Please check out my new books, "Bullied to Death: Chris Mackney's Kafkaesque Divorce and Sandra Grazzini-Rucki and the World's Last Custody Trial"
Saturday, June 20, 2009
The Inside Story of ACORN 8
The story of the formation of ACORN 8 can be summed up by a new saying, "it's the crime AND the cover up".
In May of 2008, it was first revealed to the board of ACORN that nearly a decade earlier Dale Rathke had embezzled about one million dollars from Citizens Consulting Inc., the financial services arm of ACORN, and Wade Rathke, the long time CEO of ACORN, along with 8 other lieutenants, had covered it up. As such, at the next board meeting, Karen Inman, board member from Minnesota, brought a motion to remove Dale Rathke from the organization as well as remove Wade Rathke from his post as CEO. The motion was seconded by about twenty other board members and motion eventually passed later in the meeting.
Because of the seriousness of the crimes, ACORN also decided to form an investigative committee. The committee was given the duty of investigating the embezzlement and anything related to it, so that such criminality would never happen again. The committee would consist of Ms. Inman, who would focus on legal issues. Marcel Reid , board member from Washington D.C., would focus on the organizational structure of ACORN. Meanwhile, Carol Hemingway would focus on financial issues.
For the next two months, the three ladies began investigating ACORN in order to make sure that any systemic and structural problems were removed. They found all sorts of anecdotal evidence that the organization was involved in much more criminality than simply the embezzlement. For instance, in an email, ACORN's attorney, Steve Bachmann. indicated to Inman that ACORN had been involved in ERISA violations. Bachmann indicated that ACORN employee pension funds were mismananged. Inman also found instances of lesser embezzlement. (between $6000 and $9000) She found instances in which affiliates that were 501 (C)3's were mingling their funds with those that were of other tax structures. (that's a tax violation because 501 (C)3's enjoy special tax protection that other organizations do not) Often, when people within ACORN would reveal past criminality, that admission would be followed by this quote "but that doesn't happen anymore". (which is interestingly enough what Mike Jones, Comptroller of CCI told Inman about the events that lead to another piece of criminality discovered outside this investigation)
Meanwhile, Marcel Reid found evidence that CCI, Citizen's Consulting Inc., was much more than merely the accounting and financial services arm of ACORN. She found evidence that CCI was the financial weigh station of all ACORN funds. Any monies, be it from charities or even government grants, would wind up at CCI first and then be transferred to anyone of several hundred ACORN affiliates. Reid even found evidence of co mingling and misuse of funds. There was again anecdotal evidence that earmarked monies weren't winding up where they were supposed to go. In other words, the government might give millions to fund health care projects in poor neighborhoods but it would wind up funding a media campaign.
What was missing was the financial evidence that would tie all of this together. That evidence lied in the financial statements of ACORN. In fact, Inman believed that a full forensic accounting audit would be necessary to get to the bottom of things. So, Ms. Inman decided to approach Liz Wolff, the Research Director of ACORN to request viewing the books.. When she came to see Wolff, Inman found her door closed. Minutes later, the door opened and walked out Wade Rathke, the same Wade Rathke that was supposedly removed from ACORN only months earlier. After meeting with Inman, Wolff refused to allow her to see ACORN's. books.
At roughly the same time, the board was also made aware that ACORN was about $2 million behind in state and federal taxes. Weeks later, both Karen Inman and Marcel Reid were witnessed to a meeting between the new CEO of ACORN, Bertha Lewis, Maude Hurd, who headed the ACORN board, and Alton Bennett of ACORN Housing. Lewis told the group that she had secured both a loan and a grant from Forest City, a loan of $1.5 million and a grant of $500,000. She wanted their approval to accept the deal. Ms. Hurd expressed reservations because the terms of the loan stated that if it ever fell behind the rate would jump to 18%. To which Bennett pronounced, "if your struggling to pay in any given month, ACORN Housing will make the payment." Hurd ultimately denied the request to allow the loan and instead ordered Lewis to gain approval of the entire board in order to approve the loan. (I chronicle the details of this loan and the backstory of what maybe a quid pro quo here)
Inman and Reid met privately following this exchange. They were very concerned by what they witnessed and they decided to immediately seek a temporary restraining order against destruction of any financial records related to the embezzlement, any communication between Wade and Dale Rathke regarding the embezzlement, and any other records related to the embezzlement. They eventually won this TRO and their lawyer indicated to them that the judge indicated that as BOARD MEMBERS THEY HAD A RIGHT TO SEE ACORN'S BOOKS.
The TRO would cost all sorts of money to maintain, however, and so if Reid and Inman wanted to see the books they would need to get a writ of mandamus. The writ was signed by eight board members, Reid, Inman, Adriana Jones, Fannie Brown, Robert Smith, Ivonne Strattford, and Stephanie Cannady.
Now, things became very contentious between these eight and the rest of ACORN. So, in early October, a negotiating committee was created between these eight and three other members of the board of ACORN. Reid, Inman, and Mobley represented the eight and the rest of ACORN was represented by three other board members including Frank Beatty of Las Vegas and Sonia Merchant of Massachusetts. The two sides met for the better part of a full day. They attempted to hash out their differences. After the meeting, Karen Inman, at least, felt as though real progress was made and she felt that things were heading in the right direction. Instead about two weeks later, they were all removed from the board of ACORN. Since they were no longer on the board, the judges interpretation of the law no longer applied either.
ACORN 8 was officially born. It's since grown and includes many more members than eight. The group is now determined to bring all of ACORN's criminality to light. Carol Hemingway, the individual in charge of investigating the financial portion of ACORN, the part that was missing in putting the pieces together (at least from the perspective of Karen Inman), is now the Treasurer of ACORN.
Whenever, either Reid and Inman, the most prominent members of ACORN 8, are interviewed people like Glenn Beck often dwell on their courage and heroism. I, for one, think that is beside the point. ACORN itself would love nothing more than to have Inman and Reid's heroism be the story. That would make this a human interest story. It isn't a human interest story. The story is very simple. The CEO's brother embezzled a million dollars from the organization. The CEO covered it up. Marcel Reid and Karen Inman were elected to investigate the matter and everything related to it. That's what they did. That was their fiduciary duty. That was their job. There's nothing heroic about doing your job. They did their job. In fact, they did it too well. As such, ACORN removed them from their board positions. You can draw your own conclusions but as my favorite Latin phrase goes, Res Ipsa Loquitor (the facts speak for themselves)
I, however, have a unique perspective to judge these lady's heorism and courage. That's because I have had the privilege of chronicling the stories of whistleblowers all over the country. Kevin Kuritzky brought to light crimes at Atlanta's Grady Hospital and his life has been ruined because of it. Dr. Blake Moore reported on a nurse at his hospital, Williamsburg Regional Hospital, that was acting as an "angel of mercy" and eventually the entire state of South Carolina did all they could to ruin his life. Jim Singer reported on serious malfeasance within Pennsylvania's Department of Child Welfare and he lost his license to practice psychology for more than two decades. Gerard Beloin reported on corruption in roofing contracts at his local high school, Goffstown High School, and he now lives in fear of his life. Dennis Lennox exposed corruption in the hiring of a prestigious Fellow at Central Michigan University and he was nearly expelled from school. Dr. Shirley Pigott attempted to expose corruption at the Texas Medical Board and she's since lost her license to practice medicine. In fact, the main reason I admire Sarah Palin is she was once a whistleblower. Blowing the whistle on corruption in any organization means that you are up against the establishment, a force more powerful than you. There are in fact very few acts more courageous than becoming a whistleblower. For that, these ladies deserve our respect, but their courage shouldn't be what this story is about. The criminality that forced them to become whistleblowers is what this story must be about.
Saturday, December 13, 2008
Some Context on the NIH, Charles Nemeroff, Corruption and My Favorite Latin Phrase
Shortly before the Senate Finance Committee began its probe into conflicts of interest among academic researchers who simultaneously receive NIH grants and pharma fees, Norka Ruiz Bravo, the NIH deputy director for extramural research, maintained the agency couldn’t simply monitor such things.The removal of Norka Ruiz Bravo was in relation to the probe by the Senate Finance Committee of Emory University Professor, Charles Nemeroff. The Senate Finance Committee found that for eight years Nemeroff took money from drug companies like Cyberonics, Glaxo Smith Kline, and Pfizer. In exchange for payments and speaking fees, Nemeroff published favorable articles about drugs that these companies were bringing to market in Psychiatry journals (Nemeroff is of course a Professor in Psychiatry). In other words, Nemeroff was, for eight years, bought and paid for by the drug companies. (as an aside he also didn't disclose most of what he earned)
To wit, she told The New York Times last March that “for us to try to manage directly the conflict-of-interest of an NIH investigator would be not only inappropriate but pretty much impossible.” She added that “I think (the system) is working to the extent that people are being honest and I think most people are honest.”
Since then, of course, she has been proven incorrect. The Senate Finance Commitee has uncovered several alleged examples of high-profile academics who failed to properly disclose industry payments, which is required by law. In a couple of prominent instances, Emory University’s Charles Nemeroff stepped down as psychiatry department chair and Stanford University’s Alan Schatzberg was replaced as the primary investigator on a grant.
