Cleveland primary care doctors fired for lack of "productivity"

[eridani]

Physicians for a National Health Program
April 29, 2010


Dear PNHP board members and activists,


We're writing to call your attention to an extremely significant event in the Cleveland area, which is sadly an increasingly frequent experience of physicians working for corporate entities.

Dr. George Randt and his colleague are board-certified internists who have had a contractual relationship with St. John Medical Center covering some 2,500 patients for several years. These two doctors have excellent records with the hospital, high patient satisfaction and retention rates, and have never had an unfavorable review. Both were awarded bonuses in 2009, and Dr. Randt's contract was renewed in January of this year.

This past month they were notified by the president of their hospital, Mr. Cliff Coker, that their contracts were being terminated due to lack of productivity and their having incurred excessive overhead expense. In other words, they weren't sufficiently profit-driven. At a previous staff meeting, the staff physicians were told by the CFO to admit just "one more Medicare patient a month" to improve hospital revenues.

If you can, please join Dr. Randt, his patients, and others at a rally at St. John Medical Center, 29000 Center Ridge Road, Westlake, Ohio, this Sunday, May 2, at 1:00 p.m. to call for the reinstatement of these two physicians and for the elimination of policies which are justified solely on the basis of maximizing the profits of a health care system. Speakers at the rally include PNHP's congressional fellow, Dr. Margaret Flowers, and Dr. Carol Paris. (See the press release below for more information.)

Call Mr. Cliff Coker today and demand that these physicians be reinstated to their position. His office number is [phone]. He can also be reached by e-mailing [email protected]

We welcome you to share your views that patients should come before profits with the newspapers in the area by writing a letter to the editor to the The Plain Dealer or Sun News.

Dismissing these physicians without cause, merely to maximize hospital revenues, is the embodiment of the derangement of our system of health care finance. This was done without any semblance of due process. The livelihood and status of skilled professionals are being sacrificed to assure profitability; this is rapidly becoming the norm within our profit-driven system. As a result, it poses the gravest threat to professionalism and patient primacy. These issues would be greatly alleviated under a single-payer health financing system that places value on health outcomes, continuity of care, and quality.

Please join us in calling for the reinstatement of Dr. Randt, a longtime PNHP member, and his colleague and an end to health care practices that place the goals of profitability over the care of patients.


Health care for all,

Quentin Young, M.D.
National Coordinator, PNHP

Johnathon Ross, M.D.
Past-president, PNHP
State Coordinator, PNHP Ohio


------------------------------------------------------------------------

Patients, physicians and health care activists to protest St. John Medical Center's plans to eliminate primary care practices

Cuts would leave 2,500 patients without their trusted primary care physician

Contacts:
Drew Smith, Mobilize Ohio Movement, [email protected]
Heather Ives, [email protected]

WESTLAKE - Patients, health care professionals, and area residents will gather across the street from St. John Medical Center next Sunday to protest the sudden closure of two primary care practices that have served the community for over two decades.

Two primary care physicians, including George Randt, M.D., were told on April 1 by the president of St. John Medical Center, Cliff Coker, that their employment contracts with Cuyahoga Physicians Network at the St. John West Shore Hospital were being terminated and that they will be laid off effective April 30 because they were not productive enough.

The decision made by St. John Medical Center to sever the relationship between approximately 2,500 patients and their primary care physicians will have unforeseen consequences for both patient and physician alike, and may have negative consequences due to the loss of the patients' established medical homes. Many of the affected patients have been cared for by the same physician for over 20 years.

"Several months ago, at a staff meeting, the CFO of St. John's told all of the physicians attending that the hospital could make a profit if the physicians would admit just one more Medicare patient a month," said Randt, who left the meeting questioning the moral justification and legal propriety of this request.

Randt said many of his patients have signed petitions, written letters and made phone calls to St. John's executive officers demanding a reversal of the decision with no response.

