Showing posts sorted by relevance for query Florida. Sort by date Show all posts
Showing posts sorted by relevance for query Florida. Sort by date Show all posts

Friday, August 11, 2023

FEEL FOR FUTURE, FACE THE PAST - Dr. Jim Glisson Sponsors Florida's and America's First Dr. Martin Luther King Jr. Day


    James A. Glisson was a chiropractor and state legislator in Florida. Glisson was born in Jackson County, Florida. He attended Palmer College and earned a degree in chiropractic studies He served in the Florida House of Representatives for the 33rd district from 1968 to 1972, as a Republican. Not re-elected the year racist Sheriff Willis V. McCall was dethroned by the Federal Government and I had to leave our town, Eustis, Florida where the Sheriff and I lived. Dr. Glisson's family lived more towards Umatilla, and the Golf Course the neighbor intelligent, imported, California Redneck kid thought cute to say I'd never be a member of. Last looked he regurfitatesin enough money in the non-paying tax suburbs most of Florida's cities probably contend with uin the manner of HONKIES not facing how disgusting they alway were. MOST OFFENSIVE? Not wanting relate to my statement BLACKS forgave long ago and those unable to rise from racist roots think that's not a good enough explanation for a hopeless soul and souls who run around paying themselves well to avoid ALL responsibility for the blame. Meaning your sister knew long ago you're just crap Scott. Many people hid their hating me much better than you but that you were so self-centered does give me satisfaction. I have to learnt fish on your boat so my time's more abused in Sanford. Probably knows Elizabeth's Penny as they seemingly loved notpaying a civic tax to Eustis from their neighborhood. 
    State you don't understand De Santis is worse than TRUMP now then face your own fates for thinking just enough RACISM is swell. NO GO RUN AND HIDE OR anything. I've released ya'll to your ____s.

Martin Luther King Jr. in Florida: Where he stayed, where he spoke, and where he was shot at January 20, 2023 C. A. Bridges 
The Daytona Beach News-Journal



    Reverend Abernathy and Dr. King's work in St. Augustine and Jacksonville. I thinkI forgot to mention to Dr. Glisson on the Ferran Park bench that Eustis High School's Coach Oscar Willis was there to greet both me and Dr. Abernathy when we arrived for the University of Florida speaking engagement where Dr. Abernathy shook hands and talked afterward. Watched over by Coach Willis who'd taken Dr. Abernathy aside and reminded him they'd worked together in Jacksonville. Something I didn't recall tallow is the three offs went in together. Thanks Coach ... 
    This is why the following fiction happened because I had to face myself and Dr. Abernathy's helping hand(S).
     I met someone once who wondered if anyone has a real choice the way something fell in his lap. I said, "Happy Holidays" as we shook hands across what he called my "well-appointed desk."
     My meteoric career had only just begun. But his comment confirmed he'd probably never exchanged compliments across any level of executive's desk before. Slightly amusing me so I interviewed him with interest in his life because there was no pressure. I already knew I wasn't giving him any job. 
     His spur-of-the-moment suit didn't fit as he'd apparently neglected an even short inspection by the executive who'd recommended he fill our equal-opportunity quota of dead-beat white guys. I repeated it to myself like a mantra. I'm not giving him any job. But the form had to be filled out straight from the potential hiree's mouth, so to speak. Regulations can trump custom sometimes.
     I was also curious if there was a real reason for Herb's recommendation. Because the story around the office was he was caught walking the halls unescorted. Supposedly looking for Herb. But our receptionist said she had just stepped away for a moment. A real scene. Eileen was offended and confronted the messenger about his not waiting at the front desk at all. Taking extreme liberty. There was yelling about calling security. Then Herb came back, smiling as always, and recognized the package and courier and covered with "the smart-aleck" was just mimicking him. While the lawyers got their kick out of the commotion, laughing in their stern, consistently ticking, billable hours way. 
