King Drew and Grady: Comparison and Contrast

Last week, Grady Hospital entered a dubious and notorious category when the JCAHO threatened to revoke its national accreditation. Only one time previously had the JCAHO gone to such a dramatic step: King Drew Hospital in California. The conditions at King Drew were something out of a bad nightmare.

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 recurrence.

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.

While the case of Edith Rodriguez became the most visible and poignant, the L.A. Times did a full investigation including undercover work to expose a great deal of the atrocious patient care at King Drew. This five part series turned the problems at King Drew from abstract and vague to real and personal.

The investigation reveals that King/Drew is much more dangerous than the public has been told.Among the findings:

• Errors and neglect by King/Drew's staff have repeatedly injured or killed patients over more than a decade, a pattern that remains largely unscrutinized and unchecked. Some lapses were never reported to authorities — or even to the victims or their families. And some people learned of the severity of the failings only by suing or, in several instances, from Times reporters who sought them out to learn about their care.

• Although King/Drew opened in 1972 with the promise that it would be "the very best hospital in America," it is now, by various measures, one of the very worst. It pays out more per patient for medical malpractice than any of the state's 17 other public hospitals or the six University of California medical centers.

• Entire departments are riddled with incompetence, internal strife and, in some cases, criminality. Employees have pilfered and sometimes sold the hospital's drugs; chronic absenteeism is rampant; assaults between hospital workers are not uncommon. Despite King/Drew's repeated promises to regulators, the problems have gone unfixed for years.

• The hospital's failings do not stem from a lack of money, as its supporters long have contended. King/Drew spends more per patient than any of the three other general hospitals run by Los Angeles County. Millions of dollars go to unusual workers' compensation claims and abnormally high salaries for ranking doctors.

• The hospital's governing body, the county Board of Supervisors, has been told repeatedly — often in writing — of needless deaths and injuries at King/Drew. Recently the supervisors have made some aggressive moves aimed at fixing the hospital. But for years, the board shied away from decisive action in the face of community anger and accusations of racism.

Because of the reporting of the L.A. Times, the JCAHO was left with no choice but this extreme action.

While we still don't know the exact specifics that lead to the same move vis a vis Grady Hospital, you can be sure that whatever the problems are they are just as serious. (We don't know since Grady hasn't made the findings public) Unfortunately, unlike in L.A., the major media in Atlanta has been asleep at the wheel in reporting any malfeasance at Grady Hospital.

If anyone wanted to read about any specific stories that were similarly nighmarish at Grady, they only needed to read my blog.

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.

I have had many apologists try and claim these stories are inaccurate...

Ok, this story is ridiculous. I graduated from Emory medical school in 2007, and no scenario such as the one Kevin described ever happened to anyone I know. We were never left alone in charge of entire floors; that is completely preposterous. And even if I had been, I would have known enough even as a third-year med student to ASK SOMEBODY WHERE THE CHEST TUBES ARE rather than abandon sterile technique and try to insert a dirty one. My guess is that they dismissed him for some real grievance, and he is claiming to be a whistleblower to cover himself.

Unfortunately for the apologists, the facts speak for themselves. Grady isn't being threatened with revocation of their license because a few machines are broken, or some doctors are occasionally careless, or any other mild reason. The action by the JCAHO is extreme because what is going on at Grady is extreme. If this story is inaccurate, how does one explain what is going on at Grady. Since the JCAHO did what they did, it ultimately doesn't matter whether or not this particular story is true. I can assure you that there have been plenty of nightmarish incidents. I know this because the action of the JCAHO speaks for itself.

This particular story is not the issue. The issue is the reporting, or should I say non reporting, of the AJC and other media outlets in the area. For instance, in 2004 the Dept. of Health and Human Services finished an investigation that concluded,

the conditions at Grady Hospital provide a serious and immediate threat to the health and safety of the patients

This report received little if any attention from the AJC when it came out even though its very conclusions indicated that the conditions at Grady were just as dangerous as those discovered by the L.A. Times at King Drew. Had the AJC made an issue out of that particular report, it is possible that many of the problems that are currently facing Grady could have been resolved then. Instead, they treated this damning report as nothing more than a by line. No one ever fully investigated. The report damned four departments specifically: oncology, cardiology, General Surgery, and obgyn. I know this because I got a copy of the report. Only the powers that be at the AJC know why they never got a copy of it.

King Drew and Grady are connected in other ways. Several high ranking members of King Drew found their way onto the staff of Grady Hospital. For instance, Ed Renford held a high ranking position at King Drew before becoming CEO at Grady. Leon Haley was another former high up at King Drew that wound up at Grady Hospital. He was Chief of Emergency Services. This is frankly the equivalent of hiring the former higher ups at Enron to be CEO, CFO, etc at your company. Yet, this too was not something that the AJC ever paid much attention to.

Even now, the AJC isn't doing very much with the Grady story. No one at the AJC is explaining exactly what it means that the JCAHO is threatening to revoke Grady's accreditation. The layman doesn't know the difference between the JCAHO and the NCAA. If they simply read that the JCAHO is threatening to revoke Grady's accreditation, they will have absolutely no context to the story. Unless the media explains to the readers and viewers what exactly this means they aren't going to know or care.

The biggest difference between the two cases is their respective positions within each of their health care communities. King Drew was a fairly large hospital and it catered to the indigent like Grady. The difference is that King Drew was not the only game in town so to speak when it came to serving the poor folks. Thus, closing it down disrupted the health care system in the L.A. area but not to the point that it couldn't handle it. The same is not true of Grady. Grady is massive among the five biggest hospitals in the country. It serves the overwhelming number of poor folks in Dekalb and Fulton County and frankly serves the poor in other counties as well. Closing it down will unleash these folks on the rest of the medical system in the area, and no one can predict the outcome. The consequences of closing Grady are scary and totally unpredictable. Of course, the Atlanta media has done absolutely no reporting on this part of the story.

Because the L.A. Times took its first amendment responsibility seriously the nightmarish conditions at King Drew were exposed and the hospital was dealt with. Whether through incompetence or worse, the AJC has never taken their first amendment seriously vis a vis Grady Hospital. As a result, we have come to the place we have despite repeated warnings.

EPILOGUE:

For a full summary of the entire fiasco at Grady, Emory and beyond please read this piece.

Also, please take a look at the recommendations that I, and frankly mostly my colleagues, have put together for saving Grady Hospital.

Fulton County Malfeasance

Many of my allies in the story about Grady Hospital tell me that Fulton County is relatively free of corruption. I have certainly documented some of the more egregious corruption in Dekalb County. While it may stil be true that Fulton County is relatively clean, Georgia Unfiltered has discovered some rather obscene malfeasance.

You know, it's one thing to lose an election when you're out-spent. It's a whole 'nother thing entirely when you're out-spent with your own money. I've long suspected that Fulton County taxpayers' dollars were spent for political purposes regarding whether South Fulton should be a city, but today, I received the smoking gun. Today, I received an e-mail with two attachments showing copies of checks cut by Fulton County Government to pay for an advertising proposal along with a round of radio ads advocating the defeat of the City of South Fulton. For those of you wanting some background information dealing with what I'm talking about, read "$85,500 of mis-used Fulton County funds?" or better yet, just look at the proposal
for the "You Have A Third Option: Broadcast Media Campaign" (PDF File).

Please check out the link as a copy of the checks in question are up on the site. I am not very familiar with this particular story and I don't know what relevance, if any, it has to the overall mess at Grady, however I will stay on top of it and provide updates.

A 21st Century Whodunit?!?!

Last night, in response to this article I received this comment.

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. 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.

2. Speaking of which, Kevin loved to exaggerate the truth and was a great story teller. At no time at the VA was he left unsupervised. The events did happen, but it was residents (who are always there) that "saved" the patients. No one used an unsterile chest tube nor did he give life-saving blood. In fact, students can't even write orders at the VA due to their computer systems (which if any of you actually worked in that system would know immediately that nothing can be done without entering orders on the computer). Oh ya, forgot to mention that students don't work overnight, as the time frame in the blog indicates.

3. Grady is essentially our charity hospital but people don't realize that Emory and Morehouse have a dedicated staff just for Grady. True, some depts like psychiatry and dermatology cover all of the hospitals due to the low volume individually at Emory, VA, Crawford, and Grady, but then again they wouldn't have sick patients on their service and nor would he be on a service like that as a medical student. As for subpar care, I agree, but that is the function of not having any money and the patient population. It is in fact amazing what Grady can do with the resources available to them and Americans should be ashamed that we have to do this living in this country. But that is another topic and regardless of how you look at it, we will always have to cut corners at Grady in order to do what is right for the patient and have been doing so for years. Kevin was not a whistle blower; he just timed it perfectly to make him seem like one.

