense of the moratorium was 6 voting for and 1 opposed. I was the lone dissenter on this particular issue.
The following is a list of the Board Members I had the pleasure of working with. I also am giving my opinion of how they voted based on my experience. I disagreed with some of them often, but I consider them all friends and respect their opinions. I did feel that at times, some of them overlooked obvious issues related to administration. The reason for this was never clear.
Kay Garry—a truly great lady. Full of knowledge, dedicated, brilliant in oversight and finances and has become a good friend. It has been a pleasure working with her and getting to know her. She votes based on principles and the facts and always in what she felt was the best interest of the hospital.
Von Marshall—a true gentleman. Always concerned about etiquette and has been a very strong Chairman. He held each of us accountable for statements and decisions and I also have enjoyed his company and friendship. He votes on issues relative to their merit and in the best interest of the community and hospital.
Darrell Mills—always cares about the employees and is easily approachable to listen to problems and concerns. Not afraid of controversy and has some political aspirations. This has been manipulated by some commissioners but Darrell was a stand-up guy and willing to work around the issue for the betterment of the hospital. Again, he is a friend whom I will continue to work closely with. He votes on issues based on what he feels is best for the hospital and the employees.
Bob Kleehammer—intelligent and very mild mannered. Never seems to get frustrated. He is in the banking business and brings that expertise to the Board. He usually votes and sides with administration.
David Atkins—retired from a large business in Louisville. Has experience in blue collar and white collar careers as well as union issues. He is very personable. Usually votes with the CEO's recommendation.
Mary Garner—retired nurse. Widow of Dr. Garner and mother of Dr. Bill Garner and the Mayor. She is very outgoing. She nearly always votes based on the CEO's recommendation.
Newest appointee is Keith Megraw. His wife was the CEO's secretary in the past. He is in the insurance business and has been a member of the commissioner-appointed task force to look at the competing hospital issue. From what I've been told, he will likely vote based on the CEO's direction.
This is the view from my seat. We can certainly disagree on this as well.
posted by Anonymous at 5:42 AM
28 Comments:
I'm not sure I understand how Floyd Hospital runs. However, it seems to me that Floyd's biggest problem is county status. What multi-million dollar business would have board leadership chosen for it the way Floyd does? Is this typical for all hospitals? This seems to be an out-dated model better suited for animal shelter and trash pick up leadership, not complex organizations like hospitals. The private hospital will be far less politically charged than Floyd Memorial. Their CEO, (a doctor?) will answer to shareholders/investors (other docs?). This probably is a good thing. The county commissioners should do the right thing and allow Floyd Memorial to operate in the 21st Century. Again, what multi-million dollar enterprise would/could operate effectively when county commissioners select the folks steering the organization?
The board members you discuss...what is their background relating to health policy, planning, fiscal management? I totally and respectfully disagree with your assessment of some of these people. I won't get personal and I hope you had permission to use their names.
I hope this new hospital is good for everyone. I hope it's not a get rich quick scheme by angry docs.
Wouldn't a better solution be to privatize Floyd Hospital? Allow physician investors to buy into that? Why can't board members show some proficiency in health issues? No physicians on a hospital board...just doesn't make sense to me.
We had a baby at Floyd last year. I thought it was a great place to go. The doctors and nurses were very good. I hope it doesn't change.
Privatization is an option, but I would not be supportive. I have worked at many private hospitals and their focus is first and foremost profit. It comes at the expense of patient care.
County-owned nonprofit hospitals have many tax advantages, and from my experience tend to focus on community needs and patient care.
Your comments about the Board composition is very pertinent. In fact, we hired a consultant to talk about board composition and these exact issues were discussed and the information passed to the commissioners.
One of the recommendations was to increase the board size to 9 from the current 7. With this increase, they recommended having 2 physicians on the board.
As you know, the commissioners with the recent reappointment have now removed the only physician.
It is a very sad situation that shows little insight and even less competence of the commissioners.
There are more than 100 active physicians on staff that could have been appointed. Not having any is a very poor decision.
I have to say I understand how Floyd Memorial runs. I was an employee there for many years and was very proud of FMHHS and of its administration. I wholeheartedly disagree with most of what Dr. Dan has to say on this website (though not all). I have to say I am very confused by several statements - especially when he talks about the positive aspects, i.e., the employees. He states that what makes a hospital successful is its doctors in one section, however, at the end of the same section he says it is employees.
