Wednesday, April 08, 2009

Another Financial Folly?

GREENVILLE - The wait for medical personnel to arrive at an accident scene may have been considerably reduced now that Delta Regional Medical Center has merged with Air Evac Lifeteam.

As a result, the Delta now has emergency air transportation.“This is something that is needed,” said Ray Humphreys, CEO of DRMC. Beginning in July, an Air Evac helicopter will be based at the DRMC Pavilion. The helicopter and its crew will be on call 24 hours a day, seven days a week. Humphreys said the hospital sees about 50,000 trauma patients in a year, representing about 10 percent of those seen in the state.

The closest Air Evac helicopter is based in Batesville. The new Greenville facility will reduce reaction time to and from an accident scene.“This is so valuable to Washington County in terms of the lives that it will save,” said Washington County Board of Supervisors Mike Gordon.

Emergency air transportation is not cheap.

According to Bubba Bell, a former Greenville firefighter who will be the program director of the DRMC operation, and DRMC Board of Trustees member Bill Schultz, an average flight is around $15,000.

While no one who needs the helicopter service will be denied, there will be a membership program. For $50 a year, an individual will not have to pay for an Air Evac flight if needed. Membership costs $55 per couple and $60 for a household of three or more. “It's a very smooth flight,” said Schultz, who flew in for Monday's lunchtime press conference. “I wasn't worried at all.”

The concept here is great and could prove to be a life-saving service. However, my concern is not the wait time for transport to DRMC, but the wait time once you arrive at the ER... and the quality of care. Inadequate staffing (both nurses and physicians) remains a major problem at DRMC.

At a cost of $15,000 per flight, it will take 300 "members" to pay for one uninsured, non-member's flight. The majority of patients treated at DRMC are medicaid or "self-pay" (which equates to "no pay"), so this will rapidly become a very expensive venture for our county hospital. Since no one will be refused this service, there is no incentive for the the uninsured or under-insured to pay the very reasonable price of membership.

I am afraid that given our demographics, the membership fee would need to be at least $1,000 per year to offset the massive costs of indigent care that will be provided... and we all know who eventually pays for "indigent care."

Don't get me wrong. In a medical emergency, we are all thankful for every service that can be provided. The issue is cost... and who will eventually pay the price. Is this something that Washington County can afford and is it a prudent expenditure in this time of national economic crisis. Medicaid is already operating in the red and hospitals are facing additional taxes to support these programs for the indigent.

As much as we dislike thinking of hospitals as "businesses", they are, and the leaders have to be responsible with the public funds which support them. Once again, my advice to DRMC is to focus on their quality of basic acute patient care and quit having delusions of becoming a "TV Emergency Room."

If I were ever a member of the DRMC "flight club" for $50 a year, I would tip the pilot $1,000 to just take me to Memphis!



What is the US government thinking? said...

Georgia Arms is the 5th largest retailer of .223 Ammo in America . (they sell 9 mm, .45, etc ammo)

They normally buy spent brass from the US Dept of Defense - 'one time used' shell casings by our Military - from training on Military bases, etc. They buy the brass and then re-load for resale to Law Enforcement,

Gun Shops, Gun Clubs, Wal-Mart, and etc.

They normally buy 30,000 lbs of spent brass at a time.

This week the DOD wrote a letter to the owner of Georgia Arms and said that from now on the DOD will be destroying the brass - shredding it. It is no longer available to the Ammo makers - unless they just buy it in a scrap shredded condition (which they have No use for). The shredded brass is NOW going to be sold by the DOD to China as scrap metal....after the DoD pays for it to be shredded. The DOD is selling the brass to China for less money than Ammo manufacturers have been the DOD has to pay to have the brass shredded and do all the accounting paperwork. That sure helps the US economy now, doesn't it? Sell cheaper to China - and do not sell shells at all to a proven US business. Any agenda working here???? Obama going after our ammunition!!!!!

