According to the Dallas Morning News article Parkland's auditing practices in their pharmacy are not up to standards. Let's look at UT Southwestern's standards on audits for patient care.
In June, 2007 a UT Southwestern surgeon who was the Chair of the Division of Burn, Trauma and Critical Care, and Holder of a Distinguished Chair of Surgery, was demoted. He complained about residents performing surgery without proper faculty supervision. By definition, if the surgeons are not properly supervising the surgery, that results in billing fraud.
The Chairman and Vice- Chairman of the Department of Surgery, Drs. Robert Rege and Jim Valentine, were constantly telling new faculty who had been recruited from outside institutions, that they needed to reduce their supervision of surgery.
They should allow the residents to do surgery on their own, provided it was at Parkland, and not at St. Paul or Zale-Lipshy, where private patients are treated.
Complaining about this type of practice is legally protected behavior. An employee who raises concerns about an illegal, immoral, or unethical behavior is protected by Whistleblower laws in most states, including Texas. The Dallas Morning News covered this at that time.
http://www.dallasnews.com/sharedcontent/dws/news/healthscience/stories/DN-surgeon_20met.ART0.State.Edition1.43de887.html#slcgm_comments_anchor
http://www.dallasnews.com/sharedcontent/dws/news/localnews/stories/DN-doctorhearing_04met.ART.State.Edition1.433eca9.html
This doctor, recruited from Harvard Medical School, where he was Chief of Trauma and Critical Care, was criticized by residents within his first week of taking call at Parkland that he was supervising the surgery too much, and not letting the residents operate on their own.
He made strenuous efforts to reform the system, to no avail, and was eventually relieved of his position. But he could not be fired because he had tenure. He filed a whistleblower lawsuit
UT Southwestern has taken his case all the way to the Texas Supreme Court, with nothing but repeated, failed attempts to get the case dismissed. Now they are back in Appeals Court, trying yet again.
The lawsuits were filed after this faculty member used the UT Southwestern grievance process, and found that it was faulty, and violated its own rules and procedures. Dean Alfred Gilman appointed the Grievance Committee.
The faculty member asked that the committee be composed of individuals from outside the institution because the penalties for billing fraud are severe.
UT Southwestern has taken his case all the way to the Texas Supreme Court, with nothing but repeated, failed attempts to get the case dismissed. Now they are back in Appeals Court, trying yet again.
The lawsuits were filed after this faculty member used the UT Southwestern grievance process, and found that it was faulty, and violated its own rules and procedures. Dean Alfred Gilman appointed the Grievance Committee.
The faculty member asked that the committee be composed of individuals from outside the institution because the penalties for billing fraud are severe.
Appointing the UT Southwestern leadership to investigate itself was contrary to the UT Southwestern Handbook of Operating Procedures, which supposedly guarantees an independent grievance process.
The Dean appointed Mr. Dieter Lehnorrt to look into whether there was billing fraud. It is his job to make sure that billing is compliant, and that fraud is not occurring. Click to see in full size.
The faculty member protested this. He was accusing the billing compliance of laxity, conducting improper audits, and of allowing billing fraud to go on by looking the other way.
Asking the billing compliance chief responsible to conduct an audit to determine if he is allowing billing fraud, is like asking him to conduct an audit on his own performance. It would be like asking the people involved in the pharmacy-to-street dealer program at Parkland to audit the pharmacy.
It was his inability to do his job that the grievant was complaining about. Therefore, he should not have been put in charge of the investigation.
How likely would it be for him to investigate himself, find that there is billing fraud, pronounce himself guilty, get himself fired, call the police, and telling them they need to lock him up in jail pending bond. His involvement was protested by the grievant, but Dean Alfred Gilman overruled it.
The Dean appointed Ms. Leah Hurley, the UT Southwestern Vice President of Legal Affairs to be part of the Grievance Committee. Her client is UT Southwestern. The rules of her job required that she take an adversarial position to anyone who legally challenges the University. Was she likely to see things the grievant's way, turn to her client, and accuse them of fraud?
She had obvious conflicts of interest, both personally and professionally, and having her on the Grievance Committee further proved that it was a sham.
Dr. Willis Maddrey was the Chair of the Billing and Ethic Compliance Committee at UT Southwestern. The grievant protested his involvement. What was the likelihood that he would rule in favor of the grievant and say, "As Chair of the Billing Compliance Committee, I agree with the grievant that we do not enforce Billing Compliance."
The Dean appointed Mr. Dieter Lehnorrt to look into whether there was billing fraud. It is his job to make sure that billing is compliant, and that fraud is not occurring. Click to see in full size.
The faculty member protested this. He was accusing the billing compliance of laxity, conducting improper audits, and of allowing billing fraud to go on by looking the other way.Asking the billing compliance chief responsible to conduct an audit to determine if he is allowing billing fraud, is like asking him to conduct an audit on his own performance. It would be like asking the people involved in the pharmacy-to-street dealer program at Parkland to audit the pharmacy.
It was his inability to do his job that the grievant was complaining about. Therefore, he should not have been put in charge of the investigation.
