Peoria's Medical Mafia

Pre-Introduction Peoria's Medical Mafia

2006-10-11T18:33:00.000-07:00

Pre-Introduction--Peoria´s Medical Mafia

Dear Readers,

Jackson Jean-Baptiste is pictured to the right in a photo from Haiti during the Spring, 2005. Jackson died in January, 2006.

The following are the first 12 posts. There are 66 posts on this site. At the bottom of each post is an option for a "newer post" or "older post".

Synopsis of Emergency Medical Services
Introduction--Peoria's Medical Mafia
Keith's Letter
Conversations with Keith
Conflict of Interest
OSF-AMT Relationship
Emergency Room Overcrowding
OSF Emergency Room Patient Satisfaction
Fear at OSF
Conversation with Sister Canisia
Conversations in Church
Sister Judith Ann

Please go to PMMDaily.blogspot.com for updates.

Synopsis of Emergency Medical Services in Peoria

2006-07-12T10:39:00.000-07:00

Synopsis of Emergency Medical Services in Peoria

Peoria’s Medical Mafia documents thoughts regarding Emergency Medical Services (EMS) in Peoria, Illinois. There are approximately 65 posts on this web log, many of them regarding EMS.

Peoria has a population of 113,000. The Peoria Fire Department (PFD) is non transport and provides service at Basic-D level with basic medication. Several years ago the PFD purchased a very nice ambulance using the Foreign Fire Fund. The PFD applied to the Peoria Project Medical Director for permission to outfit this vehicle, their only ambulance, with various basic and advanced life support materials and equipment. This request was denied by the Project Medical Director. The PFD then sold this ambulance because it was not being used.

Peoria has an advanced life support company, Advanced Medical Transport (AMT), which transports patients and gives the only paramedic care in Peoria. It is considered a not-for- profit entity but grosses over 7 million dollars per year. AMT is supported by all three of Peoria’s hospitals. OSF-SFMC, the largest medical center in downstate Illinois, is considered the “resource hospital” for the Peoria Area EMS. All three medical centers have administrators that sit on the AMT Board of Directors. AMT suffered significant legal troubles several years ago when the federal government investigated it for Medicare fraud based on coding and charging. AMT was fined over 2 million dollars by the federal government.

The OSF-SFMC Emergency Department Director is also the Corporate Medical Director for AMT. He was the Project Medical Director for many years in the Peoria area and was salaried by both AMT and OSF-SFMC for his services. Numerous people in the area believe this arrangement constitutes conflict of interest. The PFD also believe that many obstacles have been created over the years to keep them at a basic non transport level so AMT can continue as the only paramedic and transport agency in Peoria.

I believe that Peorians have suffered and died in the pre hospital setting and continue to do so because of the paramedic/transport monopoly. Incredibly, the PFD has paramedics that cannot use their life saving abilities at the scene when they work as firefighters; however, when they “moonlight” for AMT, they are able to use their advanced life support skills.

Similar business arrangements as described above probably occur in other locations around the nation. But just because banks are robbed in many cities, does not mean it is right to rob banks in Peoria.

I hope this web site is informative. Some day Peoria will change for the better regarding EMS and pre hospital care. The system took a while to become this ill and it will take a while to recover.

John A. Carroll, MD
July 12, 2006
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September 30, 2006

Arthur Kellermann, M.D., M.P.H. published an article in the September 28, 2006 New England Journal of Medicine. He is chairman of the Emergency Department at Emory University School of Medicine.

Dr. Kellermann begins his article describing waiting in the ambulance bay at Grady Memorial Hospital in Atlanta on July 27, 1996, awaiting 35 severely injured bombing victims in Atlanta. It sounds like things went as well as possible and the ER was working normally five hours later. Would that happen in Peoria? I don’t think so.

The Institute of Medicine recently released three reports regarding Emergency Medical Care in the United States. It can be seen at www.iom.edu. Dr. Kellermann sat on a committee which did the report.

Collectively, the committees describe an over burdened emergency system that is rapidly approaching its limits. Dr. Kellermann states, “With more patients needing care and fewer resources to care for them, emergency department crowding was inevitable.”

Dr. Kellermann writes about “boarding patients in exam rooms or hallways who need inpatient care”. He notes the very negative and dark side of ambulance diversion and that cities may experience the “health care equivalent of a “rolling blackout”. Everyone’s care is affected…”

Congress enacted the Emergency Medical Treatment and Labor Act (EMTALA) in 1986 which allowed everyone in the United States to acquire legal rights to emergency care. However, Dr. Kellermann argues that because this mandate (EMTALA) was unfunded, it created a perverse incentive for hospitals such as OSF-SFMC to tolerate Emergency Department overcrowding and divert ambulances while continuing to accept elective admissions.

My letter to OSF CEO Keith Steffen in September, 2001 was asking for his leadership and help for problems in Peoria that were very similar to problems addressed by the IOM in 2006. I was fired several months after writing Mr. Steffen in 2001.

I communicated with Dr. Kellermann and spoke to the Project Medical Director of another city with 5 million people regarding the unfortunate EMS situation in Peoria. The Project Medical Director asked me what would happen in Peoria if there was a mass casualty with the Peoria Fire Department at a Basic level and nontransport. Good question, but I doubt this will be answered in Peoria, until after the problem occurs. Peoria will be in for a cruel awakening.

Dr. Kellermann stated in the article that the “IOM committee calls on hospitals to end the boarding of admitted patients in emergency rooms and the diversion of ambulances, except in extreme cases, such as community wide disasters”. OSF, are you listening?

He concludes that the IOM envisions a “coordinated, regionalized, and accountable emergency care system that is capable of delivering lifesaving treatment to all in need”.

Currently, this is not the system in Peoria for reasons outlined in this web log.
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October 20, 2006:

The September, 2006 issue of Emergency Medicine News published a letter I wrote regarding emergency department overcrowding in Peoria and the consequences of what happens when doctors bring up sensitive topics. ("Paying the Price for Speaking Up").

Introduction--Peoria's Medical Mafia

2006-03-15T09:17:00.000-08:00

Introduction-Peoria’s Medical Mafia

Medical mafia—I have never forgotten when a well-known Peoria physician used this term to describe for me how the medical system operates here in River City. Physicians and institutions in central Illinois sometimes make decisions based on what is best for their bottom line rather than the patient’s health. Greed motivates this situation and fear—fear of job loss and other financial punishments, fear of ostracization by a close knit community—keeps it in place. The term medical mafia perfectly explains much of the four-year saga I have been on since being fired from OSF St. Francis Medical Center in 2001.

In the hopes that constructive changes can be made regarding some dangerous situations, I want to share my experiences with as many people as possible. After years of attempting to work within the confines of OSF and the Catholic Diocese of Peoria, I finally realized that there is no adequate checks and balances within either system. Silence and denial are integral components to stifle ideas. Although not ideal by any means, a weblog (blog) seems the best way to disseminate this information.

My objectives are to detail serious problems related to OSF, Emergency Medical Services in Peoria, The Catholic Diocese of Peoria, and Haitian Hearts. I will show how the problems involving all four entities are linked. I will discuss how powerful men and women can hurt the not-so-powerful people in central Illinois as well as sick Haitian children needing heart surgery.

The first step toward change is an awareness of the problem. I want to educate people as to how these organizations really operate. I have 4 years of letters, articles, and notes of conversations that I have used in this blog. These sources will provide evidence for the events I will describe. I will include names at times and will leave other names out to protect people from injury.

The blog is divided into 3 main sections: OSF, Haitian Hearts, and Emergency Medical Services in Peoria. All are written in as much of a chronologic order as I could to keep 4 years of material as understandable as possible.

It is possible this site will anger powerful people and institutions. If I am told to “cease and desist” from further writing, I will let you know and take appropriate action. If changes occur in systems that our failing us now, I will also let you know.

John Carroll, M.D.

Keith's Letter

2006-03-15T09:05:00.000-08:00

Keith’s Letter

On September 26, 2001, I worked the 3-11 shift in the ER at OSF. I had elderly patients as usual and several signed out and went home when they realized how long they were going to wait for a bed in the hospital. They were sick, and I intended to admit them, but they just couldn’t take lying on a stretcher for many hours and so politely told me that they “needed to go home”.

The ER has an administrator on call every night to call at home if there are problems an attending physician in the ER would want to discuss. These calls usually did not help at the time the call was made.

On September 27, 2001 I decided that Keith Steffen, CEO at OSF-SFMC, should at least know of my concerns and wrote him a letter and copied it to all of my colleagues in the ER and to other OSF administrators. (See letter below.) Someone warned me that I might get fired if I sent the letter. I knew that to be true, but thought it needed to be done.

I did not hear back from Keith but did hear the next day from Dr. George Hevesy who had been promoted to ER director on August 1 to replace Dr. Rick Miller. His secretary handed me his letter to me as I was starting to resuscitate a man in the ER who had a cardiac arrest and was brought in by ambulance.

George’s letter put me on probabation for 6 months. It also stated that starting in November, I would only work in OSF Prompt Care. Hevesy did not disagree with the content of my letter but told me that I had gone around normal communication channels and that I would be suspended from the ED for 6 months. After I read the letter, I called George at OSF’s new Center for Health where he was working and asked him if he was really serious about what he had written. He said that he was and for me to stop in and see him sometime so we could talk.

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September 27, 2001

Keith Steffen, Administrator
OSF Saint Francis Medical Center
Peoria, Illinois 61637

Dear Keith:

I started working at OSF-SFMC in 1971 as an orderly on 8B. Most of my last 30 years have been spent inside this building. OSF-SFMC means everything to me. Please interpret the following knowing my heart and spirit are with St. Francis and always will be.

I worked 3-11 last night in the main ER. The ER mayhem and disarray that usually exists was actually somewhat manageable. However, patient-waiting time from disposition to arrival on the floor was unbearable. Two sick patients of mine, rather than staying in the ER all night, politely decided to sign out, go home, and hope for the best.

Giving appropriate care in the ER can be challenging but having no room upstairs to admit the patient can be life threatening to the patient. Should I call other medical centers around the area/state for their admission and subsequent care before I see the patient or after? Studies have shown increasing time spent in the ER increases patient morbidity. Obviously, I don't want to do this. Please tell me what to do.

An ER crisis has been occurring for many years in our ER. But last night with "home diversion" of patients we have reached an all time low. This cannot continue.
I need an immediate answer from you today as to how I should approach these sick patients and their families. I will meet with you any time today or tonight.
My pager is always on (679-1980.)

Sincerely,

John A. Carroll, MD

cc: Sue Wozniak, Chief Operating Officer
Tim Miller, MD, Director of Medical Affairs
Susan Ehlers, Assistant Admimstrator Patient Care Delivery Systems
Paul Kramer, Executive Director of Children's Hospital of Illinois .
Lynn Gillespie, Assistant Administrator Organizational Development
Emergency Department Attendings
---------------------------------

On April 6, 2006 the Peoria Journal Star published the article below regarding the new Children's Hospital that will be built. Please note Mr. Steffen's comments regarding bed capacity problems and patient diversion at OSF. Was this institutional neglect by OSF attempting to stack to many patients inside the medical center? How many people suffered under this system? When I wrote him almost five years earlier, I was immediately placed on probation and then fired three months later. Will that be Mr. Steffen's fate as well?

What the Journal Star did not report was that Jackson Jean-Baptiste, a Haitian Hearts patient, was refused care at OSF and died several months ago. Many Haitian Hearts patients are now suffering and being denied care at OSF. This is contrary to what Catholic social teaching states and the Catholic Bishops Ethical and Religious Directives mandate.

Haitian Hearts obviously did not financially break OSF with the announcement of their new 200 million dollar building. It is truly a blessing for central Illinois children. However, Haitian children deserve the best available as well.

Until OSF can change its heart and return to the founding Sisters mission philosophy, they will have the technolgy but not the touch. The picture is of a Haitian baby where I work in Haiti. This hospital has no running water...a bit different than OSF-CHOI.

A medical milestone
Saint Francis expansion will alter Downtown landscape

Thursday, April 6, 2006

BY DAYNA R. BROWN

OF THE JOURNAL STAR

An eight-story, concrete and glass addition to OSF Saint Francis Medical
Center will permanently enhance Peoria's medical skyline - and the area's
economy. This new facility will be home to the Children's Hospital of Illinois and
is the largest building construction project in Peoria history.

"It's unusual for a community of this size to have its own children's
hospital," said pediatrician Dr. Rodney Lorenz, who also is interim dean at
Peoria's medical school. "We are blessed."

The new building will be located north of the hospital's main facility. It
will sit on the site of Medi-Park 1, which will be torn down when a new $33
million parking deck is completed later this year.

Construction is difficult on the site because it slopes 60 feet from top to
bottom. But it was the only area on the hospital's 33-acre campus where
there was enough room for this facility, administrators said. The
Children's Hospital wanted to stay on the Downtown campus because there is
$45 million in annual savings by sharing services with St. Francis.

The expansion is needed because the hospital is out of space,
administrators said.

St. Francis had to divert patients to other hospitals Wednesday, and it has
been that way much of the past month because there aren't enough beds, CEO
Keith Steffen said. Just last year, more than 200 patients had to be sent
to other locations.

But when the $234 million construction project is completed, that no longer
will be a problem, Steffen said.

"We've seen significant growth over the past few years," Steffen
said. "We'd be remise . . . if we didn't respond."

The new building will be 440,000 square feet, almost twice the size of the
hospital's Gerlach Building, which houses surgery, the emergency
department, most of medical imaging and five intensive care units.

It will allow for the consolidation of all of the Children's Hospital
services, which are currently located in six buildings, and provide all
pediatric patients private rooms.

"Right now it is hard for people to find the Children's Hospital because
it's buried in St. Francis," said Dr. Rick Pearl, surgeon-in-chief of
Children's Hospital. "I just run in circles, all day long."

The new facility, which will be physically attached to St. Francis but will
have its own entrance, will bring the hospitals staffed beds from 560 to
616. It will have three floors dedicated solely to children. Another three
floors will have shared services for adults and children, including surgery
rooms and the emergency department.

The decor will be "kid-friendly," with bright colors, play areas, music and
favorite children's characters, doctors said. And the rooms will provide
space for parents to stay with their child.

"I think it's very important for a child to feel comfortable," said Dr.
Ravindra Vegunta, director of pediatric minimally invasive surgery at
Children's Hospital. "The more happy the patient, the more cooperative a
patient and that will aid in recovery."

There will be one adult cardiac floor in the new building because more
space was needed for that department, administrators said.

Moving the pediatric services out of the current facility will free up
needed space for adult patients and other hospital needs, administrators
said.

The project also will include a "much needed" emergency department
expansion. The current emergency room was constructed to serve 32,000
patients annually, but this year it will surpass 62,000, Steffen said.

St. Francis is the largest hospital in downstate Illinois, employing
approximately 5,200 people, and the only Level 1 trauma center in the area.
In addition to 850 construction jobs, the project will create a need for
another 1,000 jobs related to health care.

Children's Hospital of Illinois was formed in January 1990, and draws from
a 30-county area. Annually, it admits about 5,000 children and treats
30,000 outpatients.

Areas hospitals - including Methodist Medical Center, Proctor Hospital and
Pekin Hospital - have given support for the project, Steffen said.

If the plans are approved by the state, which is required, construction
will begin in spring 2007, with a completion date of 2009. Hospital
officials plan to file for state approval by the end of the month, and said
they believe they will be approved.

"We are in the business of patient care," Steffen said. "This project
says . . . we are going to do it more efficiently, more effectively, more
conveniently."

Dayna R. Brown can be reached at 686-3194 or dbrown@pjstar.com.

----------------------------

The Journal Star then offered this editorial--

Monday, April 10, 2006

When Keith Steffen, OSF Saint Francis Medical Center CEO, got to work Wednesday morning, he was greeted with familiar news: the intensive care unit was full. Because of overcrowding, St. Francis annually diverts 200 patients to other hospitals, 100 of them children. That space crunch is precisely why Steffen would announce later in the day a $234 million expansion of St. Francis. The largest medical center in downstate Illinois isn't big enough.

