tag:blogger.com,1999:blog-47069388364298218852024-03-05T01:11:16.995-08:00PMMDailyA frequent update of <a href="http://peoriasmedicalmafia.blogspot.com/">Peoria's Medical Mafia</a>. Also see <a href="http://dyinginhaiti.blogspot.com/">Dying in Haiti</a>, <a href="http://johncarrollsposts.blogspot.com/">John Carroll's Posts</a> and <a href="http://www.livefromhaiti.blogspot.com/">Live From Haiti</a>.John A. Carrollhttp://www.blogger.com/profile/06908526384688432087noreply@blogger.comBlogger561125tag:blogger.com,1999:blog-4706938836429821885.post-89206653330061889342018-05-21T14:05:00.000-07:002018-05-21T14:07:45.700-07:00May 21, 2018<div class="p1">
May 21, 2018</div>
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Hi Everyone,</div>
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I hope you are having a good Spring. It went from Winter to a warm Spring in Peoria pretty quickly this year.</div>
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On January 1, 2018 two new PFD Engines became Advanced Life Support--Engines 3 and Central Station in downtown in Peoria. There are now 5 PFD Engines which are ALS--Engines 3, Central, 12, 20, and 4. </div>
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I ran across this article today in Emergency Medicine Abstracts.</div>
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<b>Effects Of Emergency Medical Services Agency Ownership Status On Patient Transport Deziel, J., Prehosp Emerg Care 21(6):729, November-December 2017</b></div>
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<b>BACKGROUND:</b> Various patient demographic characteristics have been reported to influence the unnecessary use of emergency medical services (EMS) for ambulance transport of non-acute conditions. Structural factors such as generation of revenue may also be a factor. Private EMS agencies have a stronger incentive than publicly-funded EMS services to transport patients to receive insurance reimbursement. </div>
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<b>METHODS:</b> This retrospective study from Western Carolina University School of Health Sciences analyzed all 9-1-1 ambulance call data for the state of Virginia during 2009-2013 to assess differences in patient transport decisions between privately funded versus publicly funded EMS agencies.</div>
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<b>RESULTS:</b> Data included more than 4.6 million emergency ambulance requests during the study period; patients were 45% female and 36% male (19% unknown) and had a mean age of 52 years. Responding agencies were publicly funded in 70% of cases (primarily fire departments) and privately funded in 30% (mainly nonprofit organizations). Public organizations had transport rates of 56.5% for fire departments and 61.8% for government non-fire organizations, while rates for private agencies were 73.6% for nonprofit EMS, 89.5% for for-profit EMS, and 80.0% for hospital-based EMS. In adjusted analyses with fire departments as the reference group, all other EMS entities were more likely to transport patients, with odds ratios of 1.25 for government non-fire, 2.12 for private nonprofit EMS, 4.56 for private for-profit EMS, and 4.06 for private hospital-based EMS (all comparisons, p</div>
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<b>CONCLUSIONS:</b> EMS agency ownership status appears to significantly influence patient transport decisions, with private profit-generating agencies most likely to transport. </div>
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16 references (jddeziel@wcu.edu – no reprints) </div>
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<span class="s1"><b>PMID: </b><a href="https://www.ncbi.nlm.nih.gov/pubmed/28657800"><span class="s2">28657800</span></a> </span></div>
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<b>EDITOR’S COMMENTARY: <i>This retrospective study of over 4.6 million ambulance requests in the state of Virginia looked at the decision to transport patients by agency ownership type (e.g., private vs non-profit). They found that private ambulance companies were 4.5 times more likely to transport patients than their publicly funded counterparts. The authors conclude that private ambulance services are incentivized toward patient transport.</i></b></div>
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Copyright 2018 by Emergency Medical Abstracts – All Rights Reserved 5/18 - #15</div>
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This article makes me think of AMT transporting people in Peoria. AMT is the only ALS and transport agency in Peoria. AMT is backed by Peoria's three hospitals.</div>
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Just recently, the City of Peoria hired Fitch and Associates to consult regarding EMS in Peoria. Interestingly, OSF and Methodist contributed $25 K to this study and the City of Peoria contributed $25 K to study this. </div>
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Andrew Rand, the CEO of AMT has long been a fan of Fitch and vice versa. Fitch awarded Mr. Rand their Pinnacle Award in 2013. </div>
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I wonder if Fitch will be unbiased when they come to town and look at EMS? </div>
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John A. Carrollhttp://www.blogger.com/profile/06908526384688432087noreply@blogger.com0tag:blogger.com,1999:blog-4706938836429821885.post-40879250341480610872018-02-01T05:34:00.003-08:002018-02-01T05:37:13.380-08:00Times a' Changin' in Peoria<div class="_5pbx userContent _3576" data-ft="{"tn":"K"}" id="js_f" style="background-color: white; color: #1d2129; font-family: "SF Optimized", system-ui, -apple-system, system-ui, ".SFNSText-Regular", sans-serif; font-size: 14px; letter-spacing: -0.12px; line-height: 1.38; margin-top: 6px;">
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Peoria Fire Department--Advanced Life Support</div>
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January 29, 2018</div>
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<span style="font-family: inherit; letter-spacing: -0.12px;">I was at a location the other night and a person suddenly passed out. PFD E3 arrived in a matter of minutes and began evaluating the patient. AMT arrived about 4 minutes later. Both teams of medics worked together very well. E3 just became ALS-First Response on January 1.</span></div>
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Nothing I have to say in this post has anything to do with the providers from AMT or the PFD who are working the streets in real time. The EMTs' assessment of the patient when first evaluated and the evolution of the patients' course with their interventions was very important for me as I evaluated the patient upon arrival in the ER.<br />
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John Carroll---Forum Article, PJS--January 27, 2018</div>
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Let Peoria firefighters provide advanced life support</div>
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On Jan. 1, Peoria Fire Rescue 1 on Monroe and Engine 3 on Armstrong became Advanced Life Support First Response.</div>
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They join three other advanced life support engines in Peoria — Engine 12, Engine 20 and Engine 4. This is the first time Peoria firefighter-paramedics from Rescue 1 and Engine 3 have ever been able to provide independent advanced life support when they arrive at a 911 call. Sick and injured patients no longer need to wait precious minutes for Advanced Medical Transport (AMT) to arrive.</div>
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Why did our local project medical director, Matt Jackson, M.D., allow these two Peoria fire engines to upgrade to Advanced Life Support First Response now? During much of the last two years, Dr. Jackson had opposed any PFD engine upgrade from basic life support to advanced life support.</div>
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In August 2017 Illinois House Bill 1952 was signed into law by Gov. Bruce Rauner. It stated that the “ambulance assistance provider shall be authorized to function at the highest level of EMT license … held by any person staffing the ambulance assistance vehicle.” This means that if there is a Peoria fire paramedic on a basic life support engine, and if Dr. Jackson approves, this paramedic can now provide advanced life support immediately upon arriving at the scene of a 911 call.</div>
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There were more than 19,000 medical 911 calls last year in Peoria. Peoria Fire has enough paramedics to staff all 12 engines. This law should help level the playing field in Peoria between AMT, which is supported by the powerful medical and business communities, and the shackled Peoria Fire Department, which wants to provide advanced life support for all the people of Peoria.</div>
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This two-decade-long EMS saga in Peoria shows how medicine, politics and money intersect at a dangerous point. The project medical director in Peoria should keep money and politics out of the equation and allow all of the remaining Peoria fire engines that are basic life support to become advanced life support.</div>
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John A. Carroll is a medical doctor. He lives in West Peoria.<br />
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Now the following paragraphs will be a "deeper dive" into the above article, and I will start out with this quote from Councilman Jim Ardis from the PJS in 2002--</div>
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Councilman Jim Ardis: ”If we want to have a highly trained fire and medical department in the city, there is nothing that AMT can do to prevent us from doing so.” I don’t think that anyone can make the argument that anybody would not want the best-trained people to be there for them all the time in case of an emergency. Why would you not want that?”</div>
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1. Two Engines, Rescue 1 and E3 just became ALS for the first time.</div>
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Over the last two years, there have been frequent discussions at the City Council, AMT, PAEMS, and the Peoria Fire Department. The PFD wanted to upgrade Engine 19 from BLS to ALS. The PFD has firefighter-paramedics at the station now who are not able to provide paramedic skills when they arrive at a 911 call before AMT arrives. But Engine 19 was denied their upgrade. E19 on the northwest side of Peoria is still BLS.</div>
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Dr. Jackson made a power point presentation to the City Council in 2017 and wrote several letters to the City Council stating that he saw no reason for the PFD to upgrade ANY Engine in Peoria to ALS.</div>
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It is amazing there was no media coverage when the PFD was allowed to upgrade two Engines on January 1. The silence in Peoria over this upgrade is incredible but understandable for the powers who control EMS in Peoria.</div>
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Most of Peoria has no idea that the PFD is mainly BLS. Most people have no idea that these two stations just became ALS. Most people have no idea that Dr. Jackson gave his approval for these two stations to become paramedics. Most people think that the PFD paramedics can function as paramedics...but the truth is that today when 911 is called, most PFD paramedics on duty cannot offer independent life support. And I will explain why.</div>
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We have 12 Fire Stations in Peoria but only 5 of them are ALS--12, 20, 4, 1, and 3. However, all 12 Engines could be ALS because we have 55 PFD Medics. I will come back to this in a second.</div>