How likely would it be for him to investigate himself, find that there is billing fraud, pronounce himself guilty, get himself fired, call the police, and telling them they need to lock him up in jail pending bond. His involvement was protested by the grievant, but Dean Alfred Gilman overruled it.
The Dean appointed Ms. Leah Hurley, the UT Southwestern Vice President of Legal Affairs to be part of the Grievance Committee. Her client is UT Southwestern. The rules of her job required that she take an adversarial position to anyone who legally challenges the University. Was she likely to see things the grievant's way, turn to her client, and accuse them of fraud?
She had obvious conflicts of interest, both personally and professionally, and having her on the Grievance Committee further proved that it was a sham.
Dr. Willis Maddrey was the Chair of the Billing and Ethic Compliance Committee at UT Southwestern. The grievant protested his involvement. What was the likelihood that he would rule in favor of the grievant and say, "As Chair of the Billing Compliance Committee, I agree with the grievant that we do not enforce Billing Compliance."
Other Grievance Committee members were protested as well. All were overruled. The grievant asked the dean to interview several individuals, and the Dean refused.
Anyone could see that this was not a fair process. The stakes were high, and that is why the grievant asked for a Grievance Committee that was not composed of UT Southwestern Executives.
To uphold the grievant UT Southwestern would have to refund hundreds of millions of dollars, fire many of its own leaders, and face possible charges of criminal fraud. Or, they could rule against the grievant, and retaliate against him to make his life so miserable that he would leave.
The legal discovery process yielded minutes of a meeting between Dean Afred Gilman, and Dr. Robert Rege, the UT Southwestern Chairman of the Department of Surgery, where they planned how the Grievance Committee investigation should be conducted. Since the Grievance was against Dr. Robert Rege, this is further proof of the lack of independence, and the pre-ordained conclusion.
They did some interviews of faculty, but these were just for show, because they largely ignored the results. The following documents have already been posted, but for ease of access, here they are again. Click to see on full size.
To the left is what the committee heard when interviewing a full professor and national leader in trauma care who was elected by peers to hold some of the most important positions in surgical organizations in the United States. 93,000 people die of medical errors in the United States each year. That is more than the number of deaths from car crashes, breast cancer, and AIDS, combined. This professor reported feeling intimidated by the residents when trying to participate in surgery! The operation is not going well, and the surgeon and the surgeon has to worry about the punishment that would come from UT Southwestern if she steps in and participates in the surgery.
Is that how you would want your surgeon to feel? Or would you like them, instead of the students, to be in charge? After being retaliated against, this person resigned.
The next interview is of a surgeon who stated that it is the culture that the residents make treatment decisions and execute them without informing faculty, as required by law. He felt there is a "huge" problem in fulfilling billing compliance rules and regulations at UT Southwestern. He was retaliated for not "playing with the team," and after being denied a promotion that was due to him, he left.
This echoes prior faculty members who said faculty members are never around post-op, patients rarely see faculty, but the University nevertheless bills for their services. Felt faculty presence in the OR is inadequate, even though federal regulations say that adequate faculty presence in the OR is necessary to bill Medicare and Medicaid for an operation.
This person felt that Parkland is the only place left where this type of system still exists. This person has written a textbook on educating surgical residents, and was voted best surgical teacher at Harvard Medical School, and at the University of Wisconsin. UT Southwestern drove him out after he made these statements by putting him on call all the time, while giving those who went along with the Parkland way nearly the entire summer off.
The next doctor admitted that 30% of the time the residents don't notify the faculty that they are taking his or her patient to the OR. He agrees that documentation is inadequate. And if it is not documented, you cannot bill for it. He stated that the residents make it known that his presence in the OR is not welcome, when it it his own patient who is undergoing the operation.
This is clearly a toxic UT Southwestern Department of Surgery with deficient leadership that led to the collapse of the whole trauma division when the majority of the faculty members resigned or were pushed out.
Despite these serious findings there should be no surprise about how the grievance turned out. Here is Dean Alfred Gilman's summary.
What is interesting is what follows after.
He stated that in response to the allegations, audits were conducted, and they revealed no misconduct.
In this box he states there will be multiple "further objective" audits, implying that audits have already been conducted.
Anyone could see that this was not a fair process. The stakes were high, and that is why the grievant asked for a Grievance Committee that was not composed of UT Southwestern Executives.
To uphold the grievant UT Southwestern would have to refund hundreds of millions of dollars, fire many of its own leaders, and face possible charges of criminal fraud. Or, they could rule against the grievant, and retaliate against him to make his life so miserable that he would leave.
The legal discovery process yielded minutes of a meeting between Dean Afred Gilman, and Dr. Robert Rege, the UT Southwestern Chairman of the Department of Surgery, where they planned how the Grievance Committee investigation should be conducted. Since the Grievance was against Dr. Robert Rege, this is further proof of the lack of independence, and the pre-ordained conclusion.
They did some interviews of faculty, but these were just for show, because they largely ignored the results. The following documents have already been posted, but for ease of access, here they are again. Click to see on full size.