4. I am extremely disappointed in how Emory has dealt with the other cases involving professors, faculty members but I cannot comment on those as I do not know the details. Emory has made several bad judgments and I believe they'll be punished in the long run. It's disappointing though when someone like Kevin manipulates the media to look like a saint even when he has acknowledged to committing unprofessional behavior. Btw, is anyone actually reads the medical conduct code at Emory, it states that a student can be expelled for the "first" offense. It's sad that he was expelled after 4 years when in reality he should have after the 1st year, but overall he has destroyed the credibility of all of the wonderful doctors (well some aren't but that's life) and could result in even more people with no access to health care.

I personally don't care if Kevin wins or not, but consider if you would want someone like him to be your doctor?

There is a lot that needs to be said about this comment, so I will start at the beginning. Kevin Kuritzky is a former Emory University medical student that was expelled from medical school 41 days prior to graduation. He claims it was retaliation while the school claims it was behavioral reasons. Grady Hospital is in the middle of a desperate crisis both fiscal and otherwise that has occurred as a result of a complicated set of events that I detailed and summarized here. Kevin has become my source on some of the material that I have prepared on this matter, but not on all, and at this point not even close. In fact, my biggest source so to speak is Google.com. Unlike this ANONYMOUS poster, Kevin uses his name and he gives detailed and specific accounts. Furthermore, his accounts are verified not only by other sources but frankly from internet research.

Now, this ANONYMOUS poster claims that Kevin is lying and that Grady is not as bad as I am making it out to be. What is first most interesting is that I earlier received another ANONYMOUS comment in response to the same article that started like this...

A judge ruled in Emory's favor on this one (See mention below from a highly regarded education publication). The Atlanta community needs to stay focused on the larger issues of how to transform Grady so that it can become solvent. ALLEGED NEGLECT: A lawsuit filed by a former medical student at Emory University who alleged that it neglected patients at its two teaching hospitals was dismissed last month by a Georgia judge who ruled summarily for the university. The former student, Kevin D. Kuritzky, was dismissed from Emory's medical school 41 days before he was scheduled to graduate, in 2005.

Now, the problem for these two ANONYMOUS posters is that while they both attack Kevin they give divergent information. One ANONYMOUS commenter claims that they would be more specific if they weren't party to a lawsuit, and the other claims that Kevin can be marginalized because the law suit is over and Emory won. It is one or the other. (The details of the case might even bore a lawyer however I wrote about its exact disposition here.)

Furthermore, The Emory Wheel, the Emory University student newspaper wrote this,

A lawsuit filed against Emory by a former student was dismissed last week, affirming the University’s right to expel a student based on conduct violations.

Now, either this is very shotty reporting, this person didn't reveal the truth and allowed this story to be published, or this person is lying, or maybe all of the above.

Fortunately, through the wonders of modern technology, I have been able to identify the IP address that I am certain is the one used by the person that wrote this anonymous piece.

It is...71.56.116.54. The host is...c-71-56-116-54.hsd1.ga.comcast.net.

This IP originated from Atlanta, Georgia. This computer came on my blog four times starting at 8:48 PM Central Time and finishing at 9:39PM Central and even had a stop at 9:33 PM Central time at roughly the exact moment the comment was published. Now, since this is my whodunit, it is time for me to list my most likely suspects and give evidence why I think they might be guilty.

It might be this man. As head of Public Relations for Emory University, he is of course responsible for their image. Kuritzky's accusations are quite incendiary and it is in Emory's best interests to see Kuritzky marginalized. I doubt very much that trolling through blogs and writing anonymous comments would be part of his job description, especially from home which would appear is where this originated from, however it is possible that he felt it part of his duties. Much of the evidence against this man is what we would call circumstantial. He has been identified as the most frequent guest to my site. Other strange occurrences have been identified on the internet after he has visited my site. Finally, I have attempted to make contact with him by email and he has not responded and while this is pure conjecture, maybe this is his response.


It could also be this man. As head legal counsel for not only Emory University but the Emory Wheel specifically, it would be absurd and laughable if he were the culprit. After all, he would have had to know about the story published in the Wheel. The evidence against him is also circumstantial however there are some peculiarities that make him a suspect in my mind. First, his main role is head legal counsel for Emory University. I have gathered information that leads me to conclude that he has taken on an active role in the operations of the Emory Wheel that I believe is peculiar given his main duties. For instance, I believe that in many ways he is the unofficial de facto Head of H.R. for the Wheel. Second, I already pointed out that he announced that he is not only lead general counsel for Emory University but the Emory Wheel. Now, this seems redundant to me since it would be assumed that the lead general counsel of the school would be the ultimate lawyer for the newspaper, if necessary, however he actually announced it.

Furthermore, he has a long history with Kevin Kuritzky which I detail in the link, It could also be this man. He also has history with me. I recently pointed out something that he co wrote in the Atlanta Journal Constitution that is not only absurd but probably illegal. He has plenty of motivation to not only marginalize Kevin but this blog.

It could also be someone on the staff here. The reason they are all suspects is that I reached out to them recently in hopes of making them my allies on this story. Based on their work currently regarding this Grady mess, they have currently given me the impression that they are nothing more than a mouthpiece for the administration which they are entrusted in being a watch dog for. I pointed out one article in the Wheel that had errors, and now look at another one.

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...

This article commended moves by the board at Grady. They called them baby steps on a long road to recovery. What is laughable, tragic, and absurd about the article is that not a week later, the JCAHO threatened to remove Grady's accreditation. This is only the second time in the entire history of JCAHO that it has come this far. The only other time was at King Drew Hospital and the chilling abuses there should give everyone nightmares. While we don't know the specifics, since the report has not been made public, we can assume that things at Grady are just as disastrous. In other words, commending baby steps for a hospital in this much turmoil is the height of journalistic irresponsibility. It could be that the student author is just not up to the job to find the truth in this matter or it could be something else. I don't know and that is why everyone at the Emory Wheel remains a suspect.

Finally, among the list of most possible suspects, there is Jonathon Leake. In the discovery phase of Kuritzky suit with Emory, it was revealed that Leake made several incendiary, threatening, as well as racist comments toward Kevin. Since his whereabouts are unknown to me, at least, the evidence against him ends here.

I know what some of you are thinking. This is rather flimsy evidence against everyone. That is true, and my purpose wasn't to present a strong case against anyone. My purpose was to get your attention. The IP address speaks for itself and someone out there can figure out how to identify the exact location and then we will have our culprit.

For an updated summary of the whole series of events that this particular piece is merely a small part of please go to this link.

To see the recommendations that I along with mostly my colleagues on this case have come up with for saving Grady Hospital please go here.

The Changing Political Dynamics Surrounding Grady Hospital

From a purely political junkie level the current dynamics surrounding Grady Hospital are absolutely fascinating. Here is a quick run down. Late last month, the board at Grady Hospital approved a plan to go quasi private and asked, or demanded depending on your perspective, for roughly half a billion dollars in order to stay solvent. Then, not two weeks later, the JCAHO threatened to cut off Grady's national accreditation. Now, let's take each one at a time and then look at them together.

I believe the board is playing a huge political game of chicken with the Georgia legislature. I believe this plan does NOT have the best interest of the hospital in mind whatsoever. While that is certainly important, it is unfortunately a side issue in this political battle. As a friend of mine once put it

Grady can't shut down because who would take care of all the poor folks then

Without the money called for in this plan, Grady WILL shut down. The powers that be know this, and I have said as much. While Grady Hospital has had a long history of corruption and mismanagement, much of the power structure has continued to boldly and brazenly manage it in much the same way that has landed it in its current state. The reason for this is of course quite complicated, however it is due in no small part to Grady's vital role in Georgia health care system and society at large. Remember, Grady Hospital is among the largest in the world and is overwhelmingly responsible for taking care of most Georgia's poor folks. Without it all of the many "nice" hospitals in the area would have to take care of those folks.

I have fallen in love with the Latin phrase, Res Ipsa Loquitur. (The facts speak for themselves) Given Grady's long and sordid history with corruption and mismanagement, the fact that most of the power structure in Georgia never tried to really stop it tells me that most people don't much care as long as some other entity was taking care of those that no one else wanted to take care of, THE POOR. I believe the powers that be are counting on the exact same dynamic now. I believe the only thing most of the power players in Georgia want to avoid is for the poor folks to be dropped on the rest of the health care system. As long as they are Grady's problem, in my opinion, most everyone else turns a blind eye.

Thus, we have this game of chicken. The legislature doesn't want to hand Grady Hospital anymore money. They must know that the systemic problems currently going on at Grady aren't going to be solved with this plan, however without an infusion of cash, Grady shuts down. The powers that be at Grady are counting on the legislature blinking first. The legislature meets again in January so, for now, that part of the story is on hold.

