Article's turmoil
The article in the Courier on Wednesday certainly stirred the pot again. Physicians have been complaining for weeks to administration about the bed and staffing situation. The ER staff and nursing staff had voiced their concerns repeatedly and again felt as if it fell on deaf ears. I, being the most visible and outspoken, have again taken the criticism even though many have made similar comments.
But once it became outwardly public knowledge through the newspaper, then it certainly moved up on the priority list. The article put substantial pressure on administration to address a critical patient care and safety issue that had been known for weeks.
Since I was quoted in the paper, certain people at Floyd are making comments that I am out to hurt the hospital.
This is absolutely false. This bed problem and nursing problem has been a significant issue for weeks and addressed by a number of physicians, staff and Board members. In fact, month after month last year, the Board asked the administration how staffing was going for the new addition and we were repeatedly reassured that it was “on-track”.
Why is it that trying to fix obvious and glaring problems affecting patient care, safety, morale etc is hurting the hospital? Not appropriately addressing the issue is what is hurting the hospital. Again, ask to see the patient satisfaction results. How can the ER ever even attempt to improve scores when this problem continues?
Besides that, I didn’t approach the newspaper. Someone else notified them of the situation probably because they too felt helpless but realized it was a significant problem. The newspaper contacted me and asked specific questions about the situation and about the memo that was sent to physicians. Should I have lied or marginalized the problem to prevent bad publicity? This is a community owned hospital and a problem of this magnitude should be acknowledged and fixed. The County Commissioners should also be addressing this problem or held accountable.
This typical response of never airing the “dirty laundry” is part of the ongoing problem. The problems are real and visible. How people choose to deal with them will be the real question?
If everyone wants the Hospital to be the best, then problems such as these need to be prevented through proactive measures rather than reacting to them when they occur. Pointing fingers at me or anyone else does nothing to solve these problems.
When physicians cannot admit patients to the hospital where they have privileges, it is not good for the patient’s medical care.
Hopefully Monday we can get back to some other health topics and allow this to settle.
But once it became outwardly public knowledge through the newspaper, then it certainly moved up on the priority list. The article put substantial pressure on administration to address a critical patient care and safety issue that had been known for weeks.
Since I was quoted in the paper, certain people at Floyd are making comments that I am out to hurt the hospital.
This is absolutely false. This bed problem and nursing problem has been a significant issue for weeks and addressed by a number of physicians, staff and Board members. In fact, month after month last year, the Board asked the administration how staffing was going for the new addition and we were repeatedly reassured that it was “on-track”.
Why is it that trying to fix obvious and glaring problems affecting patient care, safety, morale etc is hurting the hospital? Not appropriately addressing the issue is what is hurting the hospital. Again, ask to see the patient satisfaction results. How can the ER ever even attempt to improve scores when this problem continues?
Besides that, I didn’t approach the newspaper. Someone else notified them of the situation probably because they too felt helpless but realized it was a significant problem. The newspaper contacted me and asked specific questions about the situation and about the memo that was sent to physicians. Should I have lied or marginalized the problem to prevent bad publicity? This is a community owned hospital and a problem of this magnitude should be acknowledged and fixed. The County Commissioners should also be addressing this problem or held accountable.
This typical response of never airing the “dirty laundry” is part of the ongoing problem. The problems are real and visible. How people choose to deal with them will be the real question?
If everyone wants the Hospital to be the best, then problems such as these need to be prevented through proactive measures rather than reacting to them when they occur. Pointing fingers at me or anyone else does nothing to solve these problems.
When physicians cannot admit patients to the hospital where they have privileges, it is not good for the patient’s medical care.
Hopefully Monday we can get back to some other health topics and allow this to settle.
posted by Anonymous at 6:07 AM
40 Comments:
Every large organization operating with finite resources has to make difficult, often painful, decisions about the level of funding or management attention that will be directed to the infinite number of demands for resources at any given time. That must be especially difficult within the current healthcare environment where the demand for services is growing while the funding for services is flat or decreasing.