     Consequently companies remember how money disappears. Even our president had to be told about that lost half-hour. So it was a little shock when Herb recommended for our mailroom, this particular bike messenger. Who probably cut his own hair and shaved as if it didn't matter. And sat forward in his seat complimenting my "well appointed desk" and effusively thanking me "for this opportunity." 
     Everyone's polite in interviews. I said, "You're welcome. Everyone has something to offer. So. Let's find out what you're capable of here." I soon raised my eyes from his application asking, "You graduated high school, but left college without graduating? It appears you stayed long enough. Five years? Why didn't you finish?"
     He said, "It sounds arrogant."
     Which made me smile, so I said, "Then tell me, by all means. Arrogance is business' most interesting part." 
     He officially stopped smiling and said, "Well. I always wanted to be an historian. But at the precipice, from my student's perspective, professors are required to periodically publish quality which is daunting. When I learned I wanted to write something like Russia's Nineteenth Century novelists who influenced the revolutionary Twentieth Century." 
     I wanted to say uh huh. But in my position said, "Intriguing. And how is that project working out?" 
     He shrugged and there's a lesson. Even if it's your answer, don't shrug your shoulders in a job interview.   
     I said, "Let's move on. I see you've been a bike messenger for a decade?"
     "Courier," he said.
     I said, "What's the difference?" 
     He said, "Professionally it's very significant for some people. Couriers carry packages that's commerce. While messengers carry messages people prefer not to deliver themselves."
     Maybe that's what Herb thought? He could communicate directly with messengers. Correctly citing their delivering what we didn't have to ourselves. But giving up a degree to pretend to be a Russian novelist? It was doubtful he could communicate with anyone. Because so far his only duty was to impress me and he'd failed, miserably. Plus since I'd pre-judged him unsuitable anyway, I was ready for him to leave and cut the interview short. I said, "You've been with three courier companies. Any reason to fire you?"
     He just grinned without volunteering an answer. I said, "Something amusing?"
     He said, "Yes and no. What happened scared the crap out of me. So technically it wasn't amusing and I wasn't actually fired. Technically."
     Relating I asked what the technicality was so his review of me would be I was polite. But, seeing nothing in his application, I said, "This is just conversation to learn from. Companies hiring and firing aren't often born of incidents." I wondered if he caught I meant his interview was a lark? 
     But he ignored me, reflecting, then just started in. "In 1986 I was technically fired," he said. "A dislocated disc in my back probably irritated me and I forgot I was asked a few months before to make sure this specific delivery went smoothly without a hitch."
     So the applicant was giving me a story when I distinctly just asked for an explanation. Then he just stared over my shoulder out my window. Ignoring my whole facial expression telling him to just wrap it up. His commitment was to explaining in my office what seemed to gain steam from his staring harder out the window as if his listening was as important as mine. 
     He said, "I'd made my central location an area of Madison Avenue in the vicinity of Rockefeller Center at 49th Street. Lately I wait for work at the New York Public Library at 40th and Fifth. But back then, 49th and Madison was my spot. Tragically I liked carrying this particular company's correspondence. The telephone in the lobby of their office building is an art installation and the company is The Carnegie Corporation, no less. The philanthropy built by the fortune of Andrew Carnegie who practiced the policy of paying workers less, when he could afford more, because workers would just drink more alcohol to their detriment. In retrospect not really what expanding capitalism is about. But the benevolent Carnegie Corporation has contributed to bettering discrepancies. I got to ride the elevator from their floor to the first, alone with the famous journalist Charlayne Hunter-Gault. I embarrassingly asked if she was really herself and she said she was and pronounced her name and, well, it really was a very nice introduction." 
     I was waving both a pencil and pen, ready to be rude too and intrude. 
     He said, "It was morning. I'm hanging around not making money because my back is bad. If you can't keep the pace no one is giving you money. So I'm no smooth operator but the beeper beeps and I'm given this special delivery and right away I lose it thinking some big deal dropped in my lap. My dispatcher asked if I was clear about what I was doing." 