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And I want to emphasize that AMT is the only provider in Peoria who can transport the patient. AMT is supported by the titans of Peoria--Peoria's three hospitals, influential businesses, and by many of our politicians. AMT's revenues are 23 million dollars transporting patients around the state of Illinois. That is where the money is. I want to make it clear that during the last two years the PFD was not asking to transport anyone. The PFD does not own an ambulance.</div>
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2. Bill 1952</div>
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What did Bill 1952 really mean?</div>
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The idea for the creation of this bill came from Peoria but was sponsored by representatives from different parts of Illinois...specifically NOT by Peoria's representatives. The feeling is that our sponsors representing Peoria could shy away from supporting Bill 1952 due to the hot politics in Peoria regarding EMS.</div>
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What do I mean by hot politics? How can an issue of prehospital care in Peoria be a hot topic? The answer is AMT wants to remain the only transport/ALS business in Peoria like it has been for the past 25 years. And when AMT is supported by Peoria's bosses, the influential business and medical community in Peoria, beware if you rock the boat. There is a lot of money involved. And when AMT and PAEMS, which is located at OSF, put obstacles in the way of the firemen, politicians are simply afraid of AMT and OSF and the business community. The politicians want their support and their money. Big businesses stick together. OSF supports AMT. In other words, our local politicians don't want to make AMT and OSF upset with them.</div>
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Well, this bill was written to help Peoria Fire Fighters give advanced life support in Peoria.</div>
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Having said that, Bill 1952 passed unanimously except for Ryan Spain who voted "present" due to several family members being on the Board of Directors at AMT. In other words, all of the state representatives voted that they believed that paramedics on a basic engine anywhere in the state of Illinois should be able to offer ALS at the medical 911 call. This, of course, makes sense. The bill was signed into law in August by Gov. Rauner. Every representative in the state of Illinois voted "yes" except for Ryan Spain.</div>
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I want to make clear that R1 and E3 in Peoria did not become ALS under this new law from Bill 1952. I happen to believe they were "gifts" to the PFD by the project medical director. Why do I call them gifts? I think that since Bill 1952 now gives all the Peoria Fire Engines ability to be ALS if the PMD signs off. Unfortunately, I believe that the PMD has plenty of pressure put on him to keep the PFD as "basic" as possible.</div>
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However, did you know attempts were made in Springfield to stop Peoria from being covered by Bill 1952? Oh, yes. There is a lobbyist in Springfield named Molly Rockford who was hired by the Illinois College of Emergency Physicians (ICEP) and represented ICEP. She lobbied that Bill 1952 should pass for the entire State of Illinois...except for Peoria. Sounds incredible, doesn't it? Why would she lobby for this? Why would ICEP not want Peoria included where the PFD paramedics would not be allowed to provide advanced life support at the scene? I don't know for sure. But I do know that George Hevesy, who still works at OSF and is the President of the Corporate Board of AMT, was the President of ICEP years ago and is a councilor on the Board of ICEP now. (Another OSF physician holds a similar position on the ICEP Board.) In other words, ICEP lobbying to exclude Peoria from Bill 1952, MAY lead right back here to Peoria.</div>
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3. So, this brings up the next question: I wonder what the PFD needed to do to swap this time with AMT and PAEMS to give more Peorians advanced care.</div>
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Why do I say swap? Because it is a matter of politics and money and making deals in Peoria. This discussion has never been about providing improved patient care.</div>
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Right now our politicians in Washington, DC are bartering for the lives and futures of about 2 million immigrants under DACA and the Dreamer's children versus a 25 billion dollar wall and enhanced border security. In DC they are bartering 2 million lives for a 25 billion dollar wall to be built along the Mexican-US border. That is how politicians work.</div>
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So what does this have to do with Peoria? I will tell you.</div>
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In 1996, the PFD wanted to upgrade their service from BLS to Intermediate Life Support for the people of Peoria. But the PFD didn't quite make it. In fact, the headline of an article in the Journal Star from May 1, 1996 stated:</div>
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“Ambulance Plan Abandoned–Fire Department to Add Defibrillation Program”.</div>
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The PFD met resistance in 1996 from AMT's CEO Andrew Rand and from George Hevesy, MD who was PMD and receiving a salary from AMT and from OSF.</div>
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Rand, of course, did not want the PFD to upgrade.</div>
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Rand stated that the PFD should spray the "wet stuff on the red stuff" and stay out of EMS. Dr. Hevesy, his sidekick, explained to the City Council during those years that there would be "duplication of services" if the PFD upgraded.</div>
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The PFD finally backed down to the powers that be but were able to do something very incredible for the people of Peoria. The PFD stated that if you give us the ability to defibrillate patients we will not seek to upgrade. This was truly amazing.</div>
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So the trade was electricity to save lives for PFD BLS engines that would not upgrade to ALS.</div>
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When a person's heart stops suddenly and they are in cardiac arrest, their heart is usually beating too fast or quivering and needs to be shocked to start beating again effectively. And for each one minute the heart is not shocked, the chances of recovery go down by 10%. So if the person has a witnessed arrest and five minutes go by before the first shock, the chances of that person coming back are down 50%.</div>
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Defibrillation with portable monitors has been done since the 60s. It is the only proven weapon to save people from out of hospital cardiac arrests.</div>
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In 1996, defibrillation, or shocking the patient, was standard of care around the developed world even for Basic Engines like all 12 of the PFD Engines. But amazingly the PFD in Peoria was not using the best technique to save lives in out of hospital cardiac arrests--electricity.</div>
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AMT WAS using electricity. Why wasn't the PFD? I was a resident physician at OSF in the early 80's and people were shocked frequently in-hospital and out-of-hospital cardiac arrests. It was called "standard of care".</div>
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How many people died in Peoria as outpatients prior to 1996 because they were not shocked in time by the earliest arriving EMT which was usually the PFD?</div>
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Our Basic PFD, of course, should have been shocking people back to life..but they weren't. Where was Dr. Hevesy? Did he insist to the City Council that the PFD as BLS providers use defibrillators? If he did, I am not aware of it.</div>
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Why did our PFD have to barter to shock people in 1996? Because that is how it works in Peoria. I wonder what would have happened if the PFD still wanted to upgrade? Would Hevesy and Rand have told the PFD that they would remain as they were--BLS without the paddles to shock the patient?</div>
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4. What happened in the 2000's?</div>
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Early in the 2000s, after the death of a man at a restaurant in Peoria where the firefighters were first on the scene but unable to use ALS skills, Rick Miller was the PMD. Behind the scenes, Miller changed the protocol, which stated that the PFD paramedics could use their skills only when the AMT paramedics arrived. This was never published in the newspaper or in the public media in Peoria-- just like we have today with R1 and E3.</div>
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And as the years went by in the 2000s, even though I was told it was a dead issue at the City Council meetings by someone who was high up in the ranks, three stations were able to upgrade--Engines 12, 20, and Engine 4. And it took until 2013 for this to happen. Please remember, that even though these three Engines became ALS, they did not have an ambulance and transport was not a possibility. And it still isn't today in 2018 for the PFD. Transport is where the money is for AMT and they don't want to lose it.</div>
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Summary--</div>
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Peoria EMS has been fraught with problems for years. In my opinion, the PFD has been obstructed for years in their battle to provide ALS for the people of Peoria.</div>
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Last year the PFD voices were silenced for fear of a significant fine or imprisonment. Peorians as a whole are quiet also because they don't want to lose their jobs, their health insurance, and their seat at the Peoria Country Club. And well-meaning citizens have been threatened with possible lawsuits if they dissent too much. And as I said before, THE PFD HAS BEEN THREATENED WITH FINES AND JAIL TIME IF THEY SAY TOO MUCH.</div>
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In my opinion, it has never been about patient care in Peoria. It is about money.</div>
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People in Peoria don't know that their tax dollars are being wasted. The PFD medics make 2.5% more than a non-medic. And if these medics are not allowed to use their skills for the 911 patient, what is all of this about?</div>
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So what needs to happen?</div>
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With the recent passage of Bill 1952 into law, the next step should be that the PMD gives his approval for the remaining 7 BLS stations to become ALS. They would need a four thousand dollar box filled with ALS material on their Engine to function as independent paramedics--just as AMT has done for the past 25 years.</div>
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I think there has been a concerted effort to keep the PFD from upgrading during the last 22 years. Bill 1952 is law and can be used by the Basic PFD Engines if Matt Jackson, MD, the current Project Medical Director, agrees. Dr. Jackson just signed off on R1 and E3 to become ALS, which goes against what he has been saying and writing during the last two years.</div>
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For the Peoria neighborhood not covered by an ALS Engine, it will take a critical mass of people to influence their City Council Members to advocate for the Engine upgrade.</div>