The single biggest private building project in Peoria's history, if approved by state regulators, will shoehorn an eight-story building onto the Downtown campus and position St. Francis to meet the medical needs of central Illinois and beyond for the next 25 years. Once the so-called Milestone Project is done, St. Francis will have three new floors for the Children's Hospital of Illinois, three more for diagnostic services and surgery, one for adult cardiac patients and a new and bigger emergency room.

With the expansion, all of the hospital's 616 rooms - it has 560 now - will be private, which has health and customer satisfaction advantages. New surgery rooms will be large enough to accommodate robotics and other technology, some $47 million worth. A larger ER will no longer have to operate at twice capacity.

Simply put, the 440,000-square-foot addition - twice the size of the Gerlach Building that spans Glen Oak Avenue - will make St. Francis more competitive in a changing marketplace. Rural hospitals are referring more patients to Peoria than ever before. Some 35 percent of St. Francis' customers come from outside the Tri-County. One of the biggest growth areas is pediatric care, especially for high-risk infants.

OSF officials say the added efficiency will help keep a lid on inflation-shattering medical costs. The Children's Hospital, for example, is spread across six buildings. Now make that one. Administrative offices scattered across the city also will come under one roof after construction is completed in 2009.

This project benefits more than just St. Francis. First, it will create 850 construction jobs and up to 1,000 more permanent ones, including 300 more nurses and technicians. Second, it anchors Peoria's medical community Downtown for as far as the eye can see. When St. Francis built its Center for Health on Route 91 five years ago, there was a fear the hospital might eventually move north. No more. Between this project, OSF's $33 million parking deck now under construction and Peoria Surgical Group moving to the medical school campus, private medical investment Downtown will approach $300 million. What a boost for Renaissance Park.

This also will create a new front door for St. Francis off a rebuilt Interstate 74. Anything that makes it easier to navigate this labyrinth of a hospital is a plus. Finally, this expansion was endorsed by Methodist and Proctor hospitals. Hallelujah. Doesn't happen enough.

There will be naysayers. Indeed, it's a lot of money to add fewer than 50 patient rooms. Then there is the question of need. The Illinois Health Facilities Planning Board initially refused to approve the Center for Health on that basis. Ultimately jam-packed surgery rooms and full intensive care beds showed the flaws in that analysis. It's hard to imagine state regulators not looking favorably on this request.
----------------

My comments:

Finally, after many years, it was stated that the ER at OSF was operating at twice its capacity. Even Mr. Steffen stated that they would be "remiss" if changes weren't made. OSF has been "remiss" for many years now regarding excessive patients in the ER and inadequate bed capacity in the main house.

In the April, 2006 issue of Academic Emergency Medicine an article regarding overcrowding in the emergency department describes the problem very clearly. The journal reports, "The phenomenon of emergency department crowding has become recognized across the globe as a serious public health threat. ...experts widely agree that crowding in the emergency department (ED) is a system-wide problem, not one that results solely from problems in the ED or one that can be addressed using only ED based solutions. Crowding has become a shared burden for emergency providers. Each of us has a collection of stories to tell about how crowding has affected our patients, their families, our cowokers, and our own professional satisfaction."
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June 16, 2006
Emergency System Called Very Ill

On June 15, 2006, USA TODAY had the above headline over an article on their front page.

The nation’s emergency medical system is in a dangerous state of crisis, says a new series of landmark reports. The Institute of Medicine recently released extensive reports which were prepared by a 40-member board after a two-year investigation. The IOM report states that the U.S. life saving system is failing.

The IOM reports detail how hundreds of thousands of lives are affected every year by EMS deficiencies that are not obvious. The chair of the panel, Gail Warden, stated that “in most communities, there is a crisis under the surface.”

Many emergency rooms barely can handle their daily patient loads, children don’t always get good care, and the quality of rescue services is erratic, the report says. A USA TODAY probe found a 10-fold difference between major cities in cardiac arrest survival rates.

Dr. Arthur Kellermann, director of the Center for Injury Control at Emory University School of Medicine in Atlanta stated that the problem with hospital bed capacity slows the emergency department admission of sick patients and more patients are diverted to other hospitals. In every minute of every day, an ambulance carrying a patient is turned away “diverted” when an emergency room says it is too full to take patients.

This sounds very much like OSF in Peoria. Throughout this website, I have questioned the monopoly of paramedic transport care in Peoria. The IOM report mentions, crowding and ambulance diversion also occur because of lack of coordination among emergency medical response teams and hospitals…as well as entrenched professional interests. With regards to Peoria, I would say the “entrenched professional interests” are centered around the medical centers and their relationship with Advanced Medical Transport.

There is a “crisis under the surface” in Peoria that will eventually become apparent.
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Emergency Medical News
October, 2008

In 2006 there were 119.2 million ED visits in the United States.

Dr. Arthur Kellerman agreed that it was easy to blame the problems of crowding on the uninsured. "It gives the decision-makers an excuse to ignore it or blame an unempowered segment of society. These aren't contributing to the growth of emergency department visits," he said. "We know the major problem in crowding is the boarding of patients."

Dr. Peter Viccellio commented on crowding in the ED: "...the problems and solutions are necessarily institutional, and cannot be addressed by focusing on the ED in isolation."

I believed in 2001 and still believe in 2008 that my letter to Mr. Steffen, other OSF administrators, and to my colleagues in the ER was was appropriate and that changes needed to be made to protect our ER patients.
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February, 2009

Well, the financial crisis in the U.S that is putting many people out of home and job is also putting many of them in our overcrowded ER's. See this post.

So in addition to OSF's greed, the dismal national economic picture in 2009 will imperil people's health all the more.

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Conversations with Keith Steffen

2006-03-15T08:56:00.000-08:00

Conversations with Keith

I spoke with an OSF administrator, Dr. Tim Miller, in early October, 2001, and he stated that I was right and that “OSF had ignored the main campus”. He was referring to my letter to Keith Steffen regarding lack of bed capacity in the hospital for emergency department patients. The focus had been on the Center for Health that OSF had just competed north of the City. It cost 38 million dollars. Some of our patients in the ED didn’t even have pillows on their gurneys to lie on. I thought the ER was quite dysfunctional and our patient satisfactions scores were 33%, the lowest at OSF.

I copied excellent articles from the journal “Society for Academic Emergency Medicine” regarding ER overcrowding for multiple administrators. I heard back from no one in administration at OSF regarding the articles.

My first meeting with Keith was on Oct. 5. I expressed to Keith my concerns with lack of bed capacity at OSF and the long waiting times for patients in the ER, and also discussed the fact that Hevesy had placed me on probation for 6 months on September 28, 2001, the day after I wrote the letter to Keith. Keith told me that things were being done about the bed problem and that he (Administrator of OSF-SFMC) could do nothing about Hevesy putting me on probation.

However, Keith changed the topic of the conversation very quickly. He seemed to be very concerned about a petition that was going around in my support and asked me the names of the nurse or nurses who started the petition. I did not tell him because I feared for their jobs if he found out their names. He repeatedly tried unsuccessfully to get their names from me.

Keith then likened me metaphorically to an uncontrolled hemorrhage in the ED and a cancer in the ED that needs to be “cut out before it metastasizes”. I was quite surprised to hear this. I really didn’t know Keith well but figured out this was going to be tough go.

He also was fixated on the concept of fear. He told me, “Fear is a good thing amongst employees.” Rather strange, I thought.

As the next couple of months went by, very unusual things happened in Keith’s office. During one meeting with him, Keith said, “You know, John, the Apostolic community has a problem with you.”(Keith is an Apostolic Christian). This statement totally caught me off guard. The Apostolic Christians in the area were host families for Haitian kids and very close friends of mine. I couldn’t understand what he was talking about. Keith would look at the carpet, shuffle his feet, smile and say, “You know, John, when this comes out about you, it won’t be good.” I would ask him the same question each time—“When what comes out about me, Keith?” He would never answer but would just shake his head and smile. He went through this same ritual several times with me over the course of a couple of months.

I wasn’t the only one he planted these seeds with.

My brother went in to talk with Keith during the next couple of months and he told Tom, “There is a side of your brother that you don’t know.” This disturbed my brother greatly because there is no side of me that he doesn’t know. What could Keith be doing or thinking with this mantra of his?

On December 5 Keith had a meeting with two Apostolic Christian nurses who had important positions at the medical center to his office and stated the following: “John has done very bad things. People don’t know this side of John.” One of the nurses had helped start another petition on my behalf that really irritated Keith. Keith threatened to sue that nurse even though she had done nothing wrong and cleared it with Human Resources at OSF before she started the petition. Keith wanted to know the status of that petition as well, and the nurse told him that people were very afraid. Keith replied that was good. He then reiterated that the people did not know what they were signing and they did not know the whole story and they did not know the “real John Carroll”. Keith told the nurses there should actually be greater fear in the hospital. Keith went on to tell the nurse that he had spoken to Representative Ray Lahood and Monsignor Rohlfs and that they now understand that I have the problem. I had spoken to both of them and they were quite complimentary towards me. (I heard through the grapevine that Keith had made a very urgent phone call to Rohlfs one day to try and explain his side of things.) Keith even went on to say that “Rick Miller had been right all along.” When I asked the nurse if she meant that Keith was referring to me being frustated in the ER, she said “no”. It appeared that Keith was referring to something else, something much worse than frustration. The other nurse said nothing but was listening to all of Steffens comments about me.

A well known lady in the Peoria community, whose family had hosted a Haitian Hearts child, told me how she went in to Keith’s office and he told her that they had asked me to seek counseling and that if she knew the OSF side of the story she would agree with Keith and OSF. She didn’t know what to think. Keith was definitely doing some damage and spreading seeds of doubt regarding me outside the medical center. She told me this story with her husband present. I could tell they were very apprehensive about what was occuring. Her husband had no idea what to say or do. They both have excellent jobs in the Peoria community and both knew what would happen if they went to bat publically for me.

Another business lady in the community who had never met Keith went in on my behalf after she was told by Sister Judith Ann to do so. Keith talked a lot about the devil with her and stated, “When the devil ensnares someone and pushes him up against the wall, we find out what that person is made of.” This lady was quite scared and wanted to leave Keith’s office at that point. Keith commented to her on the way out that if she talked about their conversation “…maybe we won’t be friends anymore.” (She had never met Keith prior to this.) She couldn’t wait to leave his office. When I asked Sue Wozniak about this a couple of months later she said “ it sounded like a threat”. The business lady thought so too.

Keith talked about my employment at his church in Washington, Il. I know who he talked to. They told me. At one point, Steffen stated, that “each time he (Steffen) sees a Haitian child, it makes me (Steffen) want to puke.” Keith’s inappropriateness knew no bounds.

So there really wasn’t any confidentiality with Keith. OSF attorney, Doug Marshall, would monitor Keith at times in Keith’s office and tell him to watch what he was saying because I was shaking my head and writing everything down. Keith’s mantra to me about “the other side of me will come out and it won’t be good” was never said in front of Marshall, that I know of, so Keith can deny this if he wants. But he will have to deny it a lot if ever questioned under oath because he said it to many people.

Does this sound like the way the CEO of the largest employer in Peoria should act? Doesn’t seem to be great management skills to me. Open and honest communication, one of the Sisters mission statements was absent with Mr. Steffen.

After Keith fired me on December 18, 2001, he distributed a fax to the rest of the medical center (that was written by hospital spokesman Chris Lofgren) as if he was trying to protect me. A lot of people told me about this nonsense. (See post "Conversations with Chris").

Then things got worse.

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Before I met with Keith as described above, I sent him this note pleading for help for the Emergency Room from OSF administration:

Handwritten Note from Dr. John Carroll

10-01-01

Dear Keith,

As you mayor may not know, the ER is in "tough straits" - patient care and waiting time is very lengthy.

I would love to have you or another administrator spend a couple of shifts with me this week in the ER. I work 3-11 and 5-1. You would see patients with me. The objectives of this would be to:

1. See the ER from "ground zero" - this would prompt ideas on how to solve some of these issues. I will tell you how I see the issues and how time could be saved for the patient (from triage to final disposition). There is a huge crisis occurring in our ER now.

2. Your presence would definitely be a "morale improver" for the ED staff and for the patient when he realizes an administrator is personally concerned as well.
I really believe an administrator's presence would be a "win-win" for OSF and ER patients.

Please strongly consider joining me in the ER.

Sincerely,

John

Addendum:

May 22, 2008--Keith refused to come to the ER when I proposed this to him in 2001. He stated that if he came to the ER other hospital departments would want his presence, and he could not be everywhere.

As I look back at it, I doubt the ER had his full attention compared to other big money making departments (like Surgery) and the new Center for Health. The ER and its overcrowding would just have to wait.

In the May 15, 2008 issue of the New England Journal of Medicine is an article written by David J. Shulkin, M.D.

Dr. Shulkin makes late night administrative rounds at the hospital where he is president and chief executive officer. He noted the "stark discrepancy in quality between daytime and nighttime inpatient services."

His goal is to improve his hospital quality of care during the nighttime hours.

Dr. Shulkin writes:

"The consequences of service deficiencies during off-hours include higher mortality and readmission rates, more surgical complications, and more medical errors."

He feels that his midnight rounds were proving a good way to help him understand and address concerns of off-hours staff.

"In order to identify problems and design effective solutions, it is critical to gather such front-line information, and to do so, senior hospital administrators need to see firsthand the working of the "other hospital". I strongly encourage my counterparts else-where to conduct at least 1 week's worth of night rounds each quarter."

"Close attention should be paid to the needs of patients and their families, any procedural and communications issues among staff members, and most important, the quality of dialogue between administration and staff members regarding the organizatiion's inpatient service and safety priorities."

Keith probably needs to read this NEJM article.

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May 14, 2006

In this weeks New England Journal of Medicine, George Annas wrote an article, "The Patients Right to Safety--Improving the Quality of Care through Litigation against Hospitals.

Annas reports, "...safety must be an explicit organizational goal that is demonstrated by clear organizational leadership...This process begins when boards of directors demonstrate their commitment to this objective by regular, close oversight of the safety of the institutuions that they shepherd."

He continues,"...(hospital) safety cannot become an institutional priority without more sustained and powerful pressure on hospital boards and leaders---pressure that must come from outside the health industry. In hospital care the challenge is to reform corporate governance to make hospital boards take their responsibility for patient safety at least as seriously as they take the hospital's financial condition."

“The major safety-related reasons for which hospitals have been successfully sued are inadequate nursing staff and inadequate facilities. Since providing a safe environment for patient care is a corporate responsibility, understaffing is corporate negligence. “

In 1991, for example the Pennsylvania Supreme Court stated simply, “Corporate negligence is a doctrine under which the hospital is liable if it fails to uphold the proper standard of care owed the patient, which is to ensure the patient’s safety and well-being while at the hospital.”

During one of my first conversations with Keith Steffen, I told him I was worried about “institutional malpractice” at OSF. He asked me to define what that meant and I remember replying that he would understand the concept better than I would. He did not reply further. I thought that too many patients were being kept for long periods of time in the ER in 2001 to their detriment. I realize that Mr. Steffen is a small player in the entire scheme and agree with Annas and the New England Journal of Medicine that the Board of Directors at OSF needs to play a bigger role in guaranteeing safety of patients at OSF.

Keith Steffen and the Apostolic Christian Community

2006-03-15T08:47:00.000-08:00

Keith And The Apostolic Christian Community

The only reason I bring up this topic is because Keith Steffen talked about them so much in his office with me, he seemed to be fixated on the Apostolic Christian community in the area. Keith is an Apostolic Christian as well.

During one of my initial “conversations” with Keith, he smiled, looked down, and told me that the “Apostolic Christians in the area have a problem with you”. He never told me what this meant but would add that the “other side of you is going to come it won’t be good”. He never explained this either. I asked him what he meant by these statements and Keith would just smile, shake his head, shift his feet, and look down at the floor in his office.