To the left is what the committee heard when interviewing a full professor and national leader in trauma care who was elected by peers to hold some of the most important positions in surgical organizations in the United States. 93,000 people die of medical errors in the United States each year. That is more than the number of deaths from car crashes, breast cancer, and AIDS, combined. This professor reported feeling intimidated by the residents when trying to participate in surgery! The operation is not going well, and the surgeon and the surgeon has to worry about the punishment that would come from UT Southwestern if she steps in and participates in the surgery.Is that how you would want your surgeon to feel? Or would you like them, instead of the students, to be in charge? After being retaliated against, this person resigned.
The next interview is of a surgeon who stated that it is the culture that the residents make treatment decisions and execute them without informing faculty, as required by law. He felt there is a "huge" problem in fulfilling billing compliance rules and regulations at UT Southwestern. He was retaliated for not "playing with the team," and after being denied a promotion that was due to him, he left.
This echoes prior faculty members who said faculty members are never around post-op, patients rarely see faculty, but the University nevertheless bills for their services. Felt faculty presence in the OR is inadequate, even though federal regulations say that adequate faculty presence in the OR is necessary to bill Medicare and Medicaid for an operation.This person felt that Parkland is the only place left where this type of system still exists. This person has written a textbook on educating surgical residents, and was voted best surgical teacher at Harvard Medical School, and at the University of Wisconsin. UT Southwestern drove him out after he made these statements by putting him on call all the time, while giving those who went along with the Parkland way nearly the entire summer off.
The next doctor admitted that 30% of the time the residents don't notify the faculty that they are taking his or her patient to the OR. He agrees that documentation is inadequate. And if it is not documented, you cannot bill for it. He stated that the residents make it known that his presence in the OR is not welcome, when it it his own patient who is undergoing the operation.
This is clearly a toxic UT Southwestern Department of Surgery with deficient leadership that led to the collapse of the whole trauma division when the majority of the faculty members resigned or were pushed out.
Despite these serious findings there should be no surprise about how the grievance turned out. Here is Dean Alfred Gilman's summary.
What is interesting is what follows after.
He stated that in response to the allegations, audits were conducted, and they revealed no misconduct.
In this box he states there will be multiple "further objective" audits, implying that audits have already been conducted.
One month later on June 13, 2007, Mr. Lehnorrt made an appearance at the Burns, Trauma, and Critical Care Division Meeting to go over billing rules. The grievant was not present.
Technical stuff not of much interest here, scroll to next page.
Dieter is saying that a focused audit has not been completed, but is underway. This contradicts Dean Gilman's statement that "compliance audits initiated in response to your allegations have revealed no pattern of questionable practices." In other words, the audit had been completed.
Since Dieter promised to return to a division meeting when the focused audit was complete, and this was as issue that had already appeared in the Dallas Morning News twice, and hundreds of millions of dollars of local, state, and federal taxpayer refunds were at stake, you would think there would be some haste in completing the audit.
The grievant waited ten months and then wrote to Mr. Lehnorrt, asking if the audit he promised was ready yet? The inquiry is on the left, Mr. Lehnortt's response is on the right. He said they are almost through, and it is normal procedure to take ten months to conduct a focused audit despite media attention, the gravity of the charges, and a requirement that audits be conducted quarterly.
The Dean denied a grievance, saying that audits proved the grievant's allegations to be false. Ten months later the Billing Compliance Officer stated that he hadn't finished the audit that the Dean claimed to have used in making his decision.
The grievant responded as follows:
Technical stuff not of much interest here, scroll to next page.
Dieter is saying that a focused audit has not been completed, but is underway. This contradicts Dean Gilman's statement that "compliance audits initiated in response to your allegations have revealed no pattern of questionable practices." In other words, the audit had been completed.
Since Dieter promised to return to a division meeting when the focused audit was complete, and this was as issue that had already appeared in the Dallas Morning News twice, and hundreds of millions of dollars of local, state, and federal taxpayer refunds were at stake, you would think there would be some haste in completing the audit.
The grievant waited ten months and then wrote to Mr. Lehnorrt, asking if the audit he promised was ready yet? The inquiry is on the left, Mr. Lehnortt's response is on the right. He said they are almost through, and it is normal procedure to take ten months to conduct a focused audit despite media attention, the gravity of the charges, and a requirement that audits be conducted quarterly.
The Dean denied a grievance, saying that audits proved the grievant's allegations to be false. Ten months later the Billing Compliance Officer stated that he hadn't finished the audit that the Dean claimed to have used in making his decision.
The grievant responded as follows:
Are we really supposed to believe that ten months later the audit hadn't been completed yet?
Dean Alfred Gilman's statement that they had conducted an audit to look into the allegations, and would continue to conduct frequent audits, and Mr. Lehnortt's statements, are contradictory.
If it takes one year to audit a division of 11 surgeons, when millions of dollars and potential felony indictments that could send UT Southwestern executives to jail are at stake, it is not surprising that these two organizations joined at the hip have so many problems with compliance.
Meanwhile, UT Southwestern and Parkland continued to be out of the control. Here is a note the grievant sent to Dr. Robert Rege, Chairman of the Department of Surgery, in March of 2008, concerning consent forms. It reports a meeting he had with another faculty member, who has since resigned. The heavy redaction is to protect that former faculty member from to UT Southwestern and Parkland Hospital's retaliation.