Enter the JCAHO. Just last week they publicly threatened to revoke the accreditation of Grady Hospital. To put this move in perspective only one hospital, King Hospital in California, has ever actually lost their accreditation. Many of allies on this story have extolled this move as pivotal. I am a lot more skeptical. There must have been the same kind of excitement when State Senator Charles Walker was convicted of 127 felonies at Grady and beyond. Yet, he, along with his daughter and the companies they ran, were the only ones that were convicted, and of course he got the absurd sentence of ten years. In 2004, the department of Health and Human Services conducted an investigation that concluded this...

the conditions at Grady Hospital pose a serious and immediate threat to the health and safety of the patients

That was pretty damning however besides the then CEO, Dr. Andrew Agwunobi, no one lost their job as a result of this report and the power structure stayed in place despite its damning findings.

Even in the late 1990's, Georgia Attorney General found Grady Hospital guilty of Medicare fraud. All of these were opportunities lost to clean up the corruption at Grady Hospital. The reason it didn't happen is also quite complicated, however I believe much of the blame goes to the media in Atlanta, headed by the Atlanta Journal Constitution.

In each of these stories, the truth is quite complicated and it was never fully explained to the citizens of Georgia. For instance, in the case of the HHS report, the report itself was damning, however how many people know the specifics of the report? Four departments were singled out: oncology, cardiology, General Surgery, and obgyn, in the report. Each of these departments had heads. None of these people lost their jobs because the specifics of the report weren't ever reported properly in the media. Furthermore, the heads of these departments had one boss, the Chief Medical Officer. His name is William Casarella and he has since been promoted within Emory University. This also happened because the media didn't properly report the specifics of the case. All people knew, if anything, about the investigation was the conclusion. While that was damning enough blame was impossible for a layman to determine without understanding the specifics as I now explain them.

In the case of Medicare fraud in the late 1990's, three departments were also identified: cardiology, obgyn, and oncology. Again, these departments have heads and a Chief Medical Officer above them. All of them including the CMO should have been and would have been fired if the media had properly exposed that case. As you can see the same departments are now coming up in multiple reports. No one outside the Grady structure knows this because the media, either through incompetence or worse, doesn't report the specifics of each case.

There is one other case that the media did an atrocious job of reporting. That is the case of Dr. Sam Newcom. He was for about a year, the head of Oncology at Grady Hospital and Emory University Professor. He tried to speak out about the corruption and poor patient care at Grady Hospital and he was fired and ultimately paid off and silenced, but before that he wrote an article entitled Fighting Class Cleansing at Grady Memorial Hospital. You won't find this article in any mainstream Atlanta publication. As head of Oncology, you would be right in concluding that much of his indictment centered on his own department. In other words, oncology is the subject of a great deal of indictment from people of varying motivations and knowledge.

Nothing much has happened to clean up the oncology department and that is because the media has been asleep in reporting the specifics of what is going on at Grady.

Then, there is Emory University. When the heat gets hot on Grady, Emory does a great job of distancing itself. In fact, they are doing their own disappearing act now. The truth is that they are for all intents and purposes one and the same. Each of these departments indicted by several different groups was run and almost fully staffed by staff at Emory University. The Chief Medical Officer, Dr. William Casarella, during much of this malfeasance has since been promoted within Emory. In other words, when there is sytemic problems at Grady Hospital, the blame must be laid at Emory University since it is staffed overwhelmingly by Emory professors and students. When Dr. Newcom indicted oncology, he was indicting his own colleagues since oncology is overwhelmingly staffed, like most of Grady Hospital, by Emory University personnel.

Now, what about the JCAHO findings? We know they are threatening to cut off accreditation however why? That, we don't know because for reasons unknown (I plan on calling the JCAHO on Monday for further explanation) the specifics of the findings aren't known. We can assume that multiple specific departments are the cause of it. It might be oncology, General Surgery, obgyn, cardiology, etc. The heads of any of the departments involved must be removed. If your department contributed to an investigation that ultimately lead to the accreditation of your hospital being threatened, THAT IS GROUNDS FOR REMOVAL, in my opinion at least. The current chief medical officer, Curtis Lewis, must be removed. If you are overseeing a hospital and the hospital is threatened with the removal of its accreditation, THAT IS GROUNDS FOR REMOVAL. The Current CEO of Grady Hospital is Otis Story, Sr. He must be removed for the same reasons. In fact, the entire board ought to be removed, however the board is overseen by Vernon Jones, and anyone that knows anything about Jones knows not to expect that to happen. Of course, how many Georgia folks know the real story behind Vernon Jones? That would require the media in Georgia to actually competently report the whole truth.

This whole case proves why the first amendment, the free press, is first not second or tenth. I hope everyone sees what happens when the media itself cedes its own freedoms and doesn't bother to report the whole truth. In order for this cycle to stop, the whole truth of the JCAHO findings must be reported by the media in Georgia. The media must keep the pressure on until all parties are held responsible. That is what has to happen.

Here is what will probably happen. There will be no more then a few more articles in the AJC about this report. Anymore reporting will be on the eventual deal made between Grady and the JCAHO, a deal that will no doubt be made in some back room. The major media in Georgia will NOT reveal the specific departments responsible for this latest investigation. They won't name names and they won't demand for heads to roll. Finally, they won't call Emory out when they distance themselves. Emory University will throw its significant weight around the Georgia Legislature and no one will report it. Grady will be given a golden parachute and none of the obvious systemic problems I have pointed out will ever be reported on or addressed. I hope I am wrong and I will be watching.

For more information on this case, please read this article. Also, please read the recommendations that my colleagues have come up with and compare them to the current plan.

Attacking Corruption: The Power and Frustrations of the Blogosphere (Updated)

INTRODUCTION: I have been known to tell many of new found allies in the case of the corruption that I have found at Emory University, Grady Hospital and beyond that our opponents cannot control what I am doing because the internet is not controllable. It is a force beyond anyone's control.

For instance, a few weeks ago I wrote this story linking the murder of Derwin Brown, the suicide of Charles Hicks to a culture of corruption in Dekalb County under its "leader" Vernon Jones. The story started its journey on the front page of Real Clear Politics\ and then traveled its way across the country until hundreds of people began emailing it to each other (I know this through the technical way in which my stat counter tracks my visitors. It is too long and boring to explain so you will have to take my word for it) I even received this email in response to the story.

Mr. Volpe, Greetings... I have recently been reading many of your comments specifically relating to corruption, politics, and particularly Dekalb County.. You Sir are right on point!!! The dynamic that resulted in the ELECTED by the people Sheriff Derwin Brown (as opposed to the establishment "appointed" Sheriff Tommy Brown) was certainly a result of a vast conspiracy not merely the action of a single individual(Sid Dorsey)..

Derwin had himself uncovered many instances of longstanding good ole boy wink and nod politics and outright corrupt practices. Additionally, he aligned himself with individuals ( such as yours truly) who had personal knowledge of corrupt practices and deals that government officials elected in Dekalb had engaged by formed cozyrelationships with business people for their personal gain and pecuniary benefit. All be it strip club operators, county vendors, bail bondspeople, or off duty officers with private security accounts; Derwin represented the end of this type graft. These miscreants wanted him stopped and they stopped him. Maybe by not necessarily pulling the trigger but by creating an atmosphere and culture that resulted in demented and ignorant individuals like Dorsey, Cuffie, et al feeling that it needed to be done and should be done..

These tacitly involved individuals have Derwin's blood on their hand to the same extent as the trigger men... Moreover, allowing individuals like Vernon Jones, Charles Hicks, Louis Graham, and Thomas Brown (the prmier figurehead) to run the government is nothing short of a farce.. Mr. Hicks may have truly had a crisis of conscience and therein lies the reason for his unfortunate death (be it suicide or murder). The real power brokers (Bob Wilson, Ray Suddeth, Mark Dehler, Frank Redding, and Sembler) are the ones reaping the real benefits $$$ from these shenaigans in Dekalb County government over the last 15 years. Unfortunately, it is at great cost to the taxpayers and underminds the sheer fiber that our Constitution is foundationed upon and yes cost at least one hero his life..

I received several such emails and a host of new and important contacts as a result of internet travels of that story. No amount of corruption can stand up to the power of the internet, email, and how that dynamics brings everyone together.

The feedback hasn't always been good. For instance, I recevied this email from Dr. Michael Ward of the University of Cincinnati. He has some incendiary things about Kevin Kuritzky, the whistle blower that first turned me onto this story.

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

I invited Dr. Ward etc. etc. to back his vague and incendiary statements up with examples and evidence. He has declined and since the email is now my property I have decided to use every opportunity to use it to expose him as the fraud. He is of course welcome anytime to back up any of these statements. In the meantime, his own words will be on the internet for everyone to see.

