Wednesday, February 18, 2009

Looking Back...You can Disagree to a Point...but then be Careful

My comments today follow the article.

Journal Star
January 9, 2002


Fired doctor: Dispute began over suggested ER upgrades -- OSF official declines comment on issue

PEORIA - Dr. John Carroll was fired from OSF Saint Francis Medical Center in a dispute that began over more patient beds for the emergency department where he worked, he said Tuesday.

Carroll, an award-winning physician and founder of the Haitian Hearts program that brings sick children from Haiti to St. Francis for treatment, said he has no regrets about pushing for improved service for emergency patients.

''Would I do it again? Yes,'' he said.

Carroll said his job problems began with a letter he wrote about bed capacity in the emergency room, a letter which caused the hospital to discipline him in a ''punitive'' manner.

''The letter precipitated the incident and the discipline I disagreed with,'' he said.

The discipline involved placing him on ''probation'' for six months, Carroll said. The letter of dismissal that St. Francis sent to him mentioned ''disobedience,'' he said.

The 48-year-old Peoria native worked at the hospital for 21 years. St. Francis has been his only employer.

Hospital spokesman Chris Lofgren would not discuss the matter. ''It's an employee issue. We won't talk about it,'' he said.

Lofgren then added that Carroll ''was not fired because of ER issues. That's the only thing I will say at this point.''

Carroll said he was not offered another position at the hospital as the situation between him and his employer deteriorated. Both sides ''dug in their heels,'' he said.

Carroll acknowledged that the letter he sent to his colleagues and hospital officials circumvented the usual chain of command at the hospital. He knew he was taking a risk when he sent that letter, he said, adding, ''I wrote the letter with some trepidation.''

Carroll's firing, a week before Christmas, stunned his friends and supporters.
''He was by far the most compassionate doctor we had there,'' said a co-worker who didn't want to be identified. ''John has high standards of care and expects that care to be delivered to patients.''

The person said ''we are afraid to talk,'' for fear of being fired. ''We are in complete, absolute fear.''

''All he wanted to do is improve the ER procedures,'' a colleague said. ''He was frustrated. Others are also.''

People who have worked with Carroll confirmed Carroll's concerns about the emergency department. It was built to serve 35,000 patients a year but now is serving more than 60,000 annually. Some wait for hours, co-workers said.

Lofgren confirmed the usage figures, and said the hospital is planning to spend more than $2 million to alleviate the crowded conditions. The plans have been in the works ''for some time,'' he said.

Carroll has talked about his personal situation reluctantly, but said the truth should be told. He still believes in the hospital's mission, he said, and also does not want to jeopardize the hospital's support for the Haitian Hearts program.

He is leaving for Haiti soon and plans to stay there for a month. He said he has no idea what he will do about his career when he returns. He still retains physician privileges at the hospital, and his medical work was not an issue in his dismissal, he said.

Carroll has consulted an attorney about his dismissal, he said, but is reluctant to sue the hospital, because he doesn't want to enrich himself at the hospital's expense.

''It's not about money,'' he said of his dispute with St. Francis.

My comments on this article today, February 18, 2009:

1. While I was writing the letter to Mr. Steffen and my colleagues in September, 2001, another OSF employee in the Emergency Department strongly warned me that I may be fired if I sent the letter.

I viewed the ER overcrowding as a "hospital problem" that needed to be solved with everyone involved. Plus, I did not believe that Drs. Hevesy and Miller were strong enough or politically inclined to try and solve the overcrowding issue on their own.

2. During my first meeting with Mr. Steffen in early October, 2001 he told me in his office that "whenever there is bleeding the bleeding must be stopped before it turns into a hemorrhage" and that a "cancer needs to be cut out before it metastasizes". (Not exact quotes but very close.) He was referring to me.

3. During that same meeting with him, I told Mr. Steffen that I was worried about "institutional neglect" regarding the overcrowded Emergency Room. He asked me what "institutional neglect" was.

4. Mr. Lofgren may not have wanted to comment in the Journal about my termination, but he was sure talking inappropriately with other OSF employees. And I WAS fired regarding ER issues. Mr. Lofgren was not being truthful to reporter Elaine Hopkins.

5. The patient and employee satisfaction in the OSF ER was the lowest in the medical center. Dr. Hevesy looked at me once and said look what I have inherited. He meant that the ER was very dysfunctional under Rick Miller's direction.

6. And as Elaine Hopkins documented, we were seeing tens of thousands of patients more each year than the ER was designed to see. Elective (insured) patients were filling inpatient beds, so ER patients like mine had to wait a long time to be admitted. And studies performed since 2001 have documented increased morbidity and mortality for ER patients that are boarded in the ER.

7. I invited Mr. Steffen to come to the ER and work with us. I really thought it would be a win-win situation if he would come and join us for an evening. I thought that ER personnel attitudes would improve if they saw him working on the overcrowding issue, and I also thought that patients and their families would take solace in talking with the OSF administrator regarding their long wait in the ER.

Mr. Steffen declined my offer.

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