He also states that Bryant Hanson rules by intimidation. Having known both men and worked with both men, I would have to say that I see that as the case with Dr. Dan. He has repeatedly been the one who wants it "his way or no way". He states he is interested in patient care, however, I can think of several instances where he refused to work with the case management staff when it came to discharge plans for the pt. and put the patient last and his ego first. One such instance I remember is when one of my co-workers was trying to move a pt. to SIRH and they did not want to accept the pt. on the current diet regimen that he had prescribed. The case manager called him, the admissions nurse from SIRH called him and they both explained that in order for the pt. to be transferred he would need to make some changes. He refused (being the egotistical jerk that he is) and it finally took a call from Dr. Shaw at SIRH to change his mind. When it came to listening to nursing staff, he had his head up his ass. No matter what (and I experienced this myself) recommendations that the nurses TAKING CARE OF THE PATIENT AT THE BEDSIDE had to offer, he would not listen. He often refused to make referrals to Floyd's home health service (even when the pt. specifically asked for them or had them in the past and was pleased with them). One day he was screaming about a problem to my boss, Carol Mullen. His focus was not on fixing whatever problem he had, he kept saying "I want to know who to blame" more than once. This is what kind of person he is. The only difference between him and God is that God doesn't go around thinking that he is a family practice doctor. As far as employee morale, he is one of the doctors that most employees would say they don't want to have any contact with. Just for giggles, I was at the hospital today and asked a few ex-co-workers what they would think of Dr. Dan being the CEO. One laughed and did not answer, another stated "God help us all if that happens" and another stated they would be looking for another job asap.
As far as employees "seeking him out" to complain, maybe a few disgruntled people. I have also been told that employees who are also his patients have been asked by him in his office about what is going on at the hospital and if they have any complaints.
From day one of his service on the board, he has bucked for Mr. Hanson's job. It is obvious that this has been a personal vendetta all along. No matter the issue, no matter the vote, HE ALWAYS SIDED AGAINST BRYANT.
As far as supporting the hospital, where was he when we were at the commissioners' meetings regarding the private hospital issue? He says he supports Floyd Memorial and he supposedly took an oath to do just that, however, I never once saw him at any of the meetings (he refused to go) in which he could have lent his support. And he was a board member!
He knows as well as anyone that this new private hospital is an endeavor by a few disgruntled physicians who don't want to follow someone else's rules. They want to go their own way and line their pockets along the route. Dr. Stavens has a reputation among the nurses at Jewish as being a major Asshole that no one can get along with and when he wants things his way, his throws a fit. He yells, screams, threatens people, etc. Same with Eli Hallal (who by the way stood toe-to-toe with Jeff Moberly in the hallway at the commissioner's meeting and swore up and down he had no financial or professional interest in a private hospital - LIAR, LIAR, LIAR!). Dr. Hallal is known to the employees of Floyd as a jerk who yells, screams, threatens and anything else to get his way. And there are those (including myself) who wonder about his mental stability.
If these two actually open a hospital, I feel sorry for the patients. The biggest thing I wonder is how the hell they would get employees and how long they would keep them. If it was a fair competition (instead of them cherry-picking patients), Floyd would beat them hands down as far as service and care, and the new hospital wouldn't be open long. However, as we all know, it is not fair competition and the only people to suffer are the public. Again, the rich get richer and the poor get screwed. How all of these profit-minded people get around the Stark Act is what I would like to know. At any rate, that is a WHOLE 'NUTHER BLOG.
In the end, I would just like to say that people see through you Dr. Dan. They know that although you are capable of being a good family practitioner, you have somehow lost your way and let your ego expand to where you have alienated so many people - employees, management, even the general public. Have you been drinking the same stuff as Eli Hallal? Perhaps you got it from Roger Baylor who doesn't know jackshit about Floyd Memorial but likes to play armchair philosopher and because he is a personal friend of yours, thinks you are sooooo compassionate and kind. Perhaps he ought to give up the liquor business and get a job at Floyd so he can see what really happens in the day-to-day operations and see how conceited and selfish you are . In the meantime, I think he needs to shut the hell up about Floyd and focus on what he does know about - beer.
And by the way, I am ex-employee because of health problems - not because I wanted to leave. I have worked many years at Norton's downtown, Clark Memorial and served four years in the Navy at various naval hospitals. Floyd Memorial BY FAR exceeds the service and care thresholds of any place I have worked.