The problem I have with you is that you don’t care about “context.” You don’t have to operate the hospital within a budget. You don’t have to meet the payroll. You don’t have to balance the interests and demands of doctors, patients, employees, regulators, insurance providers and community leaders. All you have to do is identify the things that aren’t as highly prioritized as others at a given moment and then spotlight them so you can achieve your goal of criticizing hospital administration.
You have clearly stated that you don’t like Bryant Hanson and believe he should be removed. His thirteen years in charge of a hospital which has done a better job than most of navigating through an extremely difficult time for all healthcare organizations and providers doesn’t count for anything in your mind. The awards and recognition that the hospital has received don’t register with you. The fact that Floyd is financially more stable than its peers you attribute to factors outside management. The bottom line for you seems to be that if Hanson did it, it is wrong. If he didn't do it, it should have been done.
Running a complex organization requires hard work and tough decisions. Throwing grenades is easy. Terrorists do it all the time.
We're back and we've been quiet for several days but we are tired of anonymous bad-mouthing Dr. Dan.
He did what everyone else wanted to do. We have been overworked, understaffed and on diversion ever since opening the new addition. Patients have been at risk because of these probelms
We have complained, voiced suggestions, worked harder and absolutely nothing got done until it went public.
The hiring was not done appropriately and administration has had 3 years to prepare. We guess that is Dr. Dan's fault as well.
Why doesn't Mr. Hanson and the rest of you VP's cut your salaries. Mr. Hanson makes more than $300,000 plus benefits and than a huge bonus every year from what we hear.
We never see administrators here on weekends trying to shuffle patients, appease families, make room. You just keep your 9-5 job and go home.
Then when someone with enough guts to challenge you, you make anonymous remarks and bash him.
Dr. Dan knows the problems with business but there are other ways to meet all the needs you describe. Administration is just never willing to listen
Employee 101. Did you read his blog last month on what would make everything right at the hospital? Take a look at this quote from him:
"I believe that collaborative partnerships between hospitals and physicians are absolutely the best means for success. Partnering will mean that hospitals will split the profits of activities they for years have taken 100 percent. Without collaborative arrangements, physicians will partner with each other and continually drain the hospital of the lucrative procedures and tests and leave the hospital managing mainly money-losing inpatient care."
He wants hospital revenue to be diverted to doctors. That may or may not be a good strategic solution but,regardless, that money has to come from somewhere. Whatever goes to docs will come out of employee salaries, or facility maintenance or staffing or something else that is currently being funded. It won't make the financial pie any larger...just the amount that goes to docs. So how is that you think he has your interests at heart?
Even though I disagree with HB much of the time, I do appreciate his efforts to educate us. Most of us know little of the actual operation of FMH. I think this blog has been and will be a big help in understanding. To blame HB for trying to hurt the hospital is not fair.
Also not fair, IMO, is the almost total condemning of Mr. Hanson and the administration. Anonymous 8:35 makes a good point about FMH navigating the difficult healthcare environment. On the other hand, waxing on about awards and recognitions leaves out something else important. FMH had to go searching for an agency to accredit them because they failed with the agency they had been with. While not an insider in hospital matters, I do know that when these agencies come to evaluate there is plenty of notice. It is not an unannounced visit. Very few hospitals ever lose theirs and, if memory serves, FMH also lost on appeal. That seems pretty serious.
As usual, I am windy. I appreciate HB's blog and those who post on it.
Basic economics would say that if physicians partner with each other and take 100% out of the hospital, employees really get hurt. I bet our salary would be cut way before Mr. Hanson or Mr. McCurry.
You can't fund anything unless the patients come to our hospital. You still don't get it.
iamhoosier got it right. Most of those awards were things our marketing people solicited and filled out applications for.
We flunked Joint Commission and it was also swept under the rug
Bless you 103!! I don't know for sure how "right" I am but after the bashing I have been taking on another blog this week your comment felt good. (smile)
Sorry not many replies, but it has been a really busy week with all the illnesses.
I appreciate the support from my friends.