     He sighed but still beat me to speaking and said, "I told the dispatcher Michael, 'Yes, I was clear.' But really, I somehow forgot I'd been asked earlier to deliver this specific envelope without a hitchI was already there waiting so I took time to write a poem to where the envelope was going. The sanctioned country of South Africa did not have a Permanent Mission to the United Nations then. But they had an office on 46th Street between First and Second Avenues. A nice building I guess they sold because the South African Mission is on East 38th Street near First Avenue now. 
     "When I picked up the package from The Carnegie Corporation, the African-American woman I received the package from, second-guessed sending it with me because I said something about doing the right thing. But I reassured her and I don't think I was lying telling her it would be okay, nothing would go wrong."  
     He saw me look at my watch and continued as if the clouds outside were all he needed following him. He said, "Well, apartheid like religious war are bad traditionsI wrote five copies of the poem before picking up from Carnegie. I walked right in South Africa's first-floor office entrance after I imagine I was buzzed in. But I don't remember that detail, except it felt like I just waltzed right in the perfectly sized Reception Area without room for requiring crowd control." 
     He smirked. "I really had no way of thinking through what I was doing. I went to the Front Desk bullet-proof partition and put the envelope in the trough with the poem on a small piece of paper. The room was how I'd thought it would be with a table lamp and couch, so I backtracked circling the room placing copies of the poem until before reaching the two chairs the powerful South African official's voice stopped me declaring, 'What is this?'
     "Unbelievable. I was just trying to seriously convey racism should end without violence. There was bounce in my step back to the window where I pleaded, 'Come on. I didn't mean to sound mean. It's just time. You just have to stop the violence.
     "He said what I did would not be taken lightly and I'd lose my job and he wouldn't take the package. I wouldn't stop smiling and he said I'd done a very bad thing interfering where I don't belong. He had me pick up the other poems while the whole time I'm apologizing for the extreme voice I used in the poem. It was the poem that made me beg. The act was supposed to be about acceptance and tolerance but the poem lacked any sentiment. I was apologizing profusely how sorry I was, please. I didn't mean to sound so mean, it's just, I said, 'I meant to emphasize how rude callous is. You have to stop the cycle of revenge.' 
     "But what I wrote was,
Black backs brought your wealth from the ground.
Black backs enabled your wealth to grow beyond profound.
Give back their ground and get out of town.
     "South Africa actually kept the package but the man at the desk promised it wouldn't be opened and I never returned to The Carnegie Corporation again. When I left the building a female and male New York City Police Officer stopped and questioned me. Patting me down they found my wide back-brace belt which caused them a short alarm. But somehow my numb smiling calmed the officers and I explained my bad back problem probably caused my frustration inside that the cops said 'happens all the time.'
     "Hence why I was asked to deliver that package without a hitch dawned on me. Knowing next I'd face my ruthless boss. No one ever yelled at me like him."
     He sighed again and said, "Everyone acted their roles and my boss didn't fire me but I've never set foot in The Carnegie Corporation again. Turned out the package was paperwork for Archbishop Desmond Tutu's visa to the United States that was a prickly issue for them in their efforts to stem worldwide sentiment. And I'd broken my boss' word. I should have recused myself. Because not only had I ridden in the elevator once with a civil rights icon, Charlayne Hunter-Gault. But when I was around maybe five years old, I was dressed up with two other guys as The Three Kings to sing the hymn before the whole church. Before while preparing our robes in our Sunday School classroom a kid in the back said I was the black one. And not only that. My home I was raised in was an African-American funeral home in a white neighborhood whose mortgage paid for my university education. And after hearing Reverend Ralph Abernathy speak at my school he stepped from the aisle down my row to shake my hand and we said some things. Apparently I forgot a lot and moved on bare instinct. Even though I had no choice I still feel a little grateful South Africa reconciled so however insignificant my interference was the dream is above sabotage." 