I have recommended many family and friends to either work there or go there for their healthcare needs and will continue to do so in the future.
In closing, I would like to say I don't mean to be so disrespectful because I do believe you are a good doctor - but you need to do some serious thinking about the way you have acted and the people you have hurt. If you dislike the hospital administration so much, please, go practice elsewhere. Leave Floyd Memorial to people who really care about it.
I'm still not sure I quite understand how hospitals work. Can't a for profit hospital be a good thing? After all, as a doctor, are you not in charge of me in the hospital? Can't my doctor tell the hospital what things to do for me?
I would guess that most docs are like small businesses. They make money...why can't hospitals?
I just cannot believe Floyd Hospital has no doctors on the Board. How do they (the board)know health care any better than me? I know nothing about that stuff, but I trust that my doctor and nurse do.
Why can't some people that actually touch patients for living be on the board? Can an actual hospital employee be on the board? Who is my advocate about good care if they are bankers, police, retirees? How do they get trained? This seems outrageous. Are you kidding me...an insurance guy on the board? I can barely afford my premiums now! Can I apply for the Board or am I asked by the county? I guess my ignorance was true bliss. This sounds scary to me. Everyone seems so mad at this place, but as I said earlier, they sure hid it from me and my wife. They were very nice people there. All the yelling must occur in a specially padded room!
Here's a hint for everyone...stop being so angry and start caring about patients and the skyrocketing costs of health care.
I actually didn't read the blogger above me until now...Please don't tell me...no doctors in administration either? Principals are usually teachers. I always thought that a president of a hospital was a doctor. Maybe the blogger who said Mr. Hansen meant Dr. Hansen. Again...who is making decisions that knows where my spleen is and what it does? I bet the insurance guy doesn't...he just knows how much he can make on it...
"Perhaps you got it from Roger Baylor who doesn't know jackshit about Floyd Memorial but likes to play armchair philosopher and because he is a personal friend of yours, thinks you are sooooo compassionate and kind."
All I've done is try to refer thinking people to this blog so that they can engage in precisely the sort of dialogue that is developing here, although I must admit that anonymity has a tendency to spoil the debating broth, as it were.
In fact, I'd guess that I've proffered fewer opinions on Floyd Memorial Hospital than on virtually any other topic, and for the reason you state: I know nothing about it, and don't recall suggesting I have.
(Shrug) I'm a known entity. My e-mail is listed within the profile, and you almost certainly know where to find me if you want to discuss it further, although I don't really understand what it is you wish to discuss.
Just take off the mask, okay?
Cue the "Gunsmoke" music...
Dr. D: Hanson...this town aint big enough fer tha two of us...
Mr. H: Doc...ya better smile when ya say that...
Dr. D: Them sounds like fightn werds ta me...
Mr. H: Are ya man enough? Cuz ya look perty yeller ta me...
Dr. D: Don't make me git mah prostratin finger out mister...
Mr. H: Yer prostratin finger and who's army, buster...
Dr. D: Ah aint even gonna lube fer ya...
Mr. H: I likes like that...
Dr. D: Ahm a givin ya till sundown Hanson, then pinky goes ta werk...
Mr. H: I'll be a waitin here fer ya...
Comming soon....Hanson aka "Half Cent" (West Coast) vs. Eichenberger aka "D.J. Self-Righteous" (East Coast) get old school. Someones gonna pop a cap in they ass!
Unfortunately, there are no physicians on the board of Floyd hospital. If you look at the composition of other hospitals in the 'Kentuckiana' area, they are composed of business leaders, community leaders AND physicians. (Jewish and Norton's, for example). As Dr. D said, physicians refer patients to the hospital - LIKE IT OR NOT - the hospital is dependent on the patient volume to sustain their operating margin. Shouldn't physicians have a voice at the highest level? Thankfully it sounds like there is a retired nurse on the board, at least someone who understands patient care, and has provided it firsthand. Why is it that the Floyd County Commissioners get to appoint board members? Couldn't this be done by election? We are missing out on potentially 'great' board members with varied skill sets: local business leaders, members from university settings, and committed physicians - all who could provide many perspectives to the issues at hand, maybe with objectivity that is lacking in former/current members.
And, Dr. D - LIKE IT OR NOT - There has been nothing but continued growth and success under the current leadership's tenure; however, I am in total agreement that the hospital needs physician representation on the board. PERIOD.
Well, except for the hate offered by one, overall good discussion and I do appreciate the positive as well as negative comments.