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Clearly, the people who have controlled EMS in Peoria for a quarter of a century need to be replaced now. A fire chief of a very large city in Illinois told me years ago regarding EMS: "You have a very unfortunate situation in Peoria." And we still do.</div>
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"These titans stick together in the way that many titans do, not because they share some special affection or particular philosophy but because each sees in the others’ stature an affirmation of his own." (NYTimes)<br />
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John A. Carroll, MD<br />
January 29, 2018<br />
Peoria</div>
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John A. Carrollhttp://www.blogger.com/profile/06908526384688432087noreply@blogger.com0tag:blogger.com,1999:blog-4706938836429821885.post-55326107497756498222018-01-04T06:54:00.001-08:002018-02-07T07:30:47.063-08:00Peoria Fire Stations Advance to Paramedic--January 1, 2018<div style="background-color: white; color: #1d2129; font-family: helvetica, arial, sans-serif; font-size: 14px; text-align: justify;">
January 4, 2018</div>
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Dear Everyone,</div>
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Happy New Year. It is cold in Peoria. Very cold. Polar vortex and global warming combining to make the midwest very cold.</div>
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Great news regarding the Peoria Fire Department--</div>
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January 1, 2018--</div>
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This full moon lighting up the Illinois River and Peoria tonight on the first day of 2018 is the largest and brightest – <a href="http://earthsky.org/space/what-is-a-supermoon"><span class="s1" style="color: #e4af0a;">supermoon</span></a> you have ever seen.</div>
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But even bigger news than the supermoon is that today the PFD Rescue 1 Engine in downtown Peoria is offering independent Advanced Life Support for the first time ever. The Firefighter Paramedics will now be able to respond to a 911 call and offer the people of Peoria Basic Life Support and Advanced Life Support even when the AMT Paramedics are not on scene.<span class="Apple-converted-space"> </span></div>
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Engine 3 on Armstrong in Peoria will be doing the same starting today also.<span class="Apple-converted-space"> </span></div>
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<span class="Apple-converted-space">John Carroll, MD</span></div>
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<span class="Apple-converted-space">www.peoriasmedicalmafia.blogspot.com</span></div>
John A. Carrollhttp://www.blogger.com/profile/06908526384688432087noreply@blogger.com0tag:blogger.com,1999:blog-4706938836429821885.post-39135964417232814562017-04-08T08:10:00.001-07:002018-01-04T07:11:14.369-08:00OSF/Joe Piccione--2017Yesterday the Peoria Journal Star had <a href="http://www.pjstar.com/news/20170406/what-rules-must-catholic-health-care-organization-follow">this article</a> regarding the Ethical and Religious Directives for Catholic Medical Centers in the United States.<br />
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Joe Piccione, OSF's Catholic ethicist said that "we don't live by the ERD." This meant that OSF will follow some of the Directives but don't need to follow all of the Directives established by the US Bishops.<br />
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OSF allows its physicians to prescribe oral contraceptives so they don't lose the physicians. This is promoting oral contraceptives which the Directives say cannot be done by medical centers such as OSF.<br />
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"<span style="color: #232323; font-family: "crimson text" , "georgia" , "cambria" , "times new roman" , "times" , serif; font-size: 17.5px;">When OSF Medical Group was created in the 1990s, some physicians didn’t want to sign on if it meant giving up their ability to prescribe birth control to patients, something that ERD allows for treatment of underlying conditions but not for the purpose of family planning. But OSF was able to create a loophole, allowing those physicians who wished to prescribe birth control to do so of their own volition, covered by their own supplemental liability insurance as a sort of practice within a practice."</span><br />
<span style="color: #232323; font-family: "crimson text" , "georgia" , "cambria" , "times new roman" , "times" , serif; font-size: 17.5px;"><br /></span> <span style="color: #232323; font-family: "crimson text" , "georgia" , "cambria" , "times new roman" , "times" , serif;"><span style="font-size: 17.5px;">This Journal Star article does not mention that it was Joe Piccione who constructed this loophole with the blessings of The Catholic Diocese of Peoria which still continues today. </span></span><br />
<span style="color: #232323; font-family: "crimson text" , "georgia" , "cambria" , "times new roman" , "times" , serif;"><span style="font-size: 17.5px;"><br /></span></span> <span style="color: #232323; font-family: "crimson text" , "georgia" , "cambria" , "times new roman" , "times" , serif;"><span style="font-size: 17.5px;">Mr. Piccione was also on the Diocesan Haitian Hearts committee which effectively ended Haitian Hearts patients from returning to OSF for follow-up heart surgery. A number of them have died. This action also is against the ERD for Catholic Medical Centers.</span></span><br />
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<span style="color: #232323; font-family: "crimson text" , "georgia" , "cambria" , "times new roman" , "times" , serif;"><span style="font-size: 17.5px;">Here is the article which is hyperlinked above:</span></span><br />
<span style="color: #232323; font-family: "crimson text" , "georgia" , "cambria" , "times new roman" , "times" , serif;"><span style="font-size: 17.5px;"><br /></span></span>
<span style="color: #232323; font-family: "crimson text" , "georgia" , "cambria" , "times new roman" , "times" , serif;"><span style="font-size: 17.5px;"><span class="byline-item" style="box-sizing: border-box; clear: left; display: block; float: left; font-family: "Roboto Condensed", "Helvetica Neue", Helvetica, Roboto, Arial, sans-serif; font-size: 15px; font-weight: 700; line-height: 1.4em; transition: all 0.1s ease-in-out;">By <a href="mailto:lnightengale@pjstar.com" style="box-sizing: border-box; color: #989898; text-decoration-line: none; transition: all 0.1s ease-in-out;">Laura Nightengale</a> <br style="box-sizing: border-box;" />Journal Star reporter <br style="box-sizing: border-box;" /><iframe allowtransparency="true" class="twitter-follow-button twitter-follow-button-rendered" data-screen-name="lauranight" frameborder="0" id="twitter-widget-0" scrolling="no" src="https://platform.twitter.com/widgets/follow_button.eaf4b750247dd4d0c4a27df474e7e934.en.html#dnt=false&id=twitter-widget-0&lang=en&screen_name=lauranight&show_count=false&show_screen_name=false&size=m&time=1515078538594" style="box-sizing: border-box; height: 20px; position: static; visibility: visible; width: 65px;" title="Twitter Follow Button"></iframe></span></span></span><br />
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<span class="article-meta-date" style="box-sizing: border-box; transition: all 0.1s ease-in-out;">Posted Apr 6, 2017 at 6:33 PM</span><span class="article-meta-updated" style="box-sizing: border-box; display: block; transition: all 0.1s ease-in-out;">Updated Apr 6, 2017 at 7:34 PM</span></div>
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PEORIA — Hospitals and health care organizations have to follow not just state and federal laws, but a moral compass when delivering care to the communities they serve.</div>
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While nearly all health care providers and professional organizations have some form of a code of ethics or statement of mission, vision and values, many Catholic-based hospitals and health systems also adhere to a document called “<a href="http://www.usccb.org/issues-and-action/human-life-and-dignity/health-care/upload/Ethical-Religious-Directives-Catholic-Health-Care-Services-fifth-edition-2009.pdf" style="background-size: 5px 1em; box-shadow: white 0px -0.175em inset, rgba(105, 128, 150, 0.8) 0px -0.2em inset; box-sizing: border-box; color: #698096; display: inline; text-decoration-line: none; text-shadow: white -0.05em -0.05em, white -0.05em 0.05em, white 0.05em -0.05em, white 0.05em 0.05em; transition: all 0.1s ease-in-out;">Ethical and Religious Directives for Catholic Health Care Services</a>.” Created by the United States Conference of Catholic Bishops, ERD, as it is more simply known, helps organizations such as OSF HealthCare make policies for how care will be delivered and prioritized within their systems.</div>
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<span class="diigoHighlight id_4a4c6b4d50f869f3727f3116581e0c5d type_0 yellow" style="background-color: #ffff99; box-sizing: border-box; color: inherit; display: inline; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; position: relative; text-align: inherit; text-decoration: inherit; zoom: 1;">“The ERD is not the story of our life,” said Joseph Piccione, senior vice president of ethics for OSF Healthcare.<span class="diigoHighlightCommentLocator" style="box-sizing: border-box; line-height: 0; transition: all 0.1s ease-in-out; vertical-align: text-bottom;"></span></span><span class="diigoHighlightCommentLocator" style="box-sizing: border-box; line-height: 0; transition: all 0.1s ease-in-out; vertical-align: text-bottom;"></span></div>
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It’s less of a step-by-step guide for providing health care under a Catholic tradition than it is big-picture advice that sets priority and tone for Catholic health systems.</div>
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There are parts of ERD that are quite specific — the definition of abortion, Piccione said, is “one of those directives in which every word counts” — while others give more general advice that hospitals interpret and apply with guidance of their local bishop.</div>
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Some parts of the ERD are unoriginal. The first directive under the category of “professional-patient relationship” in ERD states, “The inherent dignity of the human person must be respected and protected.”</div>
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Similar sentiments are included in the codes of ethics of the American Medical Association and American Nurses Association, as well as individual health care organizations.</div>
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UnityPoint’s <a href="https://www.unitypoint.org/peoria/working-at-unitypoint-health.aspx" style="background-size: 5px 1em; box-shadow: white 0px -0.175em inset, rgba(105, 128, 150, 0.8) 0px -0.2em inset; box-sizing: border-box; color: #698096; display: inline; text-decoration-line: none; text-shadow: white -0.05em -0.05em, white -0.05em 0.05em, white 0.05em -0.05em, white 0.05em 0.05em; transition: all 0.1s ease-in-out;">Mission, Vision and Values statement</a>, for example, contains the phrase, “We connect with each person treating them with courtesy, compassion, empathy and respect.”</div>
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Other parts of ERD are sometimes inapplicable to certain organizations. The ERD explicitly forbids Catholic care organizations from performing euthanasia, though physician-assisted suicide is legal in only six states.</div>