I have known many Apostolic Christian (AC )nurses around the OSF medical center for 25 years. Many are close friends. I ate dinner with them in their homes, took care of their family members, and they took care of my family as well with any needs we had. They universally showed empathy for their patients. The closeness of their families and the sincerity of their church and community is remarkable—something that all faiths should try and achieve. When a Haitian child died in the Peoria area, the Roanoke Funeral Home conducted the services, the Roanoke AC church was filled with white, middle class church goers, the Haitian child lay in a casket that was nicer than her home in Haiti, and her Haitian mom and sister were flown to the States to be with her during her last days. The dead child's mom and sister sat in the first pew as the AC community supported them with tears in their eyes. One had to be there to see the best side of the U.S. showing its support for their Haitian neighbors who have nothing but God in their corner.

Anne is a great friend of mine and an AC nurse at OSF. She travelled to Haiti many times and worked in our clinics there. Haitian Hearts and its children could not have survived without her. She took care of kids with heart problems in Haiti, arranged their travel, found host families in the Peoria area, took care of kids in her home, helped with the kids in the hospital, took care of them postoperatively, and took them back to Haiti to their parents. She helped raise funds ($1.1 million) for Haitian Hearts that all went to Childrens Hospital of Illinois. She gave talks all over the area for Haitian Hearts and Children’s Hospital. Her brother adopted a baby from Haiti who had heart surgery. Her entire family was involved with Haitian kids. Anne never complained about her incredible work load.

Through Anne and the host families from her church, I met many Apostolic Christian families who hosted Haitian children in their homes. The kids were part of their families and in their Christmas pictures. These families spent many agonizing days in the OSF-ICU with these kids after surgery. They took the kids on vacation with them when they were better. They travelled back to Haiti with me and gave the kids back to their biologic Haitian moms and saw the shacks and slums where these kids lived. They built new homes for the families and sent the Haitian kids to school. Great things happened with these relationships that Steffen was trying to destroy. Why Steffen would say that the “Haitian kids make me want to puke” remains problematic for these host families and for all of us involved in the care of these kids.

Steffen talked to members of the AC community about me at his church in Washington prior to firing me. (He denied this to my brother.) I took the liberty of talking to Steffen’s elder (Ron Messner) about the problem. I requested a meeting with the elder, Keith, and another AC member of the community who had travelled to Haiti with me many times. I thought that OSF’s administrator needed a good talking to by his elder. The elder agreed but when I was leaving his office, he told me he would “never see me again”. I e-mailed Steffen to tell him the good news of a meeting that would foster open and honest communication, a mission statement at OSF that Steffen constantly referred to. Steffen sent my request to OSF attorney, Doug Marshall, who stated that Steffen would not be part of this meeting. Just like the elder predicted. I don’t blame OSF for not wanting him to be there. He might talk again. (Neither the Apostolic Christian Church nor the Roman Catholic Church would be able to control the powerful leaders at OSF.)

Prior to Steffen firing me, he met with a couple of nurses in the medical center who happened to be AC. He said very bad things about me and threatened to sue one of the nurses who was supporting me. From my understanding, ACs don’t sue. What was Steffen thinking? Did he not agree with this religious principle of the AC church? Was he trying very hard to intimidate this nurse who had would do more real work for the Sister’s mission in one day than Steffen every did? Another nurse who is not AC told me that Steffen referred to the nursing staff at OSF as “widgets”. She did not view this as complimentary. And when the some of the nursing staff were considering unionizing a couple of years ago, Steffen came out with a diatribe about the nurses threatening them not to unionize at OSF. (A friend of mine’s wife was a nurse at OSF and was asked my management nurses if she was going to sign the petition to unionize…maybe a little intimidation and fear were being used…) Steffen told me in his office that if any nurse wanted to leave OSF, this was fine with him. But at the same time, OSF was raiding the Phillipines for foreign nurses to try and help fill the nursing shortage that plagues OSF as it does other medical centers in the United States. Referring to OSF nurses as “widgets” seems quite inappropriate with or without a nursing shortage.

I agree with Steffen’s suggestion that much of the AC community did have a problem with an OSF employee. However, that employee wasn’t me.
---------------------------------

June 3, 2006

The nurses in the OSF ER were very discontent with how things were going in 2001. Employee satisfaction in the ER was poor. I knew how Keith Steffen treated a nurse, spoke of nurses, told me that it was fine with him if nurses left OSF, and strongly discouraged a nursing union at OSF, so it did not surprise me to learn that OSF was traveling to the Philippines to recruit nurses. As doctors and most administrators know, nurses make or break a hospital.

The New York Times ran an article on May 24, 2006 “U.S. Plan to Lure Nurses May Hurt Poor Nations”. The article stated:

“Public health experts in poor countries, told abut the proposal in recent days (the proposal to allow foreign nurses to immigrate easily to the United States), reacted with dismay and outrage, coupled with doubts that their nurses would resist the magnetic pull of the United States, which sits at the pinnacle of the global labor market for nurses...

Removing the immigration cap, they said, would particularly hit the Philippines, which sends more nurses to the United States than any other county, at least several thousand a year. Health care has deteriorated there in recent years as tens of thousands of nurses have moved abroad.

“The Filipino people will suffer because the U.S. will get all our trained nurses,” said George Cordero, president of the Philippine Nurse Association. “But what can we do?”

Dr. Jaime Galvez Tan, a medical professor at the University of the Philippines stated, “...the flight of (Filipino) nurses had a corrosive effect on health care. Most Filipinos died without medical attention in 2003, just as they had three decades earlier. Tan went on to say, “I plead for justice. There has to be give and take, not just take, take, take, by the United States.”

As stated in the article, providing appropriations for domestic nursing programs would be morally much more acceptable than bleeding the nursing work force in the developing world.

OSF, are you listening? Joe Piccione and Dr. McShane, where are you? This seems like a topic that Bishop Jenky should involve himself in quickly to help protect the people of the Philippines from the tactics of OSF in Peoria.
-----------------
June 14, 2006

Poaching Nurses

The Lancet medical journal June 3, 2006 contains an article “Poaching Nurses from the Developing World”.

The article gives grim statistics. The American Hospital Association reports that here are 118,000 current vacancies of qualified nurses in the U.S. Nursing schools in the U.S. do not have sufficient staff and 32,000 students were refused entry into Baccalaureate level nursing programs in 2005.

Developed countries have long looked upon the developing world as a nearly limitless source of willing labor to fill the nursing shortage. 50,000 nurses have immigrated to the US in the last decade. Most of the countries from which these nurses come are facing extremely serious public-health problems, including epidemics of HIV/AIDS, malaria, and tuberculosis. These are the same problems we see in Haiti everyday. Haiti and the rest of the developing world cannot afford to lose these nurses who frequently manage an entire ward of a hospital when there is no doctor available.

The Lancet reports, “Only 10% of the global burden of disease is concentrated in the Americas, but 37% of all health professionals work there”. A UN report reinforces that this brain drain of health workers is effectively subsiding care in the rich world. Clearly, further migration of workers will be disastrous for developing countries.

OSF-SFMC in Peoria and other large medical centers in the U.S. that attempt to lure nurses from their dirt-poor home countries should realize what they are doing. Diana Mason, editor of the American Journal of Nursing, said the main problem here is the “primary moral issue of draining these countries of their much-needed nursing resources and further undermine their healthcare infrastructure and the health of their people (and thus of their economies).” Mason states that a recent report by the Institute for Women’s Policy Research suggests that the nursing shortage continues as a result of collusion among hospital administrators to keep wages down and of longstanding gender-based wage discrimination. Can you believe it?

According to Lancet, the U.S. Congress should be creating ways to fund and strengthen the nursing infrastructure in the US, thereby developing a local workforce. Nursing salaries could rise and the poaching of nurses from the developing world would no longer be necessary. And most importantly, patients in the Philippines, Africa, and Haiti wouldn’t lie in their hospital beds without care.

Conversations with George

2006-03-15T08:44:00.000-08:00

Conversations With George

Dr.George Hevesy became Director of the OSF-ED on August 1, 2001. He replaced Dr. Rick Miller. Two other attending physicians "ran" against George as ED physicians voted over the phone. Sue Wozniak was given the phone vote and George was made Director of the Emergency Department at OSF. Business would continue as usual.

I wrote my letter to Keith Steffen, Administrator of OSF-SFMC, on September 27, 2001 detailing my concerns regarding bed capacity at OSF and long waiting times for patients in the ER. George put me on probabation the next day and said I would no longer see patients in the main ER starting November 1.

On October 5 and November 9 I met with George in his office. The following notes are from both meetings:

George stated that he agreed with the content of my letter. He did not agree that I had gone outside of communication channels. He also that the emergency department lacked a leader for the last one and one-half years (Rick Miller). He said he would be frustrated also. I wrote directly to the head of the hospital because I did not think George would really do much with my complaints and “bed capapcity” at OSF was an issue for administration.

George told me that all I needed to do to get back into the main emergency room was to see Dr. Richard Lee who was in charge of the Wellness Committee at OSF because I was “burned out”. His original letter, of course, had not mentioned this. My whole future flashed in front of my eyes when George said this. I could see what was going to happen. An attending physician in the ER had questioned George and Rick Miller that if they thought I was really burned out, why were they letting me continue to work in the main ER until November 1. George came to his senses and realized he should be consistent and moved me to Prompt Care shifts after my colleague made that observation. (The real issue was that George did not want to have to change the work schedule because the other attendings would be quite upset with him.) So I started 10 hour Prompt Care shifts in October and worked more hours than any other attending physician in the department until I was fired in December.

Interestingly, at a prior Emergency Department staff meeting directed by George in August, he told the entire room of physicians that “we are all crispy critters”. This meant that we were all burned out with the dysfunctional emergency room that was overcrowded, noisy, with lengthy patient waiting times and very sick patients. He scolded four physicans for their treatment of nurses and the language that was used against one nurse by a physician. When I asked George if all the physicians in the department were going to have to see Dr. Lee, he replied, “of course not”. I told George that his measures against me were very punitive in nature and were slapping the messenger because of the message. On November 11, when I asked George twice to give me examples that showed I was burned out, he shook his head and gave no examples whatsoever.

What most people did not know, were the conversations that I and others were having with Keith Steffen upstairs. Steffen was saying to me “when this comes out about you, this won’t be good.” He was telling others the same and that “John Carroll has done bad things” and that “John Carroll is a bad person”. He told my brother ‘there is a side of John that you don’t know”. Steffen would not tell me what he was talking about. He was talking to people in his church and to various community leaders about me. Steffen even told me that if I saw Dr. Lee, there would still be “some baggage”. A number of my physician partners told me they would see Dr. Lee also, if I would, so I could retain my job. My partners did not want to see me fired. They were not aware of the seeds of doubt that Steffen was creating in the community at OSF and outside the medical center. I was trapped and the witch hunt was going full force.

(Interestingly, I talked to Dr. Lee on the phone. I have known him for greater than 20 years. He told he that Rick Miller had talked to him about me in the summer and Dr. Lee told Miller to “handle it in the department”. He could see no good reason for the referral.)

I continued to work my shifts and take care of Haitian Hearts patients in the hospital. Steffen told me he would fire me if I had not seen Dr. Lee by December 11, 2001. I travelled to New Orleans that day with Paul Kramer. As the plane took off from the Peoria airport, I looked at my watch and it was 11:10 AM. I told Paul, “I just got fired…” Paul didn’t say much. I gave a speech to the National Business Aviation Association for OSF Childrens Hospital and Haitian Hearts the next day to 1,000 private jet owners regarding the good work being done in Peoria. August Busch III was the keynote speaker.

When I got back in Peoria, Keith sent for me. I went in to his office and asked him if he fired me while I was in New Orleans. He said he had not because “I was trying to raise money for Childrens Hospital with my speech in New Orleans regarding Haitian Hearts and Children's Hospital of Illinois”.

While I was seeing patients in Prompt Care at OSF in the morning on December 18, Hevesy came to the area and said that Steffen wanted to see us. I passed a colleague of mine walking down the hall who had been called in to work for me. He nodded. I knew what was going to happen. As we walked down the main hall near administration, Sister Canisia was putting up Christmas decorations. Hevesy said, “Good morning, Sister.” She didn’t even look up at him.

In the administrative office was OSF’s attorney Doug Marshall, Dr. Tim Miller, George, and of course Keith. They all looked so serious and solemn as they sat on Keith’s couch like good little soldiers. Keith’s bible was in its usual prominent location. Interestingly, Keith was not shuffling his feet nervously, smiling at the floor and saying “another side of me is going to come out.” Keith handed me a two page letter firing me from the medical center that I loved so much. I was fired because I did not see Dr. Lee as George had demanded. Not doing what Hevesy and Steffen demanded was the best move I ever made. It took a total of about 3 minutes to let me go after 21 great years at the hospital I loved.

Keith asked me if I had any questions. I had many, but it was too late. Steffen told me that I needed to leave the hosptial then. I picked up my stethescope and brief case from Prompt Care, a nurse hugged me, and I was gone.

-----------------------------

Letters from Dr. Gene Couri and Dr. Sonja Simenauer:

October 3,2001
George Hevesy M.D. OSF/SFMC
Dear George,

After reading John's letter, and finding out your response I felt it imperative to write you as your friend and your employee as to how this will affect our group and most of all our patients. I have known John for 17 years, share few common bonds with him outside of work, and have an incredible admiration and respect for him as a fellow physician and human. In these times of frustration, and chaos it is easy to see those particular points about someone that are irritating to us. John like all of us does not break this rule, but those things that are sometimes irritating are also his greatest assets.

A dedication to his patients needs that exceeds the distractions about him. When I work with John I have learned the importance of attention to the individual patient. Patient's medical needs are addressed with a focused comprehensive history, physical, and appropriate lab evaluation. No matter how busy, how chaotic, John will not saaifice this standard to the distractions of the ED.

A dedication to the art, and science of medicine. I have always admired John's discipline for furthering his knowledge base and frequently in adult and pediatric patients I tap this knowledge base on line. It had been frustrating and intimidating to work with someone like this as the residents staffed with him, and gave him the teaching awards. This had challenged me to work harder, read more, and hopefully teach in a better fashion.

A dedication to the mission of OSF. What can be said about a man who forsakes having children, and dedicates the vast majority of his time and money to saving the lives of someone else's impoverished children? These actions certainly remind us of what we should be doing, or at least helping with, and yet we are not pushed by John only self reminded of our shortcomings.

A dedication to the search and revelatim of the truth. This by far is John's greatest asset that defines who he is, and at the same time his greatest liability. My interactions with John have not always been pleasant, but have always been truthful and from his heart. John could certainly be more tactful or politically correct but truth to him is either black or white, and unfortunately he has not learned shades of gray.

George it certainly has appeared that in the past few years we have been pushing John out the door. His academic hours have vanished, his colleagues are afraid to agree or associate with him as he has not been politically correct, and the new nursing statff has brought preconceived prejudices to the ED. I was certainly hoping that your handling of our most valuable asset to the group would be done with patience and wisdom realizing what John brings to our ED. I understand there needs to be order in our group, and hope that this problem can be resolved as rapidly as possible to bring John back to our ED. I know it was not your intention, but by letting our most outspoken member go you send an all too familiar message to us all. Our worth should not be determined by our ability to "get along", but to serve our patients and the mission of Saint Francis. The integrity of our work should be determined by how much we are willing to personally sacrifice for our worth in our job.

John has put his job on the line for what he believes is the best interest of our patients. Life in our group would be easier without John, just as our life would be easier without a conscious. John represents the "Gold Standard" of an OSF employee, and I truly believe you have the ability to use this for our groups' benefit.

George our group needs to make a radical change, no more of the old smoke and mirrors, but a clear . delineation of what we need to do for our patients, you/our administration, and our hospital. We as your employees need to be rewarded for making the difficult choices and self-sacrifice, and politics as we once knew it needs to go away.

Thanks George,

Gene Couri

Sonya D. Simenauerer,D.D.S., M.D.
PROCTOR PROFESSIONAL BUILDING 5401 N. Knoxville Avenue Peoria, Illinois 61614 Telephone: (309) 692-1496

November 2, 2001
Dear Mr. Steffen:

I was shocked to learn of the loss of Dr. John Carroll in the emergency room. He is a wonderful addition to St. Francis Hospital and one of the best pediatric ER doctors. He has displayed great dedication to the needy children of Haiti and brought credit to your hospital.

