By Hillel Aron
By Joseph Tsidulko
By Patrick Range McDonald
By David Futch
By Hillel Aron
By Dennis Romero
By Jill Stewart
By Dennis Romero
(Incidentally, King/Drew intern Dr. Adi Klein of the JCIR, whom I cited in my last King/Drew piece, says he wants it made clear that his organization isn’t associated with that letter.) Over the years, this column has reported some glaringly bad management: Dr. Eugene Hardin, for instance, who forged much of the publications record on his credentials, then continued to hold his chair of Emergency Medicine after Finucane was informed of this error by a county audit. We’ve mentioned Ludlow Creary, who retained his chiefdom in Family Medicine after months of refusing county auditors access to his clinical records and years after facing a mammoth cash judgment and consent decree on his Bay Area clinical operations.
King/Drew’s problems no longer affect just that institution and its patients. They also appear to be causing problems even in Finucane’s own office. Last summer, Finucane’s own top assistant, Dr. Donald Thomas III, was eased out for his role in signing off on certain enterprises of senior King/Drew physician Jeffrie Miller. The problem was that Miller somehow arranged, through the DHS system, to get $900,000 in federal pharmaceuticals diverted to patients of his for-profit Metro South Provider Network. Under law, these drugs were reserved for nonprofit operations. When asked to pay what was owed, MSPN went into bankruptcy (another for-profit operation that benefited from the same ill-placed largess, John Wesley Community Health, paid up what it owed). Thomas has taken the case of his ouster to the county’s Civil Service Board, where it awaits action early next year.
Thomas was, according to an official August 7 DHS memo, let go because he was the person in charge of the DHS contract employee who actually did the deal, one Dr. Janet Aiso. But Thomas has told reporters that he initially objected to this contract, and only authorized it after his own objections were ignored. On the basis of my own dealings with Thomas and the general laxness of DHS discipline, I’m inclined to believe him.
Finucane correctly notes that his department “is facing very significant financial and policy challenges in the coming years.” What he probably means here is that the federal government, which funds most county health operations and which has — with increasing reservations — generally tolerated DHS’s slow progress toward reform over the past five years, cannot be counted on to do so in the future. Particularly under President George W. Bush. Finucane implies in his letter that, with more money, he could solve some of the county’s health-service problems. With more money, we could all solve all our problems, or so we all like to think.
In practice, as our Republican friends delight in pointing out, this doesn’t always work.
But what is really needed to make King/Drew in particular and the DHS in general work better is a precious commodity without a price tag: courage.
As I understand his letter to this paper, Finucane’s going to try once more to persuade the supervisors to hire Dr. Rodney Armstead to assist him in some major DHS reorganization. I do hope Armstead’s qualifications include deep reservoirs of courage. If he gets the job, he’ll need it.