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To understand the complexity and varied specificity of ERD, consider its conglomeration of directives for providing end-of-life care, which makes mention of specific interventions without a simple list of dos and do-nots.</div>
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ERD states that “a person has a moral obligation to use ordinary or proportionate means of preserving his or her life,” followed by a directive that says “a person may forgo extraordinary or disproportionate means of preserving life” and leaves the determination of what’s extraordinary or not up to the patient. It explains the moral obligation to provide patients with food and water, while stating that providing such becomes “morally optional” when they can’t be expected to prolong life or would be excessively burdensome.</div>
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It goes on to recognize “a person has the right to prepare for his or her death while fully conscious” in the same paragraph that it says patients should be “kept as free of pain as possible” and that “patients who experience suffering that cannot be alleviated should be helped to appreciate the Christian understanding of redemptive suffering.”</div>
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Because ERD is created by a group of bishops and updated periodically, the Catholic approach to health care has adapted to modern technology.</div>
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“When transplantation and organ donation was first clinically available, Catholic health care had a hesitancy about it because there was a thought that could be wounding a human person, the destruction of a person,” Piccione said. “And only as time developed it was clear that this was a work of charity, of love, for someone. Now it’s encouraged and placed in ERD.”</div>
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As the bishop of the local diocese is responsible for guiding health care organizations in their application of ERD, each bishop and organization has some ability to maneuver the directives.</div>
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When OSF Medical Group was created in the 1990s, some physicians didn’t want to sign on if it meant giving up their ability to prescribe birth control to patients, something that ERD allows for treatment of underlying conditions but not for the purpose of family planning. But OSF was able to create a loophole, allowing those physicians who wished to prescribe birth control to do so of their own volition, covered by their own supplemental liability insurance as a sort of practice within a practice.</div>
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The real application of the 72 directives of ERD is much more than restrictions on reproductive treatments.</div>
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“It’s an affirmative document,” said Steve Mattern, vice president of mission services.</div>
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“The ultimate, ultimate reason that we exist to care for those who are sick, is we want to create an environment where people, at a time of most vulnerability, pain and suffering, are able to experience the greatest care and love. And we hope and pray they also experience something that helps them connect with God’s love for them.”</div>
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<em style="box-sizing: border-box;"><strong style="box-sizing: border-box;">Laura Nightengale</strong> is the Journal Star’s health and lifestyle reporter. </em></div>
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<span style="color: #232323; font-family: "crimson text" , "georgia" , "cambria" , "times new roman" , "times" , serif;"><span style="font-size: 17.5px;"><br /></span></span> <span style="color: #232323; font-family: "crimson text" , "georgia" , "cambria" , "times new roman" , "times" , serif;"><span style="font-size: 17.5px;">John A. Carroll, MD</span></span><br />
<span style="color: #232323; font-family: "crimson text" , "georgia" , "cambria" , "times new roman" , "times" , serif;"><span style="font-size: 17.5px;">www.haitianhearts.org</span></span>John A. Carrollhttp://www.blogger.com/profile/06908526384688432087noreply@blogger.com0tag:blogger.com,1999:blog-4706938836429821885.post-9882849330317662142017-01-03T15:05:00.001-08:002017-01-03T15:08:26.238-08:002017Dear Peorians,<br />
<br />
Just wanted to let you know that EMS in Peoria is confusing. The only thing that is straightforward is understanding the conflict of interest involved in pre-hospital care.<br />
<br />
Now, most people do NOT know the following:<br />
<br />
If you suffer a medical problem in the area covered by R1 (main fire house in Peoria), you or your family member or your friend, calls 911. When R1 arrives at your side, which is usually faster than AMT arrives at your side, R1 can only give you Basic Life Support. They cannot give you Advanced Life Support even if R1 has Paramedics working for them and have the knowledge base and the ability to help you. The PFD Paramedic can’t even start an IV. They cannot give you medication. They can only give you Basic Life Support. They have a great knowledge base but they are not allowed to offer advanced life support skills that they have. You must wait for AMT and their paramedic to arrive. Then, and only then, can the PFD Paramedic help you. And this, in turn, helps the AMT medic.<br />
<br />
Does this make sense to you? Not really?<br />
<br />
Let me tell you something. People's lives in Peoria are being risked every day in medical scenarios where the PFD and their Paramedics are restricted from caring for you. And during the last 15 years, I am aware of many precarious medical situations that have happened after 911 was called.<br />
<br />
There is a lot of fear in Peoria about this. AMT has many businesses supporting them. People in Peoria are afraid to like or share a post like this. They do not want to lose their jobs. Rich people do not want anything to change. Poor people are just getting through the day and can’t take on another battle. So both rich and poor are silent on this issue for completely different reasons.<br />
<br />
Bishop Daniel Jenky is aware of the problem. The Sisters at OSF are aware of the problem. They will do nothing to improve the prognosis of the 911 patient in Peoria. Trust me. The ethics committees will bury their heads in the sand. The majority of Peoria medical community will stay quiet. Nothing will change until the politicians legislate for improvement in Peoria’s EMS. Or there is a lawsuit.<br />
<br />
Please consider the following: Engine 4 is located on the South Side of Peoria. It has been a Paramedic Engine since 2013. During the last 11 months, Engine 4 responded to 2,140 EMS calls. Yes, you read that correctly. And during October and November 2016, just two months, Engine 4 Paramedics provided 49 Advanced Life Support interventions. Yes, you read that correctly also. So, do you think the South Side of Peoria is better off with Engine 4 staffed by Paramedic/Firefighters since 2013? Remember, that for many many years our leaders told us that it was NOT necessary for Engine 4 to advance to Paramedic. Wonder what they say now?<br />
<br />
<span style="color: #1d2129;"><span style="background-color: #f6f7f9; font-size: 12px; letter-spacing: -0.24px;">I think it is way past time to listen to the PFD. It is way past time to listen to Rick Waldron who has been a firefighter-paramedic for greater than 10 years working at ground zero in Peoria regarding EMS calls. </span></span><br />
<span style="color: #1d2129;"><span style="background-color: #f6f7f9; font-size: 12px; letter-spacing: -0.24px;"><br /></span></span>
<span style="color: #1d2129;"><span style="background-color: #f6f7f9; font-size: 12px; letter-spacing: -0.24px;">At the scene of an accident, multiple firefighter-paramedics are often needed to extricate and give advanced life support care. This is not hard to understand. When Peoria has a shooting or multiple shootings, multiple paramedics are needed. This is not hard to understand either. </span></span><br />
<span style="color: #1d2129;"><span style="background-color: #f6f7f9; font-size: 12px; letter-spacing: -0.24px;"><br /></span></span>
<span style="color: #1d2129;"><span style="background-color: #f6f7f9; font-size: 12px; letter-spacing: -0.24px;">And at a house fire where there are flames, smoke, and people with smoke inhalation and burns, potentially with superimposed chronic medical problems, there is only one agency to call in Peoria to handle all of these problems—the PFD. This is not hard to understand either.</span></span><br />
<span style="color: #1d2129;"><span style="background-color: #f6f7f9; font-size: 12px; letter-spacing: -0.24px;"><br /></span></span>
<span style="color: #1d2129;"><span style="background-color: #f6f7f9; font-size: 12px; letter-spacing: -0.24px;">Peoria needs to wake up before even more lives are lost due to a corrupt and inefficient Peoria Area EMS.</span></span><br />
<span style="color: #1d2129;"><span style="background-color: #f6f7f9; font-size: 12px; letter-spacing: -0.24px;"><br /></span></span>
<span style="color: #1d2129;"><span style="background-color: #f6f7f9; font-size: 12px; letter-spacing: -0.24px;">John A. Carroll, MD</span></span><br />
<span style="color: #1d2129;"><span style="background-color: #f6f7f9; font-size: 12px; letter-spacing: -0.24px;">www.haitianhearts.org</span></span><br />
<span style="color: #1d2129;"><span style="background-color: #f6f7f9; font-size: 12px; letter-spacing: -0.24px;"><br /></span></span>
<span style="color: #1d2129;"><span style="background-color: #f6f7f9; font-size: 12px; letter-spacing: -0.24px;">-------</span></span><br />
<span style="color: #1d2129;"><span style="background-color: #f6f7f9; font-size: 12px; letter-spacing: -0.24px;"><br /></span></span>
<br />John A. Carrollhttp://www.blogger.com/profile/06908526384688432087noreply@blogger.com0tag:blogger.com,1999:blog-4706938836429821885.post-63861186693274944392017-01-03T12:55:00.002-08:002017-01-03T12:55:53.963-08:00Conflict of Interest in PeoriaJanuary 3, 2017<br />
<br />
Dear Everyone,<br />
<br />
Happy New Year.<br />
<br />
Please see <a href="http://peoriasmedicalmafia.blogspot.com/2006/03/conflict-of-interest.html">this post</a>.<br />
<br />
The Peoria Fire Department has three Engines that can give paramedic care--Engines 4, 12, and 20.<br />
<br />
During much of 2016, the PFD tried to have Station 19 upgraded to paramedic. So far the powers that be have been able to rebuff these attempts to improve pre-hospital care medical care in Peoria.<br />
<br />
Please stay tuned.<br />
<br />
JohnJohn A. Carrollhttp://www.blogger.com/profile/06908526384688432087noreply@blogger.com0tag:blogger.com,1999:blog-4706938836429821885.post-56878727932361651732015-05-21T05:30:00.001-07:002015-05-21T05:30:18.617-07:00Nursing Homes and EMS in Peoria<a href="http://pjstar.com/article/20150520/NEWS/150529912">Peoria Fire Department could revive station to house emergency medical technicians</a>John A. Carrollhttp://www.blogger.com/profile/06908526384688432087noreply@blogger.com0tag:blogger.com,1999:blog-4706938836429821885.post-89291743630011561182015-01-28T19:00:00.003-08:002015-01-28T19:06:51.837-08:00Chillicothe 33 and Conflict of Interest in Central Illinois<div class="clearfix _5x46" style="background-color: white; color: #141823; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 12px; line-height: 12.2880001068115px; margin-bottom: 11px; zoom: 1;">
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Doug Marshall is Peoria Area Emergency Medical Services attorney. He is also OSF-SFMC’s attorney.</div>
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Matt Jackson, MD is Medical Director of Peoria Area Emergency Medical Services. He is also OSF-Emergency Department Emergency Medical Services Medical Director.</div>