Maybe the audit was done, and they kept saying it wasn't because the results showed the lack of supervision that so man of the doctors said were present
ReplyDeleteThe Parkland Hospital Code of Conduct/Ethics, complete with a letter from DR. Anderson dated 1/26/10 is interesting and after reading this blog appears to be a meaningless document.
ReplyDeleteFOR EXAMPLE:
Page 24.
A "CULTRUE OF SAFETY" Which includes reasonable precautions to follow all rules, regualtions to maintain a safe environment.
Is there another hospital in this country which allows resident trainees to operate w/o attending supervision? THis is considered safe at Parkland.
PAGE 25
: REPORTING VIOLATIONS AND RAISING CONCERNS WITHOUT FEAR OF RETALIAION.
How do they explain the demotion in June 2007 of the UT Southwestern surgeon who was the Chair of the Division of Burn, Trauma and Critical Care. IT seems this demotion occurred after he complained about residents performing surgery without proper faculty supervision. THis is not considered retaliation?
If the surgeons are not properly supervising the surgery, that results in billing fraud.
These examples epitomize an unsafe work culture and retaliation!
I will review Parkland’s Code of conduct/ethics in relation to billing fraud. This should be interesting.
Given the charges, there is no way an audit took a year. In addition to not giving this guy a fair hearing, they were clearing lying to him.
ReplyDeleteThis is clear cut employee retaliation. Why have you not filed a complaint with the Texas Work Force commission who handles this for the state of Texas.
ReplyDeleteThis Doctor followed the guidelines and then was demoted. That's retaliation in my book.
Their audit could not take a year. This is BS, pure and simple. They gave the grievant the shaft to hide billing fraud. Given the charges, they would have had the compliance office workers go to medical records and pull at least 100 charts and go over them. That couldn't take more than 1 day. One way or the other, either Gilman or Dieter were not dealing straight with the doctor, and instead of getting a fair hearing, he got the shaft.
ReplyDeleteIn the history of Parkland/UTSouthwestern, I am billing to bet this is the first time ever that anyone has gone up against them. Here is a David going up against Goliath. They have never had anyone question their illegal, unethical, and immoral practices, so since they are accountable to no one, they can cheat, rob, lie, steal, etc. to make themselves look good. In a Twelve Step Program one has to be accountable to a sponsor, so that the character defects stay in check and not run wild. Obviously, these crooks answer to NO ONE. What a shame, and my tax money pays their salaries and bonuses. DMN bring this to the public and we want to hear how Parkland/UTSouthwestern will manage to defend themselves on this, especially the two-tiered system.
ReplyDeleteMaybe no one questioned it because there was nothing wrong with it. This all looks fine until it is tested against the actual facts and the law. All you are doing with this blog is giving the other side a preview of your case. I am still at a loss to figure out how any of the activities you allege would benefit the management at Parkland or UT Southwestern. It sounds like a difference of opinion on how the two organizations should be run with the losing side (which clearly holds a minority opinion) questioning everyone's ethics, professional conduct and understanding of the law except their own.
ReplyDeleteOh here come the smooth talking attorney saying lets see what the court will say.
ReplyDeleteGood evening Anonymous - April 19, 2010 12:10 PM. It nice of you to join us. Since your posted this at 12:10 pm, I bet you are at lunch and working on your company computer.
Isn't that against the rules? Some where I think you complained about that. Double standards?
As to the "losing side" or "minority opinion" you again don't get it. Only you as a member of the inside circle that we call Executive Management believe this blog content is wrong.
But what I would like to see is how long you keep you jobs when the public finds out what's going on. The court is one thing, but public opinion is another. You are a smooth talking attorney who does good in court. Let's see how you do here in the real world.
I asked you for some answers, you haven't answered them. Are you unable to or are you just not high enough to be allowed to defend the "inside circle"?
Tillos, he doesn't have the athority to say anything. That's why his posts are only trash talk.
ReplyDeletePlease re-read the blog. A lot of people questioned it, not just one person. Many quit over it at great cost to their families, their careers, and their finances.
ReplyDeleteI appreciate your concern that this is just giving the other side a preview of the case.
However, almost all of what has been posted on this blog was obtained through the legal discovery process, the 5 or 6 court hearings, the thousands and thousands of pages of legal briefs submitted to various courts, and thousands of pages of depositions.
I haven't given them anything they don't already have.
It is all public material that you have a right to read. The internet just makes it easier than having to go down to Austin, or to the Dallas courthouse downtown.
The court hearings have all been unsuccessful attempts by UT Southwestern to get the cases thrown out on a technicality because they do not want this material to ever see the light of day.
If they can't deal with the rapid dissemination of information, it's like the people who couldn't accept the telephone replacing a lot of what was previously done over days by the post office. It's not so easy to keep things hidden anymore. Free speech is more easily exercised.
If this case ever goes to court the two-tiered system and racial discrimination that it represents will be national news.
That is why they are spending millions of dollars of taxpayer money by hiring three of the largest legal firms the country, some that are international legal firms, to oppose a single doctor and am attorney in a solo private practice.
