Nurses Launch Billboard Campaign Against Renewal of Desert Regional Medical Center Lease

The California Nurses Association and National Nurses United have launched  a billboard campaign against the lease renewal of public-owned, Palm-Springs-based Desert Regional Medical Center to Dallas-based Tenet Healthcare (Figure 1) (1).

Figure 1. National Nurses Union billboard off Highway 111 West of Palm Springs near the I-10.

The billboard campaign is in response to the posting of two videos that showed a water leak in Desert Regional's neurological intensive care unit and an infestation  of cockroaches in the emergency department break room (2,3). Desert Regional is a public hospital governed by an elected district board. Tenet Healthcare is a private company that leases and runs the hospital. The nurses’ union said Tenet has a long-standing practice of short-staffing Desert Regional, which they said has caused patient safety issues (1). Tenet is currently in the process of renegotiating another 30-year lease with the hospital, which would include the option to purchase the hospital from the Desert Healthcare District at the end of the new lease (1).

Desert Care Network — composed of Tenet-operated hospitals Desert Regional, JFK Memorial in Indio, CA, and Hi-Desert Medical Center in Joshua Tree, CA — provided the following statement: "The California Nurses Association continues to spread misleading information about Desert Regional. These claims are unwarranted, and these tactics will not change Desert Regional's unwavering commitment to the Coachella Valley. Our hospital takes maintenance and cleanliness standards seriously. This includes addressing repairs needed due to people flushing non-flushable cleaning wipes or issues after heavy rains such as pest control. Consistent with sound operational protocols, we proactively closed areas for a short time to remediate issues. These unrelated occurrences were addressed immediately and disclosed promptly to the staff and the Desert Healthcare District" (4).

Desert Regional’s governing Board of Directors are elected to four-year terms by Palm Springs voters. No statement has been made to date by the Board or have any statements been made by state healthcare inspectors such as the California Department of Health  or national healthcare inspectors such as the Joint Commission and Centers for Medicare & Medicaid Services. Although lack of cleanliness does not necessarily equate with lack of quality, cleanliness if often used as a substitute measure for safe healthcare, much like restaurant cleanliness is used as a measure for safe food.

Richard A. Robbins MD

Editor, SWJPCCS

References

1. Tayor M. California nurses use billboard to voice opposition to hospital sale. Becker’s Hospital Review. February 29, 2024. Available at: https://www.beckershospitalreview.com/nursing/california-nThe urses-use-billboard-to-voice-opposition-to-hospital-sale.html?origin=BHRE&utm_source=BHRE&utm_medium=email&utm_content=newsletter&oly_enc_id=6133H6750001J5K (accessed 3/2/24).
2. National Nurses United. Ceiling Leaks in Neurological ICU at Desert Regional Medical Center. February 24, 2024. Available at: https://vimeo.com/914927727?share=copy (accessed 3/2/24).
3. National Nurses United. Cockroaches at Desert Regional Medical Center. February 24, 2024. Available at: https://vimeo.com/914925049/f9d46c5890?share=copy (accessed 3/2/24).
4. Sasic E. Desert Regional nurses launch billboards to spotlight concerns; hospital pushes back. Palm Springs Desert Sun. February 27, 2024. Available at: https://www.desertsun.com/story/news/health/2024/02/27/desert-regional-nurses-launch-billboard-campaign-palm-springs-area-hospital-news/72752162007/ (accessed 3/2/24).

Cite as: Robbins RA. Nurses Launch Billboard Campaign Against Renewal of Desert Regional Medical Center Lease. Southwest J Pulm Crit Care Sleep. 2024;28(3):32-33. doi: https://doi.org/10.13175/swjpccs013-24 PDF

$1 Billion Donation Eliminates Tuition at Albert Einstein Medical School

Albert Einstein College of Medicine in the Bronx joins NYU Grossman School of Medicine in becoming tuition free. Einstein’s tuition was eliminated by a $1 billion donor gift from Ruth Gottesman EdD (1). Dr. Gottesman, a retired clinical Professor Emeritus of Pediatrics (Developmental Medicine) at Einstein, has been a specialist in learning disabilities at the school since 1968 and is currently Chair of the Einstein Board of Trustees and also serves on the Montefiore Health System board. Announced to the cheers of the assembled student body, Dr. Gottesman announced that beginning in August, tuition will be free "in perpetuity". Tuition at the school is nearly $59,000 per year, leaving nearly 50% of the students owing more than $200,000 after graduating.

Dr. Gottesman’s fortune came from her husband, David "Sandy" Gottesman an early investor in Omaha, Nebraska-based Berkshire Hathaway, Warren Buffet's multinational conglomerate. Mr. Gottesman died in September 2022 at the age of 96 leaving his widow with a large stock portfolio and instructions to “do whatever you think is right with it”.

The gift evolved from Dr. Gottesman’s close friendship with Dr. Philip Ozuah, the pediatrician who oversees the medical college and its affiliated hospital, Montefiore Medical Center (Figure 1).

Figure 1. Dr. Philip Ozuah and Dr. Ruth Gottesman.