Ms. Ruiz was removed because the NIH had given Nemeroff millions in grants to run OBJECTIVE studies on many of these issues. By failing to find the conflicts, the money was essentially wasted. Ruiz, as the article illustrates, felt that investigating such conflicts of interest was not her duty or responsibility. The NIH disagreed and she was removed.
As for Nemeroff, he recently stepped down as Dean of the Department of Psychiatry and Behavioral Sciences. He does however continue to maintain his professorship and six figure salary at Emory University. In other words, even though a Senate investigation clearly proves that Nemeroff used his position to corrupt, steal tax payer money, and most of create profit for himself at the expense of his craft, this is not enough for Emory to remove him. Furthermore, Nemeroff has an impressive list of awards and organizational memberships. The list is nearly one hundred and here is a snippet.
Current Editorial BoardsEditorial Board, Regulatory Peptides; Editorial Board, Synapse; Editorial Board, LIfe Sciences; Editorial Board, Advances in Neuropsychiatry and Psychopharmacology ; Editorial Board, Journal of Neuropsychiatry and Clinical Neurosciences; Editorial Board, European Archives of Psychiatry and Clinical Neurosciences; Editor-in-Chief, Neuropyschopharmacology; Editorial Board, Harvard Review of Psychiatry; Editorial Board, Psychoneuroendocrinology; Editorial Board, Journal of Psychiatric Research; Associate Editor,
...
Society of the Sigma XI, Society for Neuroscience, American Association for the Advancement of Science, New York Academy of Sciences, International Society for Psychoneuroendocrinology, American Society for Neurochemistry, International Society for Neurochemistry, The Endocrine Society
None of these societies and awards have been made aware of his corruption.
Moreover, according to this chain of emails, Dr. Claudia Adkison, a Dean at Emory's Medical School (as such one of Nemeroff's boss' since the college of Psychiatry is in the Medical school) freely admits to subverting the truth to reporters and attempting to sweep the story under the rug. Here are some of the most relevant quotes.
in working on handling the reporter I tried to make this story go away because Emory's name is in the middle of it
....
I am embarrassed and uncomfortable that I write to colleagues around the country to try to defend this when I know all the issues.
One of the recipients of these chain of emails is Dr. Tom Lawley, another Dean of the Medical school. Furthermore, according to other documents, Emory's higher ups, Lawley included, suspected that Nemeroff was being paid off as far back as 2000 and did ABSOLUTELY NOTHING. Neither Lawley nor Adkison have been disciplined in any WAY SHAPE OR FORM for their behavior. They continue to collect salaries estimated to be deep in the six figures. (Emory's tuition can run up to 40k per year for undergrads)
Finally, in 2004, then medical student Kevin Kuritzky was expelled from medical school at Emory University 41 days prior to his graduation. He had recently prior to that been approached and testified to investigators as part of Department of Health and Human Services investigation into poor medical care by Emory staff at both Grady Hospital and the V.A. Hospital. The stated reason for the expulsion was several tardies. Kuritzky continues to have a civil suit against Emory to this day.
My favorite Latin phrase is Res Ipsa Loquitor, the facts speak for themselves. When analyzing corruption, often that's the best way to look at the situation. In this case, the corruption is obvious. Emory's hands are all over it. The NIH had an incompetent employee and the employee was removed. Emory had a corrupt professor and he was merely asked to step down from his position as Dean. All those that looked the other way while he continued to commit this corruption faced absolutely no sanctions. Kuritzky attempted to shed the light on the very same type of corruption and he was dealt with swiftly. Who is corrupt here and how bad is the corruption? Like I said...Res Ipsa Loquitor.
Epilogue: I have recently attempted to make contact with both Lawley and Adkison and neither responded. Here are each of the two emails. First, here is my email to Dr. Adkison.
Dr. Adkison,
My name is Michael Volpe and I am a blogger at http://www.theeprovocateur.blogspot.com/. Recently, I was given the heads up about the on going investigation in the Finance committee of one of your professors, Charles Nemeroff. I wrote this piece last night. http://theeprovocateur.blogspot.com/2008/12/broken-corrupt-record-of-emory.html
In documents found on the web site related to this investigation in the finance committee is a chain of emails in which you are going back and forth between Dr. Nemeroff and your own superiors. In it, you stipulate that you have been attempting to quash the investigation. You admit that it is difficult to speak to colleagues from other schools knowing what you know. You are even once thankful that a reporter wasn't "sophisticated enough to ask the right questions". Do you believe that the sort of behavior you admit in this email is appropriate of a high level dean of your stature?
Furthermore, what are the "right questions"? I am curious given the obscene level of corruption discovered against Dr. Nemeroff why he continues to be employed. Is it really appropriate for your school to continue to give him a six figure salary? Furthermore, according to records on the site, you have had suspicions of this as far back as 2000. Yet, according to the Emory Wheel, your investigation continues to be ongoing. How long will your investigation last?
Also, in 2004, Kevin Kuritzky was expelled from Emory Medical school 41 days prior to graduation. I believe you had first hand knowledge of that situation. He was expelled for a few tardies. Why is Kuritzky expelled for a few tardies, while Nemeroff continues to be employed despite engaging in million Dollar corruption?
Given your admission that you were in fact attempting to subvert the truth from the media, is it really appropriate for you to stay on as Dean? Is a Dean that admits to running interference against the truth in an investigation involving millions of Dollars, corruption,fraud, and conflicts of interest? How can those that report to you have any confidence in your own leadership when it has been so clearly compromised by your role in this corruption.
Finally, I checked the website for the Emory Wheel and I notice that this story has been written about four times, and one of the pieces compliments that administration's response to this scandal. I was personally shocked when I found out the details. This, in my estimation, should be a story that is seriously investigated. Isn't the Emory Wheel the newspaper of record for all things Emory University? Why does this get so little coverage in a newspaper dedicated to keeping the students abreast of things that are happening on campus?
I would like to schedule a time for us to speak so you can clarify the issues I have raised in this email. Please let me know when you are available.
...
Here is the one to Dr. Lawley
Dr. Lawley, my name is Michael Volpe and I am a blogger. I was recently made aware of the corruption perpetrated by one of the professors under your command, Dr. Charles Nemeroff. I was tipped off to the story and wrote this about it. http://theeprovocateur.blogspot.com/2008/12/broken-corrupt-record-of-emory.html
On the website of the Senate Finance committee, I found a startling chain of emails in which Dr. Adkison is corresponding back and forth with yourself and Dr. Nemeroff. In this chain, she freely admits that she is engaging in subverting the truth of the matter from the media. She freely admits that Nemeroff did a lot more wrong than she is disclosing to the media. You received all of these emails. Why didn't you remove her immediately? Do you believe that it is proper professionalism for a Dean to engage in covering up the truth in a matter in which millions of Dollars have been corrupted?
Furthermore, the investigation makes clear that Nemeroff took money from drug companies, didn't disclose it, and didn't even report the full extent of it. While he has been removed from being the Dean of your psychiatry department, he continues to be a professor and collect a paycheck in excess of six figures. Is this what the massive tuition your institution charges should go to? Given what you know about Dr. Nemeroff's behavior why hasn't you and your entire university not informed the proper authorities so that an investigation can be started so that could eventually lead to his PHD status being removed? Do you think it is appropriate for a PHD to be bought and paid for by drug companies?
Furthermore, I know that in 2004 you were intimately involved in expelling Kevin Kuritzky from yur medical school. Your reasoning for this was that he was tardy to a number of classes. Are you then saying that Nemeroff should continue to be employed despite being involved in corruption worth millions of Dollars while Kuritzky should have been expelled because he was late to class a few times? Dr. Lawley, you are included in emails in which there is admission of a conspiracy to withhold the truth of crimes being committed. Doesn't this fact alone mean you are no longer fit to lead?
How can those underneath you possibly trust your leadership given how badly it has been compromised because of your involvement in this scandal?
Dr. Lawley's email is tlawley@emory.edu
and Dr. Adkison's email is cadkison@emory.edu
Always be respectful, but let them know how you feel about the corruption they are party to.
Tuesday, December 9, 2008
The Broken Corrupt Record of Emory University
In this letter from Senator Charles Grassley, Grassley details a web of fraud, tax evasion, and an utter failure to report repeated incidents of conflict of interest.
This is a copy of a chain of emails within the Medical Department of Emory University on July 20, 2006. In it, one of the Deans of the Medical School, Claudia Adkison, is corresponding back and forth between Nemeroff and her own superiors. She admits to attempting to cover up this egregious fraud. She even alludes to being thankful that a Wall Street Journal reporter wasn't
sophisticated enough to ask the right questions
...
in working on handling the reporter I tried to make this story go away because Emory's name is in the middle of it.
...
I am embarrassed and uncomfortable that I write to colleagues around the country to try to defend this when I know all the issues.
(I wonder what the right questions would have been)
More than one internal correspondence within Emory University show that the school was aware of the fraud going back as far as 2000. Only last month was Nemeroff finally removed from being the Dean of the Psyschiatry and Behavioral Science. He continues to be employed as a full and tenured professor making well over six figures. Nemeroff appears to have made $2.6 million in income from the cumulation of payments from all these drug companies in an eight year period. He only reported about $90,000 in fees.
To understand the total context of this story you need to go back to 2000 to another case involving Emory University. The National Institute Health approached then Professor Jim Murtaugh of the Pulmonology Department. Murtaugh began to blow the whistle on misuse of Federal NIH grant money. In July of 2001, Emory University and Jim Murtaugh entered into an agreement in which Emory University paid $1.6 million for his silence. Soon after that, docuements related to the NIH investigation began to disappear, and soon after that, the investigation was swept under the rug and went away.
In June of 2004, the Department of Health and Human Services approached Kevin Kuritzky, then a medical student at Emory University, about illegal and unethical activities at the V.A. Hospital Emory staffs and Grady Hospital, which Emory also staffs.
One night that is what happened. One time he was left in charge of the entire step down unitfrom 4 PM to 2AM. The first emergency came from one patient who was recovering from lung surgery. The patient's lung collapsed and Kevin was called in to save his life. The patient was suffocating and time was of the essence. Kevin was
panicked and needed to move quick. He needed to find a chest tube, but because of his own inexperience, he didn't know where they kept the chest tubes. In a rush, he did the only thing he could think of at the time. He grabbed the dirty chest tube that had already been used on the patient and injected into their lungs.
Next, Kevin was asked to read an x ray of the patient's lungs to determine if they were stable. This is again not something a medical student is supposed to do on their own and without supervision but since their was no supervision there wasn't much choice. Kevin gave it his best estimation and determined the patient was fine however as it turns out that was just a lucky guess. This patient survived but it had nothing to do with the type of care that was provided them at Grady.
In April of 2004, Kevin Kuritzky was expelled from Emory University 41 days prior to when he was scheduled to graduate. The reasons given related to a handful of tardiness by Kuritzky. The information that Kuritzky provided eventually lead to another investigation of Grady Hospital that concluded
the conditions at Grady Hospital pose an immediate and grave danger to the health and safety of the patients.
Nearly the entire staff of Grady Hospital is faculty and students from Emory University. Kuritzky described being left alone as a medical student without any supervision while he took care of an entire step down unit for days on end.
On top of this, Grady Hospital was also implicated when corruption there and beyond lead to the conviction on more than 130 counts by then State Senator Charles Walker.
The current investigation is both remarkable in the brazen manner in which the corruption is carried out and in the total lack of context that the investigators and the media place on it. It seems with each successive investigation no one from the media to the investigators seems to put two and two together. The common thread is Emory itself. In fact, most of the players remain the same. One player I haven't mentioned yet is Kent Alexander. Alexander is the lead Counsel of Emory University. He arrived just before the NIH approached Jim Murtaugh. Formerly, Alexander spent a great deal of time in the Federal Prosecutor's office, including eventually becoming the U.S. Attorney for the Northern District of Georgia which included Emory University. In the link I provide a mention an email in which he asks his former colleagues to quash the investigation that Kuritzky was leading.
What we have in the current reincarnation of Emory corruption is ironically unremarkable. In fact, just in the last year, Emory has been embroiled in much bigger scandal than its current reincarnation with Nemeroff. At the end of last year, things got so bad at Grady Hospital, Emory University's Medical School's prize possession, that JCAHO, the governing body of hospitals, threatened to shut it down. Had it followed through Grady Hospital would have joined an exclusive club with one other hospital, King Drew in L.A. That hospital got shut down following the disclosure of a tape of a woman begging on the floor for forty five minutes, getting no help, and then dying. For reasons only known to JCAHO, Grady, and Emory after JCAHO threatened to shut down Grady JCAHO eventually dissipated the investigation and it went away. At the same time, Grady was begging everyone in the Atlanta area for dare I say a BAILOUT. They were in need of an infusion of $200 million or face potentially closing. This would have unleashed a medical disaster on the Atlanta area. Grady is not only one of the world's biggest hospitals it is the primary care facility for almost the entire indigent population in the area and provides the only trauma center for hundreds of miles.
As such, Grady was finally given a lifeline only that lifeline came from the Woodruff Foundation. This foundation is named for former Coca Cola CEO Robert Woodruff. Woodruff's name also graces an enormous amount of the buidings at Emory University. While there is no direct links between the Woodruff Foundation and Emory University many Emory faculty and administrators can also be found on the board of Woodruff. Grady has and continues to pay Emory University $50 million yearly in order to staff its hospital. After being infused with money, the hospital also created a 501(3)C board to oversea the hospital. Much of the board is made of folks from Emory and Woodruff and Pete Correll can be found on pretty much every board.
For real conflicts of interest we only need to look no further than Pam Stephenson. She is currently simultaneously a State Senator, Chairwoman of the Board of Grady, and it's interim CEO. As the head of the Board, she played a key role in securing herself the interim position of CEO. Furthermore, she was instrumental in the peculiar firing, after only seven months on the job, of Otis Story Jr, the previous CEO.
In other words, everything currently revealed in the case of Charles Nemeroff has been done by the powers that be at Emory University over and over and in much worse scenarios really. Just think about this. Charless Nemeroff received millions in unreported income. He failed to disclose cash payments while he wrote favorable articles in trade journals for companies that paid him routinely. He failed to disclose consistent conflicts of interest while he acted in much the same way as a hired gun for most of the pharmaceutical companies. For this, he was asked to step down from his post as Dean of his college. He didn't however lose his job entirely and continues to draw a six figure salary from Emory. Kevin Kuritzky was late to classes on a handful of occasions and he was kicked out of Medical School and deprived of a medical career entirely.
This is the proper context of this story. It is a story incidentally that has been reported, poorly I may add, in the New York Times, the Atlanta Journal Constitution, and the Wall Street Journal. The Emory Wheel has dedicate all of four articles to the matter. This one commends Emory University for its handling of the situation and points out that the investigation is still ongoing which would mean it continues for a ninth year.
The reality is that this latest piece of brazen corruption is the latest in a long line of seeming never ending corruption at Emory University. Whistleblowers are routinely silenced. The media is incompetent, corrupt or both.
Friday, November 21, 2008
Grady Hospital and the Auto Bailout
Although the hospital is unique in many ways, the code red at Grady is emblematic of the crippling effect America’s health care crisis has had on public hospitals around the nation. Though Grady is among the most distressed of the country’s 1,300 public hospitals, others have faced similar challenges in recent years, including those in Miami, Memphis and Chicago, said Larry S. Gage, president of the National Association of Public Hospitals and Health Systems. There are 300 fewer public hospitals today than 15 years ago, with hospitals having closed in Los Angeles, Washington, St. Louis and Milwaukee, Mr. Gage said
....
Like other public hospitals, Grady is operating on a business model that is no longer sustainable. A third of the hospital’s patients, including those treated as outpatients, are uninsured, among them a rapidly growing group of immigrants
...
Like tens of thousands of Atlantans over the last 115 years — like Gladys Knight, the soul singer, and Vernon Jordan Jr., the presidential confidante; like more than one in three babies born here in the last decade — Ms. Vaughn entered the world at Grady Memorial Hospital, one of the nation’s largest safety-net hospitals.
...
The hospital, sandwiched between downtown and the neighborhood where MartinLuther King Jr. was born, was the place where victims of the 1996 Olympics bombings and countless other disasters have been treated. It is so intrinsic to the city’s identity that Maynard H. Jackson Jr., the first black mayor, liked to say that Grady babies should be allowed to vote twice.The bearded, middle-aged man was bleeding from a self-inflicted gunshot wound to the left side of his chest. “Don’t let me go out in pain,” he moaned in a drawl to the doctors and nurses treating his injury. “I was born at this hospital.”The patient in Trauma 3 was a Grady baby, though no one could have guessed it when the ambulance pulled in at 1 a.m. that Saturday.
The defense for bailing out Grady Hospital was that it did good work, it was vital to the neighborhood, and the health care crisis its closing would unleash is intolerable. Every argument defenders of bailing out Grady made were technically accurate. Grady Hospital did do a lot of good work in the community, what hospital doesn't. It is vital to the Atlanta area community. Of course it is. It's one of the three largest hospitals in the country. That is the nature of the beast with a hospital that size. It would unleash a health care crisis if it were closed, and I said as much. Grady Hospital is a roughly one thousand bed hospital that serves almost exclusively the indigent, the poor. Without it, the poor would be unleashed on a health care system that has no desire to treat them.
All of these points were also, frankly, beside the point. By the time this crisis had exploded so that Grady was on the brink of running out of money, I had developed contacts with whistle blowers and activists and so I had a unique perch in understanding why Grady Hospital was in a position to need so much cash. Grady was being run for the benefit of those running it at the expense of its own viability. Grady had for years been corrupted so that it became a nearly endless money pit for the corruptors. Grady was hemorrhaging cash because it was being weighed down by a series of contracts and obligations that benefitted the other side far more than it benefitted Grady. Grady paid $50 million to Emory University yearly in order to staff the hospital. (mostly with residents and medical students who also paid Emory for the privilege of being trained at Grady) A couple years back, they signed a massive contract to build a massive new addition with an architecture company run by Robert Brown, who then also served as the Chairman of the board at Grady. These same corruptors were at the center of demanding yet another life line. (Grady eventually received a dubious private infusion)
Grady's problem came down to simple math. If those corrupting Grady benefitted from each and every Dollar that filtered into the Hospital, there wouldn't be any money left for other things like expenses, equipment, viability. For years, contracts had been written to benefit of those that used Grady as their own piggy bank like Emory University, Robert Brown, and the corrupt political class that surrounds Atlanta. None of those supporting the bailout of Grady had any intention of making the sort of systemic changes necessary so that any new injection wouldn't merely prop up a failing hospital but rather lead eventually to a viable hospital. By the end of the year, Grady was injected with cash. A few months later it was announced that State Senator Pam Stephenson orchestrated a scheme to simultaneously name herself both interim CEO (after orchestrating the removal of then CEO Otis Story) and Chairwoman of the board of Grady and gave herself a benefit package worth seven figures. Beyond any shadow of a doubt, the new injection of cash was going to the exact same practices that put Grady in a position to ask for the obscene sum to begin with.
....
What I have seen from those defending the automakers is mirroring from the defenders of Grady's bailout in a very troubling and startling way. Yesterday, I saw the mayor of Lansing, Michigan on Fox News pleading for a bailout of the automakers. He pointed out that the automakers had become a fabric of our society. He said that experts estimate that for every one auto job, the economic effect creates seven more. He said that the automakers had made the difficult transition when the credit crisis hit. He pleaded that the automakers were far too vital to allow to fail. He pleaded that any sort of bank ruptcy proceeding would be far too disruptive to all those that rely on the industry like his own citizens.
He dismissed all talk of restructuring as premature. He pointed out that some contracts had already been renegotiated. The whole thing was far too familiar. The corruption of the automakers by its unions and the cities and states that rely on them is certainly not intentional or as blatant as that of Grady Hospital. It is, however, no less corrosive. Those that want the autos bailed out have no intention of seeing the kind of fundamental changes in the industry necessary to have the industry survive long term. Rather, this bailout will serve their constituencies. The unions will see that their contracts and pensions are fulfilled. Mayors and governors will see that their cities and states won't lose jobs.
None of this, however, benefits the automakers. Much like Grady Hospital, the lack of viability by the automakers is simply a matter of numbers. Because contracts and pensions are so rich, they make operating costs so large that domestic automakers can't compete with their foreign counterparts which have no unions. Because taxes are so high, the automakers can't compete on talent with their foreign counterparts which generally locate in less tax pernicious areas. The unions aren't about to sit down and renegotiate contracts and pensions so that the new deals can create costs that make the big three competitive. The cities with Michigan and the state itself aren't about to talk about lowering taxes so that the big three can locate themselves in business friendly areas. They simply want the big three to continue in the same way that got them to this point.
None of the folks that support the bailout want to change any of these fundamental problems though. They want business to continue as usual at the automakers even though this has no chance of any long term success. Much like those that supported the Grady bailout though, these folks don't have the long term viability of these companies in mind when they demand the bailout. These folks represent interests that benefit from having the autos stay in business, no matter how unprofitable that is (much again like the situation at Grady Hospital), and their only agenda is making sure their constituencies are taken care of. If federal tax payers are ripped off in the process, so be it, and this is also much the same as the agenda of those that demanded a Grady bailout. Much like with Grady Hospital, a bailout, without fundamental changes, will only mean that some point soon we will be in this position again.
Wednesday, July 30, 2008
Pam Stephenson and the Cover Up of Corruption
How could such a heainous crime and the obscene corruption that followed it be met with such a marginal response? It's because the media in the area took little interest in what the department did in the aftermath of this heinous crime. Because the media cared very little just how much reform the aftermath of Derwin Brown's death would bring to the department, very little reform was actually brought. Unfortunately, when examining the crime at Grady Hospital and the areas surrounding it, one finds a very troubling pattern like the one followed in the aftermath of Derwin Brown's death.
Back in 2004, the Department of Health and Human Services completed an in depth investigation of Grady Hospital and its conclusions were
Grady Hospital poses and immediate threat to the health and safety of the patients
Much like the cosmetic reforms after Derwin Brown's death, the media in Atlanta gave very little attention to this report. One would find nothing more than a by line in the Atlanta Journal Constitution and the television media barely made any mention of it. There was little examination of how it came to be that Grady, one of the biggest hospitals in the country, was becoming a threat to the very people it was meant to heal. Because they didn't, Grady Hospital did little to fix the inherent problems that created these findings and no one noticed.
In 2005, Kevin Kuritzky was expelled from Emory University Medical School with 41 days left before he was to graduate. At the time, Kuritzky was leveling serious charges of corruption at the higher ups with Emory and Grady Hospital. Yet, he fellow students would have no little of his situation because the Emory Wheel, the schoo's newspaper, wrote exactly 2 stories about the situation. Thus, while one of their colleagues was being expelled on the eve of his graduation, the entire student body was kept essentially in the dark because their media refused to cover the story.
At the end of November 2007, JCAHO threatened to revoke the accreditation of Grady Hospital. This was a stunning and nearly unprecedented move. It had only happened once prior in the history of JCAHO, King-Drew Hospital in Los Angeles. After a flurry of attention after JCAHO made the announcement, this story, like most involving Grady Hospital, lost all appeal in the Atlanta media. In fact, since threatening Grady with revocation of their license, JCAHO has actually wound up doing absolutely nothing. Furthermore, the actual report that JCAHO filed that produced this action has never been made public. No one in the Atlanta media has made an effort through FOIA to attempt to make this report public. As such, after making a big deal of it in November, there has been nearly no mention of this since. Many local area activists I have spoken with have made their own attempts to take a look at the report. Many of them have told me that they have been stone walled by higher ups within Grady Hospital. In fact, one name mentioned as a perpetrator of the stonewalling is Pam Stephenson, herself.
Back in February of this year, Otis Story Jr. was fired as CEO of Grady Hospital after less than a year on the job. The circumstances surrounding his firing have never fully been explained besides nebulous statements like "going in another direction". Sources I have spoken with suspect that Story simply wouldn't go along with the program of corruption. Whatever the reason, one thing is clear is that the media has no interest in finding out for itself what it is. Of course, after he was fired, the board replaced Story with Pam Stephenson. To say this was a controversial move is an understatement. At the time, Stephenson was also simultaneously Chairmwoman of the Board at Grady Hospital and a State Senator. This obscene conflict of interest and accumulation of power also received little if any attention.
Months later, this story received new media attention when Stephenson used her centralized power to award herself a contract that potentially could reach seven figures. Of course, that was nearly three weeks ago. That particular story turned out to have a twenty four hour life in the Atlanta area news cycle. Since then, there has been scant attention paid to the situation. As such, it appears that Stephenson will be able to consummate the contract and media will again look the other way.
This latest episode continues a long legacy of corruption and media disinterest involving all things Grady Hospital. The first amendment's main value is not in the freedom of speech it provides individuals. In fact, the first amendment was meant so that media like the Atlanta Journal Constitution provided a check against the powerful so that this very corruption would exposed if and when it occurred. In fact, the best check on corruption is a vigorous media always looking to expose it. One of the biggest factors for the long term systemic corruption at Grady Hospital is the media total lack of interest in reporting on it. Time after time, corruption goes on and the media is largely silent in the face of it. What has occurred with the contract involving Pam Stephenson and the manner in which the media in the area has treated it, is yet another example. Until the media decides that corruption is unacceptable Grady will continue to be corrupted and the corruptors will operate with impugnity.
Thursday, May 22, 2008
Lennox, Kuritzky, and Sham Peer Review
Medical peer review is the process by which a committee of physicians investigates the medical care rendered in order to determine whether accepted standards of care have been met.
A Medical Peer Review is meant to provide independent medical opinions conducted by an objective group of physicians and relevant medical staff that quickly resolve complex problems that hospitals, physicians and insurance carriers face. They are often used to help solve systems problems endemic to healthcare institutions and thereby reduce legal liability associated with them. The review of chart notes and other medical reports are used to help render objective written opinions.
The term has been improperly used, however, as a synonym for performance appraisal. Several organizations have co-opted the term "peer review" as a guise for performance appraisals meant to be used as negotiating tools.
A medical peer review committee can act at the request of a patient, a physician, or an insurance carrier depending on the politics of the venue.
When medical peer review is corrupted it is known as sham peer review.
Sham peer review or malicious peer review, a concept explained by Roland Chalifoux in Medscape General Medicine, is the practice of using a medical peer review process to remove a doctor who is seen to be disruptive, too great an advocate for change, or competitive with other doctors within the same institution.[1] While technically sham peer review is a concept that applies to every discipline, it has most commonly been applied to the healthcare industry recently.
In healthcare, the lines between peer review of physicians and performance appraisal by non-peers has been blurred. Administrators, nurses, and even patients play a role in performance appraisals, while peer review is a system that is only supposed to involve the physicians themselves.
Scientific peer review has traditionally been held to be achievable only when research and investigations are able to be examined openly. Medical peer review, in contrast, is protected from open examination by rules of confidentiality. In this way it also diverges from true peer review.
I have over the last several months introduced examples of how sham peer review has threatened doctor's livelihood and disrupted their lives in tragic ways.
In South Carolina, Dr. Blake Moore discovered that one of the nurses, Lynetted Vaughn, on staff at his hospital, Williamsburg Community Hospital, was administering legal doses of drugs to terminally ill patients. In other words, he discovered a serial killer. He reported her activities to hospital administration. Vaughn is exactly the sort of medical professional that medical peer review was intended for. Unfortunately, rather than disciplining Vaughn (for what should have been the beginning of criminal proceedings), the entire hospital administration turned on Dr. Moore himself.
A colleague accused him of making racist remarks, and this started a long process of sham peer review. In that case, as with all cases of sham peer review, the problem could be defined by this: judge, jury, and executioner. The employee who accused him of racism had been sent at the behest of the hospital administration to claim false charges. Dr. Moore was a whistleblower and sham peer review is a common tactic of corruptors to deal with whistleblowers. The problem was that the peer review was being administered by other corrupt entities that were in bed with the administration.
In Texas, Dr. Shirley Pigott became a target of yet another sham peer review. What she discovered was that her main insurance provider, Blue Cross/Blue Shield, had determined that she was charging them an unacceptable level of fees and they decided to use sham peer review to punish her and force her to cut her fees. BCBS used Dr. Keith Miller, who was simultaneously head of the Texas Medical Board's Disciplinary Committee and a part of the super secret Blue Cross Blue Shield Texas Medical Advisory Board, to orchestrate a sham peer review against her. In fact, there are likely thousands of doctors in Texas that were the victims and I highlighted to stories of two others, Dr. Bill Rea and Dr. Chris Kuhne, here.
The reasons for sham peer review range because this is a problem that is systemic. (I hope to introduce many more stories of medical professionals that had been wronged in the months to come)It ranges from punishing rivals, to whistleblowers, to jealousy, to mere corrupt individuals drunk on power. The thing that ties them together is that corrupt forces join together to create charges, prosecute them, and make judgement. If the same corrupting force charges a doctor, prosecutes the doctor, and acts as the jury, you can see that the proverbial deck is stacked against that doctor. That of course is a sham and that is why it is referred to as sham peer review.
Now, the only difference between the cases of Kevin Kuritzky and Dennis Lennox and the standard sham peer review is that neither Kuritzky or Lennox were doctors. In fact, what first drew me to the situation surrounding CMU was the similarities between the way in which the administration treated Lennox and they way in which Emory University treated their student, Kevin Kuritzky.
Kuritzky began reporting serious abuses in patient care at Emory's teaching hospital, Grady Hospital. Rather than having his concerns looked at, the administration deemed Kuritzky a threat. Emory employed William Casarella to not only investigate charges against Kuritzky but to prosecute the charges and act as the head of the jury at Kuritzky's disciplinary hearing. As such, 41 days prior to graduating from medical school, Kevin Kuritzky was expelled.
Emory claims Kuritzky was dismissed for "plagiarism, repeatedly missing required clerkship training involving patient care, lying to his professors, and engaging in other unprofessional, dishonest and unethical conduct."
In fact, Kuritzky has told me that just prior to the start of his expulsion hearing, Casarella approached him and told him that he was through. Does this sound like Kuritzky was part of a fair process?
So, we get to the situation surrounding the confrontation between Dennis Lennox and CMU. The elements here are largely the same. Lennox ran a painstaking campaign for more than a year to try and expose corruption that he saw in the hiring of Gary Peters to the distinguished Griffin Chair. Peters was simultaneously running for U.S. Congress in a district hundreds of miles away. As such, Lennox felt that Peters should choose one or the other. He continued to challenge the administration and refused to drop the matter until Peters made the choice.
He was ultimately proven right as last week CMU announced that they would likely change their policy and force all administration to choose between running for Congress and serving in the administration.
Of course, as the events were unfolding, the administration didn't see it that way. Thus, in October, Lennox was approached by a member of the administration, Peter Kofer, in the evening inside a university building. Because Lennox refused to identify himself, Kofer immediately took formal action. Kofer's complaint went directly to Peter Voison who is not only a member of the CMU staff but a colleague of Peter's himself. This incident lead to formal charges and ultimately a formal disciplining of Lennox. The disciplinary hearing was conducted in secret without Lennox' attendance, so we don't know who was on the jury. That said, I think we can all bet that the jury was made up entirely of colleagues of Gary Peters.
The common elements are the same. The same corrupt administration that viewed Lennox as a threat brought charges against him. They prosecuted the charges and they acted as the jury. In fact, in Lennox' case, the administration was so brazen that the hearing was held without his attendance. He wasn't even allowed to be there to defend himself. If the same corrupt administration brings charges against you, prosecutes them, and acts as the jury, then that is a sham.
What both Kuritzky and Lennox faced was the academic equivalent of sham peer review. It's important to keep that in mind as we analyze the outcome of the fiasco that surrounded Lennox, CMU, and Gary Peters. Last week, the administration announced that they would likely change their policy and Peters would be forced to choose between running for Congress and being a Griffin Chair.
While that is great, what hasn't been resolved is what will happen to th perpetrators of the sham that targeted Lennox. The common thread of any third world nation is obscene corruption at all levels. The sham perpetrated on Lennox exposed a corruption at all levels of the university. His case received a great deal of media attention. Yet, at all times, the case against him moved forward with no one in the administration ever stepping in to do the right thing. From the President, Michael Rao, to the Dean of Students, Pamela Gates, to everyone else, these folks were either actively in on the sham or they looked the other way while it continued.
Sham peer reviews don't happen by accident. They are carefully orchestrated to create a desired outcome. Neither was the sham perpetrated against Dennis Lennox merely a twist of fate or an accident. This was a carefully orchestrated plot that either involved all levels of the administration or merely had some look the other way. As such, if the administration is allowed to continue with their jobs in tact, then the message is that the sham perpetrated against Lennox is acceptable. Furthermore, these shams don't happen in a vacuum. If this administration orchestrated this sham on Lennox, they will do it again. They must be held accountable for their corruption or CMU will find itself tolerant of more of it in the future. Unless we want to deal with the next Dennis Lennox the next time they step out of line, the entire administration must be held to account for the sham that they orchestrated.
Thursday, January 24, 2008
Another Interesting Email in the Evolving Saga at CMU
I, like several area bloggers and even conservative powerhouse Redstate, feel he is being targeted and his constitutional rights are being squelched because he is attempting to expose the truth. While I make no secret of my natural bias, I also believe that I can source all my opinions with facts. As you will read further, this is not my first brush with a powerful admin trying to squelch a student's rights. I take this seriously and frankly personally, and I hope everyone else does also.
In response to my concerned email to the President of CMU, Michael Rao, his assistant sent me an emailed response. I am told that this response is a form letter and several folks received the same email. (though it should be noted that it was personally addressed to me). First, here is the email.
Dear Mr. Volpe:
Thank you for writing to the president to express your views. I am responding on the university’s behalf.
By Federal law, all CMU students are entitled to privacy in their relationships with the university. This puts the university at a distinct disadvantage when statements are made that are untrue. The university is limited in its ability to contradict those statements.
The university compares favorably with any higher education institution in its defense of the rights of all members of the community to express their opinions. The board and president have defended the rights of a wide variety of persons to express views and advocate their positions and will continue to defend these free speech
rights.
The university has an Advocacy Policy that has been in place for many years. It describes where students and others may engage in advocacy activities. Students have very wide rights of advocacy outside on the campus. The policy does not allow hand-billing and many other advocacy activities inside university buildings, except in connection with university sponsored events or in specified locations. That policy is applicable to everyone. Violations of the policy are dealt with through the student discipline procedures and employee discipline processes.
The Code of Student Rights, Responsibilities and Disciplinary Procedures (Code) has a long-standing and fair process for listening to both sides when students are subject to the university’s discipline procedures. This process follows the best practices recommended for public universities and has withstood challenges in the past. The Code lists twelve possible sanctions that may be imposed for violation of university regulations, ranging from written reprimand to dismissal (for the most egregious violations). Students who decline to respond to charges are provided a hearing.
The university’s processes for investigations and student discipline offer the persons involved a full opportunity to tell their side of the story. When they refuse to do so, the university makes a decision based on the information it has before it. It cannot allow persons to prevent closure on anything simply by declining to participate in legitimate processes.
Mary Jane FlanaganSecretary to the Board of Trustees and
Executive Assistant to the President
There are several things of interest here. The most important is this...
By Federal law, all CMU students are entitled to privacy in their relationships with the university. This puts the university at a distinct disadvantage when statements are made that are untrue. The university is limited in its ability to contradict those statements.Now, without mentioning Lennox, there is a clear insinuation here that he lied and that if they weren't legally handcuffed his lies would be exposed. This is not the first time I have seen this tactic used. A similar tactic was used toward Kevin Kuritzky in the fiasco at Emory. Let's examine the comments of an anonymous reader to this piece.
Due to some involvement in the ongoing lawsuit by Kevin against Emory, I am unable to reveal my name but was interested to see what was going on with the case. I never knew there was so much publicity surrounding the case and it was interesting to read about both sides for once. I believe in due justice but wanted to clarify a few things.1.Modus Operandi, mode of operation, is a close second to Res Ipsa loquitor (the facts speak for themselves) in my pantheon of Latin phrases. Studying both of these incidents, I continue to find more and more similarities that are frankly part of the Modus Operandi of corrupt admins that deal with students that attempt to stand up to them. This is one. This comes down to simple debating tactics. If the facts are on your side, you argue the facts. If they aren't, you try and marginalize your opponent. That is what is going on in both cases. In both cases, the facts are on the side of the students. If they weren't the admin would have pointed out the facts. Since the admins couldn't argue the facts, they attempted to marginalize their opponent by attacking their character. Dennis Lennox is insinuated to be a liar and Kuritzky insinuated to be unfit to be a doctor. In both cases, specifics or details are subtly not given and the lack of detail is explained away by vague and undefined legalisms. Modus Operandi.
Although I am unable to give details, Kevin's pattern of behavior should have led to his expulsion way before his senior year. This went beyond "simple" things as tardiness and even plagurism. Unfortunately for other Emory grads, there were other students displaying "unprofessional" behavior at the same time and they were treated the same. I agree the timing of his expulsion raises some eyebrows, but nothing that he "revealed" was a secret.
This isn't the first time that administration officials attacked Lennox' character and the comment I alluded to wasn't the first attack on Kuritzky's character. In Lennox' case, administration officials traded this set of emails back and forth.
Mr. Lennox is not only someone with noxious political and social beliefs, but someone who has mental health issues, and someone who seems to be losing control. The psychologist's advice (he has been following some of this on the news) is the following: "Don't provoke him. Don't initiate a confrontation of any sort, be it email, letter, or a face-to-face. He will respond in kind and escalate. Do not respond to correspondence, taunts, or 'stalking behavior' other than by calling the police...
So are you saying that this kid is dangerous? As in Virginia Tech dangerous? Let's not ignore the warning signs
I received this unsolicited email from Dr. Michael Ward (currently of the University of Cincinnati though he went to medical school at Emory at the same time as Kuritzky) regarding Kuritzky
Mike, Just wanted to let you know that you shouldn't get taken in by Kevin Kuritzky. The guy is a pathological liar and I have personally been taken in by his stories only to realize that he was flat out lying. I also know numerous other people who have experienced the same. It is quite sad because he is a very charming, intelligent person. He just uses these skills to manipulate people. Don't get taken in by him.Mike--
Michael Ward MD,
MBA
Resident
Physician
Department of Emergency Medicine
University of Cincinnati
This was one of several times when university officials or those close to them referred to Kuritzky as pathological. I have been told by sources that University officials even characterized Kuritzky as a sociopath to Atlanta media.
Again, while this is shocking and disturbing, but frankly not surprising. The administration's attempts to marginalize their opponents knows no bounds, especially when the stakes are as high as they are in these two cases. The admins will use any opportunity to smear their opponents because their marginalization is paramount in each case. That's because their opponents are presenting the truth, and because they are, they must be marginalized. Each administration has gone on a concerted effort to make Lennox and Kuritzky the issue rather than the actual issue at hand, and the allusion in this email is just one example.
The second intriguing part is this...
The university compares favorably with any higher education institution in its defense of the rights of all members of the community to express their opinions. The board and president have defended the rights of a wide variety of persons to express views and advocate their positions and will continue to defend these free speech rights.I personally don't know how favorably CMU compares to other campuses, however in the case of Dennis Lennox, his constitutional rights were so threatened that in pure strange political bedfellows, even the ACLU came to his aide
Right Michigan has obtained a letter from the American Civil Liberties Union addressed to Central Michigan University President Michael Rao and dated November 27th requesting that the University lift a ban on videotaping Professor Gary Peters on campus, a ban targeted at a conservative student, Dennis Lennox. According to the ACLU the University's decision "violates Mr. Lennox's First Amendment right to engage in political advocacy."
Agree or disagree with Lennox's tactics, or with the ACLU's position on most other things, for that matter, but they're absolutely right about this one.
Lennox videotapes a Professor in a public setting at a public university on public property. CMU's targetted ban (it didn't exist before Gary Peters and Dennis Lennox) is a direct attempt to scuttle his First Amendment rights and, in fact, the rights of every Michigan taxpayer. Props to the ACLU for getting this one right.
Lennox has already had his right to use video equipment in public threatened. He was already sanctioned for distributing literature too close to a doorway. Now, he is being threatened with expulsion for distributing literature inside a building. Whether or not CMU's policy on free speech is fair or not, it sure doesn't appear to be applied fairly in this case.
The next intriguing part of this email is this...
The university has an Advocacy Policy that has been in place for manyKeep in mind, Lennox placed his literature next to the student newspaper which was also distributed inside the building. The student newspaper was in violation of this policy (which of course has no logical rhyme or reason. What purpose would it serve for a school to ban distribution of literature inside a building). If the policy is applicable to everyone as the email claims why is it that only Lennox is being held accountable? Also, is exercising one's right to speak freely too aggressively really the sort of thing that a formal hearing is for? Even if Lennox was in technical violation of their code, is his use of his own free speech too aggressively really the sort of behavior that needs to wind up being formally processed? Is the student code of conduct really supposed to be used to threaten a student with formal sanctions because they happened to put literature in a place they technically weren't allowed? Really, is that what it is for?
years. It describes where students and others may engage in advocacy
activities. Students have very wide rights of advocacy outside on the
campus. The policy does not allow hand-billing and many other advocacy
activities inside university buildings, except in connection with university
sponsored events or in specified locations. That policy is applicable to
everyone. Violations of the policy are dealt with through the student
discipline procedures and employee discipline processes.
Since we are talking about fair, is it fair that only after handwringing and three months after the initial incident that Lennox was finally allowed to actually see the evidence against him? How can he mount a proper defense when the evidence is presented to him only a week prior to the hearing? If CMU is really fair, and Koper filed formal charges at the end of October, why did CMU wait until the end of January to present the evidence against him to Lennox?
Finally, I will note that an assistant responded to my complaints to the President. This is not out of the ordinary however it is quite ironic that when the initial complain was filed the President, Dr. Michael Rao, was carbon copied himself. If he is too busy to respond to complaints about the action, why does he need to be carbon copied in the original email filing the complaint?
Sunday, January 6, 2008
Peer Review: Judge, Jury and Executioner...
Medical peer review is the process by which a committee of physicians investigates the medical care rendered in order to determine whether accepted standards of care have been met.
A Medical Peer Review is meant to provide independent medical opinions conducted by an objective group of physicians and relevant medical staff that quickly resolve complex problems that hospitals, physicians and insurance carriers face. They are often used to help solve systems problems endemic to healthcare institutions and thereby reduce legal liability associated with them. The review of chart notes and other medical reports are used to help render objective written opinions.
Unfortunately, it has been used in corrupt institutions like Grady Hospital as a means of retaliation rather than a fair and impartial method of reviewing medical performance. That's because the job of accuser, judge, jury as well as prosecutor usually falls into the hands of the same group of people. Many times peer review is a tool used by administrators as a means of retaliation against whistle blowers in their department. The watch dog group, the Semmelweis Society, has documented corrupt peer reviews.
Professional peer review is intended to protect the public fromincompetent or unethical practitioners. However, it could andoften does remove the most honest, ethical, and competentphysicians, to the advantage of unscrupulous competitors. The
Health Care Quality Improvement Act (HCQIA), which wasenacted with the support of the American Medical Association,immunizes false testimony, thus allowing gossip to be convertedinto testimony and depriving physicians of independent judicial review. The accused physician is often ruined financially. The victim must pay his own legal fees, whereas his accusers are not responsible for any legal fees, which are paid by the hospital. TheNational Practitioner Databank (NPDB transforms disciplinary actions into a professional death sentence. The abuse of the process is, unfortunately, widespread.
The article continues...
My own experience with sham peer review began in 1979. As is true in many cases of sham peer review, the attack was initiated byjealous competitors who viewed a hospital computer printout anddiscovered that I was doing approximately twice the volume thatthey were doing. Never mind the fact that I was going into thehospital, at hours when they would not, to take care of gunshotwounds and indigent patients. My numbers were larger, and they were intent on doing something about it. And thus the first attackagainst mewas launched.The problem is quite simple and yet it is an epidemic, pardon the pun, at many hospitals. The problem is that the same folks that bring charges against you also run the peer review as well as act as the jury. This is, of course, a stacked deck against the accused. The problem becomes even more troubling when that accused is themselves a whistleblower. If someone is making incendiary charges against hospital officials, a corrupted peer review process is a great tool to eliminate them. (in my most recent article about the fiasco at CMU I found a similar problem. The same administration that brought charges against Dennis Lennox will also be in charge of his punishment) Clearly, the medical peer review process is corruptable unless the judge, jury and prosecutor are NOT the same as the ones doing the accusing.
The pretext concerned a 6-year-old boy who presented to the hospital at an inconvenient hour with an epidural hematoma (life threatening hemorrhage on
the brain). I prevailed upon a neurosurge on friend of mine to come into the hospital. I assisted him in the surgical evacuation of the hematoma, and the child's life was saved.Although I was only the assistant surgeon on the case, competitors brought charges against me, accusing me of operating outside of my area of competence and expertise. My qualifications, however,as assistant surgeon in this case included training at City Hospitalwhere I did 19 emergency neurosurgical cases. And in this
case,three neurosurgeons had refused to come in to the hospital to care for the comatose child before I was called. This was a true emergency,I responded appropriately, and the documentation in the chart was accurate and complete. As I soon discovered, however,truth is not an impediment to sham peer review.
The surgery department held a fact-finding meeting, which was tape recorded, and two nights later a formal peer review hearing was conducted. Since the tape was favorable to my case, thehospital CEO ordered it to be destroyed. I continued to obtain appropriate consultations when needed, and my privileges remained intact. But this was only the beginning. Other chargessoon followed. Attackers coordinated their lies and stories, and it was open season again. Often the only evidence they could offer was...it is so because I say it is so. off with his head!. It was a collaboration
between Alice in Wonderland and prestigious purveyors. The charges against me
were mounting, and the predators were moving in for the kill...
In the case of Grady Hospital, court documents show that peer review was used as a retaliatory tool against Dr. Jim Murtaugh. Since his is the only case to be unsealed, we don't know how many whistleblowers were threatened with retaliation at Grady with this corrupt method.
In the case of Kevin Kuritzky, he wasn't retaliated by peer review because he was still a medical student. That said, the some corrupt process applied to his review in his case of expulsion. The same individual, William Casarella, who brought charges against Kuritzky was also in charge of the panel that ultimately decided his fate. Like I mentioned earlier, the same dynamic is in place at Central Michigan University with regard to the disciplinary action against Dennis Lennox.
A corrupt medical review process has now formally been referred to as sham peer review, and that is what it is. If the same group is not only charging you, but prosecuting you and deciding your fate, then the whole entire process is a sham. It also becomes a tool of corruption and its original purpose is twisted again beyond all recognition.
In Georgia, State Senator David Shafer is looking to propose legislation to keep medical peer review from being corrupted. The answer appears simple to me. The panel deciding a professional's fate must be independent. That means that either a panel is formed to decide all medical peer review for the hospitals in the state or at least that the panel has no ties to the hospital in question. For instance, Grady Hospital would go to hospitals in the area or state in order to form a panel for peer review. The same should be true in the case of cases like Kevin Kuritzky and Dennis Lennox. Outside panels must also be set in place in order to keep those processes from being corrupted as well.
Thursday, December 27, 2007
Emory Wheel/Emory University = Pravda/Soviet Union
This is the first amendment to the Constitution.
Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.
There is a reason why the first amendment is first, not second third or tenth. It is the most important amendment and to me the most important part is the establishment of a free press. While the right to speak freely is virtuous and deeply important, the right of the press is especially important because the press has a reach and power that single individuals don't have.
To understand how important the first amendment is one only needs to look at press that aren't free. In despotic regimes all over the world the press hides the truth from its citizenry and instead engages in the practice of being a mouth piece for their administration. In despotic regimes everywhere the press is a tool of propaganda rather than truth telling.
I believe that the Emory Wheel is engaged in exactly such a practice for the administration at Emory vis a vis Grady Hospital and other malfeasance as any press in any corrupt and despotic regime. The only difference is that in regimes like Iran they cover up murder, slaughter, torture and terrorism while at Emory University they are "merely" covering up the administration's contribution to the pilfering of one of the biggest hospitals in the world, while poor folks get nighmarish treatment and the tax payers have millions of dollars corrupted. Obviously, everything is relative however in this case merely being mentioned in the same breath is not only shameful it is downright tragic.
The unfortunate thing is that the right role of the Emory Wheel is to be a watchdog of its own powerful forces and in their case those forces are the administration itself. Rather than use their first amendment powers to check the administration, that newspaper has become nothing more than a mouthpiece.
The first evidence is a simple word search of the Emory wheel. If you enter Grady Hospital into the Emory Wheel word search, you find 26 articles. Let's compare that to some other searches. The girl's basketball team leads the word searches with 520 articles. (all right the cynic will say that given their sports section this would be natural...fine...) Even the shuttle service is covered more than Grady Hospital. It has 50 articles. The absurdity doesn't end there. The Dalai Lama is referenced more in the Emory Wheel (86 times) than the main teaching hospital at its own medical school.
Keep in mind. Grady isn't merely one of the three biggest hospitals in the country. It isn't merely the main teaching hospital for the Emory University Medical School. The medical school doesn't merely account for about 75% of the revenues at Emory University. Grady hospital is in a state of financial crisis. It has also been cited by JCAHO for patient care. JCAHO is now threatening to revoke Grady's accreditation. This is only the second hospital in the history of hospitals to have such a step taken. The other one being King Drew in California. In other words, there is all sorts of big news all around Grady Hospital. Thus, it isn't merely inexcusable that Grady has a near communication shut down at the Emory Wheel but it is corrupt. I am fond of the Latin phrase, Res Ipsa Loquitur (the facts speak for themselves). Given everything that I just mentioned Res Ipsa Loquitur applies when trying to prove that the Emory Wheel has become a corrupt mouth piece for the administration.
The cynic would argue that incompetence and youth could explain the facts I just laid out. The cynic might be right if those were the only facts.
Let's look at the case of Steve Stein. On September 9th, he wrote this...
It’s not exactly a smoking gun, but the latest revelation in the Grady hospital saga — that Emory may be taking advantage of its influence with the struggling trauma center — raises questions the University must answer soon. State Senator David Shafer (R-Duluth) went on the attack in a recent blogpost (http://www.davidshafer.org/), implying that Emory doctors improperly bill Grady for their services. Similar allegations have already been made, but Shafer outlines the most compelling critique of Emory yet.
Shafer, who based his blog post on a two and a half year old audit of Emory’s record keeping he acquired through an open records request, writes:“[I]n a practice that is denounced by the auditors, its faculty physiciansrecord their time at Grady a mere four weeks each year (one week per quarter)and then make a guess at how much time they spend at Grady for the remaining 48weeks of the year, using the four weeks of recorded time as a guide. Emory thenbills Grady for the full 52 weeks of work. Doing the math, that means there is no documentation for 92 percent of Emory’s bills for supervisory and administrative services.”
This was a rather damning and incendiary article. That's why it was quite peculiar to find the same author eight days later writing this...
A town hall meeting about Grady Memorial Hospital last week served as a perfect metaphor for the troubled trauma center’s saga: snide attacks superseded solutions, chaos trumped compromise and Emory became the focus of unjustified attacks — again.One thing is certain: The crusade against Emory by people like loca lactivist Ron Marshall and state Sen. David Shafer (R-Duluth) has officially turned into a witch hunt.
Last week, I wrote that Shafer had raised important questions in his blog about the Emory-Grady relationship that the University had to answer. Most importantly, I wanted to know whether allegations that Emory doctors improperly billed Grady for their services were accurate.
Emory has answered these questions and has done so convincingly —the answer is a definite “no.” In a recent press release, School of Medicine Dean Thomas Lawley and Executive Vice President for Health Affairs Michael Johns provided evidence to show that the University’s time-recording practices compare favorably to those at other hospitals. Lawley and Johns made a more than adequate defense of their position. The attacks, however, have not abated.
That is a near 180 degree turn around in eight days. Only Stein knows what motivated him, however the facts as they have come out since have shown that his first article was a lot closer to the truth than his second. If Emory is the victim of "unjustified attacks", why is the hospital that is staffed 90% by their faculty now being threatened with revocation of their accreditation. Furthermore, it was the work of Ron Marshall, the activist that Stein claims was conducting a witch hunt, that was most vital in forcing JCAHO's hand in this matter.
As for Shafer, the other person that Stein refers to as the aggressor in a witch hunt. It was Shafer that lead the charge to unseal the records in the case of Dr. Jim Murtaugh. In it we found out that Dr. Murtaugh was paid off to the tune of 1.6 million dollars and silenced at the exact same time that the NIH was investigating Grady Hospital. Furthermore, Shafer discovered this...
Former Grady trustee Bill Loughrey tells me that the settlement with Dr. Murtagh was never approved or even accurately described to Grady’s board of trustees. He says that he was stunned to learn that tax dollars were paid to Dr. Murtagh, conditioned on his silence. He thinks the agreement is invalid and that the judicial process has been misused.
In other words, a public hospital used public funds to pay off and silence an employee without the permission of its board. Again, Stein can claim that Marshall and Shafer are on a witch hunt however the facts speak for themselves.
Keep in mind that Marshall was a main driving force in the subsequent decision by the JCAHO to threaten Grady with revocation of its accreditation. Again, this isn't a small step but a huge step. This has only happened once before and that was to King Drew. This is the story that force JCAHO's hand.
It might have gone down as the death of a "quasi-transient" woman with a history of abusing drugs. That's how the May 9 death of Edith Isabel Rodriguez was initially reported to the Los Angeles County coroner's office.But five weeks later, her demise has become a cause celebre, a symbol of bureaucratic indifference. It is fraught with significance not just for one struggling inner-city hospital but for political and health leaders in the Los Angeles area and perhaps beyond. The county Sheriff's Department, health officials and the Board of Supervisors all are feverishly trying to determine who was to blame and how to prevent a recurring...
Despite a long history of problems at Martin Luther King Jr.-Harbor Hospital, two things set the Rodriguez case apart: the existence of a security videotape showing the woman writhing for 45 minutes on the floor of the emergency room lobby and the public release this week of two 911 calls in which witnesses unsuccessfully pleaded with sheriff's dispatchers for help.
Grady is now in a dubious category with a hospital that stood by while a patient pleaded for help for forty five minutes before collapsing on the floor an dying. In other words, JCAHO didn't move simply because some records were misplaced. They moved because the patient care at Grady was equivalent to the case at King Drew. So, while Stein referred to Shafer and Marshall as perpetrators of a witch hunt, it is clear that their concerns weren't merely demagoguery. Stein's contribution to this story end there.
The Wheel's don't. Then, there is this commentary from the editorial staff. (This was entitled Baby Steps for Grady)
It’s two steps forward, one step back for Grady Hospital.
After a two-month recess, Grady’s board of directors has finally agreed to cede power over to a non-profit organization. Such a move follows the recommendations made to the hospital months ago by state politicians, area businesspeople and Emory itself and will allow the hospital to seek funding more easily from outside sources, not just Fulton and DeKalb counties.
But the changeover comes with a catch: The board will allow the new management to take charge only if the Georgia legislature and local business leaders pledge in writing to raise nearly half a billion dollars for Grady — $50 million of which would be due before the board changes power. The legislature will be required to pledge an additional $30 million annually to help keep the hospital up and running. Of particular note to Emory, which along with Morehouse supplies the doctors who work at Grady, the board also wants to freeze current staffing levels at the hospital.
More money for Grady isn’t a bad thing. With funding like that requested, the hospital could pay back its debts, including nearly $45 million in labor costs owed to Emory. Unfortunately, now is not the time for ultimatums from the hospital’s directors. State officials have made it clear they aren’t willing to be told what to do by the governing board of a hospital. If the board can’t reach an agreement with the legislature and other sources of funding, then they say there may be no restructuring, and Grady will be back to square one, struggling to stay afloat.
The reason that I say that this is laughable is that this piece came a week before JCAHO's damning indictment. JCAHO's action means that this hospital is in need of a complete overhaul not baby steps. More importantly, JCAHO's damning indictment or any analysis of it wasn't ever reported in the Emory Wheel. Just this semi puff piece in which they claimed that a privatization plan would allow Emory to seek funds more easily was published in the Wheel.
Next, there is the case of Eileen Smith. Smith is a former veteran staffer, twenty plus years even, of the Emory Wheel. Here is a brief rundown of her story.
The surprise departure of the longtime general manager of Emory University’s student newspaper has journalists there accusing administration officials of trying to assert more control over the twice-weekly paper’s operations.
On Wednesday, Karen Salisbury, assistant dean for campus life and director of student activities at Emory, sent an e-mail to the editor of the Emory Wheel, Geoff Pallay, indicating that Eileen Smith had resigned her position as the paper’s general manager. In that position, Smith helped students garner advertising revenue to fund the operations of the paper.
“I expect that you may want a statement for the paper and also that you may have questions (both from a journalistic standpoint and as a practical matter) about what steps will be taken and when to go about finding a replacement for Eileen,” Salisbury said in the e-mail. “I’m not sure what those answers are just yet.… I’m sure you understand that as a personnel issue all information is confidential, and I am not at liberty to speak to you or anyone else about any details of this matter.” Salisbury was unavailable to elaborate on her comments for this article.Pallay was incredulous. “I talked to Eileen the day before and everything was fine,” he said in an interview Wednesday. “She talked about being in the office the rest of the week.”
Smith had also recently moved to a house closer to Emory’s campus, and she e-mailed several current and former newspaper staff members to share the news of her departure. She declined to comment for this article. Her daughter indicated that she is seeking legal advice about her situation.
First, what is really peculiar is that the article I referenced comes from a blog I found through a Google search not from the Emory Wheel. The story is this. Smith, suddenly over one week end, either resigned or was fired and then immediately became silent regarding the details of her departure. I have been able to discover some more back ground details. First, Smith had been in contact with former Emory student Kevin Kuritzky in the weeks leading up to her dismissal. Kuritzky was a former med student (who just happened to be expelled 41 days prior to graduation) that had leveled serious charges against Emory and Grady Hospital. Kuritzky told me that Smith was ready to publish his story right before she was dismissed. I also found out that Smith's daughter attended Emory at the time of her dismissal and subsequent silence.
A search of Emory Wheel for Eileen Smith finds all of seven articles and NONE, NONE, related to her sudden dismissal and silence. It appears that the sudden, unexpected, and mostly unexplained dismissal of a twenty year staffer from the Emory Wheel is not worthy of being covered in the Emory Wheel. In fact, blogs, the AP, and other outside sources had significantly more information about this story than anything published in the very paper she worked at.
What about Kevin Kuritzky? He has leveled some serious charges against Emory and he has been expelled 41 days prior to graduating from medical school. I would say this is a story. There are two references to Kevin Kuritzky in the Emory Wheel. The first is a story that talks about the initial suit Kevin filed. This story spent far more time discussing Emory's motion to dismiss than anything Kevin had to say and it spent no time detailing any of the specific charges that Kuritzky made against Emory vis a vis their care at Grady and the VA. The second is this one by Dua Hassan claiming that the suit against Emory by Kuritzky had been dismissed. The problem is that the suit hasn't been dismissed but rather Emory won a motion and it has been appealed. This is a peculiar piece of misinformation.
What is more peculiar is that a medical student is mysteriously expelled 41 days prior to graduating. That student claims to have leveled serious and DOCUMENTED charges against the school and the hospital they run (the same hospital that is now in need of 500 million dollars to stay afloat and also is being threatened by JCAHO with revocation of its license) and the school newspaper doesn't see fit to run more than two stories about the matter. Is it not news that a medical student was expelled? What if Kuritzky's allegations are true? Isn't that something the student body needs to know? If an Emory student read the Wheel, they wouldn't know if he was or wasn't telling the truth because his allegations aren't investigated or reported.
Like I said, when proving that the Emory Wheel is nothing more than a corrupt mouthpiece for a corrupt administration, the Latin phrase, Res Ipsa Loquitur, applies.
Now, some cynics may even ask, why should I care? So what if some college newspaper is run poorly or even in a corrupt manner. I believe that the Emory Wheel is vital in the plans of the administration at Emory University. In order for their pilfering of Grady Hospital to continue (If you are still unconvinced that Grady is being pilfered and Emory is in the middle, I suggest you read this summary or a full dossier can be found here) the students at Emory must be kept in the dark. In fact, the administration must even be portrayed in a positive light. Information must disseminated in a very careful manner. God forbid that any student sees something that isn't controlled by the administration. That's why my blog is such a threat to the administration and why their admin IP 170.140.62.42 pays my blog a visit daily. If anything but the carefully crafted image that Emory has wielded is ever discovered by enough of the student body, the perverbial wheels, no pun intended, would come off. Thus, it is my supposition that the Emory Wheel must remain a mouth piece not an independent newspaper in order for the corruption, I believe exists, to continue.
Epilogue:
Much of the information that I have provided in this piece was actually discovered a while ago. I initially held out in writing this piece because I attempted to reach out to the Wheel in an attempt to insist that they do their duty and expose the truth. Because they didn't respond to my request, I am forced to pen this piece. I warned the Wheel that history will judge the heroes and the villains in this case. I warned them that I would play a significant role in the way history was written on this matter. I warned them that if they didn't reach back they would be painted as the corrupt mouthpieces for the corrupt administration that they are. They didn't heed my warning and I was left with this.
Finally, as I mentioned earlier, this story has many mazes that can be difficult to follow. You can either read the entire Grady Hospital tag, or more realistically, you can read this summary. Also, Grady Hospital is in need of an overhaul. Despite what the Emory Wheel claims I believe the privatization plan is nothing but a sham. I believe it will only lead Grady further down the abyss. Here are the recommendations that I along with mostly my colleagues have put together.