I have allowed anonymity up to this point, but I would like it to remain civil. I have no problems with addressing conflicts or disagreements and do not take it personally as evidently some do.
To clarify, I do butt heads with case management but overall have a fairly good working relationship. I am not characterized by comments stated, but hothead 1 is entitled to her opinion.
For those who don't know, case management are those individual who have no personal relationship with the patient but have the job to make sure patients do not stay in the hospital unless they meet some abstract criteria given to them by insurance companies.
They repeatedly call physician offices and tell us that our patients don't meet criteria to be in the hospital and want us to send them home or elsewhere.
I understand their job, but I also know my patients, the families and home situations better than they ever could. I will continue to fight for what I think is best for my patient and if that means the hospital may lose a buck or two than so be it.
We can deal with the money issue after the patient is taken care of.
I apologize to Roger that he is being attacked as well.
These are the exact types of behaviors that are common. People would rather stir things up behind the scenes rather than be open and honest about how they think.
I feel comfortable disagreeing and working towards compromise rather than continuing to hide behind anonymity or subordinates as is done in the administration.
Just thinking we should explain to the readers why many physicians and case managers have conflicts.
When patients go to the hospital and are placed in a room for whatever reason, they believe they are admitted to the hospital.
In actuality, patients are categorized as either being admitted or in observation status. Nothing is different with the bed, the location or care recieved between admission or observation.
Doctors do not treat them differently.
But case managers are required to make sure that patients are categorized correctly for only one reason. So the hospital gets paid.
They do help expedite certain things so patients can get out sooner, but their primary job is to be sure the criteria is met for payment.
That is why doctors and case managers don't always see eye to eye. It's hard to have to tell the patient that I am sorry but your inusurance company says you don't need to be here any longer and if we don't find alternate care, you may be respoinsible for the bill.
This is what happens every day and it is frustrating for phsycians. We do not keep patient in the hospital because we enjoy seeing them. We keep them there because we believe it is in their best interest. We could care less if the hospital categorizes them as being admitted or in-observation. That has absolutely nothing to do with patient care.
In retrospect, was it OK to use anonymity when promoting your own candidacy for board reappointment? Is it also OK for you to malign the honesty and competence of county commissioners, board members and administrators, based on second hand reports of conversations or your assumptions about who might be posting here and for what purpose? For goodness sakes, don’t you EVER examine your own motives and methods?
I'm an anonymous person...I'm the guy who posted questions about the board process and who doesn't know how hospitals work. I'm finding this very interesting and I do not want to "go ugly" so to speak. I'm not going to identify myself because I operate a very small business in the area and if I lose customers that's a problem. I'm Mr. Average. Average height, weight, income, 2 kids (one born at Floyd Hospital). I've never blogged.
I've posted 3 previous notes here. I'm the person that doesn't understand how hospitals run and probably never will. I like Floyd. I just didn't know all these things...job keeps me working to a point that makes me clueless from the rest of world's issues...even local ones. I own a small franchised service company and want to please everyone who hires me.
I think health blogger must be a doctor. This is an education for me and for selfish reasons of finding this topic interesting, I want to keep the talk going. This is a new world to me.
I've never taken an interest in county politics...too busy trying to work. I'm not a working class hero either. I have some college but no degree. I want a good hosptial with good doctors that care about my kids and my wife when they are sick.
Other than the birth and some sore throats and ear aches thank God we haven't needed to go to the doctor much. We do have insurance. It's very very expensive. I can hardly afford it, but the way I look at it, I can't afford not to have it.
Our doctor goes to Floyd I'm sure. I'm think going to talk to him. I'm about as small a fish as they come. What questions should I ask him? I don't want to make him mad...this is really none of my business.
I have never been afraid ask questions. But I don't want to put my business at risk. When I read that there are no doctors involved at Floyd I still don't understand. I thought doctors did that kind of thing...very interesting. I think doctors should have a say in my care even though I really dont need to go now. Can't someone just ask one of the doctors in this town to get involved or is this just another case of me not getting it?
Commissioners are elected officials and Board members are political appointees. They therefore are subject to scrutiny and criticism.
They should be held accountable for their decisions.
I do believe it is ok to promote someone's own candidacy for a position.
How many of these other people you so adamantly defend are willing to be open to dialague and criticism?
I'd be happy to debate any of these issues openly in any forum and let ALL the truth be known.
Are you??