Above all when my father was in a coma at St. Francis ICU, he stopped by everyday to comfort me even though he was not involved in my father's care.

I have directed all of my patients to go to St. Francis ER because of the good care that your doctors, like Dr. Carroll, give to my patients. His reputation, commitment, and dedication to others is an asset to your hospital.

Thanks for your time,

Sonya D. Simenauer, D.D.S., M.D.

(After Dr. Simenauer wrote this letter to Mr. Steffen, Dr. Hevesy called her and was very upset with her for writing this letter of support for me.)

Conflict of Interest

2006-03-14T16:36:00.000-08:00

Conflict of Interest

During the fall of 2001 many people told me that Dr. George Hevesy was receiving a salary from Advanced Medical Transport (AMT). This seemed unbelievable to me. They usually followed up their statements with, “You know this is conflict of interest”. Another physician in the OSF ER screamed at me in anger about Hevesy’s conflict.

Hevesy was wearing many hats. He was the newly appointed Director of the ER at OSF and had been the Project Medical Director (PMD), for about 10 years. As PMD he was in charge of all the ambulances in central Illinois—approximately 70 agencies. Hevesy was (and is) Corporate Medical Director of AMT. The following year, OSF-SFMC would appoint him as President of the Medical Staff at OSF.

I filed under the FOIA at the Illinois Department of Public Health in Springfield for a conflict of interest statement. The document arrived after many months of trying.

Below are some excerpts from the IDPH statement regarding conflict of interest. It is not signed. It begins,

“In accordance with Section 515.320 j Scope of EMS Service, the Peoria Area EMS System is herein notifying the Department of a Stipend received by the EMS Medical Director from an EMS Provider in the System. Specifically, the Peoria Area EMS Medical Director, Dr. George Z. Hevesy, receives a stipend paid by an ALS provider, Advanced Medical Transport of Central Illinois.The stipend is justly provided to the EMS Medical Director for oversight and consultation provided to this comprehensive EMS provider. This EMS provider accounts for the majority of the System’s EMS responses and interfacility transfers. Additionally, this EMS agency provides a unique regional critical care (inter-facility) transfer service under the direct medical control of the EMS Medical Director.

This stipend does not create an agreement or atmosphere which makes the EMS Medical Director answerable to or directed by the EMS provider. Nor has it influenced the Medical Director’s assistance of other providers.

The Peoria Area EMS Medical Advisory Board and the Ambulance Board of Directors, consisting of representatives of the Peoria area hospitals, have reviewed the stipend and believe there is no potential or actual conflict of interest.”
----------------------------

The “EMS provider” stated above is AMT. I wonder what the PFD would say about influencing the medical director’s assistance with regards to the PFD? The Ambulance Board of Directors must be the AMT Board of Directors because there are no other ambulances in Peoria.

This is truly an amazing document. (Please see last post in this blog regarding Doug Marshall's comments regarding PAEMSS and IDPH and the confusion that is created by the statement in the Journal Star that PAEMSS is an arm of IDPH. Doug Marshall is OSF attorney and PAEMSS attorney.)

Locally and nationally, people in EMS told me this represents conflict of interest. Firefighters stated that they “tap their toes nervously” and wait for AMT to arrive when they have a patient with severe breathing problems and are unable to help the patient other than give basic life support, even though the PFD had firefighters with advanced skills (Intermediate and Paramedics). Many firefighters in the Peoria area, told me that Hevesy “obstructed” their departments when they attempted to upgrade their services for their citizens. The municipal fire departments are not paying Hevesy; AMT is. AMT is the only paramedic and transport service in the city of Peoria.

Three are two fundamental ethical premises that guide prehospital medical care. The principle of justice implies that the system be fair and equitable. The principle of beneficence requires that actions and intentions are in the best interest of the patient.

In the April 5, 2005 Annals of Internal Medicine a Position Paper regarding medical ethics stated the following: “The physician must seek to ensure that the medically appropriate level of care takes primacy over financial considerations imposed by the physician’s own practice, investments, or financial arrangements. Trust in the profession is undermined when there is even the appearance of impropriety.”
“…Physicians must be conscious of all potential influences and their actions should be guided by patient best interests and appropriate utilization, not by other factors.”

Do you think this constitutes conflict of interest?

In December 2002, my brother and I met with Monsignor Rohlfs and the Canon Law Lawyer for the Diocese of Peoria, Patricia Gibson. We met with them in Monsignor Rohlfs office. We expressed our concern with the conflict of interest regarding our EMS system as described above. They helped us draft a letter of petition to the OSF Sisters requesting a Catholic tribunal court against OSF because of OSF’s association with AMT and Hevesy.

However, in February of 2003, when I met with Monsignor Rohlfs and Patricia Gibson, they told me that if I pursued a tribunal regarding OSF’s role in this matter, the Diocese would withdraw its support from Haitian Hearts. They also stated that they would blame me in the media for the failure of the program. I was stunned to hear Monsignor Rohlfs say this. The Diocese effectively held the Haitian kids who needed heart surgery hostage to protect OSF from a Church tribunal. This was very hard to accept.

I filed the petition anyway with Bishop Jenky, who refused to consider it. (See his written response below.)

OSF-AMT Relationship

2006-03-14T16:35:00.000-08:00

OSF-AMT Relationship

On September 27, 2001, I wrote a letter to Keith Steffen, CEO at OSF-SFMC, stating that I thought the bed capacity at OSF was not sufficient for the number of patients we were seeing in the ER. We were just keeping people too long in the ER before getting them upstairs and in their hospital bed. I sent this letter to my ED colleagues and other administrators.

Dr.Hevesy suspended me from the ER the next day, put me on probation for 6 months, and banned me from the main ER at OSF for writing this letter.

In October, I had a meeting with Hevesy in his office. He had been appointed director of the ED on August 1. People warned me that Hevesy was meeting with Andrew Rand in his office, but that didn’t mean much to me at the time. Many people in the area had recently told me that Rand was paying Hevesy for his services and they thought this represented conflict of interest.

I waited outside Hevesy’s office for 15 minutes, until Rand came out. I asked Hevesy why he had me wait while he met with his business partner. Hevesy had no immediate answer.

Why Rand was even allowed on OSF’s campus was questionable. AMT, under his watch, the year before had been fined $2 million for Medicare fraud by the federal government. AMT had been “upcoding”, i.e. charging the patients too much and the taxpayer was footing the bill. But Rand retained his position as director of AMT. This news was downplayed in Peoria and the 3 medical centers in Peoria helped bail AMT out of this financial mess. OSF is the biggest supporter of AMT and has significant interactions with this not-for-profit agency.

AMT grossed over $7 million a few years ago. Several years ago, Rand’s salary was $183,000 and Hevesy’s annual income was over $400,000 per year. But the PFD, who responds to approximately 10,000 health related 911 calls per year collects nothing for their responses.

Unfortunately, in Peoria there is a long history of friction between AMT and the PFD. It’s simply about money.

On May 1, 1996 there was an interesting article in the PJS headlined: “Ambulance Plan Abandoned–Fire Department to Add Defibrillation Program”. The article seems like it could almost have been written yesterday. AMT was worried that the PFD would go into the ambulance and transport business. Rand was worried about AMT. Chief Ernie Russell stated, “When we first started looking at this we had to answer was the service being offered now at a quality that we wanted. We said “no”. We wanted quicker response and the defibrillation ability…”

So what this all meant from my sources was that the decison was made for the PFD to stay at basic level. They couldn’t even give basic drugs and had to wait for AMT to arrive if the PFD was at the scene first for AMT to give advanced drugs and shock the patient. But the firefighters bought their own defibrillators to shock hearts during a cardiac arrest in ‘96 or ‘97. In a PJS editorial that preceeded this article on February 18, 1996, the editors state, “What we have heard is a medical community speaking up in support of AMT…George Hevesy, emergency services director at St. Francis Medical Center, says he fears city-run service would lack the expertise, the funding and the medical supervision to provide a high quality of care.”

This was an amazing statement by Hevesy because he was in charge of all the emergency agencies in central Illinois including the PFD and if the PFD lacked the expertise or lacked the medical supervision, that was Hevesy’s responsibilty. The Journal Star did not report that Hevesy was on AMT’s payroll and that their was obvious conflict of interest.

Where were Hevesy’s statements encouraging the PFD and helping the PFD acquire the life saving defibrillators prior to 1996? The American Heart Association stated in 1992 that all basic units (like the PFD) should be shocking people at the scene of a cardiac arrest. AMT was doing this in 1992, why not the PFD? Patients were being defibrillated at the scene of a pre hospital cardiac arrest since 1967! Where was Hevesy and his boss Rick Miller regarding this in Peoria? Why do the administrators from all three Peoria hospitals come to the City Council meetings over the years when AMT is the topic?

The Journal Star stated everything was fine with the emergency medical services in Peoria in 1996 just like almost everyone is saying in 2005. It is not based on any statistics. It is just a “feeling”. And a fair amount of local business pressure to keep things as they are in Peoria.

What would the public and the PJS say if the PFD were slipping the doctor in charge of all ambulances in Peoria a nice salary? Would that be reported in the media?

Emergency Room Overcrowding

2006-03-14T16:32:00.000-08:00

Emergency Room Overcrowding

The letter I wrote to Keith Steffen, adminstrator at OSF-SFMC, dated September 27, ‘01, described my thoughts and concerns about the OSF- ER after working an afternoon shift the day before. Elderly patientes signed out and went home because they just didn’t want to wait for a bed in the hospital to open up so they could be admitted. I felt very uneasy signing these sick people out of the ER to go home.

The Annals of Emergency Medicine headline an article in the January, 2000 issue “Overcrowding in the Nation’s Emergency Departments: Complex Causes and Disturbing Effects”. During the 90’s, overcrowding in emergency departments became a national issue. It didn’t just involve OSF in Peoria. The article stated, “ED overcrowding has multiple effects, including placing the patient at risk for poor outcome, prolonged pain and suffering of some patients, long patient waits, patient dissatsifaction, ambulance diversions in some cities, decreased physician productivity, increased frustration among medical staff, and violence….Unless the problem is solved in the near future, the general public may no longer be able to rely on ED’s for quality and timely emergency care, placing the people of this country at risk.”

In my opinion, this described OSF-ER almost perfectly. Thus, when I wrote Steffen my concerns and then met with him for the first time in early October, I had no idea that he would metaphorically refer to me in the meeting as a “cancer in the ER that needs to be cut out before it metastasizes” as well as a “hemorrhage that needs to be stopped before the bleeding gets out of control”. How his medical descriptions of me as a cancer and a hemorrhage related to bed capacity and overcrowding at OSF, remained a mystery to me. He didn’t seem to be focused on the important issues for OSF. He seemed to be focused on the concept of fear amongst employees and finding out from me which nurse started a petition in support of me and the problems I had addressed. And the ER director, George Hevesy, put me on probation for 6 months from working the ER the day after I sent this letter.

Almost a year after Steffen fired me from OSF, an article appeared in the journal “Academic Emergency Medicine”–The Elusive Nature of Quality. It discussed that systems need to change before emergency rooms can change for the better:

“Front line care providers (doctors working in the ER) are the frequent targets of criticism regarding the quality of care, and are often the recipients of the metrics we use to measure quality. These dedicated, skilled, and talented clinicians are often powerless when systems changes are needed, but they are held accountable for their actions within a SYSTEM THAT CANNOT ALLOW SUCCESS.

“The true route to achieving quality begins with an enduring commitment from the highest leaders of the organization, willing to exercise their authority for productive benefit. If the board of trustees and the CEO do not actively support excellence in the ED, enduring improvements are unlikely.

“If the messasge is not loud and clear that the patients in the ED must be served optimally by every service with impact, then mediocrity will be the norm. Responsibility must be properly allocated, which is a task of the leaders. No system is successfull without effective leadership.

“If we accept that the formula for quality begins with leadershhip, then the top of the hospital administration must set the expectations for all critical congributors to the ED.

“The essential element of leadership is strong principle.”

These paragraphs define the situation perfectly, in my opinion. However, Steffen and Hevesy must not believe in their validity based on their punitive actions against someone who pointed out to them the problem that needed their attention. And both Steffen and Hevesy told me that there were serious problems with leadership in the
OSF-ER.

On June 3, ‘05, a tiny article appeared in the Journal Star: “Peoria Hospital Opens New Emergency Unit”:

“OSF-SFMC opened its new $2.4 million Emergency Care Unit on Thursday. The 13-bed facility…will serve as an observation area for patients with chest pain, heart failure and asthma.

Mike Cruz, the assistant director of the OSF-ED stated, “It should help significantly…because of the operational components. This will increase total capacity (for emergencies) by about 30 percent. Given that we haven’t had a new facility recently and there has been a volume increase…it will help”.

Notice that it wasn’t Hevesy or Steffen that made this announcement to the public. This needed to happen years before and “the main campus (downtown OSF) had been ignored” according to Dr. Tim Miller in OSF administration when I met with him in September, 2001, after I had written my letter to Steffen.

In April, 2006 when OSF announced its new 234 million dollar campus renovation, Keith Steffen stated that this would include a "much needed" improvement in the Emergency Room which was built for 32,000 patients but is currently expected to have 62,000 visits in 2006.

Why did Mr. Steffen refer to me as a "cancer in the Emergency Department" when I brought the OSF bed capacity problem to his attention in 2001?

OSF’s leadership definitely is lacking, not based on strong principle, and needs a change.

OSF Emergency Room Patient Satsifaction

2006-03-14T16:30:00.000-08:00

Emergency Room Patient Satisfaction

The OSF Emergency Room patient satisfaction as reported in the Press-Gainey statistics was very low. When I was fired in December, ‘01, the reported patient satisfaction was 33%, the lowest at OSF-SFMC. I sure didn’t have all the answers to the problems of the ER, but I thought that the ER Directors, Rick Miller and George Hevesy, were not forceful enough with OSF’s administration. They seemed to be lackeys for administration. They didn’t seem to advocate enough for the ER.

The ER seemed to be on the “backburner” compared to other OSF projects like the construction of the OSF Center For Health—the new OSF facility that costs 10’s of millions of dollars and positioned in north Peoria. At an Emergency Department Staff meeting in 2001, mention was made of the lack of pillows for our patients’ stretchers in the ER. An attending physician (not me) even stated he would borrow a friend’s pick-up, go to Wal Mart and buy pillows with his own money for the emergency room. This offer enraged Dr. Miller at the meeting because it showed how far the ER had plummeted under his watch. Miller was on his way out the door as Director and wanted not to inflame administration any further as he cut himself a nice deal as a “regular” ER doctor.

I stated to Miller over the years that I did not think we had good control over the environment inside the ER. I thought the ER was dysfunctional. I told him it was like practicing medicine on a street corner in Haiti. Miller asked me to write down my comments for the Patient Satsifaction Committee which I did on February 8,2000.

Here are excerpts from my letter:

“Patient Satsifaction Committee:

Rick Miller called me into his office after hearing second hand my comments at your Patient Satsifactiion Committee meeting. I offered to put into writing some thoughts and suggestions concerning my perception of our ER since I have spent the majority of the last 20 years of my life at OSF-SFMC. (Since 1989, I had spent more hours on line seeing patients in the OSF ER than any other physician in the department.) Rick asked me for specific suggestions regarding patient satisfaction or lack therof.

1. As I stated quite clealy last week, the ER needs to become the central focus of the Emergency Department. Our individual agendas, problems, and distractions need to be muted and care of the patient needs to take precedence over other matters. The patient needs to become the center of focus for attendings, residents, nurses, and everyone working in the ER. At the present time this is not the case. This concept is quite simple and definitely not original. We seem to want to make all of this harder than it really is. Thousands of dollars will be spent on teaching us how to act and what to say. This shouldn’t have to be the case. Should we need outside speakers giving us pep talks? We should be more adept at communicatiion and attempting to achieve patient satisfation than anyone in the hospital.

