Monday, February 06, 2006
OSF: A More Controlled Rant:
A couple of posts ago, I went off on OSF St. Francis, for good reason. Those non-Irish Catholics out there may have considered my words and attitude too bitter. Perhaps it was. But Jackson’s life was at stake, and I think it was atime for some bitterness. Let me discuss OSF St. Francis Medical Center in a more considered fashion.
First of all, in 2001, they fired John after he worked 13 years in the emergency department. By all accounts—co-workers, patients, satisfaction reports, awards—he was an outstanding, caring physician. He won numerous awards for his teaching of med students and residents. This excellence was recognized by many, including administrators involved in his firing, one of whom brought his son to the ED and asked for John to put in his stitches.People wanted John to be their doctor because he’s good and they know he cares. His skill has come from decades of intensive studying combined with a touch that I think he was born with. When he was a resident, one of his attending doctors called him “the best diagnostician in Peoria.”
So why was such a good doctor, who incidentally is a devout Catholic who completely takes the mission statements of the Sisters to heart—-he still carries a card with the mission statement printed on it around in his wallet—fired? John was always agitating for change in the ED; he wanted things to improve for the patients. The satisfaction rate for the ED was only 33 percent. His agitation culminated in a letter to the hospital administrator,Keith Steffen, in which he discussed his concerns about a shortage of beds for emergency room patients. The night before he wrote the letter, some of his patients had discharged themselves because they were tired of waiting. John offered to meet with Mr. Steffen to discuss ways that the situation might be improved. John copied his supervisors, including Drs. George Hevesey and Rick Miller on this letter.
This letter resulted in John being placed on probation. A little over three months later, he was fired. Lots of ugliness was directed by hospital administrators at John between the letter and his firing. Many big institutions and systems resist change, even if the change is positive. John’s only desire was to improve the functioning of the ED and the hospital. People in responsible positions weren’t interested in this—maybe it would create more work for them, perhaps they didn’t like the problems they were responsible for being pointed out, emergency dept. patients aren’t the highest priority.
Lots of people are unjustly fired; they go on about their lives. Physicians have left Peoria because of things OSF has done, like close their mental health unit. It helps to understand that John cares about St. Francis in a way that few of us—at least me—have cared about their work places. He loves St.Francis. These feelings began when he worked there as an orderly when he was 18. In his last year of med school, the only place he listed as a residency choice was, you guessed it, St. Francis. While he worked there, he loved it.He felt that practicing medicine in a Catholic hospital allowed him to align his work with his religious values. Being an emergency room doctor also gave him the flexibility to spend part of the year working in Haiti. He also loved teaching the residents and med students. John is always interested in learning and improving, another trait that makes him such a good physician.
Despite the words of Chris Lofgren at the time of John’s firing that the hospital’s support of Haitian Hearts would continue, such was not the case.Less than a year later, the hospital withdrew support from HH claiming the program owed them a lot of money. People who volunteered for HH raised well over $1,000,000 that went directly to OSF to pay for Haitian children’s medical care. Almost a half million was raised during the year OSF discontinued its support.
OSF can do what it wants. It can discontinue a program and no one can force them to continue. But we can point out the moral discrepancies in their behavior. They are supposed to be a Catholic hospital. If they aren’t going to consider caring for new Haitian patients, don’t they have some kind of moral obligation to care for those pathetically poor Haitians who have already been their patients?
In the case of Jackson, his mitral valve that had been repaired at OSF now needed to be replaced. This diagnosis was made in May 2005. John notified OSF and asked them to accept Jackson as a patient. He offered OSF$10,000 for Jackson’s care. OSF refused. In December, when Jackson was so critically ill, John upped the offer to $20,000. A company would donate the heart valve, as they have in other cases. HH is not swimming in money; we have under $50,000 in our account with much of that money earmarked for patients less critically ill than Jackson who have been accepted at other hospitals. What kind of a Catholic hospital turns its back on poor Haitians who were once its patients? Jackson would have had a much better chance at life in May. Furthermore, it is difficult to find hospitals willing to operate on Haitian children who were operated on at another hospital.
OSF would say that they no longer want to work with John because of his efforts to point out the flaws of the hospital, regarding HH and its role in the emergency response services in Peoria. But shouldn’t their concern be Jackson, their poor, Haitian patient? In my opinion, Jackson died in part because OSF refused to accept him. And I believe they had a moral obligation to do so.
