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 a time 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 in the year before OSF discontinued its support. Their claims of what was owned were never substantiated by any bills.

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, a 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.

1 comment:

David Volk said...

Well written, Maria.