“You Can Choose Your Doctor”-HAH!

In the current debate over Obamacare, the Republicans keep emphasizing an issue which is irrelevant to those of us in rural areas- the ability to choose a doctor.

Paul Ryan seem to think that those of us outside the major urban areas actually HAVE a choice. Most of us don’t.  I’ve been waiting since January to see an orthopedic surgeon here and won’t see him/her till May. By that time will my January MRI even be useful?

And for the record, when I DID live in the  Bay Area and was on Blue Shield, I did NOT pick the best doctors.  I picked the only doctor in town who was treating allergies with steroid shots.  Bad pick.  Eventually,   I got on Kaiser and spent 25 years on it.  No “doctor choice” unless you absolutely loathed your doctor, but I got excellent healthcare anyway.  Once I moved back here,  I was on Health Net (“Hell Net”) and Blue Shield but the choices kept shrinking.  Now I’m on Medicare, and will be going to Eureka Family Practice for the rest of my life, I guess, because who else is taking new patients?  Up here you’re lucky to HAVE a doctor; shopping around is a fantasy.

Someone tell that to Paul Ryan.


LOCAL Resolution Care featured on PBS News TONIGHT

Jonathan Speaker of StreamGuys forwarded the following  regarding Dr. Michael Fratkin’s local initiative re: palliative care.  Sorry for the short notice!

While ResolutionCare has enjoyed a fair bit of media interest to date, the bar is raised dramatically TONIGHT with the broadcast of a seven minute segment on PBS Newshour with Judy Woodruff and Gwen Ifill. From my perspective, the strength of the piece is the participation of three people and families that generously and bravely shared their stories and experience to a national audience.

The nature of news broadcast scheduling has limited our ability to notify the community to these few hours of lead-time on the day of broadcast. A link to the segment will be available shortly after broadcast, and I urge you all to share that that link with your families, your networks, and everywhere you think that it might make a difference to support this work.

Here’s the info for the broadcast in Humboldt County:

▪ KEET HDTV TV Channel 13.1 at 600pm and Midnight
▪ KEET World Channel 13.2 at 700pm
▪ PBS Newshour Live Stream http://www.ustream.tv/pbsnewshour at 300pm

Three Followups: Brius/Redwood Healthcare, Palo Alto and Tragedy at the Grocery Outlet

 I ran into an employee  of one of the facilities involved in DA Gallegos’ lawsuit against Skilled Healthcare as described in this blog a couple of days ago.  That person informed me that the employees at those facilities are still very concerned about understaffing. Sure enough , the morning’s Times-Standard confirmed that the situation is so bad the facilities are not taking new patients. A very bad situation.

On a happier note,  the good people of Palo Alto may be returniing to their liberal traditions.  Two Santa Clara County supervisors, Joe Simitian and Dave Cortese, are proposing a measure to buy the mobile home park, Palo Alto’s only low or moderately priced housing, so that the 400 residents won’t have to move.  Good for them, and we hope they succeed.

Finally, I should have known better but I had my heart broken again when the Grocery Outlet stopped carrying those wonderful little avocados they were selling for two bucks a bag. They were just right for a single serving or any time you didn’t need beautiful uniform slices. O you Grocery Outlet~  you get us hooked, then you pull back! That’s the way it goes at an outlet store. Hope you bring  those little avos back real soon.

Have a great weekend. Eat lots of oysters!


Brius Not Out of the Woods Yet

Or perhaps we should say, not out of trouble yet. Brius, as you recall, is the outfit that bought the local operations of Skilled Healthcare after they lost their court battle with DA Paul Gallegos over substandard conditions in their facilities, which include the Seaview, Granada, Pacific, Fortuna and Eureka Rehabilitation and Wellness Centers.  The original jury award was for $62M, a lot of which went to legal fees. Brius, which does business here under the name Redwood Healthcare Services, is the largest chain of nursing homes in the State with 82 facilities.  It has come under fire from the State, which decertified three of their facilities. This is a serious sanction as it means they no longer qualify for Medicare funding. 

If you have a loved one in one of these facilities drop over frequently and on short notice and keep track, as best you can, to ensure each resident receives the 3.2 hours of daily care to which they are entitled under the law. Health care is a tough business but it’s even tougher to be a patient.


A Call From St Joe’s

I had knee replacement surgery at St Joe’s in December.  I’m the only person I know who still has operations done locally- everyone else seems to be going to St Helena or elsewhere. Me, I’m stubborn.  I live five minutes from St Joe’s and if I’m unhappy with my treatment I want to be able to find my doctor quickly and yell at him/her at length if needed.  So I stayed local.

This morning I got a call from a young man (he sounded young) asking me to “participate in a quality assurance survey regarding my recent experience at St. Joseph’s”.  I explained that my experience wasn’t over. I am still under their care and don’t have my closeout visit for another month. He consulted his instructions and said nothing required the treatment to be OVER before the evaluation. I questioned the value of doing an evaluation of a course of medical treatment that hadn’t been completed but he wanted to press on. Okay,  we’ll go on.