     Then he stood and shook my softly offered hand and walked to the door concluding, "Underneath all the publicity, history is mostly a big oh well. But how long is civilization meant to just sit on the precipice?" And left winking, singing, "Not your stepping stone." 
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Take aim beyond mere protocol President Putin, please? 
Denial's As Damaging As Racism

August 11, FEEL FOR FUTURE, FACE THE PAST - Dr. Jim Glisson Sponsors Florida's and America's First Dr. Martin Luther King Jr. Day 

Tuesday, August 7, 2012

Oh Dear, Doctors Put Profit Ahead Of Patient Care?

  Well, as a New York Times investigation reveals, it is tragic doctors can provide unnecessary billable care. But where did they learn this practice? Titling their exposé, Hospital Chain Inquiry Cited Unnecessay Cardiac Work, reporters Reed Abelson and Julie Creswell describe the problem. 
  In the summer of 2010, a troubling letter reached the chief ethics officer of the hospital giant HCA, written by a former nurse at one of the company’s hospitals in Florida. In a follow-up interview, the nurse said a doctor, at the small coastal city of Fort PierceLawnwood Regional Medical Center, performed heart procedures on patients who didn’t need them and put lives at risk.
  “It bothered me,” the nurse, C. T. Tomlinson, said in a telephone interview. “I’m a registered nurse. I care about my patients.” In less than two months, an internal investigation by HCA concluded the nurse was right. According to a confidential memo written by a company ethics officer, Stephen Johnson, and reviewed by The New York Times, “The allegations related to unnecessary procedures being performed in the cath lab are substantiated.”
  Punchline: The contract of the nurse, Mr. Tomlinson, was not renewed. A move Mr. Johnson said in the memo was in retaliation for his complaints. And no doubt The Times assessment of the ethics officer’s intent might be fairly accurate, but using the word retaliation in the memo is probably prosecutable and doubtful an ethics officer is that dumb.
  But the nurse’s complaint was far from the only evidence that unnecessary, even dangerous, procedures were taking place at some HCA hospitals, driving up costs and increasing profits.
  As noted by The Times, HCA is the largest for-profit hospital chain in the United States with 163 facilities. They uncovered evidence as far back as 2002, and as recently as late 2010, showing some cardiologists at several of its Florida hospitals were unable to justify many performed procedures. In some cases, doctors made misleading statements in medical records to make the procedures appear necessary, according to internal reports.
  Questions about medical procedures necessity, especially in cardiology, are not uncommon. None of the internal documents reviewed calculate just how many of such procedures there were or how many patients might have died or been injured as a result. But documents suggest HCA’s problems went beyond a rogue doctor or two.
  At Lawnwood, according to a confidential 2010 review, half the performed invasive diagnostic procedures known as cardiac catheterization, or 1,200, were determined to have been done on patients without significant heart disease. HCA countered recently with a different analysis, saying the percentage of patients without disease was much lower and within national averages. Seeming to contradict their uncovering improperly diagnosed shortcuts to revenue.
  Documents show at Bayonet Point, a 44-year-old man who arrived at the emergency room complaining of chest pain suffered a punctured blood vessel and a near-fatal irregular heartbeat after a doctor performed a procedure an outside expert later suggested might have been unnecessary. The man had to be revived and according to the testimony of Dr. Aaron Kugelmass in a medical hearing on the case, “They shocked him twice and got him back.”
  In another incident, an outside expert described how a woman with no significant heart disease went into cardiac arrest after a vessel was cut when a Bayonet Point cardiologist inserted a stent, a meshlike device, that opens coronary arteries. She remained hospitalized for several days, according to a person who has reviewed internal reports. Not good, but has it served a real purpose showcasing doctors as the scapegoats in the astronomical rising of medical care cost?