David and Goliath?
Please re-read the post. You have a surgeon, not the grievant saying that 30% of the time his patients are being taken to the OR and operations are being performed on them without him being notified.
That’s not a difference of opinion. That is about whether a crime is being committed.
And if UT Southwestern faculty do it that way at Parkland, but not at St. Paul, it is about racial discrimination.
It is not a single individual who complained. Read the airport encounter, read the interviews of four surgeons, all of whom were in agreement that there was illegal billing. Billing rules are not a matter of opinion.
Three of the four individuals whose complaints are on this post worked at top Ivy League Institutions before being recruited to Parkland.
The definition of medical staff is a “licensed independent practitioner” who is authorized “to provide care and services without direction or supervision,” consistent with individually granted clinical privileges.”
The Parkland Bylaws specifically state that residents are not medical staff. They cannot provide care and services without direction or supervision. They cannot take 30% of the patients to the OR and operate on them without supervision.
That is what these people told Dean Alfred Gilman was happening on a day to day basis. They all backed up their beliefs by either filing lawsuits, or by quitting.
And what do we have on the other side to dispute this? Neither Dr. Alfred Gilman nor Dieter Lehnortt were being frank with the grievant about the status of the audits. One or the other had to have been lying
The billing fraud at UT Southwestern echoes the drug diversion at Parkland, which also went on for years and years, despite the fact that monthly audits were required.
Thanks for explaining. I finally get it. Some big shots from back East showed up in Texas and decided that the hicks running UT and Parkland really didn't know what they were doing. When they were told to go rope a calf some left and one went to court. In an attempt to "prejudice the adjudictory proceedings" someone decided to create a blog where the case could be argued without the benefit of cross examination or comparing the facts to the law. A few did leave, but the vast majority of physicians at Parkland and UT Southwestern seem to thing the process and controls in place are fine. Let me assure you if the case ever gets to a trial racial discrimination will not be an issue. In fact, if the plaintiffs have their way Parkland and UT Southwestern would potentially be crippled and unable to care for patients - that would be a real contribution to the community. Some people live in an alternate reality. If they were being cross examined by a good friend of mine they would keep talking and talking until the attorney cocked his head and asked "what color in the sky in your world?"
ReplyDeleteI think you have it backward. The interviews of four people were shown on this post. One is from Canada, one is from Asia, and another is the child of a WW II veteran buried with honors at Arlington National Cemetery, and the other is from England.
ReplyDeleteThe grievant, was born on the East Coast, but went to college in West Texas, did his residency and fellowship training in Texas, and remains married to his college sweetheart, a native Texan.
The UTSW Chairman of the Department of Surgery is from Pennsylvania, and the two Vice-chairman are from New York, and Maryland.
Parkland and UT Southwestern will not be crippled if justice is served.
Several dozen medical schools have been found guilty of billing fraud by whistleblower lawsuits, including UT San Antonio, UT Galveston, and Texas Tech. All are thriving, with the exception of Galveston, and that is due to the hurricane.
No medical school closed. No one failed to receive care. It is not in the government's interest to cripple a medical school that plays a large role in delivering health care to a region, and that is also a vital part of the economy.
Don't succumb to scare tactics. UT Southwestern and Parkland have already been using those tactics with the media.
The government works things out. Two-tiered systems are stopped. Racism is not ended, but it is reduced. People who act as if there should be different standards of care based on race, skin color and income are shown the door.
In every case that I know of, the University and the community have benefited.
The bottom line is, the UT Southwestern conduct revealed in the lawsuit is a direct threat to the public interest of the people of Dallas, perpetrated by three people from the East Coast, and not the other way around.
And by the way, the Dean Alfred Gilman referred to in the post is from Connecticut.
As for being cross-examined, you also have that one backward. It is UT Southwestern that has been spending millions of dollars in donations that people think are going to improve health care, but are being spent on hiring multi-national legal firms in order to prevent cross-examinations by trying to get the case thrown out on technicalities, instead of by hearing the evidence.
Bring on the cross-examinations.
To Anonymous - April 19, 2010 7:25 PM
ReplyDeleteOne nice thing about ‘attorney friends’ is they are bound by the law and your friend would be asked to leave the court room. See Judges don’t like bull s@#$$er and bloggers don’t either. If you would like to discuss the meaning of 'supervision' or 'student surgeon' or 'immediate', I would enjoy that.
If you feel you can, bring it on other wise ‘go rope a calf’ because that the only valid thing you have talked about for the past 4 days.
So put that glass of wine down and start talking about something that can help Parkland’s position because what you are currently writing in hurting them.
So here’s some help: What would you recommend that should be done to resolve the lack of student surgeon supervision in OR.
Bob, you are going soft.
ReplyDeleteIt would be a great injustice if they were able to get this tossed out on a technicality. There is a saying, nothing fixes poor government as much as shedding sunlight on the system. It will be ten years before anyone would try to take on the system again if UT Southwestern and Parkland are able to get away with this.