Majority of doctors are just like you. They run their own small business and do not have the time or energy to "get involved". They believe their patients come first. First over time and money. They are frustrated with the increasing demands placed on them by government, insurances, and the hospital.
They absolutely should be involved and should be on the Board. Nortons and Jewish are both private and therefore do not have county politics to confuse the issues.
The decision to remove the only physician from the Board was purely political. If they did not want to reappoint me, they had more than a hundred other physicians to choose from.
I'd encourage you to ask your physician questions about his thoughts on the hospital, the patient care and the administration. I think you will be enlightened.
Thanks for the concern. You and your family's health is your responsibility and being informed is the best way to make the right decisions.
Guess I thought the doctors did run the hospital. Thats what I don't understand...
Can a doctor be punished by the board? I dont want my doctor to get in trouble if I talk to him about this. I don't want to make him mad and tell us to find another doctor either.
I'm going to keep asking people about health care because EVERYONE I know is interested. I know people in my position that cant afford health insurance. They are not bad people. They don't use drugs they just cant do it. I hope you know how crazy expensive it is...I read earlier that Floyd Hospital has insurance people on the board...thats what really caught my eye...don't make my insurance any more expensive than it is.
I've only lied on this blog once...I was at one time of average weight...really!
Becoming a member of any medical staff at any hospital requires submitting an application with all their history and credentials.
They are then reviewed by a credentials committee and followed by a Medical Executive Committee. If they are approved they get forwarded to the Board for final approval.
Once part of the Medical Staff, they agree to abide by a set of Bylaws. If they do anything wrong, there is a process in which to begin proceedings for discipline, restriction of priveleges or expulsion from the Medical Staff.
Voicing concerns and talking about the good or bad is not a problem and should not be discouraged.
The Board member in the insurance business is very knowledgeable and has a company called Health Insurance by Design. 945-2005.
www.healthinsurancebydesign.com. I am sure he could help you with your needs.
Others in the New Albnay area that have done a good job for individuals and small businesses is Ricke and Ricke associates and Selfridge and associates.
"people would rather stir things up behind the scenes"???
...yourself included?
My comments are in response to Dr. D's statements regarding Case Management.
I find it interesting that one who is making negative statements regarding Case Mangement is a physician who was on the hospital board and I thought to be more knowledgeable about these things. Especially troubling is his stating as fact and I'm sure he thinks educational for the casual reader regarding the inpatient/ observation status that patients are placed in when they come to a hospital bed. There are specific guidelines that MEDICARE requires when a patient comes into the hospital. A physician must ORDER the specific status (inpatient or observation) of the patient's placement. The physician is called when the care being given, per his orders may not be meeting Medicare's critera for the specific placement he has ordered. Yes reimbursement is an issue, however, there are other risks involved if someone did not audit and "manage" these orders. If the hospital bills Medicare for inpatient care and the orders are for admission as "impatient" and the cares ordered by the physician do not meet Medicare's criteria for inpatient care, then the hospital could eventually lose it's Medicare certification. It could be decided by the fiscal intermediary (the company that manages Medicare's reimbursements regionally) that the hospital was defrauding Medicare by not being responsible and for billing incorrectly for gain. As a Case Manager reviews her charts daily, the physician's order for correct placement is only a SMALL part of her review. She also meets the patient, welcomes him/her to Floyd Memorial and during the ensuing conversation the Case Manager really does her thing.... She takes the time to get to know the patient, how does he/she do at home, do they require help, is there family available, do they have needed equipment, is there someone to get their groceries, clean their home, take them to the physician. She has a plethora of information available for the patient. She demonstrates compassion and caring. She does not want to see the patient go home too soon, but when the patient is ready to go, is their home environment going to support their needs and be restorative? Case Managers do things that most people do not even know about. They see a need and then they problem solve. Their PRIMARY concern is the WELL BEING of the patient (golly, just like you, Dr. D.! Yes, another part of what they do is talk to the insurance companies as the patient's advocate to get the hospital stay approved and for the hospital to get reimbursed for services rendered. No hospital, anywhere can survive financially without appropriate reimbursement. IF the insurance company refuses to approve the stay the Case Manager DOES NOT kick the patient out as implied by our Dr. She goes to bat for the patient and appeals the denial sometimes even without the physician's support. And sometimes, she wins! A patient is NEVER discharged from the hospital UNTIL the physician writes the discharge order. It is not legal any other way!