  On Monday morning, in an investors conference call, company executives disclosed that in July the civil division of the United States attorney’s office in Miami requested information on reviews assessing the medical necessity of interventional cardiology services provided at 10 of its hospitals, in Florida, and two or three in other states. In the conference call and in a Web site statement, the company also referred to inquiries by The Times. HCA’s stock ended nearly 4 percent lower Monday, at $25.55. But of course doctors aren’t under enough pressure as it is, so all of them should suffer for there not being a coherent bottom line.
  In a recent HCA statement, the corporation declined to provide evidence it had alerted Medicare, state Medicaid or private insurers of its findings. Or that, as required by law, the socialized entities were reimbursed for any of the procedures the company later deemed unnecessary. Accountants can count, so what’s the problem?
  The statement said, “When the company becomes aware of a situation in which we might have a reimbursement obligation, we assess, with outside resources, what our reimbursement obligations might be.” So really the actual cost of medical care is obviously distant and removed from the actual doctor/patient relationship with both helplessly lost in the customer management quagmire that no one entity such as a private enterprise or government can solve. But make a real effort, at least, of more substance than just calculating profit while ignoring how that became the only real bottom line worth striving for.
  HCA also declined to show that it had ever notified patients who might have been entitled to compensation from the hospital for any harm. While some doctors accused in the reviews of performing unnecessary procedures are still practicing at HCA hospitals, while the real problem seems to be an obvious misdiagnosis of who the real victims are?
  The cardiologists say the reviews of their work did not accurately reflect the care they provided. And HCA says the reviews “are not, by any means, definitive,” according to an e-mail company response. HCA says it took whatever steps were necessary to improve patient care. It also said “significant actions were taken to investigate areas of concern, to bring in independent reviewers, and to take action where necessary.” Get em. Sick em. How dare anyone want more compensation than our elected officials while under the Medical Industrial Complex watch?
  Details about procedures and company knowledge are contained in thousands of pages of confidential memos. E-mail correspondence among executives, transcripts from hearings and reports from outside consultants examined by The Times, as well as interviews with doctors and others. A review of those communications reveal that rather than asking whether patients had been harmed or whether regulators needed to be contacted, hospital officials asked for information on how the physicians’ activities affected the hospitals’ bottom line. Logical. Whatever else would the purpose of the financial management sector be?
  HCA denies its decisions were motivated by financial considerations, but rather to “demonstrate the strong focus we have on quality patient care.” The company also says that more than 80 percent of its hospitals are in the top 10 percent of government rankings for quality. More people, doctors or not, involved in patient care should be a good thing. No?
  Although HCA has hospitals in about 20 states from California to Virginia and Alaska to Texas, Florida, with its large older population, is a critical and growing market for hospital chains and especially for HCA. HCA’s Florida hospitals provide about 20 percent of the company’s revenue, from which the doctors honestly receive ?.
  The need to root out Medicare fraud, billing for unnecessary procedures, for example, is high for all hospitals. In 2003, Tenet Healthcare agreed to pay $54 million to settle unnecessary cardiac procedure allegations that were performed over six years and billed to Medicare and Medicaid at one of its hospitals in California, Redding Medical Center.
  But the pressure is even greater for HCA. In 2000, the company reached one of a series of settlements with the Justice Department involving a huge Medicare fraud case that eventually came to $1.7 billion in fines and repayments. The accusations, which primarily involved overbilling, occurred when Rick Scott, now the governor of Florida, was the company’s chief executive. He was removed from the post by the board but was never personally accused of wrongdoing. How could anyone atop such large structures be personally accountable for anything? It’s not the military for gosh sakes.
  As part of the settlement with the federal regulators, HCA signed a 97-page Corporate Integrity Agreement that extended through late 2008. It detailed what had to be reported to authorities and provided for stiffer penalties if HCA failed to do so. Right, the corporation won’t stand still preparing more doctors’ heads to roll.
  Michael Hirst, a former assistant United States attorney in California, who oversaw the case against Tenet, said if there were intentional violations of such an agreement, it would mean “that a defendant, already caught once defrauding the government, has apparently not changed its corporate culture.” Mr. Hirst now represents whistle-blowers. Get em. Sick em.
