Friday, September 21, 2007

"Chew the Hay and Spit the Stubble"

"Semi-Regular Reader" offers the following:

This shouldn't be construed as an Internet flame, but since the DRMC discussions definitely draw lines in the sand, I have one question.

Of what professional quality are the doctors of DRMC or can that NOT be determined?

The rankings suggest you get mixed medical care. The outward migration numbers suggest the medical staff isn't trusted by non-emergency "customers." People planning heart surgery or other major treatments aren't weighing the corporate philosophy of hospital management into their decision of where to seek treatment. They want the best doctor they can find, not a good doctor backed by decent local marketing and town word-of-mouth.

Doctors departing DRMC in large numbers isn't good UNLESS replacements can better the medical care. That's no given - and unproven under hospital management - because DRMC's paid very high salaries in recruiting only to maintain sub-par results. If customers aren't seeking DRMC treatments, even under a monopolized local healthcare system, then those in the "trench" should look in the job performance mirror as well. It's only fair and is a reasonable request.

Another note: If you get up in the morning and absolutely dread going to your job, you owe it to yourself to, at least, look for other job opportunities. Your personal health and wellness isn't worth it and the services you're providing innocent patients can only suffer given the unconscious distraction of mental misery.

If you choose to "like it" and not leave it, then chew the hay and spit the stubble. Enough workers must obviously "like it" because the debate water is barely rippling except for Forthright's interest in the issue - which is good reading and a good communication forum (but not a journalistic outlet). It's a soapbox.

By the way, I like the idea of "Boss Hog" walking the ER and asking such customer service questions if privacy law permits. The questions posted by the commentator that should be asked by "Boss Hog" to patients should be asked by the nurses and doctors too.

And if patients complain of chatting, drinking and eating at the nurses' station - most of it is likely to be work related, but I'm not buying that there isn't enough loafing going around to make such patient complaints legitimate. The "High Horse" ain't that high, staff! Remember, the front line medical staff gives patients the impression of the care they're given. Hmm, on that one.

We should continue this discussion of alleged tyrants, tinker-bells, Bosses Hog and medical care. A "ship" as large as DRMC needs many oars and many rowers. Don't look exclusively at the Captain - but keep an eye up there!

The writer asks some very relevant questions about the quality of DRMC's physicians. The care provided is not always a question of "qualifications" as it is of "motivation". Here's the problem:

Let's say that I am an employed physician at DRMC with a guaranteed salary of $750,000 a year. I get paid $750K whether I see 25 patients a day or 2. I am not greedy, so I can live very comfortably on $750K a year in Greenville, MS. What is my motivation to work 12 -14 hours a day seeing patients when I could be on the golf course every day by 2:00 p.m.? None!

Physicians are no different from anyone else. It is noble to think that they are driven by the Hippocratic oath, but they also have personal lives, families and hobbies like the rest of us. At the end of the day, money is what gets us all out of bed in the morning... if you happen to truly love what you do, well, that's just icing on the cake.

Greenville is lucky to have as many good physicians as it has, given the underhanded politics that typically drive them away. We also have some physicians that should be barred from practice because of their incompetence and unethical practice. Ray and the "horsemen" of DRMC are well aware of these "dangerous docs", but continue to turn a blind eye to maintain their power as well as the facade that "all is well at DRMC."

The writer is also correct in stating that we can't simply blame the "Captain" for the plight of this ill-fated ship. Ray has many cronies, from supervisors to board members, whose hands reach just as deep into the county coffers to maintain their status in the "club".

I also commend the writer for recognizing the intent of this blog. Yes, it is a "soap-box" and not intended to be journalistic reporting of fact. It should be fun reading and I hope it is informative, but it is still a forum for views and opinions... some can be substantiated in fact and others may be purely personal perspectives.

Awareness of public issues is a good thing and participating in a blog discussion is actually quite fun. You can express your opinions with complete anonymity and your voice will be heard. Change will only occur when public voices unite.

Forthright

3 comments:

Absolutely Shocked. said...