The Georgia Arms owner even related a story that one of his competitors had already purchased a load of brass last week - and the DOD contacted him this week and said they were sending someone over to make sure it was destroyed. Shell Casings he had already bought! THE BRASS HAS NO VALUE TO THE AMMO MAKER IF IT IS DESTROYED/SHREDDED/MELTED. THE AMMO MANUFACTURER ONLY USES THE EMPTY BRASS SHELLS TO RELOAD DIFFERENT CALIBERS - MAINLY .223 BULLETS. Georgia Arms owner says that he will have to lay off at least Half of his 60 workers, within 2 - 3 months if the DOD no longer sells their spent brass to him. He has 2 - 3 months inventory of shells to use. By summer - he's out. If he has to buy new manufactured brass shells, then the cost of ammunitioin to the buyer will double and Obama wants to add a 500% tax on each shell.

You can read the info and see the DOD letter to Georgia Arms here:

The Shootist Site

Outrageous! said...


I was informed that the new ER policy is that no one is allowed with the patient until they have been seen by the physician.

Are they nuts? Waiting time to see a doctor can be anywhere from 45 minutes to hours long. So our loved one, child or adult, is to lay there alone, suffering with no comfort or monitoring until the doctor shows up...???

Good grief! Not with mine...where do we complain to head off this tumultuous scene? Who should we call? Ray? Didn't someone say that Pieralisi was gone now? Who took her place?

I want to call now, before I have to throw a temper tantrum fit when they try to keep me from my family member!!!!

Anonymous said...

I totally agree with Forthright and the above comment - no one is going to stop me for not being with my husband or children if they are in the ER - and the fact that there is one physician on staff to see all the many patients that are in the ER - wait time could be hours! The new air program is wonderful for those who need to be transported elsewhere but as stated before, you may never make it to the air flight waiting for the ER to get you processed and to the flight. Also if you will note the CEO has now added one more "manager" to contined growing number of managers to the mix - you have to wonder why you need a program director for a program that may only see one flight a month???? I am wondering what the CEO's management team count is now??? 125?? 150?? for a hospital who has about 150 beds in operation! the saga continues....

Who do we call? said...

So? Who do we complain to? We need an onslaught of calls complaining about the new ER limitation policy, but we need to complain to the right person!

Anonymous said...

Don't we all just love it that the only time we see our CEO is when his picture is in the paper? Every one knows that he huddles in his office all day, if he is at work, playing with his computer toys. He keeps himself away from his managers, the doctors and anyone who wants to address the running of this hospital because he can't answer or direct them on what to do. So if the person who is wondering why we have so many managers wants to really know why, it is because he doesn't know how to run a hospital and wants to have as many folks as he can around him to do the work. Too bad most of them do not know how to do it either, which is why we are in the mess we are in.

Hurry up and wait said...

The reason for the new ER policy is that Ray doesn't want anyone to be able to witness the grossly understaffed ER. Once you get into the actual ER, wait times can still exceed 4 to 6 hours before you see a doctor.

I took my father there last year with the symptoms of a stroke. If I had not been allowed in the treatment room, he would have been completely unattended for almost 4 hours. He wanted a drink of water and a blanket. I literally had to walk out and find someone to provide these basic needs. After six hours, he finally saw the doctor who did a five minute exam and discharged him stating there was nothing they could do for a stroke.

I thought the damaging effects of a stroke could be prevented by clot busting medicine if treated within the first 60 minutes. It took me five minutes to drive him to the hospital and six hours to see a doctor. If it had been a serious stroke, he would probably be permently impaired (or dead) today!

The helicopter is just another "hurry up and wait" program. In six hours, I could have driven him Jackson or Memphis. I think I will keep my $50 dollars for gas!

Curious? said...

Is that really the new policy at DRMC ER? What is the reason for that? There has to be someone there for the patient.. To help them and to see what is going on. To answer questions and such, right? Usually one or two could go back with the patient?

Anonymous said...

A friend informed me of this new policy too from her recent experience with ER. It is awful policy.

Anonymous said...

The purpose of the DRMC policy is "what you DON'T see, can't hurt them!" Law suits are rampant at DRMC because the public is aware of the horrible staffing conditions and poor care.