In early 2020, the two sat next to each other on a 6 a.m. flight to West Palm Beach, Fla. It was the first time they had spent hours together. They spoke about their childhoods — hers in Baltimore, his, some 30 years later, in Nigeria — and what they had in common. Both had doctorates in education and had spent their careers at the same institution in the Bronx, helping children and families in need. During the COVID-19 pandemic, Dr. Gottesman’s husband became ill with the virus. In the weeks that followed, Dr. Ozuah began making daily house calls — in full protective gear — to check in on the couple as Mr. Gottesman recovered.

Dr. Gottesman and Dr. Ozuah’s friendship and his commitment to assisting his patients even in threatening times likely led Dr. Gottesman to her amazing contribution. Dr. Gottesman said that not only would future students be able to embark on their careers without the debt burden, but she hoped that her donation would also enable a wider pool of aspiring doctors to apply to medical school. “We have terrific medical students, but this will open it up for many other students whose economic status is such that they wouldn’t even think about going to medical school,” she said.

Richard A. Robbins MD

Editor, SWJPCCS

Reference

1. Goldstein J. $1 Billion Donation Will Provide Free Tuition at a Bronx Medical School. NY Times. February 26, 2024. Available at: https://www.nytimes.com/2024/02/26/nyregion/albert-einstein-college-medicine-bronx-donation.html (accessed 2/27/24).

Cite as: Robbins RA. $1 Billion Donation Eliminates Tuition at Albert Einstein Medical School. Southwest J Pulm Crit Care Sleep. 2024;28(2):24-25. doi: https://doi.org/10.13175/swjpccs011-24 PDF

Kern County Hospital Authority Accused of Overpaying for Executive Services

Becker’s Hospital Review is reporting that the Bakersfield, CA-based Kern County Hospital Authority, is accused by the local employee union of overpaying two private firms that provide its top executives (1). The union alleges that Cantu Management Group and Meridian Healthcare Partners - both based in Bakersfield - have exceeded contractual amounts by 40 percent to 147 percent, leading to $23 million in overpayments over the past four years. Andrew Cantu of Cantu Management Group is also the CFO of Kern County Hospital Authority and its management representative for independent audits. Russell Judd served as the hospital's CEO until December 2021, and remains president and owner of Meridian Healthcare Partners.

A 9-page report alleges the hospital failed to disclose management compensation accurately, to properly correct the issue when notified,  and attempted to conceal the overpayments.  The union claims to have repeatedly brought questions about the hospital's financial management to the hospital and received "no substantive response." The union hired Scott McHone, a certified forensic accountant, to better understand the financials alongside their investigative team.

The union report indicates that Meridian Healthcare Partners was overpaid. Mr. McHone and the investigative team found that invoices filed with the California Department of Health Care Access and Information show the hospital paid the firm $39.9 million, although the union says the invoices it received documented only $19.3 million. The day after the union requested these payment records, the hospital's legal department took action to remove Meridian's name from financial disclosures, according to the report.

Kern County Hospital Authority denies all allegations. The hospital further stated that the services offered have been beneficial to patients, but did not directly comment on the compensation discrepancies.

Richard A. Robbins MD

Editor, Southwest Journal of Pulmonary, Critical Care & Sleep

Reference

1. Kayser A. California Hospital Accused of Overpaying for Executive Services. Becker’s Hospital Review. June 28, 2023. Available at: https://www.beckershospitalreview.com/compensation-issues/california-hospital-accused-of-overpaying-for-executive-services.html?origin=BHRE&utm_source=BHRE&utm_medium=email&utm_content=newsletter&oly_enc_id=6133H6750001J5K

Cite as: Robbins RA. Kern County Hospital Authority Accused of Overpaying for Executive Services. Southwest J Pulm Crit Care Sleep. 2023;27(1):7. doi: https://doi.org/10.13175/swjpccs029-23 PDF

SWJPCCS Associate Editor has Essay on Reining in Air Pollution Published in NY Times

Dr. Dona Upson

Dona Upson MD, an associate editor of the SWJPCCS from Albuquerque, recently had a Guest Essay published in the NY Times (1). In the opinion piece titled “The Government Is This Close to Reining in Some of the Worst Air Pollution” Dr. Upson states that the science is clear that when oil and gas are extracted and transported from wells, methane and other pollutants, including volatile organic compounds, leak out. These form ozone and may exacerbate asthma and COPD, cause cancer and birth defects, and affect the nervous system. Emissions from oil and gas production also produce nitrogen oxides, which can exacerbate lung disease. Methane is also a powerful greenhouse gas, over 80 times more potent than carbon dioxide in its warming power, though its life span in the atmosphere is much shorter. One of the fastest and cheapest ways to reduce these emissions and improve health is to prevent methane leaks, venting and flares, which would also go a long way in reducing ozone pollution.