To re-iterate for some new readers:
I chose to allow anonymous comments to this site. I could have chose to allow only known persons to respond or not allow anyone to respond and just write the daily postings.
I chose to allow all comments because nothing that has been written is without factual data to support it. I am willing to take my criticism and constructive comments. I believe in the employees at Floyd and know they want better than what is currently being given.
The employees are the greatest asset to the hospital and the best people I've had the honor to work beside. I know they are stretched beyond limits at the present time and I am willing to speak out on their behalf.
Dr. Dan is right.Many problems could have been avoided with true and honest cooperation from adminestration.They donot like physians and it will be their downfall. I just do not want the patients to be hurt.
Yes, you use "facts" all right. You simply ignore the context in which they exist. You criticize Floyd management for every failure to fully solve problems which are plaguing the entire healthcare industry. Fighting through staffing problems, for example, is an issue facing all hospitals, nursing homes and other health care providers. Go ask the nurses at ANY hospital in the metropolitan area if their facilities are adequately staffed.
In an earlier blog you mentioned that your income has been falling due to environmental factors beyond your control. I would still like to know why management at Floyd Memorial should be replaced because they haven’t been exempt from some of the industry-wide problems they face. How is it that you give yourself a pass on environmental factors but not hospital management?
Why was the Board repeatedly told that staffing for the new addition was on-track?
Why was staffing the most important concern of all the physicians regarding the new addition?
One of the reasons nursing shortages continue is because they are overworked, stressed, and shown too little appreciation.
If you look at the number of available nurses in the US, you will find a significant number has just left nursing all together because of the work environment.
If hospitals, government, insurance companies etc. would place more value on our nurses and reimburse for higher staffing levels, we could begin getting some of these nurses back into the field and fixing the shortage.
It takes someone to make the sacrifice and place the nurse/patient ratio at a higher priority. It takes leadership and I don't see this hospital, political action committee or anyone else stepping forward.
My income as well as other physicians is falling. We are taking appropriate steps. We have terminated contracts, we are renegotiating others, meeting with our representatives, trying to streamline processes, and looking for other ways to partner with colleagues.
I have attempted to rally other physicians with education and looking for ways to help them with contracting and other issues.
I am not sitting back waiting for someone to find solutions for my problem.
And yet, despite your best efforts, it continues to fall. Some problems don't have neat, easy solutions.
Here's the key difference.
Physicians are responsible for their own success or failure. We feel the financial impact personally even when their is no neat, easy solutions.
Unlike you, who can make decisions that may be devastating to the organization yet still collect your large salaries, bonuses and pensions. There is no financial risk to what you do.
That's the real difference.
HB, your free market analysis is dependent on patients being pretty knowledgeable about available services and competence and/or having ample time to become more informed when appropriate. That's rarely the case. Word-of-mouth reputation and personal experience do play into service selection but a doctor's ability to network with both insurance companies and other doctors is often a major factor in patient "choice". People don't have the opportunity to shop for a doctor the way they do for other products and services in many cases.
By the same token, an administrator answers for their actions. If you feel like they're not doing so, your beef is just as much with those who judge them as it is with the administrator. It might be worth exploring why (according to you) doctors have been so unsuccesful for so long at combating the forces that (according to you) are ruining the hospital.
BTW, are you claiming to know who the anonymous commentor is?
HB: You say: "Physicians are responsible for their own success or failure. We feel the financial impact personally even when their is no neat, easy solutions."
That still doesn't explain why you think that chronic industry problems should be easier for Floyd's administrators to solve than for you, other doctors or other hospitals?
And, once again, you assume that a line of thought different than yours must belong to someone in hospital administration. I am not employed by the hospital. I am not a board member or a part of local government. I simply have a lot of pride in our hospital and I am offended by someone in your position creating a negative image of the hospital because of your personal dislike for one man. You couldn't get your way while on the board so now you have turned to lobbing grenades in all directions without any regard for the damage they do.
bluegill,
Patients are sometimes limited in their access, but doctors are extremely limited in how they can contract. They have no bargaining power like other free markets. They can't network as you say because of current laws.