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(It is interesting that both of these key figures in pre-hospital care in central Illinois had no comment on the ongoing Chillicothe 33 saga.)</div>
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OSF has always supported Advanced Medical Transport (AMT). George Hevesy, MD, OSF’s former Emergency Department's Medical Director and Emergency Medical Services Medical Director, is still receiving a salary from both OSF and AMT. Dr. Hevesy has been a valuable employee for AMT and OSF for over two decades.</div>
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It will be interesting to see what OSF will do if Chilicothe 33 attempts to become an Advanced Life Support ambulance service for Chillicothe. My guess is that the gloves will come off yet again.</div>
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A widely used definition of conflict of interest is:</div>
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"A conflict of interest is a set of circumstances that creates a risk that professional judgement or actions regarding a primary interest will be unduly influenced by a secondary interest."</div>
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Stay tuned.</div>
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John A. Carroll, MD<br />
Peoria<br />
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<span class="_3c21">Ambulance service will answer emergency calls in Hopewell starting Sunday</span></div>
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John A. Carrollhttp://www.blogger.com/profile/06908526384688432087noreply@blogger.com0tag:blogger.com,1999:blog-4706938836429821885.post-43595461346648845822014-11-15T18:44:00.002-08:002014-11-15T18:44:44.752-08:00A Big Loss for Peoria...<div style="background-color: white; color: #141823; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 12px; line-height: 10.2399997711182px;">
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Dr. Dale Geiss, cardiac surgeon, recently moved his practice from Peoria to the Quad Cities. Dr. Geiss began his practice of adult and pediatric</div>
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John A. Carrollhttp://www.blogger.com/profile/06908526384688432087noreply@blogger.com0tag:blogger.com,1999:blog-4706938836429821885.post-82672762296611618942014-10-30T06:34:00.002-07:002014-10-30T06:35:43.583-07:00AMT Wants Peoria Heights EMS Contract<div class="clearfix _5x46" style="background-color: white; color: #141823; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 12px; line-height: 10.2399997711182px; margin-bottom: 11px; zoom: 1;">
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PMMDAILY.BLOGSPOT.COM<span class="phm" style="padding-left: 10px; padding-right: 10px;">|</span>BY JOHN CARROLL</div>
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John A. Carrollhttp://www.blogger.com/profile/06908526384688432087noreply@blogger.com0tag:blogger.com,1999:blog-4706938836429821885.post-65068030521899958842014-10-17T06:53:00.002-07:002014-10-17T06:53:30.630-07:00Dallas Nurse Risks Her Job at Hospital (New York Times--October 17, 2014)<div id="articleHeader" style="border-bottom-style: solid; border-color: rgb(197, 197, 197); border-width: 0px 0px 1px; color: #1f0909; font-family: 'PT Serif'; font-size: 16px; font-stretch: inherit; line-height: 24px; margin: 0px 0px 1.875em; padding: 0px 0px 0.8125em; vertical-align: baseline;">
<h1 style="border: 0px; font-size: 1.875em; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: normal; line-height: 1.3em; margin: 0px; padding: 0px; vertical-align: baseline;">
Controls Poor in Dallas, Nurse Says</h1>
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By <a href="http://topics.nytimes.com/top/reference/timestopics/people/s/kevin_sack/index.html" style="border: 0px; color: #1f0909; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank" title="More Articles by KEVIN SACK">KEVIN SACK</a><time style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">OCT. 16, 2014</time></div>
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DALLAS — A nurse who observed and participated in the care of Ebola patients at Texas Health Presbyterian Hospital spoke out publicly on Thursday about what she characterized as inadequate training and infection control there.</div>
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The nurse, Briana Aguirre, 30, who has worked at the hospital for three years, said in an interview that when Thomas Eric Duncan arrived at the emergency room on Sept. 28, it took at least three hours to place him in isolation, despite suspicions that he had contracted the deadly virus. Mr. Duncan had visited the emergency room three days earlier with a <a href="http://health.nytimes.com/health/guides/symptoms/fever/overview.html?inline=nyt-classifier" style="border: 0px; color: #1f0909; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank" title="In-depth reference and news articles about Fever.">fever</a> and other symptoms, as well as a history of recent travel from West Africa, but was sent home with <a href="http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/antibiotics/index.html?inline=nyt-classifier" style="border: 0px; color: #1f0909; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank" title="Recent and archival health news about antibiotics.">antibiotic</a>s after being misdiagnosed.</div>
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Ms. Aguirre described a confused and chaotic scene when he returned. “A lot of questions unanswered, staff not knowing exactly what to do, mishandling things,” she said.</div>
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The doctor handling the case, whom Ms. Aguirre would not name, waited hours to call the Centers for Disease Control and Prevention for guidance, she said.</div>
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<img src="http://static01.nyt.com/images/2014/10/17/us/NURSE/NURSE-articleLarge.jpg" style="border: 0px rgb(31, 9, 9); display: block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; max-width: 100%; padding: 0px; vertical-align: baseline;" /></div>
<figcaption style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Briana Aguirre, a nurse at Texas Health Presbyterian Hospital in Dallas, spoke of inadequate protocols for dealing with Ebola. Credit Cooper Neill for The New York Times</figcaption></div>
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“I know he spent a multitude of hours in an area where anyone could be walking up and down the hall,” Ms. Aguirre said of Mr. Duncan. “He was in a room with a closed door, but the same staff that was caring for him was caring for other people at that time and it stayed that way anywhere from three to five hours.”</div>
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She said that up to seven patients may have been in the emergency room with Mr. Duncan. Eventually, she said, the other patients were removed from the area and the emergency room became Mr. Duncan’s isolation unit for two days.</div>
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More Ebola Coverage</h2>
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Ms. Aguirre, who lauded the general quality of care at the hospital, said she had come forward because she had lost confidence in her employer and feared that fellow nurses and other staff had been put at risk. She is one of several nurses who anonymously released a statement on Tuesday night that made similar claims.</div>
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“I’m not alone in my feeling that someone needs to know what has been happening inside those doors,” she said.</div>
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<span style="font-family: inherit; font-size: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit;">On Thursday night, the hospital issued a statement saying that when Mr. Duncan arrived at the emergency room, “he was moved directly to a private room with a negative air pressure and placed in isolation,” and that the hospital’s infection control coordinator “was properly notified in a timely manner of the initial diagnosis.” It said it had followed C.D.C. guidelines in effect at the time.</span></div>
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Ms. Aguirre also helped care for her fellow nurse, Nina Pham, for several days after Ms. Pham contracted the virus while treating Mr. Duncan. Ms. Aguirre is one of more than 70 health care workers being monitored because they helped treat Ebola patients. She said that she has been instructed to take her temperature twice a day and that she receives a daily call asking if she has symptoms.</div>
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Ms. Aguirre said she and other nurses were “horrified” at the protocols used to care for Ms. Pham. She said they received instruction only once about the proper use of personal protective equipment — gloves, masks, gowns, hoods and shields — before entering Ms. Pham’s room, and then were shown how to remove the potentially contaminated gear while in the room. The garb left a triangle of skin exposed on the front of her neck.</div>
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“The very first time I was being instructed to put the stuff on I immediately voiced my concerns,” Ms. Aguirre said. “Why would I be wearing two pairs of gloves, three pairs of bootees, have my entire body covered in plastic, have two hoods on and have an area so close to my mouth and my nose exposed? And they said, ‘We know, we’ve addressed it and basically our verdict on that at this time is we’re taping that area closed.’ ”</div>
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She said the hospital had offered a single, voluntary session on treating Ebola patients a month or two before Mr. Duncan’s arrival. “There were some fliers stuck up in our break room saying they were having a seminar to discuss some facts about Ebola,” Ms. Aguirre said. “I didn’t go. I had a friend who said it was good information, very interesting, but it was not hands-on. It was just a lecture.”</div>
John A. Carrollhttp://www.blogger.com/profile/06908526384688432087noreply@blogger.com0tag:blogger.com,1999:blog-4706938836429821885.post-14884279914788459012014-09-12T06:53:00.000-07:002014-09-12T06:53:07.409-07:00Crowding Kills<div role="article">
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Exit Block: What it is and why it's dangerous. - Emergency Medicine Ireland</div>
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This a great video from the college on the significance of exit block and the effects it’s having on our patients and staff. This,...</div>
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Dr. Carroll, The Sister's have lost the battle when they allowed you to be termi<span class="text_exposed_hide">...</span><span class="text_exposed_hide"> <span class="text_exposed_link" style="white-space: nowrap;"><a class="see_more_link" data-ft="{"tn":"e"}" href="https://www.facebook.com/john.a.carroll.14#" role="button" style="color: #3b5998; cursor: pointer; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; text-decoration: none;">See More</a></span></span></div>
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John A. Carrollhttp://www.blogger.com/profile/06908526384688432087noreply@blogger.com0tag:blogger.com,1999:blog-4706938836429821885.post-25254486092868447232014-09-05T20:16:00.001-07:002014-09-05T20:16:53.159-07:00OSF Treating Haitians as Insects<div class="content clearfix" style="color: #292f33; font-family: 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 13.63636302948px; line-height: 18px; margin-left: 58px;">
