There’s Good Money in Bad Medicine

The thing about medicine is, it’s hands on, actually good medicine is many hands on. It’s about giving care, touching, and listening. It’s not a vending machine kind of product. The same is true of hospitals. Good hospital management looks at patients first, operations second and financials last. You come into a hospital to be nursed; you might need IVs, dialysis, breathing treatments. If you’re really sick you could need many doctors, a dedicated nurse, a respiratory therapist to run your ventilator, a dietitian to make sure the tube food they give you does not provoke non-stop diarrhea, and when you’re well enough, a physical therapist to teach you to walk with your accident changed body. Hospital operations are no joke, making things run well takes talent, commitment, and real hands on experience. So explaining how a 10% staffing reduction (300 people, 600 hundred hands), will have a negligible effect on patients and operations, while simultaneously fixing the “financial picture” is no simple feat.

In defense of the consultants currently running the Alameda County Medical Center, they have been dealt a tough hand. They have been directed to make massive staffing cuts without disclosing that they are crippling or closing services. Honest outright closing of services would necessitate embarrassing public meetings, which the Alameda County Board of Supervisors are determined to avoid. This has forced the consultants to come up with very imaginative, if unrealistic proposals. The lay-off list presented to the unions included staff that had retired or left the Medical Center years before. Doorknobs were scavenged from bathrooms in old clinic areas, unfortunately they forgot to tell the staff who still work in those areas and employees have gotten locked in the bathrooms. Instead of ordering more linen for the new Clinic and Critical Care Building, they just took half the linen from the hospital floors. Supply shortages create work and inconvenience, staffing shortages can lead to accidents and deaths. Fear of the bad patient outcomes has become a real concern for Medical Center employees. Some employees have pledged to bring toilet paper from home, if it would help soften the proposed caregiver cuts.

If the county of Alameda has funds to pay for two Sheriff’s deputies on jet skis’, and every County Supervisor has a staff of 6, why can’t we afford to pay nurses to give the 300 to 400 hundred doses of chemotherapy that cancer patient need each month? If the consultant’s calculations are right and you don’t actually need these nurses to give chemotherapy, perhaps Supervisor Gaile Steele and her hoards of hired help will come down, and hang IV bags for patients.

Numerous patient care and safety concerns have been raised to the Cambio consulting crew and they have finally begun to respond. They have begun an extreme public-relations makeover. They no longer call themselves consultants; they have renamed themselves and the Board of Trustees as, “our leaders.” It’s a curious choice since they have done nothing but follow the Board of Supervisors directives and they couldn’t get staff to follow them to happy hour. Hopefully, they will continue the makeover, soften the look, ditch the power suits, the cologne and the tight shoes. At the point that Temporary Chief Executive Officer, (TCEO), Mike Burroughs, puts on some scrubs and works three twelve hour shifts in a four bed room with three confused patients and one combative patient, no nursing assistant, no sheets and no toilet paper, well then he’s earned the right to be called a co-worker. When TCEO Burroughs gets real and tells the Board of Supervisors, he can’t safely run the Medical Center and give them 10 million dollars a year, the staff will gladly call him a leader. Until then the consultants proposed cuts have created fear and apprehension about the “human costs” these savings will exact.