Monday, April 30, 2007

Physician-Industry Relationships

When Dr. George Hevesy was Project Medical Director at OSF, he was salaried by Advanced Medical Transport and OSF. Many in the central Illinois area considered this conflict of interest.

The New England Journal of Medicine (April 26, 2007) recently had an article titled Survey of Physician-Industry Relationships.

There are numerous "take-home" points from this article:

1. More than one-quarter of the physicians surveyed received payments for consulting, giving lectures, or enrolling patients in trials.

2. The possibility that companies may target opinion leaders for marketing is further suggested by the higher frequency of industry payments to physicians who have developed clinical practice guidelines and to those who have served as preceptors for doctors in training.

3. The Pharmaceutical Research and Manufacturers of America implemented a code of conduct. This code states that the interactions between company representatives and physicians should primarily benefit patients and enhance the practice of medicine.

4. ...the high prevalence of physician-industry relationships underscores the need to consider their implications carefully.

Wednesday, April 25, 2007

OSF's Charity Assistance Did Not Include Jean-Baptiste

The following is from the Children's Hospital of Illinois website. Jackson Jean- Baptiste was denied care at Children's Hospital.

Jackson is buried in Goodfield, Illinois.

Charity Assistance
(309) 686-6700
(800) 421-5700

Dear Patient:

The philosophy of OSF HealthCare is that all people have a right to receive needed health care. Our doors are open to persons of every faith and ethnic background regardless of their ability to pay.

We provide help to patients in obtaining payment from third parties such as Medicaid and Medicare. If you are eligible for Medicaid, and you are not currently signed up, we can help you apply.

We also offer charity assistance for medically necessary healthcare services to persons who meet our financial terms provided they submit the needed documents. OSF Charity Assistance may be applied for when there is a balance still due on an account after we have received payment from third party payers (like Medicaid, Medicare or an insurance company) and you feel you cannot pay the full balance.

The PDF form available through the link below must be completed and signed by you. We use income guidelines established by the U. S. Dept. of Health and Human Services to determine if you are eligible for charity care. We do verify assets regarding your eligibility. So, please provide all the information promptly so we may try to help you as quickly as possible.

For more information, please call your patient accounts representative between the hours of 8am and 4:30pm Monday through Friday at 309-686-6700 or 800-421-5700.

OSF HealthCare offers high quality healthcare and we were pleased to provide that to your family. We look forward to working with you further to make sure the financial aspects of your care are handled in the same high quality way.

The Sisters of the Third Order of St. Francis

Click below to download or print the OSF Charity Assistance PDF form.

English Version
Spanish Version



Tuesday, April 24, 2007

Virginia Tech and Peoria's EMS

Wednesday, April 18, 2007
Peoria Journal Star Editorial

Virginia Tech is known as a football and engineering school, but never have so many Monday-morning quarterbacks descended upon one institution to do so much reconstructing. The worst mass shooting murder in the nation's history was just a few hours old, but already the blame game was in full throttle, going something like this:

Tech administrators waited too long to notify students after the first pair of shooting victims at a college dormitory. They were wrong to view that initial incident as an isolated case of domestic violence. They should have locked down campus and canceled classes immediately. They should have evacuated all 26,000 students, 10,000 employees, thousands of visitors. E-mails were a poor way of communicating with students; they should have been notified of the danger by cell phone. All involved should resign.

This might not have happened at all if someone had intervened more forcefully with Cho Seung-Hui, the 23-year-old South Korean identified as the shooter and described as "troubled" and a "loner." Perhaps the senior English major's professors should have done more than refer him to a counselor when they read some of his disturbing writings. Maybe his roommate should have seen this coming. Maybe his doctor should have red-flagged university officials, since Cho reportedly was on medication for depression. Maybe immigration officials never should have let his family into the country in the first place ... back in 1992. This just goes to show that it's too easy to get a gun in Virginia. This just goes to show it should be easier to get a gun in Virginia. We've just begun to mourn the 32 victims - we don't even know all their names - yet already there's talk of lawsuits.