ReplyDeleteAnd has the Attorney General started going after David Wright yet? The email where he posted that Parkland was indeed out of compliance means that the alteration of the report was commission of a fraud. This really needs to be blown wide open, with investigations at multiple levels, from the County Commissioners, to State and Federal officials.
Wolverine, that's what smooth talking attorneys are for. Our tax money pays their attorney fees and we only buy the best her in Dallas.
ReplyDeleteIt's just a shame it doesn't go the medical needs of the community. Well, neither did the bonuses.
Oh how stupid of me to think they cared about the Dallas community.
I bet all of the people who have been donating large and small amounts of money to UT southwestern and Parkland have to ask themselves if this is where they want thei dollars to go. Under Kern Wildenthal the money was donated for health care. And he would spend it on $8,000 bottles of wine day after day. The new President Podolsky spends the same amount on attorney fees.
ReplyDeleteNo more donor money until they come clean.
Sorry guys. This remains a disagreement on how the system is run. Telling people not to contribute to the medical school once again reveals that your motives are less than pure. When you win it is a victory for truth and justice, when the other side wins it is based on a technicality. We get it. No one would have had to spend a penny on attorneys if the medical school and hospital had been been sued. As I said before, the public now understands what is going on as does the news media. If you continue to libel people who are not public figures you will be the ones needing high prices attorneys.
ReplyDeleteSorry. Read Supreme Court briefs. They are on the internet. This not about opinions. It is about whether or not a crime was committed. Billing the government for services not provided is a felony.
ReplyDeleteThere is free speech, and there is libel. Libel requires the publication of statements thar are intentionally malicious and false.
To say there wouldn't be attorney fees if there were no lawsuits is wrong. There would be no lawsuits if the University and Parkland followed the law.
Donors can spend their money however the want. But there should be truth in advertising. People should know what they are getting for their money.
Anonymous - April 20, 2010 5:29 AM
ReplyDeleteOH I LOVE THREATS.
Again you just acted like UT Southwestern / Parkland Hospital Executive Management. When you can't get your way, you scream law suit instead of answering the damn questions posted to you.
You live in a world of wealth where you don’t have to spend your own money to bring grief and threats to the less fortunate. This is another great example to the two class system that this blog has described. Damn, this blog is right again.
Let me set you straight since you don't get it. Poor people like me are judgment proof and no attorney except yours would sue me. But if you were stupid enough to try it, then this suit would be in the mainstream media and posted in every one of freedom of speech Blogs. Talk about a public relation nightmare. God you are stupid.
So if you don’t like what’s being said here or who it’s said about, get off you butts and fix it. That’s what the poor people of Dallas do every day. It’s called doing your job.
Ah Bob you are back to being your normal self.
ReplyDeleteThese guys really are stupid to make a threat on a blog. It gives us something to write about over and over again. Talk about being stupid beginners.
Hummmm, every motion, every deposition, every appeal, every document would then be posted. The only way to stop it is to have a Federal Judge in your pocket and then the blog would go off shore and Bob, you could test out "International Freedom of Speech" issues.
This is going to be fun.
And as for the Donors, they can also be deposed moron. It's real good for the donation efforts. Would you like us to take that path? Do they know about this blog and what you have done?
I can’t believe Anonymous threatened the blog owner!
Ah, would you like their email addresses?
ReplyDeletePlease, for your own sake speak with an attorney and listen carefully to what they tell you. Institutions can't sue for libel. Individuals can. Individuals who are not public figures need only prove that the statements were false and damaged them. Whether they are malicious only comes into play if you are speaking about a public figure. No one is threatening you because I don't believe the people you are libeling are on this blog. Any attorney who is paid a fee will file a lawsuit whether or not there is a chance of recovery. You have outlined your concerns about UT Southwestern and Parkland and as we have both noted they will defend their positions in court - where they will be decided based on the actual facts and the law.
ReplyDeleteAnd what the hell do you think unsupervised surgery does to the poor.
ReplyDeleteYou had an easy solution and you took a vengeful route. What did you do to the Doctor’s reputation? What did you do to his career? What did you do to his family, his life style and to the people of Dallas who could have benefitted from his knowledge and skills?
You trash talk him!
Someone earlier used a phrase, “He who lives in a glass house shouldn’t throw stones.” Well, professional people would have just let him move on, instead you just had to get your revenge.
And you have been given every opportunity to correct the contents of this blog. If we are wrong, please supply us with the correct information. We have asked you to point us to the correct laws, rules and codes that govern training hospitals.
Or you could have gone to the Dallas Morning News.
Instead, you have selected not to address your perceived errors. This isn't libel, it's again your inaction not to address or correct the answers that have been given.
And whose money is going to be used to pay for the attorney? Yours or the Public’s.
Yea, we know, it’s just another example of how UT Southwestern / Parkland Executive Management act. Revenge!
Ah, the last time I heard, a blog and it's content is covered by the First Amendment.
ReplyDeleteAm I missing something here?
No, just UT Southwestern / Parkland Executive Management's double standards.
ReplyDeleteIt's ok for them but look at them scream when someone does it back!
