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A hat tip to friend and colleague John Yunker at the Global By Design blog for the nudge.
Up next: Another guest expert weighs in with her comments about the 'R' word tomorrow. Stay tuned.
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Where lies the future of Paris’ hospital?
Staff reports
The Paris News
Published January 27, 2008
It’s been a long time coming — and it may very well be quite some time before we actually see it happen — but Paris Regional Medical Center recently announced that it was another step closer to what it calls “campus consolidation.”
Chris Dux, the hospital’s CEO, told employees a couple of weeks ago that the hospital had purchased two new heart catheterization labs and a 64-slice CT scanner. One of the labs and the CT scanner were destined to be installed within two months at the hospital’s North Campus, the former McCuistion Regional Medical Center. The new equipment is to be part of the hospital’s planned Cardiac Center of Excellence, a facility dedicated to the prevention, diagnosis and treatment of heart disease, providing a level of care previously only available in larger metropolitan hospitals.
As exciting as news of the advancement of the cardiac center is, the announcement that the hospital was another step further along in its long-range plans for the North Campus was just as exciting to the community at large.
As far back as the merger of Christus St. Joseph’s and McCuistion, Paris’ two long-time independent hospitals, into a single provider, hospital officials began to formulate long-range plans to make greater use of the facilities on the North Loop, expanding services offered there and building new structures on the open ground surrounding the main structure.
“Our long-term goal remains for Christus St. Joseph’s to relocate all services to the North Campus," said Monty McLaurin, chief executive officer of CSJ, as reported in an Aug. 8, 2002, story in The Paris News. The remark was part of a report on short-term relocation of services to the South Campus, a move designed to improve cash flow for the hospital.
When Essent Healthcare bought the hospital soon after, Essent officials went on record that they, too, saw the wisdom in eventually making greater use of the North Campus, with its open acreage and fewer busy city streets cutting through the grounds.
Dux told hospital staff at the meeting recently that the new equipment was “the first step in our campus consolidation.” He also announced that Essent had hired the nation’s largest designer and builder of healthcare facilities to assist the hospital with “a clear long-term plan for future expansion and growth of the North Campus.”
Such an announcement can’t help but make the people of Paris optimistic that Essent is prepared to do what it takes to make PRMC a first-rate medical facility. The hospital’s willingness to go forward with plans that will make best use of all available facilities should be encouraging to those of us who have watched the hospitals with a wary eye these past few years. We hope we are witnessing the first steps in returning Paris to its standing as a strong, stable center of regional medicine for Northeast Texas and Southeast Oklahoma.
Personally, I'll believe it when I see it- but if it happens, it can't be soon enough. The south campus is landlocked, and I don't believe Brookshire's is going to close its doors any time soon, so expansion there is out of the question. --anonymous
My take is: status quo. There are some minimum upgrades needed for the cath lab...minimum to staying open. Putting in a 64-slice CT at the North campus might be just to appease Dr Hashmi...it becomes as unwieldy as the MRI when needed for a South Campus patient. By the time it would start to be utilized fully, it will be as outdated as the one it replaces....frank
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"As far as ExIm Bank, you'll have to talk with them.Note from LD: Interesting "definition" of Export-Import (Exim) Bank at Answers.com.
As far as recession, the US is not in a recession, which is commonly defined as two quarters, that is a period of six months, over which the size of the US economy actually shrinks. For the third quarter of 2007, that is through Sept. 30, the economy actually grew almost 5%, far above the long-term average growth rate of the economy. Although growth will almost certainly be slower in the fourth quarter of 2007 than it was for the earlier part of the year, one quarter of slow growth does not equal "recession."
Concerning job creation, small businesses often create well over one-half of all net new jobs in the economy. Please refer to the link below on our website:
6. How many new jobs do small firms create?
Over the past decade, small businesses created 60 to 80 percent of the net new jobs. In the most recent year with data (2004), small firms accounted for all of the net new jobs. Firms with fewer than 500 employees had a net gain of 1.86 million new jobs. Large firms with 500 or more employees lost more jobs than they created, for a net loss of 181,122 jobs. For information on employment dynamics by firm size from 1989 to 2004, see www.sba.gov/advo/research/data.html#us.
On small business and exporting, 2007 will be a record year with small businesses racking up over $400 billion in exports. While in the third quarter of 2007 the economy grew 5%, exports grew by 19%. So long as the dollar remains weak and other countries' economies strong, the outlook for exports is bright."
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What makes this interesting is Dr Gunder's pending departure from Paris. That and why a hospitalist is being sued based on an ER turnaway. I imagine we'll see in the months to come...frankJerry Dean, individually and on behalf of the estate of Wanda Dean v. Adam Gunder M.D.; Paris Regional Medical Center LP; EHC PRMC GP, LLC; EHC PRMC LP, LLC; Essent PRMC LP; Essent Healthcare - Paris Inc.
1/25/2008 208cv027(It is a medical malpractice suit, alleging the person died from a heart attack after she was turned away from Paris Regional Medical Center's emergency center. )
Ours, of course, the gang of 10 (John Does 1-10, Happy Hour meeting at Applebees on Fridays)
NONA HARRIS VS. KHALID SHAFIQ, M. D., RAPHAEL LUI, M. D., AND ESSENT PRMC, L. P., D/B/A PARIS REGIONAL MEDICAL CENTER
WORLDWIDE IMAGING TECHNOLOGIES-TEXAS, LLC VS. ESSENT PRMC, L. P. D/B/A PARIS REGIONAL MEDICAL CENTER
DEBRA BROWN AND IN THE INTEREST OF BRITTANY BROWN VS. PARIS REGIONAL MEDICAL CENTER
This one has a default judgement, but 01/17/2008 lists an "ORDER GRANTING MOTION FOR NEW TRIAL."