2. A number of employees have left the ER recently. Why? What is wrong? Our leaders need to look very carefully at this issue. The right questions have to be asked. Respect for each other is often lacking. Disagreement and reasonable dissention should be fostered not squelched. Nurses and doctors and everyone should not be afraid to make suggestions. I know many are… Open face-to-face discussions should occur. There shoud be zero tolerance for gossip and innuendoes. Happier employees could beget happier patients.

3. Attending physicians need to spend quality time with patients. At their bedside. When time permits, residents should present appropriate cases at the bedside with the patient and family listening and contributing. The patient’s nurse needs to be in the room. This would show her interest as well. I frequently solicit the nurse’s advice as to what she thinks is going on with the patient and frequently do what the nurse tells me. The nurse would automatically be reintergrated as part of the decision making process that is unfolding. Duplication of efforts would be reduced tremendously. Patients would sense an effort on their behalf. Watching us read real estate magazines at the nursing station would be supplanted by patient medical staff interaction.

4. The noise pollution and interruptions in the ED are huge problems. I believe that if most interruptions were actually analyzed, 90% would be unnecessary. ICU’s don’t allow it. Surgery doesn’t allow it. Caterpillar doesn’t allow it….This cacophony of activity that plays out daily in the ER shows no respoect for the paitent who we are attempting to satisfy. It disrupts thinking, history and physicals, reading medical records, teaching, and most of all quality of care rendered to the patient.
So how can we decrease these distractions?

Here is a partial list of my suggestions:

Think before you yell at someone across the ER. Is it really necessary to yell it?
Idle chatter, cursing, and whistling Chrismas carols should be prohibited. (Respect for the patient and his condition needs to be shown.)
Over head announcements should be kept to a bare minimum by everyone.

Limit two visitors per patient at a time. There is simply too much traffic in the ER.
I counted 20 people (staff, EMT’s, etc.) mlling around talking outside of the nursing station on one occasion. Frequently it is diffficult even to get a booth to chart.

Remove medical communications from the ER or staff it full time with someone dedicated to that and only that. ( I put this in because it was very time consuming and distracting to answer these calls. Hevesy was in control of all ambulances in central Illinois and OSF was and is the resource hospital and base station. All radio calls from ambulances came to OSF ER whether the patient was coming to OSF or not. Doctors had to answer the calls, write up the conversation, call the receiving hospital, and have the chart faxed to the receiving emergency department. It was helpful at times to the patient, but could have been handled by the receiving hospital because they were listening to the call as well and the EMT’s on the ambulance followed protocols that had been established by the project medical director anyway. I thought that the job done by the EMT’s and paramedics in the Peoria area showed sincere care on their part and their notes and my conversations with them in the ER was very valuable to the care of the emergent patient arriving by ambulance. The EMT’s, volunteer fire departments, municpial fire departments, and AMT paramedics and EMT’s found themselves in very tough circumstances with many patients. I didn’t know in 2000 that Hevesy was on the payroll at AMT and for him to show his power base at OSF with medical communications was important to him for reasons that I did not know. Answering the radio pulled us away from our patients already in the ER at OSF and delayed and fragmented their care all the more. )

5. As I said last week go back to the basics of any primary care specialty–the ABC’s. This is often the hardest for me to do but the most important. Emergency Medicine is not rocket science. We need to do accurate appropriate vital signs. Attendings and residents need to learn how to do vital signs again. The physical exam (not technology) needs to be resurrected and utilized. The patients need to be undressed in appropriate clinical scenarios. Continuous pulse oximetry and telemetry frequently does not constitute appropriate or even necessary vital signs. Frequent reassessment of the patient at the bedside by the doctor and nurse is difficult but necesssary.

As you all know I want my family and friends to come to this Emergency Department and OSF-SFMC when sick or injured. Central Illinois is very blessed to have this medical comples.

I finished the letter as follows:

A ton of money and new technology is not necessasry. Common sense and making the effort to do a good job is necessary. People in the trenches like me need to do the basics over and over in a friendly and structured environment that gives the patient a chance. Our leaders need to listen, suspend political and ecomonic agendas, and refocus on the ER and its people.

Respectfully,

John A. Carroll, MD

Only two people on the Patient Satsifaction Committee responded to my letter and behind closed doors told me that they liked it. I think most others were afraid to say anything because of the content of my letter and the issue about medical communications because that was Hevesy’s baby.

In the fall of the following year as I was under indictment at OSF, Hevesy told me during one of my meetigs with him that the ER had been without a leader for one and one-half years. He told me that he would be frustrated also. Keith Steffen even said there were “deep problems in the ER” and leadership problems in the ER (phone conversation November, ‘01). Tim Miller, assistant administrator at OSF, told me that the “OSF main campus had been ignored.

After I was fired in December, the patient satisfaction rate continued to be very low and an employee satisfaction rating from the ER at OSF came in close to last in the hosptial. 18 ER nurses had left and 12 travelling nurses had been hired by the ER. The ER head nurse was let go partially due to lack of confidence in her by other ER nurses. (She was promoted to OSF Corporate.)

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The Elderly Black Lady

In December, 2000, an elderly Black lady came to the ER for evaluation. She had a few family members with her. The lady was placed in ER room #17 which is in the back hall. She was evaluated by the nurse, resident physician, and me. However, after several trips by me to see her, it seemed like not a lot was being done for her by any of us. She was waiting too long which was not uncommon in the OSF emergency room.
I wheeled the lady up to the nurses’ station and put her under the flow board. This was the center of the ER. Many of the employees in the ED were at the nursing station hanging out. I calmly stated to her that “maybe now you will get some attention”. I went into a nearby room and began with another patient who presented with chest pain.

The nurses at the desk immediately started an IV in the lady under the flow board and moved her to closer room. Her care picked up quickly.

This was reported to Rick Miller by the nursing staff that I had pushed the patient to the center of the ER. Miller told me that this “incident” had a “disruptive effect on the department and represented the department poorly to the patient’s family”. I asked Miller if the family complained about my actions and he said “no”. Obviously, the center of focus for Miller and the nurses who reported me was not the patient’s care but the family’s perception of the ER staff. If my action was disruptive, and caused some action for this patient, I was doing my job.

Miller went on to say very clearly that my action was inappropriate and if I did the same thing again, it would affect my ability to continue working in the Emergency Department. I thought that the delay in the patient’s care was inappropriate and had hoped that Miller would support me, but he did not. Miller would not challenge the nurses. The ER head nurse would go to Sue Wozniak, Chief Fianancial Officer at OSF, and Miller did not want any part of Wozniak for many reasons.

This “disruptive and inappropriate action” on my part was the beginning of the end for me as reflected in Miller’s notes of our conversation.

posted by John A. Carroll, M.D. | 4:34 PM
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June 23, 2006

In the last couple of days, two sources have agreed that hospitals and emergency departments in the U.S. are sick. Cal Thomas and The New York Times both report that we are in the middle of a hospital crisis.

Quoting from both articles, the important points are as follows:

1. 114 million people sought treatment in US emergency departments in 2003.
2. People without insurance or on Medicare are often refused treatment in physician’s offices and sent to local emergency departments. Hundreds of thousands of seriously sick people are diverted from overcrowded emergency rooms filled with people getting care for illnesses that are not life threatening and could have been taken care of in an office or clinic. To help “unclog” emergency rooms will require extending health care coverage to uninsured and providing more primary care clinics and doctors in poor neighborhoods.
3. Hospitals are overcrowded and patients wait in the emergency rooms for hours for treatment and disposition.
4. What is not known is how many people die as a result of delays in treatment or inadequate care under chaotic conditions in emergency rooms.
5. Cal Thomas prefers “systems thinking” as opposed to pouring billions of dollars into a federal agency to fix the problem.
6. Thomas defines “systems thinking” as “basically how you see things. Instead of seeing a huge mess with one problem piled on top of another, you see differently. You see with what people call “new eyes.” You see how you and your work fit into the system, and how you and your work connect to the other people in the system.”
7. Systems thinking is being tried at several hospitals throughout the country, reducing patient waiting time, dramatically cutting costs and delivering quality care to patients, making them happier and healthier. It has also resulted in doctors, nurses, and other hospital workers enjoying their jobs more. With systems thinking, the patient comes first.
8. The question remains, “Can we afford not to heal our hospitals?”

Putting the patient first will solve most problems encountered in medicine.
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Fear at OSF

2006-03-14T16:23:00.000-08:00

OSF’s mission statement regarding the importance of open and honest communication did not seem to be followed during the months and weeks before I was fired in December, ‘01.

The Emergency Department at OSF has 24 resident physicians who do three-year residencies in Peoria to learn the speciality of emergency medicine. They are evaluated on a monthly basis for 36 months regarding their performance. I really enjoyed working with the resident physicians for the 12 years I was employed in the ER at OSF, teaching in the department and giving conferences covering a variety of emergency medicine topics. The residents are young, aggressive, and want to learn.

A resident physician told me in detail about a meeting of all ED resident physicians during the time I was suspended from working the main emergency room. I missed being in the ED and working with the young physicians. The resident physicians were told by a senior member of the ER staff that if any of them “spoke negatively” regarding the fact that I had been banned from the emergency room, they would “suffer harsh consequences”. I asked if Hevesy had made this announcement. The answer was no but that Hevesy stood next to the speaker nodding his head and affirming the threats. (OSF functions this way to protect certain individuals. Subordinates are picked out to give bad news.) The residents wanted good evaluations during their 3 years in Peoria so they could get good jobs when they finished their residencies. They knew they shouldn’t say anything.

Another resident told me that when he went in to talk to the Program Director in the ER for his evaluation after I was fired, he was asked questions about his friendship with me and what he thought about my departure. The resident did not know what to say because of the obvious implications regarding why he was asked these questions.

Interestingly, an attending physician was having an affair with one of the residents he was evaluating on a monthly basis during the time I was being fired for writing my “bed capacity” letter. This attending physician kept his job at OSF as I was terminated.

All of the nurses in the ED were talked to in 3 separate meetings by Hevesy and the director of the ER nurses. My termination was discussed. I can’t recall exactly what was said; I can’t locate my notes at present, but I do not think the nurses walked away thinking they were free to discuss the issue. The OSF nurses have no union, so they could be fair game. A nurse who started a petition supporting me told me how Rick Miller would pick up her charts out of the patient box and scan them. In her opinion, he was looking for any mistakes or oversights she have made with her documentation to use against her. (She no longer works in the ER at OSF. She left voluntarily.)

During the fall of ‘01, an attending physician in the ER was vocal in his support for me in the ER. One day while in the bathroom, he was followed in by another assistant director of the OSF-ED and told to hold down his comments in support of me. The attending physicians were told not to discuss my firing with the media. As documented in another post, Conversations with Chris, a fax went out to various places at OSF-SFMC telling all OSF employees not to talk about my firing to “protect me”. They of course were trying to protect OSF and themselves for their indiscretions.

Several days after I was fired, an ER staff meeting occurred and Keith Steffen and OSF attorney Doug Marshall showed up. Someone attending the meeting filled me in on the details. Keith wore glasses and stared at the floor a lot and appeared quite sad. He said to the doctors that “he had not been sleeping well” (concerning my firing) even though he had smiled and told me during those months in his office how at peace he was and how well he was sleeping. ( I know this seems unbelieveable and I would have a hard time if I were you reading this blog. Doug Marshall spoke a lot because Keith was so “sad”. Most of the physicians had never even seen Marshall before and wouldn’t have known who he was.

I asked the person present at the meeting if anyone believed what Keith was telling them and the answer was “no”. It was stated that my firing was the toughest they encountered at OSF citing an example of a janitor who jumped up in Keith’s office at his termination and was extremely angry. This left the impression with my colleagues that the same may have occurred with me. It did not, of course, but that was the impression created. What Steffen and Marshall left out were the seeds of doubt that Steffen was creating all over the community about me. This wasn’t mentioned to my colleagues.

After I was fired from OSF, a Haitian Hearts supporter, an OSF employee, and a good friend of mine had a meeting with OSF’s chaplain, Fr. Mike Bliss. We pleaded with him to talk with Keith Steffen about the plight of the Haitian children who needed surgery. Father stated that he would talk with “Sister” but he would not talk with Steffen about this. He was very definite about not approaching Steffen even though the Haitian kids were screaming for the Sister’s mission to be followed. He stated this would be “waving red flags as to whose side he was on”. (I assumed he was on the Haitian kids side. He had travelled to Haiti with us in the past and saw the inhuman conditions on the island where these kids lived.)

I said to Father that “you won’t be fired if you speak with Keith”. He just laughed and raised his eyebrows. I interpreted his facial expression to mean that his getting fired was a distinct possibility if he fought this too much. I couldn’t believe that the Catholic chaplain who said Mass everyday in the chapel at OSF, visited the sick every day and night, and came to the ER for pastoral care issues every time I called him, would be so intimidated by Steffen. He knew the consequences that could follow and that the Sisters probably would do nothing to stop Father’s departure from OSF. The bottom line was that Father Bliss knew who really controlled OSF. And they didn’t wear habits.

As the months went by, and I began to understand more of how things worked in Peoria, I wondered what the repercussions from the Catholic Diocese of Peoria would be against Father Bliss if he took a pro active stance in support of the Haitian Hearts children.
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August 19, 2006

OSF and Unionizing

Tom Schindler wrote an article in the National Catholic Reporter, August 11, 2006, regarding Catholic hospitals and unions. Much of what I will write in this post comes directly from Mr. Schindler’s article.

A couple of years ago at OSF-SFMC in Peoria there was some talk of the nurses forming a union. Keith Steffen, CEO at OSF, wrote a letter and discouraged the formation of a union. A friend’s spouse, who was a nurse at OSF, was asked by an upper level nurse if she was going to sign a paper in favor of a union. She viewed this as harassment. Needless to say, she didn't sign.

Mr. Schindler made the following points:

1. Catholic tradition believes people have the right to organize and bargain collectively. This is a social right.

2. In 1891, Catholic social teaching explicitly recognized unions in the Church’s first social encyclical—Rerum Novarum. In their 1986 pastoral letter “Economic Justice for All”, the U.S. Catholic Bishops reaffirmed the right of workers to organize unions and opposed efforts to block or weaken organizing drives. Why would Keith Steffen in Peoria ignore the pastoral care statement and have a hostile response? I believe the OSF Sisters are looking the other way. The Sisters could look at a nursing union at OSF as a vehicle to advance the Mission of OSF from patient care to worker justice.

3. Bishops in the United States are turning a “blind eye and deaf ear”. The late
Cardinal John O’Connor of New York, called the “patron saint of health care
workers”, ordered four Catholic hospitals to hire back strikers they had fired during one strike and forced another Catholic hospital to stop hiring permanent
replacement workers during another strike. Where was Bishop Jenky in the Catholic Diocese of Peoria? Can you imagine him doing what Cardinal O'Connor did in New York? Did he support the few nurses at OSF who were speaking out for a union? Bishop Jenky simply did not want to offend "management" in Peoria.

4. Mr. Schindler states that in the end, support for unions is a matter of human dignity. (Nurses are not “widgets” as Mr. Steffen has referred to them.) Employees in hospitals, as well as Catholic schools, have a political and social right to a voice. And given the asymmetry of power between employees and management, that right needs the protection of organization. In the case of hospitals like OSF the dignity of those who come there for treatment is also at stake.
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Conversation with Sister Canisia

2006-03-14T16:14:00.000-08:00

Conversation With Sister Canisia

In November 2001, I was able to schedule a meeting with Sister Canisia. I was still attempting to keep my job in the ER. Two pediatric cardiologists who took care of Haitian kids, one OSF-ER doctor, and a former OSF-ER nurse accompanied me. Sister Canisia greeted us in her office and we all sat down. I discussed with her my letter regarding bed capacity at OSF and the patient delays in the ER.

