Magic Bullet....2/3

From the comments:

It is strange that the upper managment of Essent seems to think that the "Cardiac Center of Excellence" will provide the resources to make their investment payoff. Cardiac surgery does not pay its own way. The diagnostic caths are no longer the cash cows that they were earlier before the costly drug eleuding stents came out (they cost many times more than medicare will pay in the DRG.)

Meanwhile, the hospital continues its crazy scheme of cutting services to achieve profitability. They have hired yet another consultant to ask the staff what they feel are important goals of the hospital which might turn things around.

Any businessman knows that in a profit squeeze you can reduce costs some; but the way out is to grow goods and services. Hiring a consultant to tell you what needs to be done--while smart in some cases--is not in this case. What the hospital needs to do is get back to the basics of providing quality medical services to Paris.

The cardiac service is now a reality, so press ahead with a plan to get serious about basic services. FOR HEAVENS SAKE QUIT CUTTING RN'S WITH EXPERIENCE. If you must cut, cut some of the GN's who are barely able to find their A__ with both hands. The so- called Terrorists may have been your best asset--in that their terrorism might have been to disagree with your self-destructive behavior toward patient safety and basic patient needs. Sometimes listening to people who disagree with you can save your butt!

However; I doubt that The Duck has ever really lisned to anyone in his life. Even carrying on a conversation with him is an exercise in futility. Moving north is the answer to so much, but doing it without moving Psych and Dubois is nuts! Going from a total of 11 ORS between the two Campuses to 6 (counting Cysto ) will cause further loss of surgical cases and provide the impetus for someone building a short stay hospital (which would be the end of Essent in Paris.)

...and this is where I diverge...

(and , by my calculations be the wrong answer for the community, since a short stay hospital would take the cream off the top of reimbursement, forever dooming the chances of a viable General Hospital in Paris) Let us pray that by some Providencial miracle Essent can survive. Who knows, if they do, they may be able to sell out to an entity who dosn't depend on GE and GMAC financing to simply meet payroll month to month.

I think a general hospital is possible--assuming that in this climate that any hospital in this community can make it. One aspect of an Obama presidency might be an increased level of insured coverage. That will help all hospitals.


The Essent Problem is not the 'terrorists', necessary or otherwise, the problem is planning--or lack of. When you have the long arm of Essent directing this marionette show, confusion of purpose is inevitable. How well have they been in tune with the community so far????

(...and no one stays employed if Essent feels they aren't 'necessary', terrorist or not....)