Now he asked:  how would I evaluate the check-in procedure? I had absolutely no recollection of checking in, except that it took place at 5AM which is an ungodly hour. He seemed to accept this.

Next question was: How would I evaluate the treatment I received from the staff?  Which staff, I asked.  Are you asking about the surgeon, the nurses, the anesthesiologist, who?  Which staff?  It just says, Staff, he replied.

At that point I cut my losses and told him I had better things to do than participate in a survey which was totally meaningless.  We all do.

If you get a call like this,- from St Joe’s or elsewhere-  remember it is YOUR time they are helping themselves to. Don’t participate in BS surveys which aren’t gathering useful information,  only being done to cover someone’s ass or to meet some bureaucratic requirement.  The corollary is to speak up or,  better, write a letter when you receive less than your due.  It’s up to us to write effective and fact-based letters of complaint.  Like the one St Joe’s is going  to get if they call me again with that survey.


Intensive Care

The first ten channels on the television in the Super 8 on the Alameda in San Jose were Indian. Bollywood Indian, not tribal Indian. So was the entire staff of the motel, including the studious young man who jiggled the reservations to find us a room that we would take a day earlier than planned without having to change rooms after the first night.  We had planned to come down Friday but when my cousin called and said my sister was “in crisis” we started driving south, badly packed and apprehensive.

My friend Chris did most of the driving while I fretted.  Thinking about my sister,  thinking about when we were kids, thinking about what shape she would be in, or whether she would still be alive,  since my brother-in law’s cell wasn’t responding. When we got to Valley Medical Center, we discovered it was still under construction. We went into three wrong parking lots before finding the right one.  The clerk at the desk was very calm when giving us directions to her room so we figured the news couldn’t be too bad.  When we got to her room my brother-in-law and a cousin were there. My sister had “stabilized” during the night, they said.  She was unrecognizable – breathing mask over her nose, stuck full of needles and cables and hoses, but she could squeeze my hand.

She had been poked in so many places that her skin was mostly blotchy purple. They were concerned about bleeding in her stomach so she couldn’t have liquids. They would let her suck on a sponge,  then five minutes later she’d ask for another. She can’t remember anything but they said this may be temporary. The nurses are wonderful. All the sappy things you’ve heard about nurses being angels is true. They are.

She is restrained so she won’t pull out the nose clip that ‘s feeding her oxygen and the food tube that also goes up her nose. She pulled out the nose thing in just an instant with both me and my brother-in-lay standing right there, she was so quick. At the end of the day they released her from the restraints and a minder or sitter was assigned to watch her overnight. Did I mention this is a wonderful hospital? The next day I stayed with her, mostly making the tiny adjustments to her bedding that become supremely important when you’re bedridden. I dared Chris to find something interesting in San Jose and he called from a Japanese garden that he said was first rate. I couldn’t talk him into going to the Rosicrucian Center, right near the hospital. A couple more family members came by. My sister was more lucid. The crisis had passed. We had a late Japanese dinner near North Fourth Street. It was wonderful.

Monday I had to make the drive back to Eureka. The drive seems longer every time. It occurred to me that I hadn’t seen a haole or Anglo other than our family members for days. 


A New Chapter for St Joe’s

(Factoids of the week: The busiest airport on the  planet is no longer O’Hare, it’s DUBAI.  And those cute little “baby carrots” at the market are actually big honkin’ carrots that have been carved by machinery down to their cute little “baby” shapes. )

But there’s also good news. More than 200 service employees  of St Joseph Hospital will now be represented by a union, the National Union of Health Care Workers. For the region’s flagship care provider, this is an excellent opportunity to retool their personnel policies. Of course, now they’ll have help.

Everyone who has had dealings with St Joe’s, and that includes most of us, has noticed how superior the staff is to the structure under which they must work. The staff, especially the nurses, are fabulous,  the hierarchy, not so much. An increased union presence is the best thing that could happen to St Joe’s.  Employees who can bargain collectively without having to beg management for each incremental improvement will, after the dust settles, be better able to provide excellent care. When management is forced to pay more, the  usual approach is to empower the employees and streamline procedures. Everybody wins.

Some of you who don’t know me may wonder how a person who is pro-business can also be pro-labor. Believe me, it’s easy. During my years at the NLRB I saw time and again the benefits of unionization. The employees can speak up without fear of retaliation and management gets to deal with a single Union rep instead of hundreds of disgruntled employees. It’s a win-win. There are many people in the County who are fearful and ignorant of unions since the demise of Big Lumber. With the nurses’ victory in 2001 plus this new bargaining unit, and the growing national revulsion toward minimum-wage jobs that do not provide a living, perhaps the tide is starting to turn.  We can only hope.