In the past several decades, Newman Regional Health has grown from the dark brick building at upper center to this sprawling medical complex as the needs of Emporia and the practice of medicine have changed.
Fred Harder was surprised when he heard that a local doctor had complained about an antagonistic relationship between Newman Regional Health and physicians who practice medicine at the hospital.
Harder, president of the hospital’s board of trustees, said that discussions with doctors about medical concerns are common. It is a subject that is talked about regularly at board and staff meetings, as well.
“I thought we were moving in the right direction, and I hope that this isn’t going to be a setback for us or anything like that, and we’re going to continue to move forward, regardless of anything that was said,” Harder said.
On April 24, during a meeting on health care and pandemics, local internal medicine physician Jim Barnett said that the hospital had an antagonistic relationship with physicians and he questioned the quality of care patients receive at Newman.
Harder talked about the accusation before Barnett and his group met with Newman Administrator Terry Lambert this week to begin working on a solution to the problems.
Harder said that the board had been looking at ways to “enhance the relationships with the different doctors and their groups” and that on the morning of April 24, he and another board member, Bill Barnes, had met with a physicians’ group for about an hour and a half. Harder thought the meeting had been productive and ended on an positive note.
Barnett’s announcement came as a surprise, Harder said.
“The board is very much concerned with the relationships between the doctors and the hospital,” Harder said. “... We talk about that all the time. We have had doctors attend the (board) meetings. ... I still intend to try to go forward to work with his group and all the other (physicians’) groups.”
Harder said that Newman has invited groups to the hospital to talk about how they can become better partners.
The hospital board is discussing bringing in a “hospitalist,” a physician who specializes in treating patients who are hospitalized. Consideration also is being given to the hospital’s employing doctors.
“Some hospitals are actually owning more doctors’ practices, and we put that out there, if that’s something we would be interested in,” Harder said. “Then we have some people who have expertise in that area that we would try to contract with to put together something.”
Newman currently does employ some doctors, such as the orthopedists who came to fill a gap left when local orthopedists curtailed some of their practices.
“This is the route that both Dr. (Michael) Yost and Dr. (Richard) Rattay chose to come to Emporia,” Harder said of the orthopedists who began serving the area within the past 18 months.
Harder said that from the hospital’s point of view, there is no advantage to employing doctors.
“The hospital isn’t really necessarily interested in owning the practices,” Harder said. “It has to be a win-win for both the doctors and the hospital.”
The advantage to the doctors, Harder said, is that the system eliminates billing and employment expenses, although those employees would work for the doctors.
“That’s the difficult part for some of the doctors who do not want to go into employment of the hospitals because there’s a certain amount of freedom they would give up for that,” Harder said. “It’s not for everybody.”
Recruiting and retaining doctors has become an issue that more and more hospitals are facing, according to Newman Administrator Terry Lambert.
“Every community is facing the same challenges that we are, and every community is doing what it can to try to recruit and maintain physicians,” Lambert said.
Some hospitals and health centers are providing “sign-on” bonuses to bring in physicians. That, combined with the possibility of less time on-call in larger hospitals, also can prompt physicians to move from Emporia.
“It’s so attractive sometimes to physicians now, even though they may be happy, reasonably happy, in one place,” Lambert said.
However, Newman and other hospitals are not allowed to compete financially for doctors currently on their staffs.
“Once you have a physician in place, legally we can’t do any kind of financial compensation to keep (them). We can’t do retention bonuses ... anything like that. That’s against Medicare regulations.”
The dwindling number of doctors available in Emporia was one of Barnett’s concerns when he said he believed the adversarial relationship with the hospital had caused doctors to leave.
Barnett cited a statistic provided by the hospital’s medical staff coordinator showing that between 2003 and 2008, the number of doctors in Emporia dropped from 42 to 32.
Nancy LeClear, Newman’s education and marketing director, said that the figures were totals for the number of doctors who practiced at the hospital during the year.
“But the fact is that there was never any one time during that year that there was more than 39 doctors,” LeClear said.
A total of 17 doctors actually left Emporia during those five years, and 17 doctors left during the 5 years prior to that.