Those are examples of using the blogosphere and the internet for positive and how it becomes the ultimate equalizer. On my site, Dr. Ward etc. etc. is no more powerful than anyone else, and through the reach of sites like Google his own words will be on display for anyone that cares. Now, I have introduced the positives of the blogosphere however this piece is about some of the filth and garbage that you find will navigating through and with that the introduction is over...


I will direct everyone to two separate sites in which, in my opinion, all of the worst of the internet came out. First, I have an admission to make. I traced a tentacle of this story down to Florida in the person of Dr. Andrew Agwunobi. He appears to be knee deep in the scandal at WellCare. Since he is currently in the REPUBLICAN administration, I see his exposure as a boon to all Democrats. Well, in terms of size and power the ultimate Democratic blogging site is Daily Kos.

While a true blue Republican would have difficulty there, I simply couldn't ignore their sheer size and numbers. I knew that I couldn't go there as myself, so I went there under the pseudonym, theprovacateur. (I know it is misspelled and so be it.) I received a lukewarm reception to my expose of Dr. Agwunobi. While most of the people that read it liked it, it wasn't nearly as popular as the most recent "expose of a Bush Lie, impeachable offense, and example of incompetence".

Next, I thought I would be more confrontational and inflammatory in a piece that was in response to another piece published by a regular of Daily Kos vis a vis Vernon Jones. Anyone who knows anything about the Kos knows that confrontational and inflammatory are not only welcomed but encouraged there. Welcomed and encouraged that is I found as long as you are attacking what they consider the enemy. Since I dared to attack one of their own, well suddenly the entire Kos site became quite sensitive. (Yes, this is a case of being able to dish it out but not taking it)

Here are some examples of the comments...

you need to give some serious thought to your approach to diarying here. You don't raise awareness about an issue by attacking another diarist who wrote something only very indirectly related to your issue, six freaking months ago. I suggest you delete this diary and try again. If Vernon Jones is your problem then write a diary about Vernon Jones. Don't write diaries accusing others of being "pathetic". That's not going to win you loyal readers.

And a last piece of advice: before you issue sweeping statements of condemnation about Kossacks, you'd better know what the f$%k you're talking about, because I will personally guarantee you that whatever the subject, there will be at least one person around who knows 10X more about it than you ever will. Now delete this ridiculous diary so that it doesn't show up on your "permanent record," and welcome to DailyKos.

Keep in mind that Vernon Jones is the subject of much of my wrath. Vernon Jones is most likely a multiple rapist, probably tied to a great deal of personal corruption, and certainly oversees not only a corrupt police force but also a corrupt public hospital. In other words this is a bad guy. Did I mention he is running for U.S. Senate? Yet, most of the wrath is directed at me, not Jones, because the language I used was "inappropriate". Those weren't the most revealing comments though. These two were.

Lots of places besides DailyKos to send this. (7+ / 0-) Recommended by:
Rebecca, JeffSCinNY, eeff, joanneleon, sbdenmon, Unduna, Goodbye Kitty
TPM Muckrakers, Open Left, FireDogLake, Americablog. Go for it. One more
crook killing people doesn't even qualify as news anymore. Good luck.

Local GA political blogs (3+ / 0-) Recommended by: Rebecca, JeffSCinNY, joanneleon
would be an even better choice. Tondee's Tavern, for example. Link's in my blogroll, if you're interested, diarist...

These folks, who claim to be appalled by all of this corruption around them, passed on actually doing anything about corruption put right in front of them. It was pretty clear that they like to chat back and forth about all of the supposed corruption they see but can't do anything about, rather than trying to tackle any corruption in front of them. Keep in mind that Jones is running for the Democratic nomination of the U.S. Senate. Despite proclaiming how large and powerful they are whenever they think it matters, they are now suddenly powerless to this corruption. Not only did I, not Jones and his corruption, become the issue, but they frankly had no motivation to actually challenge any of the corruption that many of them ceded he has caused. While they found nearly endless energy to attack me, they had none left for a real bad guy, Vernon Jones.

Of course, what happened vis a vis this piece was nothing to what happened when I published this piece that is a detailed summary of the corruption at Grady Hospital, Emory University and beyond. The first few comments were fine, however since much of my piece linked to my own blog, soon enough people noticed they were reading a conservative. Here are some of the comments that followed.

This is being cross posted with permission of Mike Volpe of Proprietor Nation
A quick look at the blogroll of PN gives us: RedState, Powerline, Michelle Malkin, LGF, Hot Air, Captain's Quarters, etc., etc. Judging by your comment about the radio show, I'm assuming you are "snooper." The top story on your personal blog is "The Leftinistra Brainwashing Our Youth." That blog's tagline currently reads: Dedicated to the men and women of the United States Military fighting the Islamic Menace that our government has wrongly mistaken as a peaceful religion. Call me cynical, but these things make me question your motives for posting here, as well as your read on the situation with Grady Hospital, given your inherent bias.

...


You have destroyed any credibility you might have here at dKos by the sources you've used in this diary. Your entire theory hinges on the ravings of a far-right loon and the company he keeps, yet you claim that to be "irrelevant."You despise Vernon Jones; we get it. GA Kossacks despise him, as well, so you're not likely to make any new converts. No one outside GA has the time to care. There's a primary or two coming up in the next few weeks, if you hadn't heard.How will that make the Democratic party look? Please. Concern troll much?

...

Here are Mike Volpe's "recommended blogs" (3+
/ 0-)
Recommended by:
joanneleon, sbdenmon, irishwitch
Volokh
Conspiracy
Varifrank
Tygrrrr Express
Twin Cities Conservative
The Mortgage Reports
The Minority Report
Take Our Country Back
Simon Power
Red State
Powerline Blog
No Hillary Clinton
Michelle Malkin
Michael Yon
Michael Totten
Little Green Footballs
Iraq the Model
IMAO
Hot Air
Hinz Sight Report
Gerry Charlotte Phelps
Faultline USA
Draft General Pace
Deborah Lipstadt
David Frum
Daniel Pipes
Captains Quarters
Austin Bay

Side note: There is a lot of room for abuse when inner city hospitals are used as teaching hospitals for universities -- that particular symbiotic relationship is a very tricky one. At the same time, this write-up is at least 75% innuendo. It reads to me like Emory is the presumptive "bad guy," when in actuality the problem is lack of oversight in hospital administration. So, no, poor medical care for the indigent is not a partisan issue, but the way this is written up sure seems to have a David Horowitz ring to it. I think you could re-assemble these facts without that central assumption and have a piece that would get a better reception.

Here is my personal favorite...

And libelous bulls$%t at that.They've got a good law school, too. You might invest in an alumni directory, unless Michael Horowitz has already lined up an attorney for you.

So, does everyone understand? I am wrong because I am a Conservative, and Emory can't be corrupt because they have a good law school. As Kevin Kuritzky pointed out to me long ago, this is not a partisan issue, it is an issue of corruption. The irony is that almost all of the allies I have gotten on this story are themselves Democrats. The worst part was that I was arguing with people who had never heard of this story before. They proceeded to think that they knew more than me and they were confident in their thoughts because I was linked to a Conservative. (at this point they still assumed that theprovacateur and Mike Volpe were two different people) For instance, I got this comment...

Yes, I read the piece. Mike Volpe alleges four professors were "paid off" -- but only gives information about one. The link shows that Dr. Murtaugh's lawsuit centers on not getting a promotion, and he get a settlement. He also alleged medicare fraud. But to say that the settlement was a payoff to silence him about the medicare fraud is a gross oversimplification.I conceded that there was probably some wrongdoing by Emory. But you completely ignored my point that this piece is fundamentally dishonest because of its anti-Emory framing -- it seems like very few of the issues are actually Emory's fault. They get paid 50 million because they staff the hospital and inner city hospitals don't staff
themselves. By doing so, you are conceding the innuendo argument.

I'm assuming that you're repeating this and are being used, and are not a troll yourself. Think of our reaction this way: suppose a diary comes up that focuses on an important misuse of CIA intelligence that led to the Iraq War, but frames it as being the fault of Senator Rockefeller because he was on the Intelligence Committee. You and I can agree on the importance of the problem, but find the framing dishonest. That's what we're saying here, and I'm not criticizing you, just trying to get you to see that supporting the recognition of the problem doesn't mean uncritically accepting everything in a diary about the problem...