DRMC.. TALK OF THE TOWN

I have become a regular reader of this blog and i have to say it always offers very interesting opinions.. (because its all opinion) Well im about to give mine i guess. Well first off i have a few questions. Number One Why the hell do u have to buy out your competition ( Kings Daughters) to prove you are the powerhouse. I believe that if you offer excellent service and provide great care. Eventually the others will fall or at least not do enough business to make a difference. I am under the firm belief that if The LEADER, CAPTAIN, or whatever you want to call him or her, were to treat people with respect and create an environment where people are happy and wake up everyday wanting to come to work you want have to worry about buying out the competition. The competition will either have to keep up or fall to the wayside. It amazing how people go to school get a business degree and just think they know everything about running a business. Its not just that simple. YOU HAVE TO HAVE SOME SORT OF PEOPLE SKILLS(Which many people at DRMC do not have). IF you cant get along and make your employees happy whatever it takes you will never have a truly successful business. I can take a person that has no formal education in running anything, but if they are a people person or can take the time and effort to try to find ways to make there employes happy that business will run every other business of the same type in the ground. Well thats enough about that.. Im SCARED REALLY SCARED. The health care situation in greenville is scary, very scary. What do you do when u have doctors that are not formally trained in the setting they are working. ( for example Emergency Medicine). Thats frightning to me. I hope and pray everyday i do not have to be one of the ones that gets some of that sub-stadard care. The question i want answered is why did the experienced ER doctors leave in the first place, and why any experience travel doctor says not NO to coming to DRMC but HELL NO... Is it that bad there.. Well i think so and many others think so... Like i have said earlier, the key to beating the competition and bringing in the money,(which im sure is the goal of DRMC) is to keep peace among the ranks. If you cant trust your leader eventually the ship will be lost at sea because all the hands rowing will give up and the ship will go anyway it wants, (probably down). That has happened at DRMC, anybody and everybody that knew the way the ship handled, knew the ins and outs and had any type of knowledge is gone, (they have jumped shipped so to speak) so what do you do. I dont know what needs to be done at DRMC, but i would guess the people need to storm the CAPTAIN'S Quarters and throw him overboard and start fresh. Thats what they did in the old days, you become stagnant and no good to anyone they replace you. I believe start at the top and work you way down, thats what needs to happen. Plain and simple. Well in the words of the once famous FOREST GUMP "THATS ALL IVE GOT TO SAY ABOUT THAT"

Anonymous said...

Forthright,
Could you tell us who are those incompetent and unethical physicians?

Anonymous said...

Let's assume Greenville is small enough that one can actually find the best MD and staff to care for you, compared to a larger city where you don't have that same information or it is much more difficult to get that information. The best anonymous sources are the nursing staff and former patients as long as they are not identified and held accountable by the hospital for identifying the worst staff and MD's. I go to certain MD's and their staff in Greenville because I know then personally and some grew up here with me and I trust them to tell me who they recommend elsewhere, and usually get 3 choices for me to make. I go to Jackson for other MD's and staff many times because they have the specialties not available in Greenville. I've been to Mayo Clinic in Minnisota. If there is a question about good vs. bad MD's in Greenville, the same question applies in Jackson, Little Rock or Memphis and we have the same problem of weeding out the bad ones. I suspect the worst ones leave Greenville. One problem with lawsuits is that even the best MD's get sued and all MD's lawsuits are paid by insurance companies, not the MD's, and the insurance is mostly paid by the hospitals for their staff; MD's who operate out of a private clinic do pay a lot for liability insurance and guess who actually pays for the insurance in the long run? You and I and our medical insurance policies pay for it and we or our employers pay for all of the costs of liability insurance. Eventually we consumers get the bill.

Another subject, dead horse, but when KDH was sold reportedly for $7 millions, I would have bought it for that! Only later were we told that there was another $20 millions involved in loans. I'm not sure the county kept that information from us on purpose? Whatever the case, DMRC no longer has any local competition and that creates a monopoly that leads to incompetence; you can't fool Mother Nature or basic economics about the problems of monopolies. I fear the banks will have to eat those loans, but then we the bottom feeder consumers will eventually pay for the loans with increased medical costs and higher interest rates from banks. National "Health Care" will be even worse for the same reasons and with little incentive to improve.

Is there a long-term solution? Yes, but the city and county doesn't seen to understand the problen and solutions. Where does it start? I could accuse every person in the city and county, the underpar education system, the lack of quality work ethic and employable workers for industry and then there are the politicians who cater to the voters with empty promises for every election cycle. The loss of Human Capital (I may be giving away my identity) is the base problem: the factors are 1. Family integrity, 2. Religious influence, 3. Work ethic, yet smart vs. hard work,4. Quality education, 5. Financial frugality. There may be more but Thomas Sowell is the author of several textbooks on culture and success of all the ethnicities in the world. His Human Capital factors are what he sees in any successful groups no matter the bias and discrimination any group faces. Sowell is no "Uncle Tom" as some call him.

Is that enough to explain the problems of Greenville, the county the Delta or for that matter, the entire country?