No wonder VT Police Chief Wendell Flinchum seemed exasperated: "You can second-guess all day. We acted on the best information we had at the time." And maybe the critics should focus on the guy who pulled the trigger.

Virginia Tech officials and police were damned if they did and damned if they didn't Monday, which is why the only fair response to their decision-making was the one given by Bradley University Vice President Gary Anna on Tuesday: "It's too early" to say what lessons can be derived from this massacre.

Of course the Blacksburg, Va., situation has heightened awareness in Peoria, where Bradley has emergency protocols in place, said Anna. Those include general response parameters, but it still comes down to "a judgment call," because every case is unique, he said.

"It is just so unsettling because our young people are under a lot of pressure and it's just hard sometimes to anticipate what might trigger something like that," said Anna. Bradley would go on lockdown immediately "if we had a discharge of firearms in any part of the campus and had any reason to doubt whether or not the person had been apprehended," he said. "It's just not worth putting in harm's way an 18- to 22-year-old."

But Anna acknowledges that the dynamics are very different at BU's much more concentrated campus, home to approximately 6,000, mostly residential students compared to more than four times that number - including a significant percentage of commuters - at sprawling VT. BU officials are looking at some different form of alarm system beyond the standard emails or residence hall staff going door to door, perhaps using their electronic carillon system. Even then, there's no guarantee that college students "with their own sense of immunity" will listen, said Anna.

Bradley's full-time police force of some 15 members continues to do its job, but it's "not as if you can put an armed guard at every building entrance," he said.
Parents may not want to hear it - who can blame them? - but in fact all of us live with a degree of risk. While we can no longer say that slaughters such as these are incomprehensible, it's impossible to plan for every conceivable nightmare.

Our "monsters" don't necessarily look the part. It seems to be coded into America's DNA that we need answers to our tragedies now, cause and effect wrapped up neatly in a two-hour, made-for-TV movie. We may never know why.

What we do know is that there was heroism mixed in with the horrific in Blacksburg, and that we will learn from this, as we learned from Columbine, in time.


There is 1 comment
John A. Carroll, M.D.
April 18, 2007 - 12:07
Subject: Mass Casualty
The Journal Star editorial is asking: What can be learned from the disaster at Virginia Tech?

What if this massacre had occurred at Bradley University in Peoria?

Peoria’s EMS system would be inadequate to suddenly care for 48 injured people. The Peoria Fire Department is Basic Life Support-D with Basic drugs. They cannot provide paramedic service for Peoria. They have no ambulances and cannot transport patients. Transport may be the single most important issue with severe trauma.

Advanced Medical Transport is the only paramedic transport agency in Peoria. If they responded to a mass casualty who would cover the rest of Peoria for people that call 911 with significant medical emergencies?

Monday, April 23, 2007

Madame Therese

The lady in the photo holding the baby is Madame Therese. She remembers growing up in the Les Cayes area in southern Haiti. Her life was good.

Her family had a garden and they had enough to eat. They were happy. A bag of cement was not near as expensive as it is today.

She lives in Port-au-Prince now. She is afraid now. She was never afraid while she was growing up.

Notice her eyes are glistening. Madame Therese prays five times per day for her family and for Haiti. She still has hope for Haiti.

I believe the Madame Therese's of the world keep the world afloat. She is filled with faith. It is not the politicians or monsignors that are keeping Haiti from sinking into the ocean; it is Madame Therese.

"Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness that most frightens us. We ask ourselves, Who am I to be brilliant, gorgeous, talented, fabulous?

"Actually, who are you not to be? You are a child of God. Your playing small does not serve the world. There is nothing enlightened about shrinking so that other poeple won't feel insecure around you. We are all meant to shine, as children do. We were born to make manifest the glory of God that is within us.

"It is not just in some of us; it is in everyone. And as we let our own light shine, we uncounsciously give other people permission to do the same. As we are liberated from our own fear, our presence automatically liberates others."

Marianne Williamson

Sunday, April 22, 2007

Vicarious Grief

"According to Chochinov, there are a couple of catches to vicarious grief. The less the victims resemble us, the less grief we feel. And we don't seem to feel this grief as acutely for those who suffer from chronic problems, which often have their common denominator in poverty."