This poster is referring to four doctors that I said were paid off. They say that I have no evidence because I have little to say about any of them besides one, Dr. Jim Murtaugh, and this poster seems to find this as evidence of my shotty reporting. Keep in mind they were paid off and silenced, and so by nature there will be little evidence of the specifics of each case. The only reason that Murtaugh's case came up is that State Senator David Shafer lead a Congressional delegation to unseal the settlement. Furthermore, someone at Kos laughably claims that my piece is dishonest because I take a preconceived bias. First, I do. I am certainly biased against the administration. This comes after two months of research in which I have concluded that they pilfer Grady Hospital, land a sweetheart deal at the tax payer's expense, and pay off or expel anyone that gets in their way. (they will even make articles disappear from internet archives if it is discovered those will make them look bad) Of course, what is laughable is the Kos claiming that an arguement is flawed if it is biased. If that is the case, they have condemned each of their own diaries.

What was really insulting is that I have no doubt that almost no one I was arguing with had even heard of Grady Hospital before I pointed it out to them. The only reason this became confrontational is because they thought that a Conservative had provided the sourcing. At this point, I have spoken with so many insiders on so many angles of this scandal that the only people that know more about it are the insiders themselves. I have traced tentacles to the Dekalb Police Department, the WellCare Scandal, and I am now working on connections to real estate developers and possibly even the Dixie Mafia. I bring this up not to toot my own horn but so that everyone understands how well I understand this story. For someone to challenge me without knowing much of anything is simply insulting.

Of course, the lunacy is not exclusive to the left of the blogosphere. I got into a verbal joust with some commenters on the Georgia blog, Peach Pundit. There were mostly Republicans and Georgia residents and so their problem with me was entirely different. Here are some examples of the comments...

Fascinating that you are so connected and interested while living in Illinois. And as far as Derwin Brown. He was my sheriff and a good man. His death was heinous. So is your ridiculous attempt to tie it into this mess.

...


It isn’t “going private” at all. Just being restructured as a non-profit, likely with state funds being provided. And given the way the laws work down here regarding following state money, I doubt it will be “impossible” to follow the money. Interesting that you throw around the term private since from the beginning that’s been a codeword for many of the anti task force activists down here.But what do I know? It’s not like I ever talk to anyone involved.

...

Oh thank the good Lord above we gots somebody smart to show us the way. Not
one of us ignorant hicks have ever questioned why some many consulting firms
were hired. Not one of us have questioned the mismanagement of Grady. Lord bless
us all that we now have this fine man to show us the way. To lead us out of the
wildereness where we are all a party to such sin.

...

Oh I don’t know, Jace. Maybe the repetitive condescension that we don’t know what’s going on. Repeatedly ignoring the fact that some have raised many of the same questions. Conspiratorially tying the Derwin Brown murder to corruption of Grady. Transitively tying any questioning of his theories into sheeplike acquiesence to being rolled by the Devil. Continually making Charles Walker’s conviction about Grady when mostly it was not. And even when us ignorant hicks refute points fall right back to saying we don’t know what we are talking about.It could be that unless we see through the God-given clear lens of Mike Volpe, we just don’t know what the hell we are talking about.Nah. It’s none of that.

In this case, it came down to tone and territory. I was too confrontational and condescending, and of course I wasn't from Georgia. I got only one defender on the site...

Why does everyone seem out to get this “mike volpe” guy? He is raising some interesting points

There are several things here. First, as I later pointed out, Derwin Brown was never sheriff because he was murdered (by the outgoing sheriff and a conspiracy of deputies and others in the police department) so the initial statement is not only condescending but factually wrong.

Second, the death of Derwin Brown and the corruption at Grady can be tied to one man, Vernon Jones, who was connected to both. (He is still currently the CEO of Dekalb County and not only overlooks the DEKALB POLICE DEPARTMENT, which Brown was elected sheriff of, but he also picks the board at Grady Hospital) Whether or not the corruption is linked directly together or not is up for debate, however I have no doubt that at minimum there is a culture of corruption that links all of it together.

Now, as for the reference to the new plan by the Grady Task Force, it is too in depth for an explanation here, so if you want to know my thoughts, please read my piece on it. (also, I welcome you to read the recommendations that me and my allies have come up with for Grady Hospital)

Also, they claim that most of the corruption committed by State Senator Charles Walker wasn't at Grady Hospital. While this is true, Walker's crime was expansive and not very picky, most of the evidence of his corruption came from whistleblower Joyce Harris, who was the head of H.R. at Grady Hospital.

Their points finally turned from factually wrong to absurd with this comment...

Is it possible that the convictions were tagged on solely to Walker because folks were out to get him? I’m not saying he didn’t do wrong - believe me, as an Augusta native, he did a lot of things wrong and deserved punishment - but he also had a lot of guys gunning for him, particularly a lot of folks in Augusta.

Could it be that the focus was to get Walker and not to investigate Grady? And that getting Walker meant piling up the felony charges?

Here is how I refuted it...

If they were “out to get him”, why did he get ten years for 127 felonies or less than a month per felony. Folks weren’t “out to get him”. Folks were out to keep his affair as quiet as they could. If the chief prosecution witness fingers everyone, then why isn’t anyone else investigated?If Walker committed so much crime that it lead to 127 felony convictions, and people were on the level, they would want to follow it further and see if the hospital involved had systemic corruption in and that lead to his crimes? That is, if people were on the level.

My point was never disputed and ultimately nothing I said in any of the debate was proven inaccurate. (something I can't say for those that I argued with)

I bring up these factual points to once again point out that I was arguing with people that were frankly a lot less knowledgeable. Once again, rather than focusing on the merits of the corruption and finding ways to connect through the power of the internet, these commenters made me the story.

The facts were no less important to these Georgia Republicans than they were to Kos liberals.
I was combative and an outsider, they immediately assumed I was wrong. They never had their facts straight, but that didn't stop them from arguing. Ultimately, rooting out the corruption in their own state wasn't the important thing. What was important was "beating" so to speak an outsider that they felt was demeaning their state.

In both cases, an opportunity was lost for people to band together to take on bad folks. Instead, it turned into the twenty first century technological version of a school yard arguement. Rather than focusing on the real bad guys, the ones perpetrating the corruption at Grady, Emory and beyond, they focused on me. I went out searching for allies in a story that not only needs to be told, but found the worst of human nature in folks from both sides of the aisle.

UPDATE:

I realize that anyone that picks up this story somewhere in the middle may get quite confused. For instance, if you happen to read this particular piece but you aren't familiar with the goings on at Grady, you will likely get lost in this particular story. Thus, I have put together a summary of the entire fiasco that tries to put all of its moving parts together in one piece. Please read it for guidance. Also, please check out the recommendations that I and my colleagues have put together for fixing Grady Hospital.

JCAHO Threatens to Shut Down Grady Hospital

The Atlanta Journal Constitution (which I believe to be a suspect news organization) broke this this morning...

As if things weren't bad enough for the financially strapped Grady Health System, now the hospital faces a list of criticisms, including issues with patient care, that put its national accreditation at risk.

In a five-day inspection last week, the Joint Commission —- formerly the Joint Commission on Accreditation of Healthcare Organizations —- identified "numerous
requirements for improvement," according to a statement issued by Grady on Monday. Hospital officials gave no details about the kinds of shortcomings inspectors found.

Dr. Christopher Edwards, vice chairman of the Grady board, said the report cited "opportunities for improvement in various areas, including patient care."

Anyone who has been reading my work, knows that the tone of this article is wrong. It is frankly long past time that the powers that be, be held responsible for the mess at Grady. Keep in mind that about three years ago, the HHS conducted an investigation that concluded this about the patients at Grady Hospital...

there is an immediate and serious risk to the health and safety of the patients

Obviously, it can't get any worse than that for a hospital. Now, three years later the hospital needs an injection of half a billion dollars to stay solvent. Before that, Grady Hospital was convicted of Medicare fraud. State Senator Charles Walker committed so much criminality at Grady and beyond that he was ultimately convicted of 127 felonies. I am fond of the Latin phrase Res Ipsa Loquitur (the facts speak for themselves), and in the case of Grady Hospital, Res Ipsa Loquitur.

One only needs to do a Google search to discover that there are serious and systemic problems at Grady Hospital that frankly, in my opinion, warranted intervention from authorities long ago. Given the current crisis and latest report from JCOHA, it is clear that proper steps weren't taken in response to the report from HHS about three years ago. I hope that this latest episode winds up with a different result.

Here is the so called inside baseball on how this transpired. Much of the credit should end up going to Ron Marshall of the Grady Coalition. He sent letters for years to JCAHO complaining about stonewalling on the part of Grady staff as far as open records requests and in answering their many questions on a whole host of issues related to corruption, poor patient care, and effective hospital management. Here is an example of an email that he sent that I got a hold of...