  In its statement, HCA said it fulfilled any obligation it had under the agreement to report “substantial overpayment.” Certainly no confusion anything comes before that stack of money. However The Times states the revelations in the documents come at a significant time in the evolution of medical treatment in the United States, from independently owned hospitals to large, corporate chains.
  HCA exemplifies the trend, and uh oh further muddling the issue, political controversy. In 2006, HCA was taken private by a group of private equity firms, including Bain Capital, co-founded by Republican presidential nominee Mitt Romney. Of course Mr. Romney by that time was no longer a Bain partner, just a dependent receiving free enterprise entitlements as everyone should know. But putting more carpenters to work, with medical coverage, should justify that. By mid-2010, the private equity owners were eager to start cashing out their investment. So HCA prepared for an initial public offering of its stock that took place in 2011, borrowing $4.3 billion to pay the private equity firms dividends. While the ability to take these financial steps hinged on HCA showing continued robust profit growth at its hospitals.
  And for that the company turned, in part, to cardiac care. As The Times titles the next section of their article, An Early Sign of Trouble stating two years after the 2000 fraud settlement, company executives uncovered problems in the cardiac catheterization lab at Cedars Medical Center, according to accounts that became public.
  An HCA hired outside consulting group provided a report that raised “questions regarding the medical necessity of some of the procedures,” the company said in a news release in early 2003. HCA said it was suspending eight physicians from doing certain cardiac procedures, and was providing the report to a United States attorney and would refund any inappropriately submitted hospital claims.
  Jack O. Bovender Jr., who was then the company’s chief executive, told investors in a conference call that February, “This issue at Cedars and the steps taken to investigate and resolve it should be seen and understood in the larger context of HCA’s commitment to quality care and patient safety.” However HCA will not say whether it had ever refunded payments for the unnecessary procedures. Medicare officials said they could not determine whether the agency had received payments, and the United States attorney’s office in Miami declined to comment. God bless transparency.
  According to HCA the hospital allowed four of the physicians to return under monitoring, and two did so. “We believe the hospital acted appropriately,” the company said in its recent statement. Still, the negative publicity swirling around Cedars worried HCA executives, according to internal e-mails. They wanted to avoid a replay when similar problems were discovered at another HCA hospital, Bayonet Point. Nestled along the west coast of Florida, about 45 miles northwest of Tampa, the town of Hudson, with its winding canals, is largely a quiet fishing community. But soon after the Cedars episode, HCA executives noticed that the hospital in Hudson, the 290-bed Regional Medical Center Bayonet Point, was implanting an unusually high number of cardiac stents, given the size of the population.
  So late in 2003, executives from HCA’s headquarters in Nashville dispatched a group that oversees its hospitals’ cardiac care to investigate. In a confidential memo, the team cited incidents at Bayonet Point where patients were treated for multiple lesions, or blockages, even when “the second lesion (or third) did not appear to have significant disease.” The team went on to note “several cases” in which patients were treated even though their arteries did not have significant blockages. Hindsight I’m sure all of us wish we could afford to keep us in line at our own jobs. And who watches the watchers exactly?
  In a transcript of confidential hearings held later, the lawyers for HCA were blunt. In looking at one physician, Dr. Sudhir Agarwal, Dr. Martin I. Kalish, a physician who served as an outside lawyer for HCA, said the “style of clinical practice leads to unnecessary procedures and unnecessary complications.” Yet who is responsible this kind of practice became seen as a shortcut to prosperity in the medical field? Weren’t oaths taken to protect customer rights at all costs? Maybe once the number involved, who’d never taken the Hippocratic Oath, was so overwhelming corruption became the major game and player in all our communities across America?