There is a side door that leads into Sister’s office that comes from Keith Steffen’s office. About 10-15 minutes into the meeting with Sister, Dr. David Gorenz, an assistant administrator, and Sue Wozniak, CFO, entered Sister's office through this side door and sat down with us. They were not invited by me or any of us. It didn’t take too long to figure out where they came from and for what reason. We tried to ignore them but Dr. Gorenz interrupted and started asking me questions when we continued the discussion with Sister Canisia. Gorenz suggested that a mediator be chosen to mediate my 6 month exclusion from working in the main ER. I didn’t give him an answer because I needed time to think about this option, and usually OSF administration was not giving me good advice. Gorenz and Wozniak were sent in to disrupt the only meeting I had with Sister Canisia and they did a good job. (Frankly, it broke my heart that Dave Gorenz came in and became part of this debacle. I had so much faith in him for 20 years. He was my mentor when I was a resident physician at OSF. I would never have expected this from him.)

After one hour, I thanked Sister for meeting with me and the other physicians. The nurse was crying. We could all see what had happened. Sister then told me to stop by Keith’s adjacent office because “he wanted to speak with me”. I knocked on his door and he opened it. I asked him if he wanted to talk with me. Steffen lowered his head, looked at the floor and said “no”, and let the door quietly close.

I called Gorenz several days later and told him that I would accept a mediator.

A few days later Keith wrote me a memo stating that mediation would proceed. I was fine with this concept. When I met with Keith a few days later, I took out my legal pad to take notes as usual. Doug Marshall, OSF attorney, was in Keith’s office as he frequently was to help monitor Keith and tell Keith to “slow down” when necessary because I was writing everything down.

Keith started out by confidently stating that “mediation is a good idea” and that “I (Keith) thought of it”. I nodded my head and kept writing. Keith continued, “However, we are not going to mediate. Doug will explain.” I started laughing and looked at Marshall. With a very flat affect, Marshall said, “We don’t mediate.” I held up Keith’s memo stating that mediation would be done, and asked Marshall if it meant anything that Keith had written it down and sent it to me. Marshall replied, “It means nothing.” That was probably true…

So mediation was no longer an option. Even the Executive Committee at OSF would not hear of my plight because there is some sort of bylaw or something that states that employee problems don’t go to the Executive Committee. I would have loved to have a neutral mediator sitting around a table with the main players there. I don’t think Marshall thought Keith’s idea was so great. Hevesy probably didn’t think so either.

Later, when my brother asked Keith about the meeting with Sister Canisia that was disrupted by his two administrators entering Sister’s office from his office, Keith responded he knew nothing about the meeting.

Conversations in Church

2006-03-14T16:00:00.000-08:00

Conversations in Church

One week after Keith Steffen fired me from OSF, an Apostolic Christian friend of mine told me she had been approached in her church by an Apostolic Christian nurse who also attended the same church. In very definitive terms, the nurse explained to my friend some rumors she had heard about me that came from a “not low level source” at OSF. (A couple of the things that this nurse stated were almost verbatim what Keith had told me or people that had approached Keith on my behalf.) The nurse warned my friend about travelling to Haiti with me in January, ‘02. I won't say what the rumors were, but you can take a guess. (When I told Bishop Jenky, he was visibly enraged.)

My friend started to cry in church at hearing these rumors and asked the nurse if she had ever heard of Keith Steffen. The nurse stated she had never heard of Keith Steffen. (The Apostolic Christian community in this area is close knit. Steffen had visited her office in the past. Also, my friend’s mother used to baby-sit for Keith and his brother when they were kids living in little rural communities near Peoria.)

When my friend called me about these rumors she stated that she thought “I needed a chance to defend myself.” When I heard this, what Keith Steffen was saying to me when he smiled and looked at the floor in his office and shuffled his feet and repeatedly said, "John, when this comes out about you, it won't be good", made sense to me for the first time. I was being set up for a big fall. The seeds of doubt were being sown by the Administrator of OSF.

The next day, I went and talked to this nurse who I was seeing and meeting for the first time in my life. She was extremely nevous and apologetic for what she had said. (One month later, she wrote me a letter apologizing for what she had said.) However, later my friend told me the nurse called her and berated her for telling me in the first place. So I don’t know how sorry she really was.

After hearing what my friend had told me, I was extremely happy for many reasons that I had not let myself be coerced into seeing the "wellness physician" to keep by job at OSF.

October 5, 2006--An interesting followup to this post is the following: Take a wild guess which office this nurse worked for when I spoke with her and she told me that she had never heard of Keith Steffen? Peoria Day Surgery Center which was also known as Peoria Urological! Recently, the Journal Star stated that Mr. Steffen had threatened to "bury" Peoria Day Surgery Center. Sadly, for Mr. Steffen and the nurse that was saying she had never heard of Mr. Steffen, Dr. Joe Banno told me in his Peoria Urological office in 2002, that Mr. Steffen had threatened his office to run them out of business. Dr. Banno told me that he did not believe his nurse had never heard of Mr. Steffen.
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Sister Judith Ann

2006-03-14T15:58:00.000-08:00

Sister Judith Ann

The day after my conversations with the nurse who was spreading the deadly rumors, I decided I needed to talk to Sister Judith Ann, President of OSF-Corporate. Sister had long been a big supporter of the Haitian kids, would eat supper with my mom, and come to the Peoria airport to greet the kids when we got off the plane from Haiti. Sister Judith Ann’s title is President of OSF. She had assured me many times over the years, that OSF would never turn away a Haitian child.

When I arrived in her office, she was quite nervous. I sat down and told her that some really vicious rumors were circulating. She interupted me immediately, without me telling them what they were, and told me, “They aren’t true, Dr. John.” She must have heard them. This is not what I wanted to hear from her—I knew they weren’t true. I told her that I had talked to the nurse the day before who was spreading these rumors and that the nurse said they came from a “not low level source” at OSF”. I strongly felt that it was Sister’s responsibility to look into this as a Corporate leader and friend of mine. I asked Sister to simply talk with the nurse. Sister immediately said “no”to my request. It didn't seem that she even thought about her answer. I couldn’t believe she would say “no” so fast. Sister had obviously heard the rumors, was told about them from someone, and said “no” immediately when I told her I had spoken with the nurse and was requestng Sister’s help.

Based on my conversations with Keith Steffen the preceeding 3 months and what a number of people told me he was saying about me, I wanted Sister to investigate thoroughly where these rumors were originating. She talked about things like “we are like squirrels running around in a cage”. Poor Sister was very agitated and nervous and had been told that bad things were coming down the pike by someone. She was also probably told to “deny”. OSF had just fired me and now Sister Judith Ann's feet were being held close to the fire. Just think what the ramifications to OSF would be if Sister found the answer or if someone ratted on someone else? These thoughts had to be going through her head. (Sister Judith Ann told me that day that Jim Farrell, Corporate Director of Marketing/Communication was devastated by the rumors. When I talked to Jim, who was a friend of mine too, he denied hearing any rumors. Sister was being given some false information that was probably fed to her. Corporate did not have their act together any better than SFMC. )

Then, incredibly, when Sister told me that if Administration at SFMC had been responsible for these rumors, she concluded that we just need to "reconcile". (Reconcilliation involves admitting one’s mistakes…would Administration have done that?) I could see Sister was going to do nothing.

As I left her office, I felt totally abandoned by the OSF Sisters whom I had totally trusted for three decades. Plus, I didn’t think they were in control of OSF any longer. In fact, I thought they were being used and their great legacy in Peoria being scandalized. They were figure heads who water plants and pray for people, but running the $1.6 billion OSF health care industry was left to the guys who drive the big cars.

Conversations With Chris

2006-03-14T15:57:00.000-08:00

Conversations With Chris

Chris Lofgren is the OSF-SFMC spokesman. When the media want to know something about OSF-SFMC, they contact Chris. His allegiance is of course to OSF which signs his paycheck. Chris is kind of like the White House spokesman, who spins things for the White House, except that Chris spins things for OSF.

An OSF employee came to my home in the Spring of ‘02 and told me that Chris Lofgren had unusual things to say about me around the time Keith Steffen was firing me in December, ‘01. (She said Lofgren had said strange things about me in November, 2001.) Why Lofgren would be talking to her remained mysterious to me. Anyway, he made multiple comments to her regarding me. One of Lofgren’s comments was that I was not married and lived at home with my mom. This was true but why would Lofgren comment on this and what did it have to do with my impending termination from OSF. Lofgren said other things as well, and Steffen had told me in his office many times that “when this comes out about you, it won’t be good.”

I asked this employee if she would meet with Lofgren with me to confirm his statements and she replied that she would. My brother and I showed up at Lofgren’s office on May 16, ‘02 but the employee was not there. She was obviously afraid to be there. Anyway, Tom and I had a talk with Lofgren who wanted to know why we wanted to speak with him. I asked him what he had been saying about me to the employee. He acted like he didn’t know exactly what I was talking about. So we left. My brother had taken off work that day as a research engineer, father of five kids, and had better things to do than sit it this office and hear Lofgren play with words.

That same afternoon, I received a voice mail from the employee who Lofgren had spoken to, and in it she said she had spoken to Lofgren that morning about his statements about me in November, ‘01. So Tom and I headed back to Lofgren’s office the next day where he admitted to us that he had made those comments and had inappropriately spoken about my termination to this employee just like she had been saying all along. I asked him what he meant by those statements and he made up something that my brother and I did not buy. Lofgren smiled at one point and said that “maybe Sister Canisia is making up the rumors”. We knew, of course, that she wasn’t but did not really appreciate Lofgren thinking this was such a funny matter. Interestingly, Lofgren encouraged us to go to Keith Steffen’s office and meet with him. I politely declined the offer. Steffen had done enough damage. (Steffen had told my brother that “the real John Carroll will be uncovered” when Tom had tried to have a rational discussion with him the previous December.) Lofgren stated he didn’t think (if I we visited with Steffen) “that I would be maligned further.” My brother could not believe he made that statement and Lofgren looked like the cat that just got caught with the mouse after he said that. (Lofgren told us that he was “intimately” involved in the administrative discussions surrounding my firing.)

As we left his office, Lofgren looked very down.

Chris Lofgren had written the following statement that was faxed to OSF-Corporate (Jim Moore, CEO OSF, and Gerald McShane, MD, Director of the Ethics Committee at OSF), the SFMC Management Team, SFMC Administration, and multiple departments in the medical center on December 24, 2001—--six days after my termination from OSF. (The statement appeared as if it came from Keith Steffen.)

Subject:Update–Dr. John Carroll

In an attempt to keep “open and honest” communication alive here at Saint Francis Medical Center, I am compelled to share some quick comments regarding the article on Friday, December 21, in the Journal Star describing the dismissal of Dr. John Carroll. Since the story ran, we have had some calls from the community asking us for details.

Dr. Carroll, like all OSF SFMC Emergency Room Physicians, was an employee of the medical center. Whenever we have an issue regarding an employee, it is our policy to maintain strict confidentiality. This is to protect the employee from having his or her situation discussed openly. I’m confident you can appreciate the importance of taking this position, from a legal as well as an ethical perspective.

Because Dr. Carroll was an employee, we MUST exstend this same courtesy of confidentiality to him. In the Journal Star article, our spokesman, Chris Lofgren, declined to discuss the particulars of Dr. Carroll’s situation. This was in accordance with the legal an ethical requirements we have to protect every employee’s privacy. We did not initiate the Journal Star story nor do we believe it was initiated by Dr. Carroll.

I ask that you not engage in conjecture about his departure nor spread rumors that are, most likely, untrue. To do so simply harms both OSF SFMC and Dr. Carroll. That’s not what our Missiion and Values are all about. Please share, as you deem appropriate with your staff. And thank you for your adherence to our policies on these kinds of issues.
--------------------------
My comments on the above fax:

The Journal Star article was factual, complete, and objective. I had no problem with it, but Lofgren was covering for OSF and himself for "breaking the rules" as he advised others not to do. An employee within the medical center had found this fax taped on a bathroom wall, right where it should have been, and gave it to me.

So by May ‘02, OSF had:

1. Fired me and Keith Steffen had metaphorically referred to me as a cancer and in the Emergency Department (while the ED had the lowest patient satisfaction and employee satisfaction in the medical center).

2. Spoken to people inside and outside of the medical center regarding my termination and other things (SFMC administrator and spokesperson).

3. Sabotaged my only meeting with Sister Canisia (Dave Gorenz and Sue Wozniak).

4. Used fear around the medial center to quiet employees and threatened to sue a nurse who started a petition for me.

5. Stated they would mediate and then withdrew it.

6. Continued to cover up the OSF-AMT conflict of interest and refused to discuss it at the Ethics Committee or with the Compliance Officer at OSF.

7. Told the media that Haitian Hearts would survive my firing as OSF was planning to stop ALL funding for Haitian Hearts in July, ‘02.

9. Ignored the main campus (OSF-SFMC) including the emergency department and its patients while funds were used for higher end projects at OSF (Tim Miller, MD).

As the months continued, I could see how the Sisters had lost control of their beloved hospital.

Ethics Committee at OSF

2006-03-14T15:55:00.000-08:00

Ethics Committee at OSF

The American Medical Association’s representative of the Ethics Standards Group sent me a copy of relevant opinions from the AMA’s Code of Medical Ethics.

During the fall of 2001, I had spoken to Dr. Gerald McShane, Director of the Ethics Committee at OSF-Corporate, regarding my opinion of the conflict of interest at OSF and its relationship with Advanced Medical Transport. Dr. McShane advised me at the time that he did not think that OSF’s ethics committee should be consulted regarding this. He just did not feel it was an appropriate topic to be brought up as an ethical issue. I thought it was appropriate for many reasons. I spoke to Joseph Piccione, Corporate Ethicist at OSF, about the same issue, and he stated that I was mandated to bring up the issue. When I wrote five OSF Corporate leaders about what I regarded was a serious conflict of interest (OSF-AMT)in May, 2002, I never received an answer from anyone.

In the Spring of 2004, a former Haitian Hearts patient, Willie Fortune, needed to come back to OSF for pacemaker surgery. Haitian Hearts offered OSF-SFMC full charges for Willie’s surgery. He was dying and needed the surgery. He was denied. I asked Mr. Piccione to take this patient abandonment to the ethics committee at OSF for formal review. I never heard whether Willie’s abandonment was even discussed by the ethics committee at OSF and never heard from anyone on ther ethics committee besides Piccione who said he was pretty helpless to do anything. (How could he be as “Corporate Ethicist”?)

So the OSF ethics committee didn’t really help out when they were needed. The issues they needed to discuss were very close to home–too close to discuss openly and without bias.

Some recommendations to OSF regarding ethics committees from the AMA may include the following from the AMA literature:

1. Generally, the function of the ethics committee should be to consider and assist in resolving unusual, complicated ethical problems involving issues that affect the care and treatment of patients within the health care institution. This would been a potential help for Willie and the thousands of people in the Peoria area who dial 911 each year.

2. Ethics committee members should not have other responsibilities that are likely to prove incompatible with their duties as members of the ethics committee. This would be to avoid conflict of interest with members of the ethics committee. Dr. McShane told me that Keith Steffen sat on the ethics committee, thus he did not think it was appropriate to bring up AMT. I also asked Dr. McShane for my impending termination and Keith’s management style in his office to be brought up to the OSF ethics committee . McShane discouraged this also due to Steffen’s presence. Maybe Keith Steffen should not be on the ethics committee. Piccione and McShane sat on the Diocesan Haitian Hearts committee and were not helpful, in my opinion, regarding the survival of Haitian Hearts at OSF. Therefore, I don’t see how Willie would get a “fair hearing” with Piccione, McShane, and Steffen on the ethics committee. (I am not sure if Steffen is still on the committee or not, but McShane told me he was when we talked in 2001.) It seems Willie took low priority or no priority in the Catholic medical center that speaks substantially about “respect for life”.

3. When a religious order operates a medical center, the mission statements should be taken into consideration in the committee’s recommendations. Respect for life, taking care of the poor and marginalized should be important to the OSF ethics committee…that is, if they will discuss the topic.

Below is an article written by Joe Piccione in InterBusiness news in 2002. In 2005, Jackson Jean-Baptiste, a Haitian Hearts patient was denied care at OSF and died. In 2004, Willie Fortune, a Haitian Hearts patient was denied care at OSF, but survived after he was operated emergently at Vanderbilt for a failed pacemaker. I have never heard from the ethics committee at OSF after multiple requests during the past six years.