Maria King

Tuesday, April 17, 2007

Gorillas Receive Better Care than Haitians

Gorillas in Brookfield Zoo near Chicago receive much better care than most Haitians in Haiti.

First of all, the gorillas are fed every day. And they drink clean water. Gorillas don’t worry about when their next meal will be. On the contrary, the majority of Haitians are obsessed every day obtaining any food or clean water for their families.

Gorillas are moved between zoos in the United States for breeding purposes. We want to protect the future of their species. When Haitians flee the poverty in Haiti in pathetic boats and wash up on our shore, we return them to their island of misery. We don’t seem as concerned about their future.

When gorillas become ill, they receive much better medical care than the Haitians trapped in the slum or living in Haiti’s vast barren mountain ranges.

A gorilla named Chicory at the Brookfield Zoo displayed neurologic signs. An MRI was promptly done which revealed a large brain tumor on the right side. The brain tumor was removed and Chicory made a complete recovery.

When a poor Haitian gets a brain tumor, he doesn't get an MRI or surgery. He dies.

Heart disease affects many gorillas. The picture shows a gorilla's echocardiogram. Obtaining an echocardiogram and surgery for Haitian children dying of congential heart disease is much more difficult than it would be for a gorilla living near Chicago.

Saturday, April 14, 2007

Maxime, Jackson, and Peoria's Makeover

Maxime, in front of the National Palace in Port-au-Prince, December, 2006.

Haitian kids like Maxime and Jackson continue to die while Peoria will spend an estimated $850 million during the next 10 years to "makeover" their two main medical center campuses. The medical centers are located one block from each other.

See editoral in the Peoria Journal Star regarding this expansion. Also, note that no mention is made of Maxime or Jackson.

Wednesday, April 4, 2007

Justice and Injustice

Liberation theologists theory of justice begins from the experience of injustice. It is rooted in reflection on the dismal poverty that submerges the majority of Latin Americans in conditions of inhuman wretchedness.

“Justice, says Sobrino, takes seriously the primordial fact of the created world in its given form; that is to say, it takes seriously the existence of the oppressed majorities. The existence of these majorities is not a fact that can be lightly passed over in speaking of the essence of the Christian message.”

Likewise, Segundo Galilea asserts that the starting point of liberation theology’s reflection is the present situation, in which “the vast majority of Latin Americans live in a state of underdevelopment and unjust dependence.”

Justice, the liberationists insist, demands that conflict be brought into the open and faced, not subsumed or denied.

Justice demands that one enter the fray, that one enter into conflict and choose sides for some and against others. As Gutierrez observes, those who seek justice cannot avoid conflict because in a society scarred by injustice and the exploitation of one social class by another, the proclamation of justice will transform history into something challenging and conflictual.

Social conflict is a reality that the liberationists, as long as they do not avert their eyes from the misery and squalor that surrounds them, cannot escape.

However, when liberationists highlight the connection between the struggle for justice and social conflict, they are not blessing conflict. They do not believe that justice can come only at the point of a sword or through the barrel of a gun. On the contrary social conflict is ultimately the product of sin; it is the historical consequence of collective sin.

Humanity need not live in conflict; persons do not need to oppress their sisters and brothers. Conflict need not be sublimated or denied; it can be resolved. The resolution of social conflict, in fact, is precisely why the liberationists give conflict such a prominent position in their work. They seek to resolve it by uncovering and then eliminating the cause for the conflict, namely injustice.

From “Liberation Theology After the End of History—The Refusal to Cease Suffering” by Daniel M. Bell, Jr.

Haiti's Plague is Poverty

The Haitian baby to the right presented with seizures, fever, bulging tense fontanelle, primitive neurologic reflex at his right hand, and eye deviation to the right. He quickly became mottled and more lethargic. He was treated quickly with IM ceftriaxone and steroids. He was comatose for several days, but woke up and began interacting and eating. Most Haitian babies don't do this well with bacterial meningitis.