  On the team’s recommendation, HCA brought in an external company, CardioQual Associates of Franklin, Mich., in 2004 to examine medical records from Bayonet Point. In a December 2004 confidential memo reviewed by The Times, CardioQual concluded as many as 43 percent of 355 angioplasty cases, where doctors performed invasive procedures to open up a patient’s arteries, were outside reasonable and expected medical practice. Worse, the investigation revealed some physicians had indicated in medical records that the patients had blockages of 80 to 90 percent when a later, more scientific analysis of a sampling of cases revealed the blockages ranged from 33 to 53 percent.
  Cardiologists generally do not operate on any blockage less than 70 percent, said Dr. Rita Redberg, a prominent cardiologist at the University of California, San Francisco. The significant disparities between the magnitude of blockage being cited by the doctors at Bayonet Point and the CardioQual review “raises real concerns that this wasn’t just error, but it was intent” by the doctors, she said.
  After receiving the CardioQual report, Bayonet Point suspended the privileges of nine physicians in late 2004. But unlike the Cedars episode, when HCA turned over its findings to regulators and authorities, HCA took steps to withhold details of its conclusions to the media and others, according to internal communications. In January 2005, David Williams, who was then the chief executive of Bayonet Point, wrote in an e-mail: “Clearly, we have protected ourselves under the peer review umbrella and have released very little information.” The recipients of his message included Dan Miller, who then oversaw HCA’s hospitals in western Florida, and Charles R. Evans, a Nashville executive who was president of all of HCA’s hospitals on the eastern side of the country.
  In his response, Mr. Evans thanked Mr. Williams for the update and asked for a “summary as to the business impact.”
  But in a later internal communication, a representative for HCA said the company had successfully used confidentiality rules to withhold the damaging CardioQual report from the Florida attorney general, whose Medicaid Fraud Control Unit had started an investigation of the physicians. In response to questions from The Times, however, HCA said it had provided “substantially all of the information in the report” to state regulators. The attorney general’s office did not return calls seeking comment.
  One of the subjects of that investigation was Dr. Agarwal. The CardioQual review of 20 of his cases concluded fewer than half were within reasonable and expected practice. Dr. Agarwal did not return a call to his office.
  Anthony Leon, a lawyer for Dr. Agarwal and the other eight Bayonet Point physicians, said in a statement: “There is absolutely no merit to any allegation that any of these doctors were performing unnecessary procedures or performing procedures that led to unnecessary complications as a style or pattern of practice.” The suspensions of Dr. Agarwal and another physician were found to have been done in error by an outside panel in hearings in 2005 and 2006, Mr. Leon added. A doctor on the panel said Dr. Agarwal’s procedures were found to be within established medical practice, and his full privileges were reinstated in early 2006. Uh oh. Everyone has reports and findings they want to hear as business remains as per usual. As Dr. Agarwal and the other eight physicians have filed defamation lawsuits in county court, claiming the actions and statements of the hospital and HCA ruined their practices. HCA has denied the claims.
  In for the kill the last section is titled A Moneymaking Practice by The Times.
Cardiology is a lucrative business for HCA, and the profits from testing and performing heart surgeries played a critical role in the company’s bottom line in recent years. Some of HCA’s busiest Florida hospitals perform thousands of stent procedures each year. Medicare reimburses hospitals about $10,000 for a cardiac stent and about $3,000 for a diagnostic catheterization. But in recent years, doctors across the country have been less quick to implant stents, instead relying on drugs to treat blockages. Medicare has also questioned the need for patients who receive cardiac stents to stay overnight at the hospital, cutting into the profitability of the procedures at many hospitals. You just have to lovingly hate the willingness to belittle the needs of the individual patient under the system’s care.
8/7/2012
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Oh Dear, Doctors Put Profit Ahead Of Patient Care?
8/7/21012 concluded: Medicare has also questioned the need for patients who receive cardiac stents to stay overnight at the hospital, cutting into the profitability of the procedures at many hospitals. You just have to lovingly hate the willingness to belittle the needs of the individual patient under the system’s care.