As a Case Manager - recently retired also, I have one regret. I regret that Case Management's inception at Floyd was met with such negativity by a very few physicians ( I can count them on fewer fingers on one hand). It is so sad that a very few - actually 2 could speak so loudly, from ignorance and maybe fear of not being IN CHARGE (but they really are!) if they accepted us, that they could cause so much disruption, and time wasting by not returning calls or not listening to what we were saying. I wonder if this lack of acceptance was a knee-jerk reaction to administration's overwhelming approval and acceptance of Case Managment. May it also be noted that even private for profit hospitals must have Case Managers. Sorry Dr. H. you will still have to deal with them! I feel like we are your pawns in this incessant game that is being played.
WE (Case Managers) ARE NOT IN THIS FOR THE ALMIGHTY $$$$. WE ARE SIMPLY NURSES WHO CARE AND ARE TRYING TO MAKE A DIFFERENCE IN OUR PATIENT'S LIVES, TOO. Working with all of the other physicians has been wonderful. We work as a team all for the benefit of the patients. God bless them all!
We are who we are today because of choices we have made over time in response to situations we have been involved in. It is sad to see the bickering going on and on in public - what a waste of positive energy.
I am proud to have worked at Floyd Memorial for the past 20 years. There is no perfect hospital anywhere. I have heard so many new associates relate the horror stories of other hospitals (on both sides of the river) and about those far away where they have worked. I have come to this conclusion we (Floyd) must be doing something right.
Incidently - I do agree that a physician should be on the hospital board.
Thanks Carol. We both agree that it is regulations that cause these conflicts and the rules change frequently. When the rules change, it is just added hassles and not a patient care issue.
You may also remember that even though conflicts arise, I was the advocate for instituting case management and beginning the D/C process at the time of admission.
I battled adminstration over this issue repeatedly as the administration drug their feet intituting this program.
Many seem to have forgotten that.
The job is extremely important and vital, but there are legitimate conflicts that arise. Working together is the key and I think overall it goes extremely smooth.
It seems like people are have very strong feelings about Floyd and health care in general.
I have given this a lot of thought. Floyd should be converted to a private not for profit hospital. Fifty percent owned by a management entity selected on qualifications, that is contractually obligated to oversee charity care and fifty percent physicians. The best answer for several reasons:
First: It provides arms length from our completely incompetent commissioners.
Second: The for profit perverse incentives are staved off.
Third: Why create inappropriate competition with a County owned facility and a for profit...one that puts profits over care?
Fourth: There is a staffing crisis. Peter will be robbed to pay Paul.
Fifth: Physicians could be invited to the table for joint ventures. Include the docs...most are very ethical and hard working people that really don't care about ego clashes that are just a part of life, folks. THE FOCUS IS ON QUALITY PATIENT CARE!
The commissioners should absolutely be ashamed of their ridiculous posturing and inappropriate over involvement. They should consider reappointing a physician. They, especially Reisert, should consider resigning. I point him out because I know him and he has a huge propensity to live in an ivory tower and work behing the scenes too much.
I also remember reading a CJ article where Dr. Hallal said he wasn't an investor in the for profit. He is a very pathetic man for a lot of reasons. He is a guy that puts himself first and provides marginal care. I have experienced this first hand. He should be humiliated.
Someone earlier mentioned elected boards...not a good idea. Floyd is a multi million dollar business...yes a business that has a meaningful social and economic mission. I think the public deserves to have smart, experienced, ethical, non agenda, clinical and interested in the huge amount of work involved in health care.
Floyd Memorial is a good place. Each time I or a family member has gone there, we have had great care.
After reading all comments on this blog, I feel sorry for the individual concerned about insurance costs. Keep blogging and I wish I knew your business because I'd use it!
I like anonymous information. Remember Watergate?
Bring on the debate. Talk and exchange ideas. Avoid the hate and name calling. This is not a game.
I like the thought of the last blog regarding making Floyd a private company.
County Commissioners, stick with what you know - county politics, not health care. That model of leaderhip may have worked way back when Floyd was built, not today. Would a fotune 500 company have leadership appointed or elected? What a farce!
Go private Floyd and level the playing field with the for profits that will be a part of the scene, like it or not.
For those who prefer elected boards, consider the elected school board...singular agendas, gridlock and ignorance of the issues. Private enterprise is one of the basic foundations of our country, even in Floyd County!