So again, what kind of Catholic hospital fires a doctor like John, discontinues a program like Haitian Hearts, a program, which by the way,benefited the hospital with excellent PR and patients who taught medical staff an enormous amount, and refuses a former patient like Jackson? What kind of a Catholic hospital? A nominally Catholic hospital. This phenomenon is not limited to OSF. Across the country, Catholic hospitals that were formerly run by Catholic sisters have been taken over by large companies and secular administrators. These hospitals have become so large and complicated to run that the religious orders have largely ceded control of the institutions to people who might not have the mission uppermost in their minds—or anywhere in their minds, except in complying with the law and garnering good publicity. This has happened at OSF in what I believe is a particularly toxic fashion.
Part of the problem is how large OSF is and how much power it wields in Peoria and Illinois. It is a $1.6 billion organization and the second largest employer in Peoria. People are very hesitant to be critical of them. And without naming names, part of the problem is some of the people they have in key positions. Another part of the problem is the large salaries that the administrators receive. Having attended Catholic schools and worked at a Catholic social agency, I have spent a lot of time thinking about what makes an organization Catholic. Is it a crucifix hanging in each room? Retreats during which the life of St. Francis is described? These are nice, but mere window dressing. I am convinced that an integral part of what makes an organization Catholic is sacrifice, even sacrifice that hurts. Where is there any evidence of sacrifice at St. Francis? Do employees make less money there?Are their poor patients treated as well as or better than rich patients? Do those in charge act like servant leaders, as Jesus did? Is ethical behavior on the part of employees encouraged and supported? How is OSF any different than its secular counterparts? I don’t think that it is, except where the law compels it to be.
I tell John that OSF isn’t the place he thought it was. But he knows there is much that is good at OSF. He is sad to see the place railroaded by a few who don’t have patients and the mission as their first interests. We can’t force OSF to change; it is too big and too powerful and others would have to join the effort. But we can continue to point out where they fall morally short. We can and will continue speaking truth to power.
Jackson shouldn’t have died.
posted by Maria Carroll @ 6:48 AM
On February 4, 2006 OSF had a bioethics seminar that I attended in Peoria. The following is a report of the seminar:
Catholic Bioethics Seminar–February, 2006
On Saturday, February 4, 2006, a Catholic Bioethics Seminar was held at St. Sharbel’s Church in Peoria, Il. The key note speakers were Father Michael Bliss, Dr. Gerald McShane, and Joe Piccione.
Father Bliss is OSF’s chaplain and a member of the ethics committee at OSF. Dr. McShane is employed at OSF Corporate and is Chair of OSF Ethics Committee. Joe Piccione is the OSF Corporate Ethicist, a lawyer, and philosopher.
Father Bliss gave the first talk. His comments included that “medical ethics is doing good for people in a good way”, “we need to recognize the patient’s dignity and realize the greatest good for the patient”, and that oral contraceptives can, at times, “bring about death”. Father held up a pamphlet describing the ethical and religious directives of the bishops and stated it was very good and easy to read. I happened to have my own copy with me at the seminar that I brought with me.
When Father was done speaking, he asked if there were any questions from the audience. I raised my hand and stated that Haitian Hearts had buried a patient one week prior who had been refused by OSF, and I wanted to know why and how we can avoid this “problem” in the future. Well, Father Bliss would have none of this and cut me off mid question and stated that he would not answer my questions and had no comments. I told him that I thought it was his responsibility to tell the public why OSF had abandoned this young Haitian man (Jackson Jean-Baptiste). He said “no further comment” and that Bishop Jenky had dealt with this problem in the past. That was it. He obviously did not want the crowd to hear my questions or comments and what was he going to say that could possibly defend OSF’s actions and went against the ethical directives of the US bishops. He was in a losing position and knew it.
The next speaker was Dr. McShane. He gave a talk on doctor-patient relationships and said that this relationship is fundamental. He had a nice but very simple handout. Compassion and caring is key. He referred to himself as a good physician. His handout referred to the emotional, physical, and spiritual needs of the patient. His handout went on and on. Dr. McShane’s voice was shaky and nervous. He stated half way through his speech that “John Carroll will probably have some questions for me”.