October 4 - November 7, 2018
Our Noblest, Best and Brightest Compromised
  Pursuit of truth's veritably muddled, to the extent the exacting sciences have their own problems with crafted knowledge diluted to the extent the public digests little we knew even years ago. Perhaps led by the doctor patient relationship that's been clearly scattered to the winds of economic oblivion by not being, taken in hand, faced, and solved. Doctors wouldn't know how to keep prices down was one riddled excuse of a premise behind the myriadical infrastructure latched onto what's actually, supposed to be, medical care. 
  The price of everything is out of context to the consumers' actual ability to pay. Co-pay should be an out-of-pocket charge for an actual cost, and not a bill of dimensions so endlessly carved and picked apart that nothing's really to do with the health of health care. Where underutilized doctors and nurses aren't really the full focus of our huge piled up conglomerations. The relationships are with statistics and not patients with their doctors. The horror and shame of this nightmare, on everyone's shoulders, hinges on everyone's absolution from direct blame. Avoiding actual responsibility. No one can change what's been done, since the screw's in, but can't be taken out. Well then, the nightmare is just so lucrative that, however deflected, too many nonchalant people are to blame. Amnesty and fix the machine? Just because all out exploitation was where everything went, doesn't mean change has to remain the same inconclusivity.
  Files aren't patient-doctor relationships. 
-------------------------------------------------------------
Climate Change
  Too serious. Not serious enough. The denial's been back-brakingly regressive in the ongoing experienced future. Tree lover or tree shrugger's the cutthroat philosophy. Tied to economic levers rather than moving them. Choked off by a heartless contrarianism? Yeah, that'll maintain things. Wrap economic growth however you please, a clear conscience isn't exactly as self-granted as its still proving to be. That look at what I can do attitude's that's quite similar to what's gotten away with.
  When toxicities lasting past our lifetimes is evidence of time marching on despite, and not because of, us. It's not all that realistic to make any claims of greatness, no matter the venue, in Mother Nature's eyes. Be realistic? Selfish. Bah. Humbug. We're smarter than this? Why, when not having to be has proven so therapeutic? 
  But voting a particular view doesn't absolve sins. Neither has it proven anywhere near facing responsibility unless deflecting every sling and arrow possibly suffices. 
November 6, 2018
  Wisconsin voted out their redneck. Texas and Florida renewed theirs. 
  "We're the hottest country in the world." So then there's no reason to not face whatever's misplaced in understanding our world? Perhaps face the notions of entitlement that've so twisted our universe. Entitlement's meaning and usage made so repetitious - that's all - repetition. Such that nothing's faced portraying confronting anything at all. Starting for instance with the situation in the city where the above quote's deliverer's from. Where adequately supervised and financed housing supported a very lucrative career. However the balance sheet's tallied. So then to justify some things at least on a culture-wide understood level we're told to see public housing as an under-appreciated failure. The marketing of less expensive housing hardly describes what we built for ourselves. Going on the prejudices of his time, and his own, Robert Moses designed New York City Public Housing barracks style, such that when you walk the narrow halls the only thing that separates you from the feeling this is exactly like a prison is the absence of cell bars. And even prisons are better supervised than the systematically shortsighted management of public housing. Saving money by not having Front Desk Personnel as thoroughly run buildings have and maintenance crews assigned to individual buildings they're responsible for. As is, but they're supposedly addressing, maintenance can seem to roam looking for the next apartment scheduled for maintenance when no one's home. One thing the working poor do is work. Scapegoating those who don't is just an excuse. This is a modern world that should handle anything, and that means shouldering the blame.
     Fleeing lawlessness results from the predatory Criminal Enterprise System's roots that're the source of all these nonsensical human relations with authority we've cast ourselves in. Generations of illegal immigrants were profitably exploited and now don't fulfill the business plan. Uh huh. If only everyone wore a uniform we'd feel safer? People need to take responsibility for how cultures develop and stop hiding behind, and scapegoating, the law. Exploiting morality like a toy. 
The Soapbox View pursues the ornery Legacies of Murphy BrownAndy Rooney 
and I.F. Stone.