Wow - seems like maybe we are getting somewhere on this blog. I want to inform Roger Baylor that I did not intend to remain anonymous when I gave my comment the other day. I just didn't want to go to the trouble of opening a blogger account and perhaps setting myself up for just some more spam. At any rate, I don't understand his insistence on "taking off the mask". You have no idea who I am. My name is Rina VanKleef. My e-mail: dutch1@peoplepc.com, my phone number (812) 366-4439 and I am listed in the phone book. See? You still don't know who I am so why the hatred for anonymity?
Also, I would think you would understand that some people must remain anonymous for fear of retaliation. Since I no longer work at the hospital, I can say whatever I want and not worry about it. However, even though you have described Dr. Dan as compassionate and kind, I would have to say that he would be one of the first ones to make your life a living hell at the hospital if you said anything against him. My opinion is based on my experience as a case manager at Floyd in the past. When you disagree with some of the physicians - especially Eli Hallal and Dr. Strouse, you get harassment in return.
I would like to clarify a few points. I was such a fan of Dr. Eichenberger when I first came to Floyd seven years ago. I believed him and his associates to be very competent (and I still do believe they are). As a matter of fact, I was a patient at their office at one time. When he was appointed to the board, I was excited. Especially when I heard that he was the one who was instrumental in getting the case management system going.
In stating this, I was very surprised that he was one of the ones who was the most resistant to the case managers when the program was implemented. I guess he didn't take into account the egos of himself and of some of the other physicians when he rallied for case management. I also am appalled that he does not - even at this late date - understand the function of case management.
Case Managers wear a variety of hats including discharge planner, utilization reviewer, patient advocate, teacher, gopher, facilitator, the list goes on and on. Dr. Dan states he understands what his patients need based on being familiar with them. I tend to disagree. Maybe he is familiar with some - possibly most of his patients, however, people's needs and situations change over time. In general, there are those who rarely go to their physician. There are some who may have a certain primary Dr. and have NEVER been to their office. Add to that the sad reality that most doctors tend to not spend even fifteen minutes of face time with their patients (not saying this is their fault) and a lot of things fall through the cracks.
This is where a case manager can help. They interview the patients and families and help facilitate the best options when it comes to their care. They do not "kick people out of the hospital" as Dr. Dan seems to believe.
One of the issues with medical care is appropriate utilization of our resources. Dr. Dan states that doctors couldn't care less if a patient is an outpt or inpt. admission. Bull! If that were the case, then why did a lot of doctors there admit patients as observations even though they knew the patient would be there for more than 23 hrs? Because they didn't like having to dictate a full discharge summary on inpatients. Plain laziness. And I know that for a fact because I had more than one tell me that. Also, there were doctors like you that had some vendetta against either Bryant Hanson or the hospital so you didn't care if the hospital ate the cost. The really stupid thing is that when it came to a lot of cases, the hospital didn't eat the bill - the patient did. Most people don't know that if their insurance company refuses to pay that they will be held responsible. So a lot of times, you and Eli Hallal were just hurting your patients. You stated that doctors do not keep patients in the hospital unless they believe it is in the patient's best interest. I disagree. There are many patients who are in the hospital daily whose needs could be met on an outpt. basis - i.e., doctor's office, urgent care center, etc. There are quite a few physicians who keep their patients way beyond what is necessary.
There are three doctors I won't name who immediately come to mind. When one of their patients was admitted, it was known immediately that their patients would be there for a lengthy period of time no matter the diagnosis. Some of the doctors order a plethora of unnecessary tests, procedures, and drag their feet on getting consults to other physicians. I specifically remember a patient that one of our ENT doctors admitted. The man was not his regular patient. The Dr. had gotten him on call and the pt. had come thru the E.D. This patient had an unknown infection and was HIV positive. It was SEVEN days before an infectious disease specialist was called in.
Just because a doctor is a doctor does not mean that he or she does not require oversight. They are still human. Some of the physicians out there are downright dangerous and people do not question them. People oftentimes will ask for a second and even third estimate when it comes to repairing their car, but will not question their doctor's recommendations because he is a doctor. How insane!
With all that being said, I think people need to understand that our health care system is in major crisis and will eventually require a major overhaul. Why is this? The fact that historically a lot of fraud, waste and abuse has occurred, greed has entered the picture and society in general has been apathetic and less than proactive about it's own healthcare needs.