Dr. Margaret Flowers, congressional fellow for the Physicians for a National Health Program, a group that favors a single-payer, Medicare-for-All health system, will speak at the May 2 event. Referring to the proposed layoffs, she said, "This is what happens under our current fractured, money-driven system of health care financing. Doctors are required to see increasing numbers of patients and spend less time with them. "

The most common way hospital executives measure physician productivity is the number of patients they see each hour, Flowers said, although some executives have been known to criticize doctors for not ordering a sufficient number of tests, even though such tests may not be medically warranted.

Flowers is one of the speakers attending the rally. Her colleague Dr. Carol Paris will be in attendance too. Invitations have also gone out to all of the patients who will be losing their medical home, as well as citizens throughout the area and legislators.

"What St. John's board is doing is unacceptable," said Drew Smith of the Mobilize Ohio Movement, the group that is planning the rally. "To leave 2,500 patients medically homeless because some don't believe that primary care is profitable enough goes against everything in the hospital's mission statement. It's a terrible blow to the physician-patient relationship. These primary care practices should be reinstated immediately."

Smith added: "If we had a single, comprehensive health plan for everyone, which spent more money on providing care and less on administrative overhead, we wouldn't be facing this kind of situation."

The Mobilize Ohio Movement supports House Bill 159 (The Health Care for All Ohioans Act), which would establish a single-payer, Medicare-style health plan for all residents of Ohio from birth to death, with no out-of-pocket expenses, and would strive to ensure that every patient has a primary care physician.

St. John sent a letter out to all of the patients of the primary care practices dated April 19 stating their personal physicians would no longer be able to see them as of the end of the month. The letter failed to mention that the hospital was closing the practices for financial reasons.

For more information:
Mobilize Ohio Movement, www.mobilizeohio.org
SPAN-Ohio, www.spanohio.org
Physicians for a National Health Program, www.pnhp.org
Healthcare-Now, www.healthcare-now.org

Physicians for a National Health Program
29 E Madison Suite 602, Chicago, IL 60602
Phone [phone] | Fax: [phone]
www.pnhp.org | info {at} pnhp.org
© PNHP 2010

[POAS]

1. Medicine for profit is ghoulish. n/t

[corpseratemedia]

2. I noted that in the future the privatization model will be eliminating physicians' jobs

..and perhaps replacing them with lower-salaried PAs (if they "can't" find drs. who will be as profitiable was they want, lol).

But to make sure that profit is maximized, to get the lowest paid PA with the least costly accountability, watch how H1-B visas rise to substitute for any American citizen who would want and (is qualified for) that PA position.



Corporate gekko-think is destructive to healthcare and education and those who work directly in those fields.



For now, one man and his free-market hallucinations have "freed" thousands from their needed medical care.

[hobbit709]

3. I hope these two hang up their shingle somewhere

and EVERY ONE of their patients at that place leaves to follow them. Let's see how that affects the corporate bottom line.

[Lochloosa]

4. the staff physicians were told by the CFO to admit just "one more Medicare patient a month"

So let me get this straight. They were told to commit Medicare Fraud or lose their jobs? Nice choice.

[proudohioan]

5. As another poster put it; goulish!!!!

Thanks for posting; I am considering attending the rally.

[eridani]

6. Please do. And if you can't alert your friends n/t

[proudohioan]

7. This is important, because I don't want doctors going the way of pharmacists....

My feeling is that the only way the drug industry has been able to flourish as it has is by opening up tons of Walgreen's and CVS's on every street corner (ever notice that trend in the past several years?). But if you want to remain "competitive", ie rich beyond your wildest dreams, you can't pay pharmacists typical pharmacist salaries, nor treat them like professionals, but more like factory workers in a button factory. So a new title was created, "pharmacy tech", which utilizes the production aspect of medicine, rather than the professional aspect.

These pharmacy techs are not highly paid; on the contrary, the starting pay is maybe slightly above minimum wage. There is no real career path for them, as you cannot take apprenticeship or work your way up to being a pharmacist; you still do need extensive post-secondary education to become one.
A girlfriend of mine had been unemployed for over a year, and having no success with finding a job, out of desperation, she applied for a "career" as a Pharmacy Tech at a local Walgreen's. According to her, she started out at $9 per hour, with the promise of earning a whole $10 per hour after working for a 6 month time period and taking a brief training class and passing a test. She stated that she was really a glorified retail clerk/cashier, working her ass off with bizarre hours/shifts, as well as being sent to other stores to "cover" other workers who had not showed up for their shifts. She lasted all of 6 months before quitting. To me, that is a sad state of our society.