Mr. Bressler,>> YOU often appear not to have the evidence we have presented to you> over the years. We hope you have protected all documents we have sent> to you from spoilage.>> NATIONAL WITNESSES: THE GRADY SYSTEM HAS FAILED> Because of the severe suffering at Grady, we cannot rest until JCAHO> violations are stopped. We are bringing on board new witnesses.

Dr.> Linda Peeno, formerly a top executive at Humana, has analyzed the> situation and finds that this is a breakdown of the medical system.> Peer review is an essential part of the system to protect patients.> Bad faith peer review effects the medical judgements of all doctors> in the system, and leads to systematic poor medical care. Testimony> demonstrates it is impossible to deliver minimal standard care when> peer review has been subverted.>> CONGRESSIONAL ALLIES> We will be meeting with Congressional allies next week, and we will> be holding a press conference. We hope we receive a statement from> you by noon, Tuesday that you will implement a plan to enforce JCAHO> regulations at Grady.>>

GOOD FAITH PEER REVIEW IS ESSENTIAL TO THE INTEGRITY OF THE SYSTEM> I know you do not want to enforce peer review standards. However, I> don't see how you can enforce any standard if bad-faith peer review> is being used to hide malfeasance at the hospital. Peer review is> part of a system to protect patient care. If peer review is> subverted, doctors and staff are unable to speak up for patients and> to enforce patient care standards. The whole system is stood on its> ear. I hope you will reconsider your position and enforce JCAHO's own> standards. Grady has violated each of the provisions you outlined in> your last letter.>> BAD FAITH PEER REVIEW HAS BEEN CORRUPTING THE MEDICAL SYSTEM FOR DECADES> This has been a horrible problem for years.

Verner Waite wrote to you> about widespread violations in peer review leading to patient harm> ten years ago, and you did not respond. It is our position that you> must enforce all standards, especially peer review standards, that> impact patient care. This is at the core of your function.>> BAD FAITH PEER REVIEW IS CORRUPTING POLITICS IN GEORGIA> We have presented extensive evidence, including evidence from an> assistant DA, that the huge amounts of money stolen from Grady has> perniciously influenced Georgia politics. The 142 felony count indictment against Senator Walker was based in large part of his corruption of Georgia's hospitals by corrupting its peer review system. Bad faith peer review is a cancer on the body politic of the> entire state. Bad faith peer review can only be
stopped by JCAHO.> JCAHOs failure to enforce its standards is harming the entire state.

HOWEVER, EVEN IF YOU WILL NOT ENFORCE YOUR OWN STANDARDS, PLEASE AT>LEAST MAKE GRADY CORRECT DEFICIENCIES IT HAS ADMITTED IN MORE THAN THIRTEEN AREAS. GRADY IS THE MOST IMPORTANT HOSPITAL IN THE SOUTHEAST THAT SERVES> MINORITY PATIENTS. PLEASE TELL US IF YOU WILL ENFORCE YOUR STANDARDS> AT GRADY.>> 1. For your convenience, we have created a database showing how> violations in JCAHO policy at Grady have resulted in severe patient harm over the last five years: http://www.geocities.com/ron_marshall21/

2. We also document how Grady has retaltiated against witnesses to> prevent you from getting evidence: http://www.geocities.com/ron_marshall21/

3. We summarize severe corruption and its impact on patients:


4. We summarize witnesses available and ethics violations:

5. Current staff document new retaliations, and JCAHO violations. The staff fear to
speak to you.

6. Patient care is greatly compromised.THE HARMS TO GRADY'S PATIENTS ARE STAGGERING. PLEASE RULE ON OUR> COMPLAINT IMMEDIATELY.> A BLUE RIBBON COMMISSION TO INVESTIGATE UNETHICAL PRACTICES IS NEEDED NOW.> ROBERT BROWN AND PAUL HOWARD MUST RESIGN.>> Thank you. We know this is a lot of information, but all of it has> been sent to you
previously. This is but a portion of the documents> already in your possession.>> Ron Marshall> George Anderson> The New Grady Coalition

While many of the names are probably unfamiliar, please note this particular email is one of many over several years. Clearly, Grady refused to respond to good faith efforts to address issues that years later JCAHO has finally gotten around to forcing them to address.

I hope that everyone grabs the bull by the horn in this situation and takes steps to institute the sorts of institutional changes that are necessary to rid Grady of the culture of corruption that seems so apparent to me. Here is the plan as set by the Grady Task Force. If anyone can make sense of it, let me know because I can't. Here is the plan me and my allies have developed. I hope that everyone has a chance to read it. The time for Grady Hospital is critical, and it is time for real solutions.

For reference on how Grady Hospital got to such an extreme point you can go to this tag, or you can read this summary.

My Recommendations For Fixing Grady Hospital

Introduction: If you haven't been following the plight of Grady Hospital in Atlanta, Georgia, here is a quick run down. Grady is one of the biggest hospitals not only in the Southeast but frankly in the entire country and the world. It has also been the scene to a great deal of corruption throughout the years. It has faced a series of financial crises throughout the years, however none are as critical as its current. Grady Hospital faces being closed down unless it is infused with cash to the tune of an estimated half a billion dollars according to some reports. Since Grady Hospital is the main hospital for the poor of Dekalb, Fulton and other area counties, this has become the subject of great debate and controversy. Because hospitals that cater to poor folks have limited profit potential, Grady is also naturally a public hospital. Thus, in the end, the taxpayers own it.

Enter the Grady Task Force which is a sort of consulting firm created by the Metro Atlanta Chamber of Commerce which has recommended a series of steps to save Grady. If you look at the link, you will see that for the most part the report is quite technical, however there is one recommendation which has become quite controversial. That is a plan to make the board quasi private. It should also be noted that Grady has paid four separate consulting firms about eight digits just in the last two to three years already. They have already hired another consulting firm even after the so called recommendations of the Grady Task Force.

I believe this plan, like the force itself, is nothing more than a sham and I wanted to offer my own alternative plan.

I want to point out that almost none of the ideas are actually my own, but rather those of folks that I have spoken with since I began tracking this story nearly two months ago. None of these folks ever saw any power at Grady, and I believe that after you read my plan you will see that there is no doubt that the wrong people are in charge. You will also see what it would actually take to turn Grady around.



The first thing Grady Hospital needs is some serious improvements in its infrastructure. For instance, its HVAC system is totally shot. Doctors have told me that sometimes it gets so bad at Grady that they themselves can't breathe. Now, imagine if you are a patient that has a breathing problem, what would such a state do to you. There is asbestos in the wall. The elevators are old and they breakdown all the time. There are patients that are in critical condition and time is of the essence. If they need to be moved from floor to floor, you simply cannot have the elevators broken. Doctors tell that this can be a regular occurrence. The computer system for tracking their medical records is old, from the seventies people tell me. Many times patients history can't easily be looked up, and thus allergies and other ailments may not be known. The building simply must be brought up to code.

If this is shocking to you, and you think this couldn't happen because the patients would talk, keep in mind the patients are the poorest folks in the area. They simply have no alternative and many times they don't know any better.

One of the tragedies at Grady is that they recently had a giant addition added. That's right, while their infrastructure was falling apart they added a huge addition about five years ago. If you want to know why, you maybe interested in knowing that powerful board member Robert Brown also owns an architecture firm and while the firm is equipped to add on to hospitals they can't fix elevators. (He is also a prominent member of the Grady Task Force and one main reason why the force is in my opinion a total sham)

Grady also needs to be held accountable, so money will be given in tiers. The state legislature will choose a committee to oversee upgrades in infrastructure, and money will only be given if standards are met.

The Grady Board, currently chosen by the Dekalb County CEO (currently Vernon Jones), needs to be elected and it must be split up by districts so that it evenly represents the folks currently treated by Grady Hospital. This board, which would serve four year terms, would be in charge of hiring and firing the Grady CEO.

Instead of paying Emory University and Morehouse (the two schools that supply the bulk of Grady staff) a flat fee for their services, the Grady Board would institute a tiered sort of grading system (based on JCOHA grades, patient feedback and whatever other measurements they chose). Keep in mind that as representatives of the people, the board would be giving Emory and Morehouse the people's money. This means they would be more inclined to grade the two schools harsher than softer. This would give the two schools that much more incentive to perform better.

Also, the two schools would be responsible for their own malpractice insurance. Unbelievably, at least at Emory, Grady pays for the malpractice insurance of Emory professors and medical students. Essentially, this means that Emory, a private institution, has it so the public, through a public hospital, covers its malpractice insurance. Not only is this an obscene misuse of public funds, but obviously can lead to all sorts of abuse. Obviously, if you aren't responsible for your own malpractice insurance, you are more likely to act a lot more recklessly. I believe that is exactly what Emory has done to tragic results. This will remove that motivation.