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"Small businesses are increasingly sophisticated global players who are able to spot opportunities, whether these are found in their local communities or across the globe. The depreciated dollar has given entrepreneurs -- many of whom had not looked at the export market before -- a golden opportunity to pursue sales abroad."Sign up for Advocacy's ListServ here.
Regarding the possibility of a downturn, Moutray referred us to this study (be prepared for an immediate PDF file download) by Craig and Kohlhase that had been released in December 2006. Note the research summary's overall finding: "Small firms play a vital role in maintaining economic growth in urban areas."
Moutray does not follow the movings of the Ex-Im Bank so there was no comment on the loan policy.
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Do you think Ex-Im Bank will cut back or be more willing to extend loans to SMEs (that qualify on exports) this year in light of a possible recession?My belief is that entrepreneurs and small businesses are typically the ones who create jobs in a downturn (refer to WSJ commentaries here and here) and that they most certainly lead the way on exports.
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Years ago, it was often said that radiology and lab was used to "rule out" this or that ailment because the doctor's didn't know how to make a clinical diagnosis. As a kid, I had right lower stomach pain and the family doctor did a simple blood test, pressed on the area that was hurting and told my parents to get me to the hospital ASAP and the surgeon would be waiting to take my appendix out. Today, it's lot's of lab work, plus a CT and then surgery. I think we can thank in large part of this particular dog and pony show to trial lawyers for driving up the price of a simple diagnosis. That's a whole different topic for another time!And:
On the plus side, CT has eliminated so many x-ray studies I couldn't count them. The numbers must be huge. Plus, the difference in radiation dose in a minimally invasive CT versus an angiogram (name your study) has to be significantly lower. And, many of these exams are performed on an outpatient basis eliminating lengthy hospital stays while recovering from such procedures. The diagnostic results are far, far superior to the "old" methods and techniques once touted as leading edge technology.
In a nutshell, CT may be over used by some physicians as a CYA defense, but on the whole, it's such a valuable tool that it has become the standard of care in medicine.
CT is a great thing. It lets us see into areas of the body that "the sun don't shine". And that's good. However, the over-use of radiation in any form is not. If you go into the ER, and I mean virtually any ER, and you have a cold, headache, miscellaneous pain, or trouble with your bowels (too active, or not enough), you will have an X-ray, and/or a CT. And, if you go there the next day, or a week later, the likelihood is that you will get the exact same treatment.
It doesn't mean that the treatment you will receive is bad, it just means that an emergency room is for EMERGENCIES. So, that's why you are directed to follow-up with your family physician. Without knowing you, the ER performs the same general screening time after time.
All xrays and lab tests are overused in the ER. I know this because I have a good friend who is a board certified ER doc and he would tell you: ER docs are the whores of the hospital. They are hired to do the dirty job that staff physcians don't want to do (ER coverage) but when the fecal matter hits the rotating blades, the staff docs won't hesitate to let the ER docs hang in the wind. So to cover their bottoms, they order more lab and xray, CT, etc than they really need, because it all comes down to our lawsuit happy society. CT is a great tool and it is over used, but it's either that or lawsuits every day and no more ER docs to cover.
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They are no longer just looking at the heart hospital but moving the whole shabang to the north campus. They finally realize the logistics and the PR of the community [needs] a new fresh start.According to the Essent, they're going ahead with the heart hospital...and possibly a new facility at the north campus location. Where is this influx of cash coming from? Probably the investors, who realize that unless they fund this properly, the whole ball of wax might melt. (Besides, no offers to buy.)
My question is will they actually try to get input from the people who will have to work there to make it a user friendly building or will they just go ahead and plow on thru with no clue to what a hospital is really for??So, what should they consider when building this medical Mecca? Functional proximity, for one thing. Room size, equipment staging and storage areas, and planning for future technology/expansion (what hospital hasn't had to expand?) HIPPA requirements (avoiding the viewing of patient records at nursing stations). Flexible tasking of rooms and floors (being able to ramp up acuity levels as needed with appropriate plumbing [O2, suction, and monitoring] in place.)
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So far, this looks very promising. Those of us who are involved in this agree with the triad of Patient-Nurse-Physician comfort and confidence. I feel that the employees are THE biggest asset a company has (maybe it's only asset, since it's the only one that a company can control, as to mix and content). However, THE engine that drives the boat is the PATIENT. We must re-establish confidence in the system.
The LIST is so far a good one and will go a long way toward providing a foundation for guidance. Thank you, Paris.
I am an interested physician who reads your blog. Would you consider asking your readership for a listing of grievances, in order to form a priority recipe, of those issues that employees, patients and physicians find most troubling with the current hospital's plight? This would help those of us who feel an intense need to help.
He's making a list, checking it twice....
1. highly skilled docs boarded in emergency medicine;
2. a nursing staff with a modicum of competence and compassion;
3. better triage procedures;
4. a bigger ER.
5. better customer service
6. CEUs
7. better attitudes
8. follow-through with suggestions and complaints
9. support for the nursing staff
10. updating equipment
11. more personal contact by physicians with patient families post surgery
12. more respect for allied health personnel
13. more community involvement
14. YOUR COMMENT
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