Anonymous said...

OH MY WORD!!!!!!!!! When I saw Ray H on the 6 pm news bragging about his latest scattered brain idea, I was FLOORED! My first thought was - Surely they are using this to get people OUT of DRMC, not fly them in!! How scary!! Needless to say, Ray had one of his cronies in tow for a free helicopter ride, Bill Schultz, who has turned out to be a huge disappointment to many here in our community. He once was a man of integrity, but he turns a blind eye to the horrendous management of our only hospital. Shame on you, Bill!

As for the ER, physicians and nurse practitioners are dropping like flies! One long time G'ville ER dok (an old KD fella) got the boot for not following the latest goofy policy. Two long time nurse practitioners have "seen the light" and decided to not practice in such an unsafe environment. That doesn't leave many qualified folks to care for you in Greenville's ER. My gosh, WHEN are these fools here gonna wake up and fire the entire board plus Ray Humphreys and Alphe Wells. We are rid of Flo and Allyson and now it's time to clean the rest of the house. And, if you don't think the board doesn't know exactly what's goin on, you are nuts - they do. And, by the way, we all hear that Ms. Allyson Williams had an unfortunate "meeting" with a surgeon at her latest job and was relieved of her duties on the spot. Thank goodness Ray wasn't crazy enough to take her back when she came calling. Staff all over the building (including physicians) were cringing when they saw her walking the halls a couple of weeks ago.

No one on the DRMC campus can believe Ray has gotten away with yet another delusion of grandeur. That is going to cost a pretty penny - one we always are hearing that "we dont have, so we have to cut back". Something just doesn't add up here?!?!?!?

Anonymous said...

I understand that the helicopter will not cost the hospital or the county a dime. The helicopter co. wanted to place one here and approached the hospital. I think its a great service.

Anonymous said...

You probably believe in the tooth fairy also!

Appreciative patient said...

I want to say a positive for the DRMC ER STAFF. I recently had a severe allergic reaction to medication with a BP of 70/40. I was obviously very ill and covered in hives and splotches. I had to be ambulanced from the clinic to the DRMC. The Ambulance staff were very kind and alert to my needs before, during and at the end of my transportation across town.

Once arriving, the DRMC staff immediately took action to admit me and determine the cause of the reaction. Every one was attentive, courteous and professional. When questioned they answered an explanation or offered it, before the question occurred.

Knowing how low my BP was, I was scared to death and doing a lot of mental praying to God from the ride in the ambulance to arrival at DRMC. Within a short time, the physician, Hilton O'Neal and staff had my symptoms back under control. I had arrived around 4:30/5:00 PM and was treated and released in much better shape by 6:30PM. At the end of the evening, I was splotch free and feeling sooo much better!!!

I was truly relieved and impressed by everyone taking care of me

Thanks to all on the ER day staff on April 14th, 2009!!

Anonymous said...

car tag fraud
you can now commit car tag fraud again. my friend took her card (which was a county address, even tho she lives in the city)and they announced to everyone in the waiting area that they were no longer checking the computer, but going solely by the card. how stupid! our city needs this revenue. what was the point of arresting the employees if you are going back to the same behavior?

Anonymous said...