WHO estimates that about 1.6 million people, including up to 1 million children under 5 years old, die every year of pneumococcal pneumonia, meningitis, and sepsis. In populations with high child-mortality rates like Haiti, pneumonia is the leading infectious cause of mortality and accounts for about 20-25% of all child deaths. In these populations, Streptococcus pneumoniae is identified consistently as the leeading cause of bacterial pneumonia, and pneumoccal bacteremia is an important cause of child mortality. HIV infection increases risk for pneumococcal disease 20-40 fold, and antibiotic resistance makes threatment difficult and expensive. Thus pneumococcal idsease is a major global-health issue.

Haitian poor children are only given the standard vaccines. They do not get pneumococcal vaccines. If any group of children need the pneumoccal vaccines it is the Haitian children.

Pneumococcal conjugate vaccines can prevent most serious pneumoccal disease. The seven to 13 serotypes included in conjugate pneumoccal vaccines are expected to prevent 50-80% of all pediatric pneumococcal disease worldwide.

Also, the decline in disease in unvaccinated people is accounted for by the reduction in colonisation in vaccinated children and thus decreased transmission to unvaccinated contacts. In the USA, this herd immunity effect prevents twice as many cases as the direct effects of vaccination alone.

Based on studies done in Africa, there is a compelling case for giving pneumoccal vaccination in Haiti. Pneumococcal invasive disease, pneumonia, and meningitis, and a decrease in all cause mortality has been documented.

What are we waiting for?

"Many fledging moralists in those days were going about our town proclaiming that there was nothing to be done about it and we should bow to the inevitable. And Tarrou, Rieux, and their friends might give one answer or another, but its consclusion was always the same, their certitude that a fight must be put up, in this way or that, and there must be no bowing down. The essential thing was to save the greatest possible number of persons from dying and being doomed to unendng separation. And to do this there was only one resource: to fight the plague. There was nothing admirable about this attitude; it was merely logical."

---From The Plague, by Albert Camus

Tuesday, April 3, 2007

Peoria's Headlines

During the last several days, the headlines of several articles in the Peoria Journal Star have been about Peoria's medical center's expansions.

"Saint Francis Vision Goes Sky High"(March 31, 2007) is an article about OSF's Life Flight air transport using its new 4.3 million dollar helipad for patient transfers to St. Francis. OSF is planning on spending about $500 million dollars on building projects over the next several years.)

Another article the same day was headlined,"Methodist Unveils Vision for $350 Million Renovation". Methodist Medical Center is one block down the street from OSF. "You can't provide 21st century health care in early 20th century buildings," CEO Michael Bryant told the Downtown Rotary Club.

Today (April 3, 2007) a small article was titled, "101 Haitians Who Landed in Florida Likely to be Deported".

The article reported," The United States will probably deport most if not all of the 101 Haitian migrants who landed off a South florida beach last week, a U.S. legislator said Monday, warning other not to risk the dangerous voyage.

"The 101 Haitians, many looking gaunt and exhausted, came ashore Wednesday north of Miami after spending at least three weeks at sea in a dilapidated sailboat. One man died in the crossing and three were taken to the hospital in critical condition."

The articles in the Peoria paper describe the incredible wealth in our world and the incredible hopelessness in the other world.

I have stood on the beaches along the western and southern shores of Haiti and have shuddered at the thought of getting in a "dilapidated sailboat" and leaving. The waters crash into the shore and seem to say, "Don't even think about leaving here." But many courageous Haitians do. They think they have no choice.

We hear of the boat people that make it to our shores, but never hear of the ones that the ocean swallows and delivers them from their misery in Haiti.

The articles in the Peoria paper describe the incredible wealth in our world and the incredible hopelessness in the other world.

I have stood on the beaches along the western and southern shores of Haiti and have shuddered at the thought of getting in a "dilapidated sailboat" and leaving. The waters crash into the shore and seem to say, "Don't even think about leaving here." But many courageous Haitians do. They think they have no choice.

We hear of the boat people that make it to our shores, but never hear of the ones that the ocean swallows and delivers them from their misery in Haiti.