Dr. Dan may not know who anonymous is, but the employees believe it is our very own CFO McCurry.
We have heard these same comments from him in meetings.
He is opposed to any change, he has been banned from the doctors lounge because he has pissed off so many physicians. He is the only administrator that doesn't go routinely in the doctors lounge.
Dr. Dan is not lobbing grenades. This is a public facility and all this information should be public knowledge. If anyone would really want the truth, they would start asking more questions.
Dr. Dan got a lot of things changed while on the Board and their was more accountability than ever before. He challenged all of them and even the commissioners to make things better for Floyd. The challenge is why he was not reappointed.
Anonymous can say he is not who he is, but we know better. The CFO is obcessed and loves being able to slam Dr. Dan anonymously. What does that say for our leadership?
Bluegill, you just need to come out and really talk to some employees before you pass judgement. You will see.
Employee 101:
Your assumptions about identity are equal to your spelling skills.
anonymous can continue to bash and hide behind the keyboard. If you are as concerned as you say and don't have any affiliation with Floyd, then identify yourself.
We would lose our jobs if our identity is known.
You are the only one launching grenades. Dr. D is using precision strikes with good "intel" at known enemy combatants trying to make this hospital safe and the best around.
In addition, it takes a lot of guts to place himself out in front of everyone like this knowing there will be people like you assaulting him personally and his family.
I witnessed personally three times this week where nurses thanked him for what he is doing and voiced their support.
There are still 47 nursing jobs posted on Floyds website this morning. We know nurses from Louisville have interviewed and are not interested because even with the $5000 sign-on bonus, they would be taking a cut in pay.
Show us your indentity and your bias so we can judge you and your intention and hidden agenda.
bluegill,
you seem to be involved in city meetings etc. Ask Board members Mrs. Garry or Mr. Mills for their opinions.
They hear a lot from concerned employees and patients because we know they are open-minded but in the minority on the board.
Rumors went around our department that the CFO Mr. McCurry wanted to limit access to Dr. D's blog. He was told they couldn't do that.
That is the type of administration we have. The only information we are supposed to receive is to be filtered through the administration first. Many people are reading but very fearful that they are being monitored. That is why there are not more comments.
For what it's worth, I'm not passing judgement. I've gone out of my way to specifically state that I'm too ignorant of hospital facts to take sides on the issue and I haven't. If anything, I'd like to think that I occasionally offer a little balance from a patient perspective.
I appreciate the fact that HB speaks out and am suggesting that, if there are a lot of doctors that feel the same way, it would be good for the community for more of them to speak out. Choosing to leave the hospital may help them and future patients, but it doesn't do a whole lot to help those patients who are left behind. Letters to the editor, blogging, etc, don't require collective bargaining.
Insurance companies sometimes only cover primary care docs in their network, limiting patient choice. Those primary care docs make referrals. Good or bad, those same insurance companies require that referral for payment. Laws or no laws, that's networking and a doctor's ability to build and maintain relationships with the insurance company and other docs who make referrals plays a part in the care a patient ultimately receives. Even if the "emergency" element is removed, there are just simply too many factors involved in the process to pretend that buying medical care is similar to being a consumer in other markets.
I realize I'm preaching to the choir about those factors. I'm sure those with more medical experience could point out factors of which I'm not even aware. I also think, though, in his zeal to make points about hospital improvement, Dr. Dan sometimes presents an overarching view of physicians as always being motivated solely by what's best for patients. While I'd assume that's true in most cases, I've had too many bad experiences to allow for that across the board. The same self-interest bias is probably evident from the adminstration, I'm sure, and should be pointed out.
While I'm not suggesting that the government should regulate salaries, I do think that a more even distribution of medical dollars could play a role in improving healthcare. There's a finite number of dollars put into the medical system each year. If administrators and doctors were willing to work for a little smaller piece of that pie, they could still live well above the average person's means and there would be more money available for other employees and services like nursing, various clinicians, and social work. While doctors do make important decisions, it's those people who typically spend the most hands-on time with patients and weigh heaviest in overall patient experience.