“The difference is ... we had 20 coming in during those same years and 17 left,” LeClear said. “During the last 5 years, we’ve only had 12 come in and we’ve had 17 leave. The issue is it is much more difficult to recruit physicians.”
Some physicians, like Barnett, receive scholarships from the state and repay them by working a number of years at a rural hospital. Often, doctors leave after those required years of payback have been met.
A former Emporia physician who came here under that state plan said she initially had encountered some difficulty working with nurses at Newman, but that problem had dissipated quickly and was not an issue in her decision to move to Nebraska.
“That was not the reason why I left,” said Dr. Suzanne Vandenhul, who now works at the Antelope Creek Family Physicians office in Lincoln. “If I could have, I would have stayed there and practiced there forever.”
She and her husband moved because, as a helicopter pilot, he was unable to find a job in Emporia. After they left, the medical helicopter service came into Emporia, she said.
“I didn’t have any problems with the administration at the hospital,” Vandenhul said. “Currently, the thing that’s keeping me from going back (to Emporia) is I do think that Lincoln has more options for schoolchildren.”
Vandenhul was hired through the “bridging program,” the state’s scholarship program that allows physicians to repay funds by practicing in a rural area.
“I stayed in Emporia for four years; I only needed to for three years,” Vandenhul said.
She did say that for a brief time, there were a few nurses at Newman who tried to override her decisions.
“And a few times, they would say something against me right in front of the patient, but that didn’t last long once they got to know me. I specifically do remember that happened. That quickly changed once they got to know me and realized I know what I’m doing.”
In Nebraska, Vandenhul is quality medical director for a network of 100 doctors.
“We’re working on physician retention here in Lincoln,” Vandehul said. “The spouse is 40 percent of the reason doctors leave.”
Vandenhul mentioned physicians Alan Grove and Elise Gerstenberger, a married couple who came to Emporia to satisfy bridging program requirements, then moved to California. The city lost two physicians when they left in 2003; it lost two more when Drs. Jay and Suzanne Ciotti fulfilled their requirements and moved to Durango, Colo., that same year.
“If you grew up in a big town and you wanted to have bigger options for your family, different things to do,” moving is a natural choice, she said.
Vandenhul said that communication among everyone involved could be the best solution for resolving a problem, if it exists.
“If you just lay blame on someone ... that’s not going to fix it,” Vandenhul said.
Another doctor, Emporia native Crystal Hill, is leaving after her husband graduates in May from Emporia State University. Her last day on staff at the Flint Hills Community Health Center was April 4. Her experience was different from Vandenhul’s.
Hill said that growing up in Emporia, she had always planned to practice medicine in Emporia.
“When I got that opportunity I came back here, but I didn’t really get the respect that I thought I would get,” Hill said. “I don’t know if it was because I was a health department doctor ... because I wasn’t in private practice.”
She said that she had always felt that she had been “looked down upon.”
“There was one time last year, about a year ago, when I had a conflict with one of the ER physicians who is no longer practicing here,” Hill said.
She went to the hospital’s administration to try to resolve the problem.
“Instead of working together with me at finding a resolution to the problem, they criticized me personally and professionally,” Hill said. “That hurt. I didn’t appreciate it.”
Six months later, in October, the second doctor at the health center moved from Emporia and she was left to handle all of the on-call duty.
Hill said that she and health center Executive Director Lougene Marsh went to Newman to talk with the hospital’s Lambert and Assistant Administrator and Chief Nursing Officer Paula Taylor. Hill said that she was struggling with call coverage and asked for help.
Marsh said that the hospital, which does not employ family physicians, was not in a position to leverage any help from other local doctors.
A hospitalist could have been a good solution, and the hospital recently announced it is considering adding the position to its staff.
“Our board of directors is very interested in this concept of a hospitalist, and we believe that it would have made a difference in our retention of both Dr. Carson and Dr. Hill,” Marsh said. “It might not have changed it, but I believe it would have been positive, a favorable thing ... and certainly would be favorable in our recruiting of physicians.”
Hill said she also had trouble convincing other local physicians to help take the calls to give her some relief.
“After I ultimately had to give up my privileges, I did sort of become the scapegoat of the medical community,” Hill said of her assessment of the circumstances. “Obviously no one was happy that everybody shares an assigned call. ... We worked with several different groups to arrange a coverage that would be acceptable, and for one reason or another, it just didn’t work.”
And while she was openly frustrated with the Newman administration, she said she did not agree with Barnett’s questioning of the quality of care provided at the hospital.
“I really don’t know why there’s these questions about quality of care,” she said. “Quality control — it’s always talked about in every single meeting we ever had as a medical staff. ... I know there’s going to be people who have bad experiences. I really don’t know where Dr. Barnett’s issue is coming from.”
Hill said that she had been surprised by Barnett’s statements because he “usually is very mindful of what he says.”
“There just seems to be a bit of disconnect between physician groups, even though we try to work together and say we’re a team, and then the administration taking sides from one group to another,” Hill said.
Comments
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Posted by anonymous1 (anonymous) on May 7, 2008 at 4:53 p.m. (Suggest removal)
As President of the hospital's board of trustees, will Mr. Harder explain why the hospital filed its claim too late against the contractor that resulted in a loss of $900,000?
Posted by emporian2008 (anonymous) on May 7, 2008 at 5:45 p.m. (Suggest removal)
I believe that because Dr Barnett is very mindful of what he says that there is a lot of truth to what he said. He wouldn't say it unless there was a good reason. I just feel really sorry for what will most likely happen to him for saying what he did. As Dr Hill mentioned, when she went to administration to find a resolution to her issues, they criticized her personally and professionally. With my own personal experiences with the hospital I can see what she is saying. They (administration) always try to turn the tables to make the person who is making the complaints look bad. I believe there are many others who feel the same way I do but are not willing to come forward and voice their opinions due to the retaliation. I know it happens. It happened to me and has happened to many others that I know. I hope and pray that everyone who has had any issues with Newman's will come forward and tell your story. The community needs to know. Do it anonymously. But do it. I'm not saying that the hospital is absolutely horrible. It can be a good place. And is at times. But the attitudes of some of the staff needs to change. It IS your job to take care of the patients in a respectful manner. And as for administration, I feel like they need to be replaced. They act like they care about the issues at hand but they really are only concerned about #1. THEMSELVES!!
Posted by Patient (anonymous) on May 7, 2008 at 5:55 p.m. (Suggest removal)
Emporia2008 you are 100 percent correct administration tells the board what they want to hear the good never the bad. They never believe the patient. What about the alleged Hipaa violation?
Posted by slipandslide (anonymous) on May 7, 2008 at 6:34 p.m. (Suggest removal)
if no one listens to the staff and patients, how can a patient have a complaint addressed, and how can the families be sure the patients are being given good care?
Posted by eiggohp (anonymous) on May 7, 2008 at 6:43 p.m. (Suggest removal)
emporia2008-
I agree with you 100%. Dr. Barnett choses his words very carefully and I know from first hand experience that what he said about the conflict between the administration/board and
the doctors is absolutely CORRECT! I know from first hand experience. I see this happening all the time, but I need a job or I would "blow a whistle" on what I have seen myself.
Posted by eiggohp (anonymous) on May 7, 2008 at 6:47 p.m. (Suggest removal)
emporia2008, for all of those who are not aware of what happened regarding the "Hippa violation", you might fill the readers of this forum in as to what happened. Thanks
Posted by emporian2008 (anonymous) on May 7, 2008 at 7:45 p.m. (Suggest removal)
As to the HIPAA violations, I don't know of any formal complaints or reports being made recently but I know that the violations do occur daily. I have been a first hand witness to this. They (Newman's) can deny it all they want but I know it is true. Many of the staff, but not all, are very inconsiderate of the privacy of the patients. They seem to have become so desensitized to the patients' situations that they ramble on amonst each other and make fun of the patients and their problems. They also don't pay attention to their surrounding when beginning these discussions. They offend patients, their families and other staff while doing this.
As for making sure that your family members receive good quality care, my suggestion is to stay as close to that person as possible at all times, ask questions and know what the doctor has ordered. If you need something, use your call button as much and as often as you need it. Don't worry about getting on the staff's nerves. IT IS THEIR JOB!!!!! With the price of healthcare you definately pay their wages. I myself have been a patient of Newman's and I was treated very poorly by certain staff. I was employed there at the time too. I've had family members go in the emergency room and admitted and I've got to say that almost every visit was a horrible one. Each time someone of my family went to the hospital I made sure I went with them. I did that because I know what happens there. I didn't want my family to become the "topic" of one of their discussions.
One more thing I would like everyone to understand. You do have the right to refuse any procedure. It is not necessarily recommended but that is your right. If you are forced, that could be considered battery. This is one thing that I was taught while employed at Newman's. However not everyone respects that. If they insist, tell them that it is your right to refuse and then take it up with your doctor. If you have a child admitted, please stay with that child. Some nurses and lab go to whatever measures they have to to obtain an IV site and blood specimen.
Posted by jayhawker (anonymous) on May 7, 2008 at 9:33 p.m. (Suggest removal)
It is obvious that there is a problem at NRH. Now it is up to the governing body, by enlisting outside assistance, to fix it, post haste. The administration cannot be relied upon to police itself - that is not fair to the administration, the board, the staff or the patients. Talk is out everywhere that NRH is not a place to send your loved ones. We need to not only keep our hospital, but to restore its good reputation in the interest of medical recruitment, economic development and, especially, for good patient care. Time is of the essence.
Posted by create (anonymous) on May 8, 2008 at 6:56 a.m. (Suggest removal)
I agree with Jayhawker; time is of the essence. This whole thing scares me and is about to convince me to go elsewhere if I ever need medical care. We need an outside entity to investigate while the current administration stands down. How can we possibly recruit good doctors to our community while something like this is going on? I assure you, unsettling news like this is already beyond the community.
Posted by slvrnblck (anonymous) on May 8, 2008 at 11:22 a.m. (Suggest removal)
"It is obvious that there is a problem at NRH. " Posted by jayhawker
I have to say that the "problem" at NRH is no different than the problems that any other hospital or business has. There is a disagreement between an employee, if you will, and management. I know that Dr. Barnett is not an employee of the hospital but he does part of his business there.
Dr. Barnett chose to speak very publically about the issues he had with the hospital. While, I do not think that was the best choice, it is what he chose to do, and by doing so, he has made this the topic of the hour for all of the online experts.
I wonder how many people out there have never had any conflict with their employer or got upset that things weren't going in the direction that they had envisioned? This is a common occurence. Most people do not speak up in the way that Dr. Barnett did by going public and I would guess that few do even to their own management. In Barnett's case, he is in a unique position to speak up about management and still not have to worry about where his next paycheck is coming from.
On another note, the care at NRH is no different than you would receive anywhere else. There are good experiences and bad experiences. Over the past few days I have read about a few instances where someone believed they received poor care or that their case was not diagnosed properly, or that the doctors and nurses tried many different things and couldn't figure out the correct solution so they were transferred to another hospital. The thing that I wonder about is why would we expect any different. The people working there are human, they are not God. They make educated guesses as far as the diagnosis or the treatment etc. They can not be perfect every time.
But, I digress, the point is that the "problems" at NRH are no different than ones that everyone encounters on a daily basis at their home, job or in public. They are working on their "problems" and I commend them for seeking to improve their service to the public.
Posted by anonymous1 (anonymous) on May 8, 2008 at 11:33 a.m. (Suggest removal)
The only way this whole mess is going to be resolved is to hire an independent third person to investigate not only the doctors' complaints, but also who is responsible for the $900,000 hospital loss.
Posted by anonymous1 (anonymous) on May 8, 2008 at 11:36 a.m. (Suggest removal)
Has Fred Harder or anyone else from the hospital's Board of Trustees personally talked to ALL of the doctors who have left, like Dr. Kosko, Dr. Amend, Dr. Lloyd, about why they left? I'm not talking about getting a rubber stamped report from the hospital administration, I'm talking about personally speaking to the doctors to find out all of the reasons they chose to leave Emporia.