The state legislature would set up a committee that would be in charge of funding Grady. They would set their own set of benchmarks for receiving funding and would also be in charge of deciding how much Grady Hospital got. Since the legislators are also spending the people's, or their constituents, money, they would also be disinclined to grade easily. This would give the board more motivation to make sure performance is up to par. We saw just how tragic it could be in the case of State Senator Charles Walker when funds are determined by corrupt reasons rather than performance.

Grady would develop a new position called the Office of Conflict Interest. Each transaction, each finance, each so called deal, would be scoured by this office to make sure that say a board member's architecture firm isn't getting the deal because the owner is on the board. I believe there are many such deals like the one I refer to with Robert Brown and the addition his company got, and that can't happen. This hospital didn't just find itself in financial crisis for no reason. It got there because its financial dealings were corrupted. This office would be in charge of making sure every deal was on the level.

Grady would need to update its by laws. First, it would no longer be allowed to have retaliatory behavior against whistleblowers. People must be able to report malfeasance without the threat of losing their job. Joyce Harris lost her job when she blew the whistle on State Senator Charles Walker. I also firmly believe that Kevin Kuritzky was expelled for blowing the whistle on serious corruption as well. These are jus two examples and I believe there are many more. There needs to be a truly anonymous tip line so that malfeasance can be reported without threat of retaliation.

Grady Hospital can no longer be allowed to stall in providing financial records to outside sources. I have been told by more than one person that getting records can be maddeningly time consuming. In fact, I was told that by the time records were received the incident or incidents in question were so far in the past that most didn't care. For instance, it took my sources several years to finally figure out that Brown's company received the lucrative contract. Grady Hospital would now be the subject of stiff fines if records aren't turned over in a timely manner. Furthermore, an outside party, a judge or a lawyer, would act as a mediator, in disputes over records requests. Finally, the by laws would declare that Grady would from now on follow due process.

Grady Hospital would no longer be allowed to settle any lawsuits under seal. I have counted four Emory professors that I believe have been paid off. The case of Dr. Jim Murtaugh is the only one that has been unsealed so far and it provides a glimpse into just how far some will go to keep malfeasance quiet. This can't go on, and it will have to be outlawed.

From now on, meetings held on the finances of Grady Hospital would be open to the public and the media. Currently, those meetings, like many others, are held in secret. Secrecy is a bedrock of corruption. By turning Grady over to a private board, it would make it even easier to maintain secrecy, and it is this diarists contention that secrecy is the end goal of the private board plan. In order to fix Grady, we need the opposite of secrecy. We need everything to be open. Keep in mind that Grady is a public hospital. It uses public funds. The public has every right to know where those funds are going. Open finance meetings are one way to assure that.

With these recommendations Grady would actually have a chance to thrive long term. While I am sure there will be those that will poke holes in it, I would dare anyone to compare my plan, less than two pages, to the plan by the Grady Task Force.

No Mike King...You're Out of Touch (UPDATED)

Here is the latest column by AJC columnist Mike King.

It takes a special kind of arrogance for the Fulton-Dekalb County Hospital Authority to stiff Emory and Morehouse medical schools out of $63 million and then demand the schools keep sending doctors to Grady Memorial Hospital. As a condition of turning over the hospital to professional management, the authority demanded that Emory and Morehouse give a written guarantee they will continue their residency and teaching programs at Grady. The money for those programs comes almost entirely from the state and federal governments, but the Grady board has kept much of it in recent years to use for other expenses. The hospital's mismanagement is now threatening the quality of on-the-job training both schools offer. It's one thing to ask Emory and Morehouse to renegotiate the debt, which both have said they are willing to do. But demanding it, as well as a promise that they won't cut back their programs, reveals how truly out of touch with reality the authority can be.

Now, really quickly, here is a run down for those that haven't been following this story. He is speaking of Grady Hospital, which is one of the largest hospitals in the country. It services the poor and is in such dire financial shape that it needs somewhere in the neighborhood of half a billion dollars to stay afloat. Emory and Morehouse provide much of the staff at the hospital (with Emory providing most between the two) and each university gets paid for providing the staff. According to King, Grady wants to not only be relieved of their yearly obligations but they insist that each university's staff remain on duty. Grady is a public hospital so ultimately it is "owned" by the folks. Lastly, and this is quite important, Grady is designed for the very poor or indigent, and by its sheer size it services almost all of the poor folks in Fulton, Dekalb and frankly many other counties. Without it, all the nice hospitals that treat wealthy folks in the area would have to treat these poor folks as well.

Now, I won't argue that arrogance is a trait exhibited by several folks in this mess, however if this is what he is focused on, he really is out of touch. First of all, there are plenty of people out there that believe that Emory and Morehouse should be paying Grady for use of their hospital, not the other way around. (for a full summary on this story including an explanation why Emory and Morehouse should be paying please follow this link) Thus, by demanding that staff continue to work without payment, seems, to many, only fair. Second of all, Grady is near financial collapse and it may take up to half a billion dollars in order to save it. Given that staggering figure, is the important point really whether someone is asking or demanding that debts be forgiven. After all, if Grady needs half a billion dollars, Emory and Morehouse can get in line with a plethora of creditors.

Ah, but unlike most creditors, Grady expects, not asks, these two to continue providing services. Of course, they expect that Emory and Morehouse staff continue to work. Emory and Morehouse account for almost the entire staff. Without them there is no hospital. Without Grady, the poor in Fulton and Dekalb have no place to be treated. If Grady is no longer the whole entire medical system in Fulton, Dekalb and beyond is in serious crisis. (Without Grady some of the hospitals for the affluent would actually have to treat these folks and no one can have that now can they)

Second Emory and Morehouse need Grady a lot more than the other way around. First, Grady is a public hospital so it really belongs to the people. If the folks want it kept open, they WILL infuse it with cash one way or the other. On the other hand, Morehouse uses Grady for nearly all of its medical school and residency training. In other words, without Grady there is no Morehouse medical school. Emory maintains several for profit hospitals however the bulk of their training is also conducted at Grady. Furthermore, Grady is the main selling point to perspective Emory medical students. Grady is one of the biggest hospitals in the country and the world, and going to Emory medical school allows perspective medical students to train there. In other words, without Grady, there is not Morehouse medical school. While there is an Emory medical school, it goes from being an elite school, to the equivalent of EastWest Texas State Community College Medical School. (please, no one be offended, I made the school up but we all know that the more words before and after the State in question the worse the school is)

Thus, of course the powers that be at Grady expect that debt not only be forgiven but that staff continue to work. They hold all the power.

Given all this we can see why they are so arrogant, but frankly this is all besides the main point anyway. King's piece is frankly most atrocious, in my opinion, because it focuses on side issues like demands over requests. King refuses to examine why Grady insists on going private and how that will impact the hospital and the tax payers. (Fortunately, you can count on this blogger to give you the straight scoop on all issues related to Grady and their plan for going private is just one of those issue. So for more info on the plan to go private please click here) By focusing on the arrogance of a group that has frankly shown nothing but arrogance for more than a decade, he really shows a total lack of understand of the issue.

The issue isn't whether or not some people are arrogant. They are and it matters very little, except to explain past, current and likely future behavior. The issue is what to do going forward. It appears obvious to me at least, that the reason the powers that be want to go private is so that their malfeasance can be even more easily hidden. Yet, that possibility isn't even mentioned. In fact, Mike King contributes absolutely nothing of substance to a debate that should be at the front of most Georgians' minds. It should be the AJC leading on this story. It isn't. In fact, if I am right, the AJC is actively participating in the corruption. That may explain why King's only contribution to this debate so far is well, so lame.

Finally, I have heard from the grapevine that Ron Marshall, of the Grady Coalition, wrote a piece that was supposed to counter King's in the AJC, and the AJC refused to publish it. No such refusals will be here. Here is Marshall's piece...

It does not surprise me that Grady voted to go private. This has been in the plan to privatize all major funding resources in America to control how money is being spent and who receives it. Look at Iraq, since when do we hire a private force to protect public interest? This has never happen in the history of war. Who benefits from privatization?

Grady changes have started the wheel of genocide. A whole community will parish (poor people and poor accident victims) in the name of profits. Not to mention the land deals that will be made. We have put a price on human life. Not only have we put a price on the life of an individual we allow the health care system to pick and choose who get’s treated and how much treatment they as humans receive. Animals get treated better than people. Throw a dog in the street and see what happens.

Our Governor had the nerve to pray for rain. The prayers should be for humanity as well as for the salvation of human life and for the protection of our planet. Now we have really fallen off the path of survival.

What’s still hidden in all of this is how did this happen and who is responsible for what happen. This has never been asked. If it has there sure has been very little said about the accountability of the officials who oversee Grady and the official who appoint the board that put Grady in this position. Why is the public being denied
access to records that will show where all the money went or is going and who is receiving it? This is not new and it seems to happen like the migration of geese heading south every year.