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OSF Treating Haitians as "Insects" <a class="twitter-timeline-link" data-expanded-url="http://blogs.pjstar.com/haiti/2014/09/05/osf-treating-haitians-as-insects/" dir="ltr" href="http://t.co/EApP1FvGWj" rel="nofollow" style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; color: #0084b4; text-decoration: none;" target="_blank" title="http://blogs.pjstar.com/haiti/2014/09/05/osf-treating-haitians-as-insects/"><span class="tco-ellipsis"></span><span class="invisible" style="display: inline-block; font-size: 0px; line-height: 0;">http://</span><span class="js-display-url">blogs.pjstar.com/haiti/2014/09/</span><span class="invisible" style="display: inline-block; font-size: 0px; line-height: 0;">05/osf-treating-haitians-as-insects/</span><span class="tco-ellipsis"><span class="invisible" style="display: inline-block; font-size: 0px; line-height: 0;"> </span>…</span></a> via <a class="twitter-atreply pretty-link" dir="ltr" href="https://twitter.com/pjstar" style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; color: #0084b4; text-decoration: none;"><span style="color: #66b5d2;">@</span><span style="letter-spacing: 0.01em;">pjstar</span></a></div>
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John A. Carrollhttp://www.blogger.com/profile/06908526384688432087noreply@blogger.com0tag:blogger.com,1999:blog-4706938836429821885.post-39293630511561404782014-08-30T07:33:00.002-07:002014-08-30T07:33:27.614-07:00A Children's Hospital Garden and Conflict of Interest in Peoria<ol class="_3rbf clearfix" data-referrer="pagelet_timeline_recent_ocm" id="u_jsonp_3_l_left" style="background-color: #e9eaed; color: #141823; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 12px; line-height: 10.239999771118164px; list-style: none; margin: 0px; padding: 0px; zoom: 1;">
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<a class="uiLinkSubtle" href="https://www.facebook.com/john.a.carroll.14/posts/10202379003906495" style="color: #9197a3; cursor: pointer; text-decoration: none;">21 hours ago</a> near <a class="uiLinkSubtle" href="https://www.facebook.com/pages/Peoria-Illinois/113848465291957?ref=stream" style="color: #9197a3; cursor: pointer; text-decoration: none;">Peoria, IL</a><div class="uiSelector inlineBlock audienceSelector timelineAudienceSelector audienceSelectorNoTruncate dynamicIconSelector uiSelectorNormal uiSelectorDynamicTooltip" style="display: inline-block; margin-left: 1px; margin-top: -3px; max-width: 200px; vertical-align: top; zoom: 1;">
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I had an incredible talk recently with an individual who has worked intimately with OSF and AMT regarding the "conflict of interest" and the ambulance monopoly here in good ol' central Illinois. It was mind blowing to say the least. During <span class="text_exposed_hide">...</span><span class="text_exposed_hide"> <span class="text_exposed_link" style="white-space: nowrap;"><a class="see_more_link" data-ft="{"tn":"e"}" href="https://www.facebook.com/john.a.carroll.14#" role="button" style="color: #3b5998; cursor: pointer; text-decoration: none;">See More</a></span></span></div>
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A Children's Hospital Garden and a Forgotten Haitian</div>
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In the Peoria Journal Star this morning a front page article described a rooftop garden built at the new Children's Hospital of Illinois in Peoria. A few minutes after I read the article this...</div>
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A few minutes ago I talked to an OSF Haitian Hearts patient who had heart surgery in Peoria a decade ago. She is currently on a loud, crowded, and hot bus on her way to Santo Domingo, Dominican Republic to see a cardiologist. Anyone who has<span class="text_exposed_hide">...</span><span class="text_exposed_hide"> <span class="text_exposed_link" style="white-space: nowrap;"><a class="see_more_link" data-ft="{"tn":"e"}" href="https://www.facebook.com/john.a.carroll.14#" role="button" style="color: #3b5998; cursor: pointer; text-decoration: none;">See More</a></span></span></div>
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PEORIA — Jerry and Lynn Flaherty banter like the longtime married couple they are. Here, on a roof of Children’s Hospital...</div>
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John A. Carrollhttp://www.blogger.com/profile/06908526384688432087noreply@blogger.com0tag:blogger.com,1999:blog-4706938836429821885.post-90806728401696585132014-08-03T18:56:00.001-07:002014-08-03T18:56:09.966-07:00Haitian Hearts Mid-Year Report--2014<div role="article">
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Haitian Hearts Mid-Year Report--2014</div>
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As of today (August 3, 2014) we have had 12 Haitian patients accepted or operated. All have been heart surgeries. Mitchena (above) is on the list for heart surgery later this year. (Mitchena...</div>
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John A. Carrollhttp://www.blogger.com/profile/06908526384688432087noreply@blogger.com0tag:blogger.com,1999:blog-4706938836429821885.post-18701696071029994882014-07-06T12:20:00.001-07:002014-07-06T12:20:06.332-07:00Oniste<div class="clearfix _5x46" style="margin-bottom: 11px; zoom: 1;">
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It's been one year now since <a class="profileLink" data-hovercard="/ajax/hovercard/user.php?id=100000534013572" href="https://www.facebook.com/onistewilner" style="color: #3b5998; cursor: pointer; text-decoration: none;">Oniste Honoré Guay</a> was operated in Colorado.</div>
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John A. Carrollhttp://www.blogger.com/profile/06908526384688432087noreply@blogger.com0tag:blogger.com,1999:blog-4706938836429821885.post-53331497277203876512014-06-25T19:22:00.001-07:002014-06-25T19:22:59.152-07:00Keith to Step Down at OSF<div role="article" style="background-color: white; color: #333333; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 12px; line-height: 10.239999771118164px;">
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<span class="fcg" style="color: grey;"><span class="fwb" style="font-weight: bold;"><a data-hovercard="/ajax/hovercard/page.php?id=42038801572" href="https://www.facebook.com/journalstar" style="color: #3b5998; cursor: pointer; text-decoration: none;">Journal Star</a></span> shared a <a href="http://l.facebook.com/l.php?u=http%3A%2F%2Fwww.pjstar.com%2Farticle%2F20140625%2FNEWS%2F140629506%3Futm_content%3Dbufferec477%26utm_medium%3Dsocial%26utm_source%3Dfacebook.com%26utm_campaign%3Dbuffer&h=CAQFU0nWwAQHOD5NuxBeZMZ2haeWBSV4PuE10PeqmwMl2rw&enc=AZM59xmn2DYVpTIM630J-cP64B4JpXEj7Eac5Gm-jkVCNxgCvA2KhyVsD2SsPGrNxMl8Z06rMpE5RK3mkZ-p5V7E&s=1" rel="nofollow" style="color: #3b5998; cursor: pointer; text-decoration: none;" target="_blank">link</a>.</span><span class="fcg" style="color: grey;"></span></h5>
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<a class="uiLinkSubtle" href="https://www.facebook.com/journalstar/posts/10152132323581573" style="color: #9197a3; cursor: pointer; text-decoration: none;">11 hours ago</a><a aria-label="Public" class="uiStreamPrivacy inlineBlock fbStreamPrivacy fbPrivacyAudienceIndicator _1_o" data-hover="tooltip" href="https://www.facebook.com/journalstar#" role="button" style="color: #3b5998; cursor: pointer; display: inline-block; margin-left: 6px; position: relative; text-decoration: none; top: 1px; zoom: 1;"><i class="lock img sp_I3h1Ik78Mvf sx_0fac26" style="background-image: url(https://fbstatic-a.akamaihd.net/rsrc.php/v2/yS/r/-cGxAdtQB3S.png); background-position: -14px -162px; background-repeat: no-repeat; background-size: 36px 482px; bottom: -1px; display: inline-block; height: 12px; margin-bottom: -5px; position: relative; vertical-align: top; width: 12px;"></i></a></div>
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<span class="userContent">OSF Saint Francis CEO Keith Steffen plans to step down after 17 years in the position.</span></div>
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OSF Saint Francis CEO Keith Steffen plans to step down</div>
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PEORIA — The CEO of OSF Saint Francis Medical Center plans to retire at the end of the year, capping a 34-year career with the...</div>
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John A. Carrollhttp://www.blogger.com/profile/06908526384688432087noreply@blogger.com0tag:blogger.com,1999:blog-4706938836429821885.post-40730738330616089292014-06-23T13:11:00.003-07:002014-06-23T13:11:36.350-07:00Whistleblowers<div class="clearfix _5x46" style="margin-bottom: 11px; zoom: 1;">
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“Intimidation or retaliation against whistle-blowers — or any employee who raises a hand to identify a legitimate problem, make a suggestion, or report what may be a violation of law, policy, or our core values — is absolutely unacceptable,” Mr. Gibson said. Administrators who retaliate against whistle-blowers, he added, would be disciplined.</div>
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The head of an independent agency within the executive branch criticized the...</div>
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THE NEW YORK TIMES<span class="phm" style="padding-left: 10px; padding-right: 10px;">|</span>BY RICHARD A. OPPEL JR.</div>
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John A. Carrollhttp://www.blogger.com/profile/06908526384688432087noreply@blogger.com0tag:blogger.com,1999:blog-4706938836429821885.post-8609558093768470492014-06-15T07:39:00.002-07:002014-06-15T07:39:17.395-07:00When A Good Hospital Loses Its Way<div class="clearfix _5x46" style="margin-bottom: 11px; zoom: 1;">
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<span class="fsm fwn fcg" style="color: grey; font-size: 12px;"><a class="_5pcq" href="https://www.facebook.com/john.a.carroll.14/posts/10201946828742386" style="color: #898f9c; cursor: pointer; text-decoration: none;"><abbr class="_5ptz timestamp livetimestamp" data-shorten="1" data-utime="1402803866" style="border-bottom-style: none;" title="Saturday, June 14, 2014 at 10:44pm">10 hrs</abbr></a> · <a class="_5pcq" data-hovercard="/ajax/hovercard/page.php?id=113848465291957" href="https://www.facebook.com/pages/Peoria-Illinois/113848465291957" style="color: #898f9c; cursor: pointer; text-decoration: none;">Peoria, IL</a></span> · <div class="uiSelector inlineBlock audienceSelector onlyMeDesignSelector _5pbm audienceSelectorNoTruncate dynamicIconSelector uiSelectorRight uiSelectorNormal uiSelectorDynamicTooltip" style="display: inline-block; margin-left: -4px; margin-top: -4px; max-width: none !important; vertical-align: top; zoom: 1;">
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When A Good Hospital Loses Its Way...</div>
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This is a blog post I wrote in January, 2007. It explains in detail my last few months at OSF. I am very glad that I took copious paper notes of conversations in 2001 and during the years that followed. Back then I had no idea of the power of a computer or a blog site and could not have defined the term "social media" during those years.</div>
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This will be painful reading for many. But I think it is better to have this information "out there" <span class="text_exposed_show" style="display: inline;">and not hidden like our powerful institutions in Peoria would like it to be. Maybe someone in the future can benefit.</span></div>
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John A. Carrollhttp://www.blogger.com/profile/06908526384688432087noreply@blogger.com0tag:blogger.com,1999:blog-4706938836429821885.post-64846109848517130462014-06-11T09:32:00.001-07:002014-06-11T20:24:02.777-07:00Why The Peoria Fire Department Should Have Been Transporting Patients During the Last Two Decades<br />
Several of the Peoria Fire Department stations are now Advanced Life Support (ALS). In other words the firefighters at these stations are paramedics and can provide ALS at the scene of a medical emergency.<br />