Yes. The first amendment which guarantees freedom of speech, does not say anything about libel or slander. If the first amendment protected people from these types of lawsuits they wouldn't be filed. The blog host has protection from lawsuits provided they do not edit the content. The blogers have no such protection. Your comment illustrates what is wrong with this blog. People who may be well qualified in their respective fields trying to play the role of a lawyer. That is a foolish and dangerous strategy.
ReplyDeleteLarry, you poor sick dude,
ReplyDeleteWhy don't you post the complete letter from Dean Gilman that reported the findings of the grievance committee. Too much information for you?
The surgeons on the committee were most amused that your people were intimidated by the residents. I didn't think that most trauma surgeons were such wimps. Why was this intimidation confined to your division?
Grievance Committee? An impartial grievance committee requires treating both sides fair and just. If the audit found illegal billing, Mr. Dieter would have lost his job. Therefore, he should not have been the one to conduct any audit.It had to have been conducted by someone who was free of self-interest. I guess that's why the doc asked for the grievance committee to be composed of doctors from outside the institution.
ReplyDeleteHave Dieter investigate himself, and putting the universities lawyer on the committee to investigate the university, and I bet the other members of the committee were cronies of Rege's as well, made this a shameful affair under which the doctor didn't have a chance.
Do you think the committee and Gilman would vote to have to refund hundreds of millions of dollars to the people and insurers paying for treatment? Do you think they would vote to find themselves guilty of felony fraud.
This was not a Grievance Committee. It was a sham committee designed to railroad the doctor.
Without having impartial judges it was obviously sham and corrupt.
The moment the Dean denied his request for outside, impartial judges, he demonstrated remarkable lack of judgment, lack of insight, and was less concerned about justice than about having to refund a millions of dollars.
If the auditors at Parkland were letting hundreds of thousands of narcotics get by, the auditors at UT Southwestern should not have been trusted when they said that hundreds of millions of dollars of illegal money was getting by.
An outside committee should have conducted this doctor's grievance.
It is not libel because it is inherently false. Errors are reported all the time. It has to be false, and deliberately false in order to damage the person. Nothing false has been posted.
ReplyDeleteI have a feeling that given how UTSW has been running from facing trial, and a libel suit would result in hearing the complaints and discussing whether or not they are true in a courtroom full of cameras, they wouldn't have the stomach for it.
I would bet the doctor who has put up so much would probably want it to happen so that he gets to prove that the allegations are false.
UTSW, be careful about what you threat. They might come true, and not to your advantage.
Come on Larry (or outraged citizen):
ReplyDeletePost the whole Gilman letter so people can see why you were really dismissed from your administrative job. Nothing to do with whistle blowing. Nothing to do with Parkand. No evidence for such complaints. Just bad leadership.
For the person who started the the day with the threat of a libel suit, I've seen that others have already commented on that.
ReplyDeleteIntimidation is what UTSW has used to make many quit. Dozens of people who have been intimidated but have been silent have contacted me, and will speak when they get an opportunity when it is in court, not where UT Southwestern and Parkland can intimidate them silence. The line will be long.
If you think a threat of a libel suit will scare me away, there are several things you need to know: 1) Intimidation doesn't work with me, 2) I know that if it is true, it isn't libel. And I didn't make up any of the documents that have been posted here. They are UT Southwestern's own documents, 3) given how UT Southwestern is doing everything they can to prevent the case from being heard, a libel suit might be the best fastest way to give me my day in court, 4) a lawsuit against me will allow resumption of discovery and depositions, all of which UT Southwestern has spent millions of dollars to block, 5) in court I can call a legion of witnesses, and get the case that UT Southwestern is spending millions of dollar to block to finally get heard, in a courtroom, with a room full of cameras and reporters, 6) discovery in a libel suit will be public, and will be carried by the media, 7) what the public finds out will cause grave concern amongst the citizens, and possibly disgrace for institutions.
That's why UT Southwestern and Parkland have been spending millions of dollars to block discovery and depositions.
If on the other hand, you were merely trying to give me legal advice and telling me to watch out for myself, then I appreciate it, and thank you.
To Anonymous - April 20, 2010 2:27 PM
ReplyDeleteIt is very easy for you to type away on the Hospital computer but the rest of us have real jobs. So sorry about me getting back so late.
Here's something you could do. Post it your self. You have the documents don't you?
To date, UT Southwestern / Parkland Hospital has done nothing but threaten people, retaliate, and have smooth talking attorneys find new meanings to the words fraud, lack of supervision, lack of consent and the other things that have been posted here.
And to the moron who keeps making threats about libel suits against the people posting. Now, UT Southwestern / Parkland Hospital Executive Management is practicing intimidation and censorship. Oh does this bring back McCarthyism.
And I don't see any example of libel here. Point it out so we can correct it. Otherwise, stuff your threats, intimidation and censorship.
If you don’t like what’s written, correct us or fix it.
Now, I wonder what next will be discussed?
You know a public discovery during a libel suit will really show the Donors what the Executive Management is really like.
ReplyDeleteAgain, a good example of the management style that is being conducted at Parkland.