That is one of the reasons why I am so passionate about fighting against for-profit endeavors. To me, when you make a huge profit from the illnesses of people, there is a moral degeneration at play. Do I think doctors deserve great salaries? I think they need to be compensated for the many years of sacrifice and education and of course for the many hours that they put in each week. My problem is with those doctors who make INSANE amounts of money and want more. Specifically, I know personally of a radiologist who makes approximately $10,000.00 PER DAY reading scans that are transmitted to him via computer to New York City.
I had surgery 4 years ago (a double lung transplant) and the surgeon who operated on me received $14,000.00 for a nine hour surgery. That is what he RECEIVED. The total bill for my transplant and 5 week hospital stay at Jewish was $350,000.00. The cost of ONE of my antirejection meds is $3,000.00 per month. I researched this med and found that the studies and research for this med was funded by the National Institutes of Health - in other words, by the taxpayers. Yet, the drug company is making major bucks off of it. Indeed, the major pharmaceutical companies have almost unheard of profit margins. There is something wrong with this picture.
There are many reasons why our healthcare system is in such disarray and I have given way too much of my opinion here. Gotta go take my expensive medication now.
I'm sorry to take up more space but to whoever posted the little ditty about the "gunsmoke episode" - your remarks were totally tasteless, ridiculous and have no value here. Why don't you grow up? Try posting on Howard Stern's website or something. Sure, I got mad and called Dr. Eichenberger an ass but I think I had a point to make - you didn't. All you did was make yourself look bad.
I'd like to clarify myself as far as Dr. Dan. I think he is a very competent physician and I would not be fearful to send a friend or family member to him. I just don't like the size of his ego.
Thanks, Rina.
Now, I'm not trying to be disputatious here, and it's a minor point ... and I've confessed already that I know next to nothing about the hospital, and it's known that Dr. Dan is my friend and my doctor ... but can someone (anyone) tell me when I used the words "compassionate and kind" in reference to him?
This seems to have provoked you, and honestly, I simply can't remember doing it.
Thanks, and to be honest, I find the retaliation defense tiresome. I'm a known entity, and as such, a potential target for anything ranging from an epithet to a brick through the brewery window.
Indeed, I still don't know you. But I'm learning a lot from the discussion, and this is as it should be, isn't it?
Roger, I wasn't even aware of this blog site until last Friday. I was referred by someone to the "breaking news" section, however, I took the time to read everything in the archives and I am sure I read the comments "compassionate and kind" when referring to Dr. Dan - just can't specifically remember where. I hope I did not attribute someone else's writings to you. When I find the time, I will research this and let you know where I found this. At any rate, the point I was trying to make is that you seem to have this unblemished image of Dr. Dan as a physician and I wanted to point out that he is a very different person when he deals with the nurses and employees of the hospital as opposed to how he appears to his patients.
Also, as far as retaliation, you are your own boss. Sure, someone could throw a brick thru your window, but the likelihood of that happening from what you say on this website is slim. However, when you are employed by someone else, you have to watch what you say. For instance, I was reprimanded at the hospital once because I was teaching a childbirth class when a student asked me what we did if a woman started screaming while in labor. I stated that we smack her and then get out the morphine. Apparently someone did not appreciate my brand of humor and hence, I was in trouble.
So, in closing, I would like to say that I would rather have a dialogue with someone who remains anonymous than no dialogue at all.
Fair enough.
My purpose from the beginning has been to further the discussion by trying to steer people this way by linking from my blog, which has a healthy daily hit count.
Just imagine it from my perspective.
As opinionated as I can be on most matters, I'd not ventured an opinion here, because I didn't think I knew enough to do so. In fact, I'm not entirely sure what my opinion is, at least yet.
I'd also kept my own doctor-patient relationship out of it, and as stated above, tried to publicize the topic being discussed here, not one side or the other pertianing to it.
Suddenly I don't know "jackshit," I'm quoted as saying things I know I didn't say, and I'm called an "armchair philosopher" -- all by someone who is anonymous.
By the way, I didn't quibble with the "armchair philosopher" part, because that happens to be true.
You also wrote:
"Also, as far as retaliation, you are your own boss. Sure, someone could throw a brick thru your window, but the likelihood of that happening from what you say on this website is slim."
LOL on this one -- you should read some of the OTHER web sites. Whoa! Suffice to say I've received a blue ton of anonymous threats over the past year -- none that I've taken seriously, but when you have a name and your attacker doesn't, it's not pleasant.
Thanks for your clarifications.
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