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However, the Peoria Fire Department still cannot transport patients to any emergency department in Peoria. Local politics have not allowed this to happen.</div>
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AudioDigest Emergency Medicine (June 21, 2014) contains this paragraph about transport of trauma patients:</div>
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Rapid transport: triage critical to determine which patients to transport first; adequate on-scene organization required to distribute patients as widely as possible to avoid overwhelming closest hospital or trauma center; ALS vs basic life support (BLS) — no role for ALS on scene if transport available; BLS can be performed by civilians (except needle thoracostomy); leading causes of preventable combat deaths or terrorist-type bombings include extremity hemorrhage, tension pneumothorax, and airway obstruction (all readily mitigated by simple BLS maneuvers by emergency medical technicians, first responders, or lay people).</div>
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What this means is that no matter if the Peoria Fire Department stations are BLS or ALS, triage and rapid transport are what are important to save lives.</div>
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I wonder how many lives could have been saved in Peoria over the last two decades if the Peoria Fire Department had been able to transport the patient quickly to one of our area Emergency Departments rather than waiting on Advanced Medical Transport (AMT) to arrive. However, the money is made in transport and this is not something that the leaders of our community who support AMT want to surrender to the Peoria Fire Department.<br />
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John A. Carrollhttp://www.blogger.com/profile/06908526384688432087noreply@blogger.com0tag:blogger.com,1999:blog-4706938836429821885.post-52018546756394515642014-05-28T05:46:00.001-07:002014-05-28T05:46:49.709-07:00Chillicothe 33 Again <blockquote class="twitter-tweet" lang="en">
Rescue 33 on track to again provide ambulance coverage <a href="http://t.co/WYzAVs6ZpH">http://t.co/WYzAVs6ZpH</a> via <a href="https://twitter.com/pjstar">@pjstar</a><br />
— John A. Carroll (@haitianhearts) <a href="https://twitter.com/haitianhearts/statuses/470587860760805376">May 25, 2014</a></blockquote>
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OSF's and PAEMS directors were not available for comment. Why not?John A. Carrollhttp://www.blogger.com/profile/06908526384688432087noreply@blogger.com0tag:blogger.com,1999:blog-4706938836429821885.post-45622279930885507322014-04-18T10:34:00.001-07:002014-04-18T10:34:22.312-07:00When Doctors Speak UpPlease read <a href="http://www.medscape.com/viewarticle/822583">this article</a> from Medscape.<br />
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John A. Carroll, MDJohn A. Carrollhttp://www.blogger.com/profile/06908526384688432087noreply@blogger.com0tag:blogger.com,1999:blog-4706938836429821885.post-56455748914242993142014-03-12T12:43:00.001-07:002014-03-12T12:43:10.878-07:00Whistleblower Lawsuit in the ER<br />
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Emergency Medicine News:</div>
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<a href="http://journals.lww.com/em-news/pages/currenttoc.aspx" style="color: #7b49ad; text-decoration: initial;" tabindex="0">March 2014 - Volume 36 - Issue 3 - p 1,25-26</a></div>
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doi: 10.1097/01.EEM.0000444854.38629.ed</div>
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Breaking News: DOJ Joins Whistleblower Suits against HMA</h2>
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SoRelle, Ruth MPH</div>
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After years of investigation, the U.S. Department of Justice has intervened in eight false claims lawsuits in six states against Health Management Associates, Inc., signing on to allegations of payments to doctors and clinics in exchange for patient referrals and to claims that the Naples, FL, for-profit chain pressured emergency physicians and hospital administrators to admit patients to meet corporate benchmarks, regardless of medical necessity. (Read the DOJ announcement at<a href="http://1.usa.gov/1foNoIo" style="color: #7b49ad; text-decoration: initial;" tabindex="0" target="_blank">http://1.usa.gov/1foNoIo</a>.)</div>
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HMA's activities have already generated considerable interest, including a segment on the CBS news program <i>60 Minutes</i> that aired in December 2012. (Watch that report at <a href="http://cbsn.ws/1foNAHE" style="color: #7b49ad; text-decoration: initial;" tabindex="0" target="_blank">http://cbsn.ws/1foNAHE</a>.) The push to increase admissions to the hospital from the emergency department is described in several of the suits, including one filed jointly by Jacqueline Meyer, a former regional client administrator for EmCare, the firm that provided emergency physician services to many HMA hospitals, and Michael Cowling, a former HMA division vice president and CEO of Lake Norman Regional Medical Center in Mooresville, NC.</div>
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The qui tam, or whistleblower, suits were just recently unsealed, providing details of alleged wrongdoing for the first time. Many of the suits allege an illegal kickback scheme for referrals to HMA hospitals, but the Meyer-Cowling filing, among others, describes HMA practices in emergency departments, including a mandate that its hospitals increase admission rates by:</div>
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<li>Setting benchmarks for hospital admissions from the emergency department: 50 percent for patients 65 and older and anywhere from 16 percent to 20 percent for the overall population.</li>
<li>Directing hospital administrators to monitor ED admission rates through daily, weekly, and monthly reports generated using a customized software program called Pro-MED. The plaintiffs said each emergency physician was tracked for the number and percentage of total patients admitted as well as the percentage of patients 65 and older admitted. Some hospitals also tracked physicians on a daily color-coded report card with green signifying that a physician had met the benchmark, yellow that he had almost met it, and red that he had missed the benchmark, according to the suit.</li>
<li>Using Pro-MED to flag each time an ED patient met criteria for admission, measures that were programmed right into the software. “Nevertheless, HMA used the criteria in conjunction with its customized Pro-MED software to coerce physicians to admit patients, regardless of the physician's clinical judgment about the patient's needs,” the Meyer-Cowling suit states. Physicians could manually override such actions, but according to the suit, physicians who had override rates of 35 percent or more received “failing grades.”</li>
<li>Holding daily “flash meetings” with emergency physicians “to interrogate them about so-called ‘missed’ admissions.” According to the suit, “During flash meetings, which were commonly referred to by the ER medical personnel as ‘daily inquisitions,’ hospital CEOs and their staff often overtly threatened the ER doctors and medical directors with termination if the physicians did not increase the number of patients they admitted.”</li>
<li>Distributing monthly <i>Forced Rank Reports</i> to hospital CEOs and administrator staff, emergency department directors, and EmCare management in which all HMA hospital EDs were ranked according to inpatient admission rates.</li>
<li>Directing hospital CEOs and emergency department medical directors not to place patients in observation status “even when medically warranted, but instead were to be admitted as inpatients so that HMA could recover larger fees for their care,” the suit alleges.</li>
<li>Implementing a Pro-MED software program “that identified a series of diagnostic tests to be immediately performed, according to what the triage nurse had specified as the patient's chief complaint, before the patient had been seen by a doctor.” The Meyer-Cowling suit says HMA also required emergency physicians to order “85% of the tests specified in the protocol, despite the fact that in many instances the tests were medically unnecessary.”</li>
<li>Setting benchmarks for calling patients' primary care physicians “85% of the time for patients 65 and over” and 35 percent of the time for younger patients “not to obtain a better understanding of patients' medical needs but, rather, to ‘sell admissions’ to primary care physicians.” HMA anticipated that these physicians would defer to the emergency physician's recommendation about hospitalization, the suit says.</li>
<li>Paying bonuses at some hospitals to emergency physicians and medical directors for meeting the benchmarks for ordering tests, calling primary care physicians, and keeping admission overrides low.</li>
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The suit also charges that “EmCare actively assisted HMA in unlawfully pressuring and inducing ER medical directors and physicians to sacrifice their medical judgment and recommend the hospitalization of ER patients and the ordering of diagnostic tests, irrespective of the medical needs of the patients.”</div>
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Ms. Meyer and Mr. Cowley claim they were fired — she from EmCare and he from HMA — because they did not go along with the push to increase admissions from emergency departments. The Justice Department is still deciding whether it will join the suit Ms. Meyer filed against EmCare.</div>
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The Meyer-Cowling suit also named Gary Newsome, CEO of HMA, as a driver of the plan to inflate patient admissions, and the Justice Department joined that action as well. Mr. Newsome headed HMA from 2008 until mid-2013 when he retired to head a Mormon mission in Montevideo, Uruguay, the suit says.</div>
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The suit lists several hospitals at which those admission activities took place. One is Carlisle Regional Medical Center, a 165-bed hospital in Carlisle, PA, that HMA had owned since 2001. Carlisle offers routine specialty care, but it is not a trauma center, and had no interventional cardiac catheterization services at the time the suit was filed in July 2011.</div>
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Ms. Meyer was assigned to oversee EmCare's contract at Carlisle in 2009. Soon after, she attended a hospital meeting that included EmCare managers and the Carlisle ED medical director, assistant medical director, and emergency physicians. According to the suit, Frank Biondolillo, DO, the executive vice president of EmCare's southeast region, told attendees, “'If you want to be successful at an HMA hospital, you are going to have to admit more patients.'”</div>
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The suit continues, “Dr. [Cliff] Cloonan [assistant medical director of the ED] angrily responded that Dr. Biondolillo was not going to make him break that law and that Cloonan was going to do what was right for the patient.” After the meeting, the suit notes, EmCare managers told Carlisle CEO John Kristel what had transpired. “In response, Kristel told the EmCare group to fire Dr. Cloonan because he ‘was not on board,’” the suit states. Ms. Meyer, however, advised against that, suggesting that HMA and EmCare consult their legal departments.</div>
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“It was an insidious situation,” said Dr. Cloonan, who is not part of any of the lawsuits. “It was not really suddenly awful. Had it been, a lot more people would have [jumped] ship.”</div>