Hello i would like to weigh in on this situation about the new DRMC merger with AIR EVAC seeing that i am in the buisness of EMS i would like to give you a little information about these services and ground services. First i agree with the reader having the air ambulance service is a great idea but not a very smart financial idea. It is very expensive to run keep up, and as you say 15,ooo for an average flight. Most average citizens would not be able to afford that. That's like paying for an midsize vehicle. Well now here is my side the ems side. The only advantage to emergency care where the air ambulance is of use would be prolonged extrications from a vehicle wreck where it would take you, lets say 20 plus minutes to get the patient entagled from the wreckage and the patient could be flown to a level 1 trauma center. Any other call is just about useless for emergency care because most ground ambulances could have the patient transported from any point in the county before the air ambulance checked the weather and did the preflight checks to get off of the ground. ON the other hand if you have a critical patient that is IN THE EMERGENCY ROOM that needs to get to ( Jackson, Memphis, ETC) the air ambulance is just the right thing because in most cases it reduces transport time by half (weather permitting). Also i dont know the details of the so called MERGER with AIR EVAC and DRMC but im sure if you do some checking AIR EVAC is a privately owned company that will not be exclusive to DRMC and Washington County. Im sure that anywhere in the delta (lake village, indianola, cleveland Etc) and anywhere within their flight area they will respond because they are in the business of making money, so when they are on a flight to another location and a critical patient is in the DRMC ER thats needs immediate transport, you see they will still go by ground and the good ol Boys of DRMC EMS!!! So once again in my opinion this is just another case of a marketing scheme to make DRMC look Better than it is. We all know you can polish a terd all you want but in the end you still have a terd.


Anonymous said...

Here's another genuine idea from the great Ray and ADM staff! The nursing staff is being asked to change their current work schedules AGAIN! Over a year ago the hospital's ADM came up with statistics that showed nurses who worked 12hr shifts for seven consecutive days proved to produce more medical errors in healthcare. Nurses are now being encouraged to go back to this rotation. This conveniently saves the hospital a few more dollars to support RayRay's latest "Plots&Plans!" By doing this, the hospital avoids paying some of its nurses 12hrs overtime. I'd hate to have a nurse take care of me on her seventh day of working! Again, putting Patient Care just below saving a few bucks! What will they sacrifice next?

Anonymous said...

to anonymous 7:04am it does not matter if the nurses work 2days straight or 20, when you have incompetent staff that does not care about anything but the almighty dollar and not patient care, they are prone to make mistakes more often which they do. I know first hand that some of the nursing staff has made huge mistakes like giving wrong medication advice over the phone, which led to a bad situation. Until you have a good working enviornment and people who care it will never work. I will say there are good apples in the bunch but more bad than good...

Anonymous said...

Well I am sure what I am about to say will be taken lightly but it is something to ponder. I live in greenville and was a part of the DRMC team for almost a decade, along with a few members of my family that also practice in the healthcare field. I have a practice in an area not so far from here with a great group of physicians that are genuine and respectable. Patients are treated like family members instead of numbers. The physicians and administrative cabinet mean what they say and say what they mean, which is a concept that has long since evaporated at DRMC. I am sure that DRMC thought that my families' exitous would never result in any sort of impact to the only hospital in greenville and its arrogant administrative panel probably still holds this opinion. (they would never admit to being wrong you know) I will tell you this, I personally refer an average of 15 patients per month to sub-specialties such as OB/GYN, Cardiologist, Internist, General Surgeons, etc.. These patients are respectable citizens of this community and the surrounding areas, 95% of them have insurance and some have more than one. Do you think that after the experience myself and my family had with DRMC that any of their physicians names roll off of my tounge when my patients are referred to another specialty or facility for a procedure? Hell no it's not! This is no blow to the physicains that specialize in greenville, it is just a consequence of having one and only one hospital in the town at which to practice. That is not the worst part, the other physicians in the clinic started asking where to send some of their patients that had sub-specialty needs as well, and why I never referred to a facility that I worked in for almost a decade. Well, guess what... The other physicians in the clinic refer to some place other than greenville as well for the most part. So now do you think that "pissing off" one little healthcare provider had an impact on the towns only hopsital? Sure it does. I know that there are people who love this town and its hospital. I was one of those people not so long ago. I believed in the facility, and even its corrupt administration. Then it became more and more evident what was taking place in the only hospital in town was something that me nor my familly members wanted to be associated with, and that was a poorly mis-managed understaffed healthcare facility.I do still reside in this town, but that is all I do here. My kids do not attend school here, my practice is no longer here, I do not buy groceries or clothes here. I will eventually move like so many more have done in the past. Until then,DRMC, I am quite sure that the referrals myself and my colleagues would have directed your way are probably adding up to quite a few thousand dollars these days.....