According to Dr. Upson the federal government has a huge opportunity to reduce methane emissions, improve health and slow climate change. The first and most important way is through a rule proposed by the Environmental Protection Agency (EPA) to cut pollution, including methane, from new and existing oil and gas operations nationwide. Outside of the EPA the Bureau of Land Management has proposed a rule to limit venting, flaring and leaks of natural gas on public lands. Dr. Upson argues in her essay for support of both these rules.

Reference

1. Upson DJ. The Government Is This Close to Reining in Some of the Worst Air Pollution. NY Times. March 14, 2023. Available at: https://www.nytimes.com/2023/03/14/opinion/air-pollution-oil-gas-methane.html?unlocked_article_code=LsW56AyPBUFnQsdIIrFwy1HaNHxISpGdOo0FpzCnqqqP1YfKdSWQWrYoynSV01-SQEQyrA5w2wi-sVQGEROE0EwLWjE-3BChLi8DB4Oe5oxhLRyMnMMG7MpddaOr7EGGc_U-aqOX8XbiFd65ISJze9VOeElVgCqstnghXBz6Q2-H0DE1GBXPOniX-vrTep6gnAwAykHSM8zOkCBLmW95ctQT6HSKVyDO9ucEUFkvD_3njOYXmq6eCS4ZajhnvvO02qZQ2kUnw8E8bu72-MBdexXamik2wvUkk7gtc_nJMaVWhHiBLWGV33W2EE635C8xGF9TLtA0MvjDNm4mdYsq1-iP6O4Jqkw&smid=em-share (accessed 3/28/23).//

Cite as: Robbins RA. SWJPCCS Associate Editor has Essay on Reining in Air Pollution Published in NY Times. Southwest J Pulm Crit Care Sleep. 2023;26(4):59-60. doi: https://doi.org/10.13175/swjpccs017-23 PDF

Amazon Launches New Messaged-Based Virtual Healthcare Service

A story in Medscape came at an opportune time yesterday (1). The article announced that Amazon had launched its latest version of virtual medical care on Tuesday, November 15, in 32 states. Called Amazon Clinic, the service omits phone and video calls but instead works through secure messaging between patients and providers. Just after finishing the story, my daughter called and wanted to know if she could buy antibiotic containing eye drops over the counter. She says that she has had “pink eye” (conjunctivitis) for about 2 weeks. Her symptoms of itchy, red eyes without discharge were mostly relieved by an over-the-counter tetrahydrozoline HCl 0.05% drops (Visine). She did not want to go to an emergency room for such a minor issue and had a demanding schedule the following day making a doctor’s appointment difficult.  I told her she probably had a viral conjunctivitis but suggested that she could try the virtual clinic since she lives in a state where the Amazon virtual clinic is available. She did contact them and below she reports her experience.

After signing into her Amazon account, she did not have a “Clinic” selection on the banner at the top of her Amazon home page. She searched Amazon using “Amazon clinic” and a page popped up directing her to the appropriate website. After selecting a diagnosis (“pink eye”), she spent about 15 minutes filling out forms which asked demographic information as well a brief history of her present illness, past medical history, and previous therapies. She also took a “selfie” as well as a photo of her driver’s license. Within about 10 minutes she heard back from a nurse practitioner and a prescription was called into a pharmacy of her choice. She was extremely pleased with the service which saved her time and only cost $35.

The service is intended for straightforward health needs in patients under 65. The virtual clinic services a list of 18 common conditions including asthma and smoking cessation. Patients with 5 established conditions (asthma, hypertension, hyperlipidemia, hypothyroidism, and migraine) can also seek medication refills. The service does not accept insurance and works on a fee basis that includes follow-up messages with providers for up to 2 weeks. After paying Amazon directly, patients can submit receipts for reimbursement by their insurer if they have one. Visit costs vary by state, condition type, and provider. Wait times for receiving a first response from a provider are also published.

The service is not available in Arizona but is in each Arizona-bordering state as well as Hawaii. Amazon's venture into health care is evolving. It offers a pharmacy service but this would have taken 4 days to have the prescription delivered in my daughter’s case. Amazon plans to shut down its telehealth service known as Amazon Care by the end of the year but recently signed a deal to acquire One Medical's telehealth service and brick-and-mortar primary care clinics according to Becker's Hospital Review (2).

Richard A. Robbins MD

Editor, SWJPCCS

References

1. O’Mary L. Amazon Launches Messaged-Based Virtual Healthcare Service. Medscape Business of Medicine. November 15, 2022. Available at: https://www.medscape.com/viewarticle/984089?src=WNL_bom_221120_MSCPEDIT&uac=9273DT&impID=4885555 (accessed 11/20/22).
2. Naomi Diaz N. - "Healthcare seen as safe bet in Amazon's cost-cutting review. Becker's Hospital Review. Thursday, November 10th, 2022. Available at: https://www.beckershospitalreview.com/disruptors/healthcare-seen-as-safe-bet-in-amazon-s-cost-cutting-review.html (accessed 11/20/22).

Cite as: Robbins RA. Amazon Launches New Messaged-Based Virtual Healthcare Service. Southwest J Pulm Crit Care Sleep. 2022;25(5):90-91. doi: https://doi.org/10.13175/swjpccs053-22 PDF