Though I don't know her, I do occasionally see Mrs. Garry at meetings. I'll try to ask her about the hospital. And, obviously, I don't support limiting access to the media, regardless of form. You can't see it, but I'm making an unpleasant gesture towards anyone who would do that in general. That's a battle I am somewhat informed about and feel comfortable fighting.
Bluegill: Your comments are thoughtful. Regarding this:
"I...am suggesting that, if there are a lot of doctors that feel the same way, it would be good for the community for more of them to speak out."
I would offer that the absence of any significant response from the medical staff when HB was removed from the board is instructive. If he had a lot of support for his postions, it would be easy for him to work within the system for change rather than taking potshots from outside it.
In social conversations, I have heard HB described as an excellent physician, but somewhat rigid and overboard in his personal biases.
The physicians have been outraged. We here it everyday in our department.
They did take a stand and for the first time in the history of the medical staff, they proposed a legal resolution asking the Board to increase its size to 9 members and place 2 physicians on the Board. This had never been done before. This was the direct result of Dr. Dan being removed and the lies from administration.
We haven't heard what the Board did with the resolution at the last meeting. The employees are angry, but have no way to voice our complaints.
If the resolution passes, would it make sense for employees to vote on their two representatives or even for one of them to be a doctor and the other a nurse or somehow representative of other staff?
It's entirely possible that the two most recent comments are both correct.
Good insight Bluegill!
From what I have heard there is no one (including hospital admin) opposed to having a doctor or two on the board. Just not HB who is too rigid, accusatory and divisive to work effectively in a collegial environment.
The nurses would love this, but there is one problem.
The Board has rules that prevent a Board member from being related to an employee. Therefore they would have to change the rules if a nurse were to serve. In fact, they tried using this rule to prevent Dr. Dan from serving four years ago. His son was working as a surgery orderly. They told him that he would have to quit his job or Dr. Dan not take the position. His son was an excellent employee but Dr. Dan stuck with the rules and his son resigned his position. Another example of what they have done to him and his family personally.
We'd encourage all the readers to look carefully at anonymous remarks. His criticism is personal. He is not a casual observer. He is the CFO McCurry. He can continue to deny it, but there is no way his remarks are from some casual and concerned reader.
I wonder if the Board, Mr. Hanson or the attorney know he is making the comments. Is he working independently or is this a concerted effort.
We've worked with Dr. Dan and we have worked with McCurry and Hanson. Dr. Dan is not the one that is too rigid, accusatory and divisive. He is always willing to work effectively in a collegial environment and that is why he is so well liked by the employees.
He is just not a yes-man
Employee 102:
If you are such an "insider" with a lot of access to what is going on in the hospital, maybe you could tell me who this McCurry person is. I have said before, I am NOT an employee. Believe it or not as you choose. But when you purport to know what is going on inside you should at least be able to correctly name the person you are accusing.
EMPLOYEE 102:
It took me exactly 10 seconds on an internet search to figure out that you must be trying to say: "Mercuri, chief financial officer." If you know so much about him, how come you don't know his name?
EMPLOYEES 101, 102, & 103:
In going back over your comments above, I couldn't help noticing that all three of you misspelled the CFO's name the same way. The website where I found his name indicated that he has been at the hospital for quite a few years. How is it that of all three of you, not one can correctly spell his name? EMPLOYEE, would you be trying to fool us by pretending there are more than one of you?
We all three work together and since I misspelled his name wrong the first time; they just copied.
Your attacks are personal and you therefore must have some underlying motive. Why don't you reveal yourself and then the readers can judge you like you have been doing.
All of us are really afraid but also really angry. We want to help and to let readers know how inaccurate your assesment really is.
Apologies to anonymous. We only go to meetings and hear about Mecuri. We don't have to spell his name.
Your remarks are interesting only because we have known Dr. Dan for so long and know he is well-liked by virtually everyone except 1 or 2 in the administration.