Is there any evidence that Parkland and UT Southwestern were involved in the Kennedy assassaination? They seem to be invoved in a vast conspiracy and was just wondering whether they were also on the grassy knoll. The Department of Surgery is an embarrassment; the protaganoist of this blog is merely an example of the dysfunctional status of a once great Department. He is part of the problem, definitely not part of the solution.
ReplyDeleteTo Anonymous - April 20, 2010 6:49 PM
ReplyDelete"He is part of the problem, definitely not part of the solution." This is the first statement we agree upon.
So what do you recommend is a "part of the solution?"
Since everyone is bitching, how do we fix it?
To Tillos: a) get a new surgery chairman. b)have the surgeons teach during operations in the OR while present. This happens 99% of the time now, it needs to be 100% c) have the attendings round with the students and residents on the wards more than onc a week. While this doesn't affect patient care it sucks educationally. d) Let the critical care trained surgeons manage the patients in the SICU rather than letting absentee general surgeons maintain "control" thru second and third year residents who are a day late and a dollar short. e) Pay gentilello enough to have him leave- he wasn't worth having before and is now just bad karma. f) get a new Surgery Chairman.
ReplyDeleteTo Anonymous
ReplyDeleteYour comment: "have the attendings round with the students and residents on the wards more than onc a week. While this doesn't affect patient care it sucks educationally."
Why does it suck educationally?
The students should have more interaction with the attendings in this setting; they would learn different things from what the residents teach. The Regents would be appalled if they realized they are providing money to Surgery for undergraduate medical education in this setting and the studnts during their surgery rotation almost never see the faculty.
ReplyDeleteAnd the Surgery Chairman is Dr. Robert Rege?
ReplyDeleteTo Anonymous - April 21, 2010 5:54 AM
ReplyDeleteYour comment: “Let the critical care trained surgeons manage the patients in the SICU rather than letting absentee general surgeons maintain ‘control’ thru second and third year residents who are a day late and a dollar short.”
Do you mean licensed trained surgeons above?
If the general surgeons are absent, where are they?
Do you think the second and third year residents are capable?
To Anonymous - April 21, 2010 5:54 AM
ReplyDeleteYour comment “have the [training] surgeons teach during operations in the OR while present. This happens 99% of the time now, it needs to be 100%”
Both from observation, testimony and documented staffing schedules show that this was impossible to have been done at Parkland. The training surgeons were not in many of the surgeries.
Why are you confident in the 99% number above?
Someone commented that students during their rotation on surgery "almost never see the surgery faculty." This must be a comment from a student or former student.
ReplyDeleteIt confirms what the blog is about, that they are not around. In a normal hospital there are regular daily rounds, where the whole team, from students to faculty, get together and see all of the patients.
Pay attention to the whole comment.
ReplyDelete"have the surgeons teach during operations in the OR while present. This happens 99% of the time now, it needs to be 100%"
The fact that it happens 99% of the time now means that the bloggers lawsuit fixed the situation. That is exactly what it designed to do.
That it happens 99% now is something that could only be said by someone who has long term experience working in the Parkland operating room. And, the statement that it is happening NOW, means it wasn't happening before. Which I guess is why the whole thing blew up, when the new faculty couldn't take it anymore.
To Anonymous - April 21, 2010 10:57 AM
ReplyDeleteSo you are stating that the "unsupervised operations" posts of this blog are in fact true and you witnessed this.
No it is word games again. "...have the surgeons teach during operations in the OR while present..."
ReplyDeleteThey do teach when they are there in the OR, but it still doesn't meet the requirement of the law.
Nor does it mean that they in the OR, instead they are on Campus. And that is any of the three hospitals that US Southwestern supports.
I do not know. This question needs to go to the person who commented at 5:54 AM and said that "it happens 99% of the time now." That 5:54 AM person has witnessed events over time, and said it happens now. That means it wasn't happening before, and the fraud and complaints on this blog must be true
ReplyDeleteWhat Anonymous - April 21, 2010 11:46 AM is talking to is the phrase "in the OR while present...". Where the word "present" is the concern.
ReplyDeleteThe training surgeon must be scrubbed and in that OR for the hospital to meet the law. But with 13 other ORs at Parkland, other residents are now unsupervised by that training surgeon.
That single training surgeon can not be in all places at the same time. Just the need for "rescrubbing" creates the "unsupervision" at the minumum.
Parkland is seriously understaffed with "in the building" training surgeons at any given time. They rely on the fact that other traiing surgeons are in the other two hospitals as back up.
Or the training surgeons that are consultants from "Plano".
Maybe so, but do they still charge Medicaid for the ghost services?
ReplyDeleteGuess who Parkland's interim and "independent" Compliance Officer is? Why, it's none other than Ron Anderson. Does anyone seriously think Ron Anderson gives a whit about maintaining compliance and preventing legal liability for the Dallas County taxpayer? H*ll no. This is typical Parkland incestuous behavior.
ReplyDeleteWe can also discuss Parkland's institutionalized employee retaliation. Got a grievance with a manager, director or officer? HR will refer you back to the very same people who are "beating" you: The manager or director in your own department.
Parkland's stated Code of Conduct and Ethics policies are a big lie. In practice they have no intention of EVER doing anything in the policy.