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Dr. Cloonan said he was an employee of the hospital when he first came to Carlisle, and he and his fellow emergency physicians continued that way for a couple of years after HMA took over and built a new emergency department. But about the same time that the hospital introduced Pro-MED, an HMA manager said they no longer wanted to employ the physicians, suggesting that the doctors consider a provider of emergency services like EmCare or form their own group. They ended up going with EmCare.</div>
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Dr. Cloonan said it seemed the best choice at the time. Besides, he and his colleagues were dealing with other issues. “I wasn't pleased with Pro-MED Blue,” he said. “It was clearly constructed not to adequately document what physicians did and facilitate their work but as an accounting tool to capture revenue. It also, in my view, facilitated fraud in the sense that there was a lot of automated test ordering. It took extra steps to undo what the computer was automatically doing.”</div>
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Scott Rankin, MD, who worked part-time at Carlisle during this period, told <i>EMN</i> that Pro-MED “generated a nice bill, but it also pushed us to order studies that maybe we would not have ordered. If a patient showed up with chest pain, nurses were mandated to hit the chest pain box, and these studies were ordered before we saw the patients. Nurses told us, ‘We have to do this.’”</div>
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Dr. Rankin said the EPs were increasingly being pressured to admit toward the end. They came out with specific numbers — 50 percent for all patients over 65 and an overall 20 percent admission rate, he said, but such numbers were not realistic for Carlisle. “I realized I was being encouraged to commit most of the fraud being described in the government-mandated program [that physicians are required to take]. I printed out a screenshot, and went out and posted it around the computers in the emergency department.”</div>
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Dr. Cloonan said he remembers the meeting with Dr. Biondolillo well. He said he pushed back at that meeting, saying, “What I just heard is that if we don't commit fraud, we are going to get fired.”</div>
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Before a monthly meeting of the ED staff, the medical director of the emergency department told Dr. Cloonan that he had been at a meeting at HMA headquarters and was told physicians would be fired — starting with him and Dr. Cloonan — if they did not go along with the program, Dr. Cloonan told <i>EMN</i>. He said he told the ED medical director that he would say nothing at the monthly physician meeting, but he would resign as assistant ED director immediately. He found a job in a nearby town.</div>
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One by one, meanwhile, other long-time emergency physicians at Carlisle began to resign. Dr. Rankin said the physicians who had worked there left voluntarily. “To have to leave their community hospital was a painful decision. However, we had that option to leave. There were other places we could work,” he said. Physicians in other communities were not as lucky, he said.</div>
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Dr. Cloonan said he was angry about what he saw happening. “There's a huge amount of ongoing fraud, waste, and abuse that is taking place within specifically government contractual elements of health care,” he said. “When HMA was talking about admitting 50 percent of patients over 65, that's Medicare. And it's not confined to HMA. We have created a system that is ripe for abuse. That's part of the problem.”</div>
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Dr. Rankin said the physicians' concern was for their patients. “We put the patient ahead of profit,” he said. “For-profit medicine does not have that sum equation.”</div>
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Robert McNamara, MD, a former president of the American Academy of Emergency Medicine, said one thing that gets lost in the narrative is the risk to patients admitted to the hospital unnecessarily. “I'm not surprised at any of it. The suits lay it out,” he said.</div>
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Craig Brummer, MD, a former medical director at Barrow Regional Medical Center and then Walton Regional Medical Center in Georgia, described in his suit against HMA the same pressures described by Ms. Meyer, Mr. Cowling, and Dr. Cloonan. He described several patients who he said were admitted to HMA hospitals without an appropriate medical reason, including:</div>
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<li>An elderly Medicare patient who underwent “a chest x-ray (that showed no issues), an EKG, and lab work. [The patient] was improperly admitted with a clinical impression of ‘neck pain.’ This 71-year-old patient should not have been admitted for ‘a chest pain rule out’ assessment,” the suit says.</li>
<li>An 11-month-old Medicaid patient who presented to the ED with a chief complaint of fever but who was admitted even after his fever dropped to normal. “He had a temperature of 104 degrees upon presentation and looked well,” the suit notes. “The infant was given a full workup of chest x-rays and labs and all were normal, but he was given intramuscular antibiotics and admitted to the hospital. [The patient] was admitted with a temperature of 98.7 with a clinical impression of fever.”</li>
<li>An 18-year-old Medicaid patient who sustained a right knee laceration. “X-rays were negative, but he was admitted for repair of the knee laceration. This patient was admitted to the hospital for repair even though his injuries did not involve an open fracture and should have been treated on an outpatient basis.”</li>
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The Justice Department's inquiry was described in many quarters as painstaking. Stuart F. Delery, the Assistant Attorney General for the Justice Department's Civil Division, said in a statement that “schemes such as this one can contribute significantly to the rising cost of delivering health care and create needless patient risk.”</div>
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The U.S. Attorney for the Middle District of Georgia Michael J. Moore agreed, noting in another statement that “HMA's submission of claims to Medicare, Medicaid and TRICARE for unnecessary inpatient stays is a serious matter that threatens the integrity of our entire health care system, and the end result is that those who need health care cannot afford it.”</div>
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HMA shareholders approved a $7.6 billion sale of the company to Community Health System (CHS) in January, merging the two systems to create the for-profit hospital operator in the United States with the largest number of facilities. Hospital Corporation of America remains largest in annual revenue. (<i>Naples News</i>; <a href="http://bit.ly/1ifr06p" style="color: #7b49ad; text-decoration: initial;" tabindex="0" target="_blank">http://bit.ly/1ifr06p</a>.)</div>
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CHS announced preliminary financial and operating results for 2013 on Jan. 6, noting that it was reserving $101.5 million to settle claims arising from the government's investigation into the company's short-stay hospital admissions and investigation at the CHS hospital in Laredo, TX. Or as the <i>New York Times</i> reported, “Investors seem to think that DOJ investigations, qui tam suits, and allegations of serious Medicare fraud are simply a cost of doing business,” said Sheryl Skolnick, PhD, the managing director and a head of research for CRT Capital. (<a href="http://nyti.ms/1euQmx3" style="color: #7b49ad; text-decoration: initial;" tabindex="0" target="_blank">http://nyti.ms/1euQmx3</a>.) CHS is also negotiating a corporate integrity agreement with the Office of the Inspector General of the U.S. Department of Health and Human Services. (Read CHS's 2013 operating report at <a href="http://bit.ly/1eNAD8V" style="color: #7b49ad; text-decoration: initial;" tabindex="0" target="_blank">http://bit.ly/1eNAD8V</a>.)</div>
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HMA refused to comment specifically on the allegations in the suits or the Justice Department's joining in the whistleblower lawsuits. “As a matter of policy, we do not comment on pending litigation. The existence of the government's investigation into the issues raised in the unsealed qui tam cases has been disclosed for some time in HMAs' public SEC filings. While our legal team addresses these matters and continues to cooperate with the Department of Justice's ongoing investigation, HMA associates and physicians who practice at our facilities are focused on providing the highest quality patient care in all of our hospitals,” MaryAnn M. Hodge, the vice president of marketing and communications for Health Management Associates, wrote in an email to <i>EMN</i>.</div>
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Jennifer Whitus, the marketing communications manager for EmCare, said in an email that the company cannot comment on pending litigation.</div>
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<strong><i>Click and Connect!</i></strong><i>Access the links in</i> EMN <i>by reading this issue on our website or in our iPad app, both available on</i><a href="http://www.em-news.com/" style="color: #7b49ad; text-decoration: initial;" tabindex="0" target="_blank">www.EM-News.com</a>.</div>
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Read Them for Yourself</h4>
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The Department of Justice intervened in eight whistleblower suits, and all are available on the <i>EMN</i> website at <a href="http://bit.ly/EMNBreakingNews" style="color: #7b49ad; text-decoration: initial;" tabindex="0" target="_blank">http://bit.ly/EMNBreakingNews</a>.</div>
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John A. Carrollhttp://www.blogger.com/profile/06908526384688432087noreply@blogger.com0tag:blogger.com,1999:blog-4706938836429821885.post-13379397819782873432014-01-17T13:54:00.001-08:002014-01-17T13:54:01.422-08:00Catholic Tribunal Courts Not Used Often Enough<br />
Bishop Daniel Jenky of Peoria refused a Tribunal Court against OSF. He wanted to protect OSF like other bishops wanted to protect pedophile priests.<br />
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<blockquote class="twitter-tweet" lang="en">
Bishop Jenky declined Tribunal Court...Pope Benedict Defrocked 400 Priests in 2 Years for Child Abuse <a href="http://t.co/X91S68DEWF">http://t.co/X91S68DEWF</a> via <a href="https://twitter.com/TIMEWorld">@TIMEWorld</a><br />
— John A. Carroll (@haitianhearts) <a href="https://twitter.com/haitianhearts/statuses/424296870010048512">January 17, 2014</a></blockquote>
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<script async="" charset="utf-8" src="//platform.twitter.com/widgets.js"></script><br />
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John A. Carrollhttp://www.blogger.com/profile/06908526384688432087noreply@blogger.com0tag:blogger.com,1999:blog-4706938836429821885.post-33887594165854598462013-11-01T06:52:00.002-07:002013-11-01T06:52:23.029-07:00Medical Conflict of Interest<blockquote class="twitter-tweet">
New Movement Urges Docs to Disclose Conflicts of Interest <a href="http://t.co/9ypMXGq9Ah">http://t.co/9ypMXGq9Ah</a> Ht <a href="https://twitter.com/DrLeanaWen">@DrLeanaWen</a> who is featured in the article<br />
— Medicalskeptic (@medskep) <a href="https://twitter.com/medskep/statuses/396025381502734336">October 31, 2013</a></blockquote>
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<script async="" charset="utf-8" src="//platform.twitter.com/widgets.js"></script>John A. Carrollhttp://www.blogger.com/profile/06908526384688432087noreply@blogger.com0