When Dr. McShane was done with his pitch, he asked if there were questions and looked at me. I again raised my hand and told him that his words were beautiful but that OSF had acted the opposite with regards to my dead Haitian patient and I wanted to know why. To my surprise, Dr. McShane stated that he would not answer my question regarding the deceased Haitian that was refused care at OSF. He told the crowd that I was bringing up this topic “every six months”. Dr. McShane is paid a huge salary by OSF Corporate to give these talks and he is very grateful for the generosity of the Sisters.
Their was a panel discussion that followed and a question was asked regarding birth control pills being prescribed by a Catholic medical center. Dr. McShane stated that it would be “sinful” to use the pill as an oral contraceptive. Joe Piccione shook his head "yes". I asked, at that point, why Joe Piccione had come to Peoria in 1993 to help establish a protocol so OSF physicians and the OSF Health Plan could offer oral contraceptives and sterilization. I had the newspaper article in my hand that described what Piccione and our previous bishop and the OSF Sisters had developed last decade regarding oral contraceptives and sterilization. Piccione tried to defend his actions and stated that Bishop Meyers agreed with him as does Bishop Jenky and actually Pope Benedict would be in agreement with OSF’s stand on birth control pills and their allocation. Piccione was really reaching when he said that the Pope would be in agreement. I asked Joe if it was about money and he replied “no”. However, I held up the PJS article where he was quoted about the need for oral contraceptives if OSF was to stay competitive in the health care field. Joe seemed to be at conflict with his statements a decade before. At that point the priest who was moderator became quite angry with me and told me that I could not ask any more questions. This poor priest is a parish priest at St. Sharbel’s and probably was worried that OSF would be upset with him if the speakers were made to look too hypocritical.
So that was that. The bioethics seminar was very elementary and misleading to the public and some of the crowd went away confused. I am also sure that most people there would have sided with the ethicists because my questions and comments were pointing out things that the crowd wouldn’t think were possible at OSF with the Bishop and even the Pope supporting. Good people, like the crowd at St. Sharbel’s, want to believe that their Catholic leaders are leading them in the correct moral direction. This is such a shame and emblematic of the horrible situation in which the Catholic Church in the United States finds itself today.
In May, 2006, we went to Haiti again. Fautina Jacques was operated at OSF in the 90's at OSF. She desperately needs to come back for surgery. Please see letter below and Faustina's picture
Date: Sun May 14 06:57:18 2006
From: "John Carroll, MD"
To: email@example.com,keith steffen,paulkramer,doug marshall
gerald mcshane,joe piccione
Subject: Faustina Jacques
May 13, 2006
Dear Sister Judith Ann, Bishop Jenky, Keith, Paul, Doug, Gerry, and Joe,
We are back in Haiti and need your help.
Last year I e mailed you a few times regarding Faustina Jacques. Faustina
is 13 years old and was operated at OSF in the late 90’s for rheumatic
heart disease. When I examined her last September, she was quite sick. I
put her on medications to control her heart rate and tried to dry up her
lungs from congestive heart failure. Her echocardiogram reveals that her
mitral valve is stenotic and needs repeat surgery.
She improved fairly dramatically with the medicines and looked much better
in December. We were disappointed not to hear from all of you regarding
this sick girl last year, but we were able to find a medical center to
accept her at no charge.
Today she and her mom showed up and she is quite ill. She lives about 2
hours by public transportation from where we are in the capital. She is in
congestive heart failure and breathing fast. She can't walk well and lives
a long ways away. So we decided to keep her with us in the same room we
cared for Jackson Jean-Baptiste in December. She is too unstable to return
to her home. I need to control her heart rate and clear up some of her
If Faustina turns the corner, we will get on the plane and fly back to
Peoria on Thursday. If she needs help once we arruve in Peoria, can I
count on you and OSF to take care of her if we need to use the emergency
department or hospital for her care before her heart surgery? Once she
improves, we could move her to the hospital where her surgery will be
performed. We cannot offer OSF any money for her care at this point, but
we have heard OSF say many times that you refuse no one and take care of
everyone with the greatest care and love.
Her host family in the Peoria area is hoping for the very best for
Please pray for Faustina that she will improve and make the trip to Peoria
I will wait to hear from you.