Welcome to InterBusiness Issues

Saint Francis Medical Center
Joseph Piccione
June 2002

Ethics a Mainstay in Health Care

When people hear the word "ethics" they tend to think in negative terms. That is too narrow of a perspective, but with the recent Enron and Arthur Andersen debacle it is easy to understand why that negative view persists.

In classical Greek philosophy, ethics was considered a positive good to be attained and aChieved; for example, doing good in a good way made for happy people. Ethics is about good character and good decisions. Health care in the West is rooted in the Hippocratic tradition with its sense of duty, but also its professional fulfillment.

Living in today's pluralist society doesn't foster a common ethical theory. More collaboration is needed before there is consensus on norms, values, and happiness. For example, the Catholic Church and likewise, Catholic health care, does not support any form of assisted suicide. Yet the state of Oregon passed a law legalizing physician-assisted suicide, not making it ethical, but making it legal in that state.

All health care, regardless of the sponsoring organization, values human dignity. In fact, the five hospitals in the tri-County area all follow and support the standards of the Joint Commission of Accredited Healthcare Organizations. On the very first page of the Standards Manual, the Commission notes, "Patients have a fundamental right to considerate care that safeguards their personal dignity and respects their cultural, psychosocial, and spiritual values." The first page ends with "managing the hospital's relationships with patients and the public in an ethical manner."

Jim Moore, OSF Healthcare System CEO, frequently states in presentations health care is the second most regulated area behind nuclear power plants. There are many checks and balances to make certain rules and regulations are followed by those of us in health care so we always do what is right. Recently, there has been a proliferation of newly-formed compliance departments in hospitals and corporate offices of health care systems to further ensure adherence to the vast number of rules and regulations (state and federal) under which health care entities operate.

The Health Insurance Portability and Accountability Act was passed by Congress and will have many positive impacts on patients and providers; chief among them are specific mandates regarding patient confidentiality which compliance departments and many others in health care are actively planning to address in time for implementation by April 2003.

Another forum to ensure we in health care do what is right is the ethics committee. All hospitals have an ethics committee which can be accessed by patients, family members, and care providers to foster patient involvement or to discuss a concern or question. Maintaining and enhancing human dignity is one of the major guiding principles of ethics committees and health care in general.

Ethics is both ancient and contemporary, and continues to be an active mainstay in health care today. Ethics has an abiding place in health care-primarily among the professionals who encounter persons at times of their vulnerability.

-------------------

Did Mr. Piccione really believe what he wrote?

Please see post below Peoria City Council---February, 2006. In this post I wrote Dr. McShane again about presenting to the ethics committee regarding the ambulance monopoly in Peoria. Dr. McShane did not respond again.

Ethical and Religious Directives for Catholic Health Care Services

2006-03-14T15:53:00.000-08:00

Ethical And Religious Directives For Catholic Health Care Services

The Ethical and Religious Directives for Catholic Health Care Services are contained in a small pamphlet developed by the Committee on Doctrine of the National Conference of Catholic Bishops. The Directives have been recommended for implementation by the diocesan bishops. In the Catholic Diocese of Peoria, the Bishop is Daniel Jenky. The document is excellent and easy to read. It makes issues very clear that could be twisted and spun by other people.

The Ethical and Religious document was written to reaffirm the Church’s commitment to health care ministry and the distinctive Catholic identity of the Church’s institutional health care services. The purpose of the document is twofold: first, to reaffirm the ethical standards of behavior in health care that flow from the Church’s teaching about the dignity of the human person; second, to provide authoritative guidance on certain moral isues that face Catholic health care today. The Directives have been refined thorugh an extensive process of consultation with bishops, theologians, sponsors, administrators, physicians, and other health care providers. The Directives promote and protect the truths of the Catholic faith as those truths are brought to bear on concrete issues in health care. (I have copied some of the above sentences directly as they appear in the Ethical and Religious Directives.)

Part One is entitiled “The Social Responsibility of Catholic Health Care Services”. The secular leaders who control OSF on a day to day basis really need to follow these beliefs and directives. Bishop Jenky needs to enforce them if he believes in them and their importance. OSF refused Haitian Hearts’ patients with full charges offered for some of their care and partial charges offered for others.

The Social Responsibility section is summarized as follows:

1. Catholic health care ministry is rooted in a commitment to promote and defend human dignity; this is the foundation of its concern to respect the sacredness of every human life from the moment of conception until death. The first right of the human person, the right to life, entails a right to the means for the proper development of life, such as adequate health care. (This would include Haitian children with heart problems.)

2. The biblical mandate to care for the poor requires us to express this in concrete action at all levels of Catholic health care. In Catholic institutions, particular attention should be given to the health care needs of the poor, the uninsured and the underinsured. (The bible in Keith Steffen’s office says the same thing regarding the mandate to care for the poor. Why did OSF cut out care for the poor from Haiti?)

3. Catholic health care ministry seeks to contribute to the common good. The common good is realized when economic, political, and social conditions ensure protection for the fundamental right of all individuals and enable all to fulfill their common purpose and reach their common goals. (OSF was going to let Willie Fortune die in Haiti if we had not found a hospital to change his pacemaker. How would OSF’s abandonment of Willie “contribute to the common good” and “ensure protection for all individuals”? And Jackson Jean-Baptiste did die in January, 2006. See below.)

The Directives that follow these statements are very straightforward. Directive #5 states: “Catholic health care services must adopt these Directives as policy, require adherence to them within the institution as a condition for medical privileges and employment, and provide appropriate instruction regarding the Directives for administration, medical and nursing staff, and other personnel.”

I doubt that the Sisters are going to be able to do the above. Many are old and infirm. They have given their lives for their vocation. However, Bishop Jenky, needs to follow the Directives as written no matter how painful it is. Providing “appropriate instruction” to leaders at Corporate, SFMC, and Childrens Hospital to follow these directives is Bishop Jenky’s responsibility.

A number of people at OSF who set policy need to be terminated because of their lack of adherence and their overt disrespect for these Directives.

Patricia Gibson and Monsignor Rohlfs

2006-03-14T15:51:00.000-08:00

Patricia Gibson and Monsignor Rohlfs

In January, 2002, we left for Haiti again and worked in a hospital on the southern coast for about a month. We brought back some kids for cardiac surgery at OSF at the end of the month. As detailed in another post, 2002 was Haitian Hearts best year raising money for Children's Hospital of Illinois ($445,000).

I felt bad that I had been fired by the hospital that I loved, but we were pressing forward with the work in Haiti.

I attempted many times to get an appointment with Bishop Jenky but was unsuccessful.

I met with a Monsignor in the Catholic Diocese of Peoria who described the “corporate malaise” at OSF. (This Monsignor was never allowed to meet with me again.) I decided to follow the Catholic Canon Law and consider filing a tribunal law suit against OSF for multiple reasons that will be outlined in further posts. (A Catholic tribunal court is a “church-court” that does not seek a financial settlement; it searches for the truth and tries to correct the problem). This type of court is described in the Bible. I discussed this with Patricia Gibson in mid-2002. Gibson is a civil lawyer and canon law lawyer who left her practice to become Chancellor of the Catholic Diocese of Peoria.

I presented my “case” to her complete with papers, articles, etc. describing the OSF debacle. She agreed completely, and would shake her head in disgust at the history I was giving her. She stated that it would be nice if this could be solved “administratively”. (The Diocese would sit down with OSF and try and figure this out around a table and see what could be done to protect the Sister’s mission and philosophy.) So for months, I met with her and other people to try and solve this “administratively”. On one occasion when Gibson and Monsignor Rohlfs (the Vicar General of the Diocese) met with the Sisters, Gibson related that Rohlfs was very disturbed about what he heard about OSF and that “Haitian Hearts is a minor problem” (compared to the others). I aked Gibson if she could be my canon law lawyer in a tribunal, if it occurred, against OSF. She declined immediately stating that “would be conflict of interest”. I didn’t completely understand this after I had poured out my heart and many specific details to her for many months regarding the problems at OSF. I thought she understood the corporate malaise as well as anyone. I was in for an education again.

I was encouraged that the Diocese would be pro active like this and when my brother and I met with Gibson and Rohlfs in Rohlfs office on December 2,2002 they helped us draft a letter of petition to the Sisters to discuss important issues to try and avoid a Church tribunal against OSF. (Four months later, both Rohlfs and Gibson told me that if I even “petitoned” the Sisters for a tribunal court, the Diocese would pull any support from Haitian Hearts in the media. Haitian kids suffering heart defects would be held hostage to not embarrassing the hospital with a tribunal court.)

During our meeting Monsignor Rohlfs looked up at my brother and me and asked us if the Diocese could be of any help to us regarding Haitian Hearts. We hadn’t come in that day (December 2, 2002) to discuss Haitian Hearts so that caught us off guard. I was headed back to Haiti in early January. We told him everything was going as well as possible, even with my firing from OSF the previous December, and OSF pulling all financial support from Haitian Hearts in July, 02. Haitian Hearts had raised more money for CHOI in 2002 than any other year as mentioned above.

Then I received a certified letter in the mail at home and understood why Monsignor Rohlfs may have been asking if we needed any help with Haitian Hearts…..
-------------------------

September 4, 2006:

Yesterday, someone sent me the following article. It is not complementary to the Catholic Diocese of Peoria. Monsignor Rohlfs had many problems on his hands in Peoria and unfortunately Haitian kids were low on his priority list.

Monsignor Rohlfs left Peoria a couple of years ago and is Director of a seminary close to Archbishop Myers.

The following article was NOT reported in Peoria:

Newark bishop off abuse panel

Myers left a 'mess' in Peoria, insider says

Thursday, September 19, 2002

By The Associated Press

CHICAGO - The archbishop of Newark is leaving a panel formed to implement the church's new sex abuse rules, a newspaper reported yesterday.

Newark Archbishop John J. Myers, formerly bishop of Peoria, is the latest member to leave the Ad Hoc Committee on Sexual Assault, which drafted a policy to punish and expel abusers, the Chicago Tribune reported. It was previously announced that Auxiliary Bishop A. James Quinn of Cleveland and Bishop John McCormack of Manchester, N.H., would leave the panel.

Myers' successor in Peoria, Bishop Daniel Jenky, removed seven priests for alleged abuse last May, and some parishioners said Myers had left the problem for Jenky. Cleveland and New Hampshire also have undergone extensive investigations of sex abuse.

"We're not saying these are bad men," the Rev. Richard McBrien, a University of Notre Dame theology professor, told the Tribune. "But when we're in the kind of crisis we're in, you have to bend over backwards to make sure that everybody who is representing the church - and in this case the bishops - is carrying no baggage whatsoever.

"John Myers left a very messy situation in Peoria," McBrien added.

David Clohessy, national director for the Survivors Network for Those Abused by Priests, said it was wise to remove the bishops.

"It's simply a smart PR move when you have scores and scores of bishops from which to choose to take men like McCormack and Quinn and Myers out of the spotlight on the sexual abuse issue," Clohessy said. "Given what's come to light about (Myers') tenure in Peoria, I think it would be embarrassing were he to be reappointed."

Myers' spokesman, Jim Goodness, said Myers was not asked to leave the committee.

"The real reason was just that he had a specific purpose for being on the committee at the time - to help draft the (policy) document," Goodness said. "Now that that is drafted, it's time for the committee to move on. It naturally would occur that some others would move onto the committee."

Bill Ryan, spokesman for the U.S. Conference of Catholic Bishops, agreed with Goodness.

"It wasn't anything based on any criticism that any of these individuals had received," he said.

Picketing OSF

2006-03-14T15:41:00.001-08:00

Picketing OSF—January, 2003

My brother and I met with Monsignor Rohlfs and Patricia Gibson in his office in December, 2002. They dictated a letter that my brother transcribed (in his Franklin Planner) requesting a petition for a Catholic tribunal court against OSF. This is a Church court that does not seek a financial settlement. It searches for the truth and Bishop Jenky would be the judge. I thought there were significant issues related to OSF that were pastoral care issues that the Bishop should address. At one point earlier in the year, Patricia Gibson stated that Monsignor Rohlfs was shocked with what was going on at OSF and Haitian Hearts was minor on their list of infractions. However, we were confused when Monsignor Rohlfs asked us if we needed any help with Haitian Hearts. We wondered why he had asked.

Even though OSF administration had withdrawn all of their economic support of Haitian Hearts on July 12, 2002, Haitian Hearts had been able to raise 445,000 dollars for Children’s Hospital of Illinois. Paul Kramer, executive director of CHOI had advised us not to build a house to sell, but we did anyway. After the house sold, Kramer badgered us for the money verbally and with letters. We donated all of the house funds (177,000 dollars) to CHOI in December, 2002, like we said we would. (Paul Kramer even made the comment, when he was asking the house contractor for the money, that there was no such thing as “Haitian Hearts”. This statement would become very important as I will document in another post.)

In December, not long after Monsignor Rohlfs question regarding Haitian Hearts, I received a certified letter in the mail from Doug Marshall, OSF’s attorney. The letter stated that OSF had called the American Consulate in Haiti (Paul Kramer, Director of Children's Hospital of Illinois, made the call), and advised the American Consulate not to grant more visas for sick Haitian kids to come to OSF for heart surgery.

I was in disbelief that Kramer and OSF would do this. Our fund raising efforts were excellent, even after I was fired at OSF. The community believed in Haitian Hearts and the good we were (and still are) trying to do. Sister Judith Ann had told me a number of times that OSF “would never turn down a child”. Now Haitian kids were going to die. OSF (Chris Lofgren) had told the Journal Star immediately after I was fired that Haitian Hearts would do just fine. But OSF cut all of their funding for Haitian kids 6 months later and called the American Consulate to stop visas for kids to travel. This did not seem just fine to us.

I needed to do something, but what? There were no checks and balances at OSF, in my opinion, and the foxes were running the hen house. The sisters were definitely not in control. Haitian kids were going to die. I decided to picket OSF, an action that seemed so foreign to me, it was appalling. Even though the Haitian kids had great support from within the medical center from the doctors, nurses, social workers, custodians, and many other people, OSF’s administration was doing all they could to keep Haitian kids outside the walls of the hospital. I thought their behavior was especially egregious.

On a cold Sunday morning, January 7, 2003, I drove to a place that makes signs. In the car, I decided the sign should say, “OSF Administration: Respect for Life Includes Haitians”. The guy at the sign company charged me nothing for the sign. His contempt for OSF and their actions was obvious.

Getting out of the car that morning was cold, lonely, and very painful. I did not want to picket the hospital that I loved and had worked at for 21 years. As the hours went by, the media appeared and did interviews regarding the signs and OSF’s actions that prompted my action. Patricia Gibson, the Canon Law Lawyer for the Catholic Diocese of Peoria, came to my mom’s house and stayed for several hours and commented that my picketing was the right thing to do.

My brother joined me in front of the hospital and as we picketed on the sidewalk, OSF panicked inside. They called the Peoria Police who did nothing. They sent the OSF chief of security (who is a friend of mine since high school) outside and he invited me inside. I politely declined. About all OSF could do at that point was to spin the truth again. Chris Lofgren, the hospital spokesman, told the Journal Star that Haitian Hearts owed OSF 500,000 dollars. They essentially made up this figure to make me look as bad as possible since I was questioning OSF’s respect for life policy. (Questioning their respect for life philosophy was to come back and haunt them in the next couple of years as they abandoned and rejected Willie Fortune, Faustina Jacques, and Jackson Jean-Baptiste, who died, due to OSF’s abandonment. I also learned a significant amount how OSF and the Catholic Diocese of Peoria worked together regarding oral contraceptives at OSF and their disrespect for the culture of life that OSF professes to have.)