Mistakes are often made when we practice medicine from a production point of view, and I feel that this is a very dangerous trend, with some very real and potentially deadly consequences. As well as undermining an entire profession.

I hope that you will be attending this rally as well.

Again, thanks for the info, as I had no idea about the event.

T.

:)

[eridani]

9. I would if I didn't live in Seattle! n/t

[proudohioan]

14. Well, that's nice of you to post something about Cleveland anyhow!

I hope that you don't have similar scenario's in Seattle!

:hi:

[WCGreen]

11. But you forget that in the old days, there was a pharmacy in every

neighborhood.

When I was a kid growing up in Lakewood, Ohio, a short ten miles from St. John's in Westlake, there was a drug store within walking distance. In fact, at one time, there were almost as many drug stores as there were Taverns or Churches in Lakewood.


BTW, I live in Westlake now and there are only 7 drug stores serving almost 45k people...

It just looks like there are more because they advertise much more than they did in the 50's and 60's...

St. John's just went from a Hospital attached to an order of nuns into a for profit enterprise.

[proudohioan]

13. No, I think there are more pharmacies....

because when I was a kid, there were no pharmacies in grocery and discount stores. When I lived in Mayfield Hts, there were 2 CVS's (within a mile of each other), 2 Walgreen's (3, if you count the one on the Mayfield-Lyndhurst border), and a Rite-Aid, in addition to the Giant Eagle, Walmart, Marc's and Target. Hillcrest Hospital also had its own pharmacy for patients (which makes sense). Mayfield Hts. is really not very big.

I do remember at least one pharmacy in each neighborhood, but they were never in grocery stores and discount stores. Maybe it is just more advertising, but we did all kind of wonder, when building the second Walgreen's and the Rite-Aid, why the heck do we need another pharmacy?

[WCGreen]

15. But there are more people in he area...

I'm talking back in the 60's when Rex-all and Leader Drug were the main franchises and then there were all the independent mom and pop shops. There were probably on pharmacist for every 2,000 people.

Here in Westlake now there is Drug Mart, Giant Eagle, CVS, Walgreen's, Rite Aid and Marc's plus Olighers in North Olmsted that Delivers. Of course there are several hospitals in the area so that counts for maybe three more. So a city with about 46k has less than 10 pharmacies...

That's all I am saying.

[proudohioan]

16. Yes, I see what you are saying.

I do remember all the independent mom & pop shops. Maybe they just didn't seem to be as "in your face" as they do now?? I don't know, but Mayfield Hts. has less than half of the population of Westlake (per 2000 census, anyhow), and it just seems that there were a whole lot of pharmacies for that small of an area/population. On the plus side, there was rarely any waiting at the cash registers or long lines at the pharmacy station, which was nice. If there were only as many grocery stores.....now THAT would be nice!

My original point was actually about the trend towards utilizing pharmacy techs as opposed to pharmacists, and the whole medical "assembly line" mentality, but I see what you mean about pharmacies. I think it just depends on the particular area. I moved to Euclid last July, which is more than twice the size/population as Mayfield Hts, and there are not nearly as many pharmacies. When I lived in Lakewood, CO, it was pretty much the same as Mayfield Hts; 2 pharmacies on every corner (and about the same amount of liquor stores as well - ha ha!)

:)

[newtothegame]

8. We'll see more of this. Government payer rates are so anemic, even high productivity can't save...

clinics/hospitals everywhere from shutting down.

[eridani]

10. In other parts of the world, the government exercises price controls

In 1996, my husband had the first stage of a root canal for 100 guilders in Gronigen, or $25 American at the time. There was a nice German car in the dentist's reserved spot, so he couldn't have been hurting much.

[Odin2005]

12. This is so evil.

:grr: