Preface: Insurance will only pay for certain actions, procedures and prescriptions in health care.
Texas Health Presbyterian Hospital in Dallas caters to wealthy people. It has some $1,100,000,000.00 or $1.1 Billion in net assets, it made $813 Million in the most recent tax period for which there is publicly available information, and it paid its president alone $1 Million a year.
THP has received high ratings for “surgery, obstetrics, and cardiac and stroke care.” It specializes in having the wives of wealthy men as officers and on its board of directors. See Kevin Sack, “Downfall for Hospital Where Virus Spread / Bungled Care in Dallas Raises Questions on Readiness” p. A1, col. 3 (New York Times Nat’l ed., Thursday, October 16, 2014).
THP’s ratings however are below U.S. and Texas averages in its treatment of people in an emergency. The most recent ratings of THP's emergency department revealed that THP took twice the time it takes in the rest of Texas and in the nation for a doctor or a nurse to look at an emergency patient.
In particular, reports reflect that it has encountered problems when treating people on Medicare who present at THP’s emergency room. See “Bungled Care in Dallas,” New York Times, supra.
The person who died from Ebola in this country returned to THP and died there after they turned him away. THP’s administration said they followed CDC Ebola protocols. Kevin Sack, “Controls Poor at Hospital, Nurse Says” p. A18, col. 1 (New York Times Nat’l ed., Friday, October 17, 2014).
Nurses at THP have revealed that THP gave potentially lethal guidance in treating Ebola: Among other things, the Ebola patient at THP was left in an area where he was exposed to other people, and where they were exposed to him; and THP advised their nurses that an opening at the neck in the protective clothing provided by the hospital should just be taped over and that would suppress infection. “Controls Poor at Hospital, Nurse Says,” New York Times, supra. Hazardous waste resulting from treatment of the Ebola patient was not disposed of by THP but instead was piled to the ceiling in a storeroom. Michael Wines, “Ebola Waste Poses Challenge to Hospitals” p. 17, col. 1 (New York Times Nat’l ed., Sunday, October 19, 2014).
These are not CDC protocols. To even suggest otherwise would be laughable if the results of this conduct had not been so tragic.
The CDC’s initial protocols were incorrect in a major respect, however. The CDC believed that all the hospitals in the American healthcare system could handle epidemics of infectious diseases. See Donald G. McNeil Jr., “Lax U.S. Guidelines on Ebola Led to Poor Hospital Training, Experts Say” p. A21, col. 1 (New York Times Nat’l ed., Thursday, October 16, 2014). As we now know, this was not true.
Most but not all hospitals practice for the treatment of infectious diseases. For example, practice and procedure are standard fare at the Carolinas Medical Center in Charlotte, North Carolina. Patricia R. Olsen, Interview With Joanne Sitaras, a registered nurse who works as an infection preventionist at Carolinas Medical Center, in “Vocations / The Infection Preventionist / On the Lookout for Ebola” p. 7, col. 4 (New York Times Nat’l ed., “SundayBusiness” Section, Sunday, October 19, 2014)(“Since summer, we’ve had procedures in place for screening patients at risk for Ebola at the earliest point of entry into our health care system, and we continually test the system with drills to identify gaps. Our facility created an area where we could isolate people with Ebola, or those suspected of being infected, from the rest of the facility. We continue to educate staff about Ebola, and we’ve enhanced our hands-on staff training about personal protective equipment.”).
In most hospitals, professionalism is still the prime directive in health care, if you will. Some hospitals, however, do not budget for practice in treating Ebola patients even though the CDC strongly encourages hands-on practice. Practicing and drills are not likely to be reimbursed by insurance in any case.
Some hospitals “train” their staffs to handle Ebola patients in less expensive ways than drills and hands-on practice, such as by a lecture. “Controls Poor at Hospital, Nurse Says,” New York Times, supra. THP was in this small group.
Next: The funding of the CDC and the goals Congress mandated for it after 911.
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