Posted by anonymous08 (anonymous) on May 8, 2008 at 11:54 a.m. (Suggest removal)
The administration needs to pay attention to the complaints they get. It is very important information or do you like being sued over malpractice cause a lot of it goes on. Personally I don't think I would go to NRH becuase of all of the bad experiences personally not just on me but also members of my family I just about lost my grandmother they gave her insulin before she had a test done and she told the nurse no to give it to her because she won't be able to eat right away well good thing I called not long after the test because we just about lost her I had to call the nurses station to get someone to her room to check on her and by the time I got to NRH the nurse said good thing you called or we would of had a big problem well when my grandmother finally came to the nurse that was saying all of this to me is the one who gave her the insulin. Well you know what I complained and she complained do you thing anything happened NOOO and that nurse is going on to become an RN. Do you not evaluate your staff. How many people have died at NRH because of things like this. If the administration does not listen to the patient or family complaints then how can you run a hospital. After all of the things that have happen to our family we will not be back to the quack shack we will take our chance driving somewhere else.
Posted by slvrnblck (anonymous) on May 8, 2008 at 12:05 p.m. (Suggest removal)
anonymous08
may I ask who brought your issue up to and how you went about filing a complaint?
Posted by anonymous08 (anonymous) on May 8, 2008 at 1:21 p.m. (Suggest removal)
My grandmother complained to the other nurses and no one would listen to her she did tell both of her doctors but i don't know what they did. I filed a complaint to the person who is in charge of the nurses. But i also had a incident with our son who was in hospital for observation well i did the observing i had to tell the nurses when to give him tylenol cause he was running a fever. we stayed at the hospital for 10hrs and not once did the dr that we had at the time come to the hospital. I had to demand that we wanted to go home cause if i would of just left my insurance would not of paid for the observation I could of done all of that at home.
Posted by slvrnblck (anonymous) on May 8, 2008 at 2:44 p.m. (Suggest removal)
There is a dept at the hospital that handles all patient complaints.
I would assume that they have very little say over what the doctors do because as we all know they are not employed by the hospital and kind of do their own thing, they would have direct influence over the nursing staff and I know they take it very seriously.
I had a friend who was in the hospital who had a poor experience with a nurse. She contacted the quality dept, I believe that is what it is called, and stated that she had a problem. The quality person came right up to her room took her information and sat down and listened to her needs. I have very little doubt that it was addressed with the nurse and rest of the staff. I believe they take every situation very seriously no matter how big or little it may seem.
Posted by anonymous1 (anonymous) on May 8, 2008 at 3:27 p.m. (Suggest removal)
skrbvkcj:
Do you know if it is regular hospital policy to advise patients and family members -- presumably upon admittance -- that if they have any problems, complaints, etc. during or about their stay at the hospital, whether with nurses, doctors, etc., that they can contact the quality department, told where the department is in the hospital, what the telephone number is and who to speak to?
Posted by anonymous1 (anonymous) on May 8, 2008 at 3:30 p.m. (Suggest removal)
Sorry the typo, that last comment was directed to "slrnblck"
Posted by slvrnblck (anonymous) on May 9, 2008 at 11:07 a.m. (Suggest removal)
Sorry, I do not know the answer to your question. But if you figure it out, it would be a good suggestion for them . :-)
Posted by orlando (anonymous) on May 9, 2008 at 1:32 p.m. (Suggest removal)
I thought the hospital had a patient advocate who can be a liaison person between the patient/family and the hospital. Also the hospital should have "how are we doing" cards like is seen in restaurants,etc. They need to know if people are unhappy. Nursing homes have a "complaint form" to fill out if someone is unhappy with something. Sounds like the hospital needs to introduce this and make it a part of the admission package. In the past, I have heard really negative comments about the ED, but this seems to be a little better with the different Ed doctors that are here now. Fortunately I haven't needed the ED or the hospital, but I hear tales(good, bad, and really bad) of all kinds from persons and their families who have used these services.
Posted by sandyestabrook (anonymous) on May 12, 2008 at 4:11 p.m. (Suggest removal)
does anyone know if Newman has a "Patient's Bill of Rights" as many other facilities do which a patient is given on admission and addresses who to contact with complaints etc.?
Posted by admireed (anonymous) on May 12, 2008 at 5:53 p.m. (Suggest removal)
http://www.newmanrh.org/nrh.nsf/View/Pat...
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