Only one person was sent to prison for stealing from Grady, Charles Walker. Walker did not steal all that money by himself. He had to have help. Somebody signed the checks and somebody got paid to keep it quiet. Why wasn’t there an investigation
conducted to find the accomplices. This is like a private (secret) Mafia, they sacrificed one to save the rest. I notice Walker has not turned on his accomplices. Is there money waiting for him when he is released?


Is having cover-up money pay for a pass as Emory has shown. They have clearly had their way with Grady’s funding with a sweet heart contract. Does being a politician automatically give you a pass when crisis’s after crisis’s shock after shock that cost tax payers millions without having them be accountable time after time.


Now we had an explosion in south Georgia and Grady no other but Grady is in the front again. The needs are clear, human lives are at stake. Is there no other real time event that shows Grady at its best.

So to feel anything is like watching killings and brutality between 6-11pm live on the news or a television program. You get use to it. The fight for justice and accountability has only hit a bump in the road, we must be protectors of justice and righteousness and we will accelerate ahead of corruption. Buckle-Up.

Many of the things he says have also been said here. It's too bad that Marshall needs my blog in order to get his message out. You can contact the AJC here about any of the plethora of issues I have raised.

(Update)

I realize that anyone that tries to pick up the story of the crisis at Grady Hospital is likely to get lost in its many mazes. Thus, if this story is your first exposure to it, it is likely you have dumbfounded look on your face. Thus, I have put together a summary of the entire fiasco that tries to put all of its moving parts together in one piece. Please read it for guidance. Then, the dumbfounded look will be removed. Also, please check out the recommendations that I and my colleagues have put together for fixing Grady Hospital.

What Does the Administration at Emory Get Paid For? (UPDATED)

Introduction: Yesterday, I published this piece. It is a detailed summary of the continued and growing scandal going on at Grady Hospital in Atlanta, Georgia. If you are unfamiliar with the details I suggest that you check out link.

Also, I have a stat counter on my site. It allows me to track in detail who, identified by IP address, comes, where from, which of my pieces they read, and all sorts of other details that turns it into Proprietor Nation's version of big brother.

The following piece is in regards to the aftermath of that piece (which received a fair amount of traffic) and one specific IP address that I have been able to identify. So, without further adieu...



I am not sure however if today is like other days then they are paid to surf the web. I know this because IP address, 170.140.62.42 (administration's IP address, probably this man) has been on my site for hours today. In fact, this IP address is by far my biggest fan. I know this because they check with me usually at least once a day, however today they have taken an unusually large interest. (I wish they would click to Amazon once in a while and buy one of their fabulous books though) Here is a run down of today's activities...




28th November 2007
09:16:51
No referring linkProprietor Nation
29th November 2007
11:01:22
No referring linkProprietor Nation
29th November 2007
12:52:22
No referring linkProprietor Nation
29th November 2007
12:52:29
proprietornation.blogspot.com/Proprietor Nation: An Updated Summary on the Fiasco at Emory, Grady, and Beyond
29th November 2007
13:04:31
No referring linkProprietor Nation
29th November 2007
13:04:34
proprietornation.blogspot.com/Proprietor Nation: A Murder, A Suicide: Connecting More Dots in the Culture of Corruption
29th November 2007
13:04:35
No referring linkProprietor Nation
29th November 2007
13:04:45
proprietornation.blogspot.com/Proprietor Nation: The Incredible Disappearing Story... (UPDATED WITH A VERY SPECIAL SHOUT OUT)
29th November 2007
14:55:47
No referring linkProprietor Nation
29th November 2007
14:58:32
proprietornation.blogspot.com/Proprietor Nation: Emory University
29th November 2007
15:00:01
proprietornation.blogspot.com/search/label/Emory%20UniversityProprietor Nation: Who Is The Real Sociopath??
29th November 2007
15:07:39
blogs.creativeloafing.com/freshloaf/2007/10/09/emorys-skeletons-in-the-closet/Proprietor Nation: The Fox Guarding the Hen House
29th November 2007
15:07:53
blogs.creativeloafing.com/freshloaf/2007/10/09/emorys-skeletons-in-the-closet/Proprietor Nation: Corruption
29th November 2007
15:08:23
proprietornation.blogspot.com/search/label/CorruptionProprietor Nation: A Plea to John Sugg of Creative Loafing



Let me explain what all of these names and numbers mean. This is the full detail of the IP address I spoke of (170.10.62.42). If you click the link it is identified and also identifies its server, Emory University. Everytime anyone visits here the date and time (Central time that is) is recorded. Those are what the dates and times mean. If a link was used to come to my site, that is also identified (for instance the one starting blog.creativeloafing is a site from which this IP linked from). If no link was used, then the words, no reference link appear. (this generally indicates the the address was typed out by the party using the computer. Thus it was likely that http://www.proprietornation.blogspot.com/ was entered into the address field in order to reach my site.) The specific web page is the web page that the party landed at. Sometimes, a party will travel within my site and so if you see two proprietornation pages, that means th party went from one page to another.

As you can see, not only is this IP visiting my site, but they are they are also visiting this story from October. (this is another story that doesn't necessarily paint Emory U in the best light)

The ongoing Grady Memorial Hospital crisis is bringing to the surface many complaints about Emory’s medical school role. In the past, Emory’s response to internal criticism has been to bully and crush the critics, and then try to keep the records sealed.

The latest on the blogosphere is about the persecution of Kevin Kuritzky, who was 41 days from graduation when Emory expelled him from the medical school. Kuritzky claims Emory was retaliating for his blowing the whistle on patient safety — or the lack thereof.

Now, I can assume that as the head of PR, one must know what is being said about their school, however isn't the work of the AJC, the New York Times, where they would want to spend their time predominantly. If I am getting this much traffic from PR, they frankly have very little time left for the AJC et al. Either that or the PR department is now exclusively focusing on surfing the internet for stories related to Emory. Why is my blog, with only several hundred hits daily, getting so much attention in the PR Department at Emory (if it isn't the PR person then frankly they really need to be fired because they are just surfing the internet to waste time then)?



I have already concluded that the powers that be at Emory removed a story from the internet archives at the AJC. I pointed out in a previous diary that this article, and more importantly Emory's response, was damning to Emory in three serious ways. (I won't rehash the story so please go to the links to catch up) I know that the article was removed in the aftermath of me publishing the piece because it is no longer there. I also know that reference to the same article was also removed from a page on Emory's own medical school site. (go to this google link and click on the top link found and see for yourself)



Now, I know that part of PR is damage control but isn't removing archived stories and web pages taking damage control a bit too far. I know that in PR you must know what the media is saying about you, but isn't obsessing about what a small blog says also taking things a bit too far. Unless of course, what that small blog is saying is true, and in that case, you probably would be obsessed. I have recently fallen in love with the phrase Res Ipsa Loquitor (the facts speak for themselves). You can call me crazy, an ego maniac, or suffering from delusions of grandeur, but I believe the fact that Emory's admin IP has become my biggest fan, shows that they know what I am saying is true.



If that is the case. Let's review what that means. Emory is operating as an all powerful sociopathic entity. They are criminally liable in providing medical services to poor folks at Grady Hospital and veterans at the VA hopsital and they have expelled a student, 41 days prior to graduation, for daring to expose their criminality. They have also paid off multiple professors with their silence who also tried to expose the corruption. Furthermore, since Grady Hospital, the subject of much of this corruption, is a public hospital that means that ultimately Emory University has committed all of these crimes and lapses in ethics and morality on the public.



Now, all of this is my supposition only, however, if my supposition is lunacy, why is the admin spending so much time on my blog? Don't take my word for it go and ask the admin yourself. I have provided the link and it has said person's email. See, what they have to say about all of this.

UPDATE:

170.140.62.42 is back. It is nothing short of surreal to update a piece about a party as that party is reading the piece themselves, however that is how it is in the internet age. Here is an updated link to what the stat counter calls the magnified user, a detailed summary of the movements of this particular IP address on my site (including the most recent and probably current visit) The only other thing I will point out is that while I have had much traffic from this IP there has been no contact by email or otherwise. There have previously been some peculiar anonymous messages, however anonymous speaks for itself, and it was also before I became savvy enough to track things down.

UPDATE:

I realize that if someone were to pick up this story somewhere in the middle they would get lost in its many mazes. Thus, if the first story you read regarding Grady Hospital is this one, you are probably confused. So, I have put together a summary of the entire fiasco that tries to put all of its moving parts together in one piece. Please read it for guidance. Also, please check out the recommendations that I and my colleagues have put together for fixing Grady Hospital.