Your remarks just seem so personal that you must be one of them. Most other casual readers do not feel obiged to continue commenting and you seem obcessed with it.
EMPLOYEE(S)(If there really is more than one of you) You seem to have a one-sided view of what constitutes a "personal attack." Since that is such a sensitive subject for you, what is your reaction to these comments posted by HB?
“Integrity is important and two of three of our County Commissioners have shown their lack thereof.”
“Chuck Freiberger had his ego threatened when held accountable for his actions, and not re-appointing Dr. Eichenberger is the retaliation.”
“Two county commissioners placed politics and egos over their duty to the Hospital and the community.”
“Commissioners like Freiberger who have their “egos get in the way of their better judgment” are doing a disservice to our community!!”
“Mr. Freiberger’s and Mr. Reisert’s decision to place politics over reason will lead to continued problems of poor accountability.”
“In my 13 years plus on the Medical Staff, I cannot remember one single new original idea developed by the CEO. It always appeared to me that the continued advances, programming, strategic moves and successes were always someone else’s ideas. But he was never bashful about taking the credit for the ideas and successes.”
“In my opinion, these things were done so that he (Hanson) would look better at the expense of the hospital employees doing the work. Double standards run amok under this leadership. This has been typical of his style over his tenure. Usually taking credit but never blame or responsibility.”
I think you've made our point.
First, you talked about context yet you just list each of these out of the context they were written in. We'd agree these are personal attacks. But they are against the people who did the original attacking.
Second, you must be obcessed by either keeping all of these or spending the time to go back and collect them. Still wondering then who you are.
Third: All of these were done out in the open with his identity known and with the opportunity to respond.
So the key differences are: He made remarks in response to personal attacks.
He did it with his identity known.
He gave facts and details about specific events leading up to the conclusions.
You have not done any of these.
If you're not Mecuri, then maybe you're Frieberger. You seem obcessed with the remarks about him as well.
How would the context change any of those quotes? I don't see anything about any attacks on him by them. They just didn't do what he wanted.
And here is a free learning opportunity: The correct spelling is: obsessed.
Well it certainly appeared to be an active topic this weekend.
No time to read all the entries now, but I will scan them later today and comment if deemed necessary.
This will teach me to start reading the blogs on the weekend. Who hijacked NA Health and put up SOLFC?
I would appear to me that this Doctor has one thing going for him above many others in health care management. It sounds to me like Dr. Eichenberger still looks out for the well being of not only the health care workers and support staff, but the people that we are all in the feild for, the patients.
If more and more health care workers, both professionals, administrative, all the way to the volunteer greeters at the front doors would take a stand such as the ones taken by this Doctor, perhaps the current health care crisis in our countrycould be corrected.
Everyone seems to be focusing on nursing shortage however; I would like to bring up the fact there is a huge problem with shortages in all ancillary services. Not only are we working with practically the same staffing but are now covering both buildings which is causing resentment and an increase in sick time. After working 12 hour shifts of running back & forth from both buildings repeatedly, many employees appear to be stressed and "call ins" are on the rise.
I do believe Dr. Dan is right. Evidently there is a shortage of nurses and people to care for the patients at Floyd Memorial. I am using my brother as an example, he was a patient, actually he was dying, and was released to be sent back to nursing home and died 1 1/2 days later. It was because they did not have enough people at the hospital to care for him and they wanted to get rid of him.
Floyd Memorial pretends they want to be a "GOOD NEIGHBOR". Take a look around the hospital and see where they put all their junk and unwanted waste. It is not in view of their facility, but on the back northwest side where it can't been seen by the public. Drive down Martin Drive and look at the mess behing the hospital, the are infringing on everyone in that neighborhood and they think it is "hidden". If they truly wanted to be good neighbors they would clean up the mess, the creek and the damage they have caused in that area. This is truly not the way to be "good neighbors". I worry the administration is trying to "hide" what goes on inside the hospital as well as what goes on at their backdoor. Please, Bryant Hanson clean up the mess that was created with the expansion of your facility.
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