Over the next couple of days in the media OSF changed the figure regarding what Haitian Hearts owed them multiple times. That had to be embarrassing for them. They brought it down to less than 400,000 dollars and then had Dr. Rick Pearl tell the Journal Star that our “debt was forgiven”. (Over the previous few years, Dr. Pearl had asked me multiple times in private to “bring me some Haitian kids to operate on”. I had asked him to go to administration and ask them to help out with these patients, but I was sure he wouldn’t because he did not want to inflame administration asking them to operate on more Haitian kids.)

We had requested itemized bills in the fall of 2002 of the Haitian kids that were operated and OSF did not comply. OSF’s record keeping was sloppy, they spent over 20,000 dollars of Haitian Hearts money on an ultrasound probe, and a physician that had donated many hours of overtime hours to Haitian Hearts never showed up on the Haitian Heart donor list over several years.

Caterpillar Foundation was generously donating 10,000 dollars each year for the Haitian kids which showed up on the donor list. However, on April 15, 2001, the OSF Haitian Hearts donor list showed that we were given credit for only 500 dollars from Caterpillar. Where did the other 9,500 dollars go? (Henry Holling, Director of Caterpillar Foundation called me AFTER I was fired and told me that Caterpillar still wanted to continue donating to Haitian Hearts. I was and still am very appreciative of Mr. Holling's offer.)

When Haitian Hearts calculated what we owed OSF after I picketed, it appeared that our balance was close to zero even with Keith Steffen cutting away all OSF economic support 6 months earlier (July 12, 2002).

Subsequent to my picketing, OSF placed Haitian Hearts on “suspension”. The day after picketing the OSF, I left for Haiti and OSF requested a meeting with the Journal Star editorial board and the Catholic Diocese of Peoria. Chris Lofgren described the situation as a "public relations nightmare for OSF". Haitian Hearts was not invited. No one from the media heard our story at all. The cards were stacked against Haitian Hearts as we advocated for the Haitian kids while others were trying to destroy the program.

The decision was made for Bishop Jenky to “take over” the program. Those of us in Haitian Hearts were worried that Bishop Jenky would not stand up enough to OSF and that Haitian kids would be left behind to die.

Bishop Jenky Haitian Hearts Meeting---February, 2003

2006-03-14T07:33:00.000-08:00

Bishop Jenky Haitian Hearts Meeting—February 5, 2003

While I was in Haiti in January, 2003, the Catholic Diocese organized a new Haitian Hearts committee. Monsignor Rohlfs and Patricia Gibson were the individuals most involved in organizing this. Haitian Hearts had been put on suspension by OSF after I picketed the hospital for their lack of respect for Haitian lives. I returned from Haiti with no kids to operate even though many needed surgery.

The new committee was filled with OSF corporate people, administrators, and various other individuals. Most knew absolutely nothing how Haitian Hearts worked, how we evaluated patients in Haiti, how we kept them alive in Haiti, how we transported them to the United States and arranged for host families in Peoria to keep them, and how we transported them back to Haiti after their surgeries, and how we raised funds for Children’s Hospital of Illinois. My brother Tom and his wife Diane were there and Haitian Hearts coordinator Anne Wagenbach was invited also. Anne is an RN at OSF and had essentially done everything for Haitian kids over the years. Keith Steffen had threatened to sue her two years before when she attempted to have a petition to save my job when Steffen was getting ready to fire me.

At the start of the meeting, Bishop Jenky and Monsignor Rohlfs mentioned a couple of times that the “Diocese did not want egg on its face” and mentioned Caterpillar. The Bishop also mentioned the Capital Campaign which is the fund raising campaign for the Catholic Diocese. What these statements meant regarding the Haitian kids with congenital heart defects was confusing. During the meeting I was able to speak for about five minutes and told the group what OSF had meant to the Carroll family over the last 100 years in Peoria. I also asked Sister Judith Ann if she thought Haitian kids were safe at OSF. (I felt that Haitian kids were not being operated in a timely fashion at OSF the previous year.) She did not answer and actually said nothing at the meeting. Monsignor Rohlfs cut me off pretty quickly. He assigned jobs to everyone in the room except Anne Wagenbach. Anne was seated next to Monsignor Rohlfs and asked him how much the Diocese was going to donate to CHOI for Haitian Hearts. Rohlfs replied “nothing”. We were all getting a crash course in how the leaders of the Catholic Diocese of Peoria actually lead.

My brother Tom asked Bishop Jenky if I could return to Haiti then and bring back a few kids for life saving surgery. Bishop Jenky said that would not be a good idea.
Bishop Jenky spent 45 minutes with us during the 60 minute meeting and that was the last we ever saw of him as the new "director" of Haitian Hearts. Patricia Gibson assured us that the next meeting would be in a few weeks. Unfortunately, the next meeting did not occur until July 16, 2003, and at that meeting the Diocese withdrew all support from Haitian Hearts and the children that needed surgery in Peoria.

Bishop Jenky's Threat

2006-03-14T07:31:00.000-08:00

As explained in another post, I met with Monsignor Rohlfs and Patricia Gibson on February 19, 2003, two weeks after Haitian Hearts meeting with Bishop Jenky. Both Rohlfs and Gibson said that they would go to the media and come out against Haitian Hearts if I filed a petition for a tribunal court against OSF. I couldn't understand why they were protecting bad behavior at OSF.

I told them I was going to petition for a tribunal court, left their office (Bishop Sheen Center) incredibly dismayed with the leadership of the Peoria Catholic Diocese, and walked down the street to the Chancery to make an appointment to speak with Bishop Jenky. I had been attempting to speak with the Bishop unsuccessfully for a year. His secretary, Fr. Jason Gray, had been denying me this opportunity. However, on February 19, Father Gray told me that I could have an appointment with bishop Jenky the next day when I told him the topic--a tribunal court.

I showed up for my appointment with Bishop Jenky the next day at the Chancery. I could tell immediately that Bishop Jenky was not all that happy to see me. Patricia Gibson sat next to him. He told me that the day before was the first time he had heard that I wanted to file a petition for a tribunal court against OSF, even though I had been talking to Gibson and Rohlfs about this for 8 months. In fact, Gibson and Rohlfs even dictated a letter of petition that my brother transcribed in Rohlfs office in December, 2002. Why was Bishop Jenky just now hearing about this?

Bishop Jenky was aware of OSF's lack of respect for Haiti's children's lives as evidenced by Paul Kramer's call to the American Consulate in Haiti in December, 2002. In my opinion, this action was in opposition to what Catholic social teaching and OSF is all about. Bishop was also aware of OSF cutting all funding for Haitian Hearts children in July, 2002.

At the meeting I told Bishop Jenky about my concerns with activities at OSF, including their corrupt handling of pre-hospital care, Keith Steffen's comments to me in his office at OSF, the seeds of doubt that Steffen had spread in the Peoria area, and what the Apostolic Christian nurses comments about me were. I asked Bishop Jenky what he would think if the same things were said about him. His eyes were very big and angry looking as he replied, "I would be mad as hell".

However, amazingly, Bishop Jenky said there would be no tribunal court against OSF and that he would not judge against OSF. He stated that OSF is a 1.6 billion dollar industry. It was very clear to me the power of OSF in the eyes of Bishop Jenky. He told me that he wore the red miter. He really wouldn't even listen to me regarding more specifics what the tribunal court would be about. He just assured me that there would be no tribunal court against OSF.

I concluded again that Bishop Jenky was very much afraid of OSF's power and their relationship with the business community in the Peoria area. Was OSF donating to the Diocese? It was at the start of the Diocesan Capital Campaign and he didn't want to imperil it any way. Bishop Jenky even told me that if I followed through with the petition for a tribunal court and Haitian Hearts fell apart, that I needed to return to him in one year and go to confession for the killing of 18 Haitian children. (I asked him to repeat this as I wrote down his comment.) I think he knew then that he would be the one withdrawing support for the Haitian kids, but needed someone to blame. He said several times, "This is not going to work..." (meaning his involvement in Haitian Hearts.)

I left the chancery fairly dejected, but it was another good learning experience for me regarding the corporate Catholic Church in the United States. I already knew the Diocese of Peoria had helped and sanctioned OSF's oral contraceptive policy, OSF-HealthPlans oral contraceptive and sterilization policies with OSF Corporate Ethicist Joe Piccione a decade before, policies which permit OSF to cooperate in the provision of artificial birth control, an action that clearly contradicts church teachings. Why? Because of money. OSF is afraid they would lose patients and important preferred provider agreements if they don't help provide artificial birth control.

Bishop Jenky was definitely not interested in hearing about the Ethical and Religious Directives of the Catholic Bishops of the United States regarding health care and social justice.

(A tribunal is a Âsearch for the truth. I was seeking Bishop Jenky's intervention for a moral and honest discussion with those involved. The truth would be discovered and justice would be served. I did not think that certain OSF physicians and OSF administrators had much of a chance in a court like this that would seek the truth. If a tribunal would become unavoidable even with the intercession of the Bishop, then an honest effort would have been made to follow Catholic Canon Law. Unfortunately, Bishop Jenky refused the possibility of a tribunal court against OSF.)

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In April, 2006 a Peorian submitted a letter to the PJS. He must have thought that OSF was totally restricting oral contraceptives. I wrote the following letter to the forum. His letter is printed below mine. OSF really has the public confused about important issues.

Peoria Journal Star Forum Submission--April 17, 2006

I was surprised to read John Leber´s Forum article on April 15 entitled "No
Religious Dictates". He is concerned about OSFÂ´s recent announcement of their
new 234 million dollar medical center expansion and whether OSF will
unequivocally promise to remove religious mandates regarding birth control.

Mr. Leber must not be aware that OSF and the Catholic Diocese of Peoria
worked on this sensitive issue over a decade ago. Through dubious loopholes,
protocols were established which allow OSF employed physicians, in OSF
offices, to prescribe oral contraceptives. Also, OSF HealthPlans website
lists an entire array of contraceptives available in their drug formulary.

I believe Mr. Leber can take solace knowing that OSF has gone on record
regarding oral contraceptives. They have sacrificed Catholic "precepts,
beliefs, and dictates" to ensure that OSF would remain very competitive and
aggressive in Peoria´s medical marketplace.

John Carroll, M.D.

The Journal Star did not publish this forum submission. Below is the forum article by Mr. Leber.
---------------------------------------------------------
Saturday, April 15, 2006

No religious dictates

I read with interest the Journal Star endorsement of the proposed expansion
of OSF Saint Francis Medical Center. Economies of scale, location and core
ability would seem to support the idea.

However, one question needs to be unequivocally answered by St. Francis:
Will St. Francis practice medical best-practices, or medical best-practices
as modified by the precepts, beliefs and dictates of Catholicism?

Will St. Francis go on record, for perpetuity, with a promise to remove
religious dictates from issues such as birth control? If St. Francis will
not, it has my respect for honoring deeply held beliefs. But if it will not,
St. Francis is a very poor choice as a cornerstone for what Peoria hopes
will become a Midwest medical center on par with Mayo Clinic.

John B. Leber

Peoria

My comment: I don't think Mr. Leber needs to respect OSF for "honoring deeply held beliefs". OSF made a financial/business decsion regarding staying competitive so they could expand their downtown campus for 234 million dollars. Oral contraceptives helped them achieve this goal. Joe Piccione and the Catholic Diocese of Peoria ("moralists", as Mr. Piccione describes them), devised ways through dubious loopholes regarding oral contraceptives and OSF. This was well documented in the Peoria Journal Star in the mid-1990's. At a recent meeting, Dr. Gerry McShane, who is Director of the Ethics Committee at OSF Corporate, stated that use of oral contraceptives would indeed be "sinful". Joe Piccione, who was sitting next to Dr. McShane, shook his head "yes". Does Mr. Piccione, OSF, and the Catholic Diocese of Peoria think that providing avenues for people to "sin" is acceptable? Also, public scandal is high on the list of things not to do in the Catholic Church. I believe that OSF's machinations regarding oral contraceptives is highly scandalous and if OSF will allow this to happen, then rejection of dying Haitian kids that need heart surgery, and the monoploy of Emergency Medical Services in Peoria is just part of the continuum of OSF's embarassing recent legacy in Peoria.
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June 17, 2006

When I left the chancery in 2002 as I described above, I felt really let down. It seemed Bishop Jenky wouldn't listen like he should have. I know his responsibilities are huge and that the Catholic Church was never meant to be a democracy, but I expected him to consider what I was saying regarding a church tribunal against OSF, especially since Monsignor Rohlfs and Patricia Gibson had been very open to the idea for many months prior to my meeting with Bishhop Jenky. Bishop Jenky told me that he would not rule against OSF. It was over. He said there would be no tribunal court against OSF by me. I don't think OSF would have done well in this court, and I don't think Bishop Jenky thought so either. Therefore, he didn't allow it.

Below is a Forum article in the Peoria Journal Star from a very frustrated lady in the area.
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Jenky failing to find reconciliation with abuse victims

Saturday, June 10, 2006

The Journal Star recently ran an article in which the Peoria Diocese reported it was in full compliance in 2005 with the United States Conference of Catholic Bishops' Charter of the Protection of Children and Young People. Bishop Daniel Jenky said he would continue to strive for full compliance. This is simply not true.
Article 1 of that document states, "The first obligation of the Church with regard to the victims is for healing and reconciliation. Each diocese/eparchy is to continue its outreach to every person who has been the victim of sexual abuse as a minor by anyone in church service, whether the abuse was recent or occurred many years in the past."

The dictionary defines reconciliation as "adjust or settle." Bishop Jenky refused to settle with nine alleged victims last year.

In the preamble of this charter it states, "We continue to have a special care for and a commitment to reaching out to the victims of sexual abuse and their families."

Bishop Jenky's way of reaching out to the victims is to let a counselor deal with it.

Many have lost their faith. Bishop Jenky has a sacred duty to foster their faith. Not only is he not complying with the charter, it appears as if he's attempting to defy it.

Jorita A. Hill

Pekin
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October 21, 2006: Please go to Preintroduction on this website. Go to October 21, 2006 to see a National Catholic Reporter article written about Peoria's Rape Protocol. Very interesting.
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Catholic Diocese Abandons Haitian Hearts

2006-03-14T07:28:00.000-08:00

Catholic Diocese of Peoria Abandons Haitian Hearts

During the Spring of 2003, there were no more meetings with Bishop Jenky regarding Haitian Hearts. OSF had placed Haitian Hearts on suspension after calling the American Consulate in Haiti demanding that no more visas be issued to children needing to travel to Peoria for heart surgery.

I was very disappointed with my meeting with Bishop Jenky in the chancery when he refused a petition for a tribunal court against OSF and repeatedly told me that “this isn’t going to work out” (the survival of Haitian Hearts at OSF). He just seemed very intimidated by OSF and the local business community and I did not think that he would support Haitian children that needed heart surgery based on what he said.

Haitian Hearts wrote up a new agreement for OSF detailing how Haitian Hearts would be run. However Sue Wozniak, CFO at OSF-SFMC, who had been placed on the “new” Diocesan Haitian Hearts committee told us she never read it after my sister-in-law presented it to her. Why would she not even read it? We had read OSF’s set of rules for Haitian Hearts which included details that OSF would even control the visas of the Haitian children. This meant that OSF could send them back to Haiti whether they were ready to go or not after surgery. Haitian Hearts thought that this could endanger the children. Also, OSF’s document stated that the Catholic Diocese of Peoria would pay for costs to children in the hospital that were not covered under the contract. The Diocese said they would not pay these costs. So the OSF document was extremely deficient and not realistic. There were going to be so many rules established by OSF, I thought it would endanger the kids and the program. That is why we had to write our own proposal that Wozniak said she did not read.

In May, 2003, Monsignor Rohlfs called me and stated that the Sisters had made a financial offer to set aside monies in Children’s Hospital of Illinois to help cover surgery. I told him I was grateful for this. He added that I needed to accept the money before any other detail of the program could be discussed. I told him that this would of course be impossible to do because of OSF’s shenanigans in the past and what there proposals were this time (like controlling the kids’ visas, etc.) Rohlfs stated that we had to have a meeting which I agreed to, but insisted that Haitian Hearts know the rest of the details of OSF’s proposal before we accepted anything.

On July 16, 2003 we finally had our meeting. Joe Piccione greeted me at the door of the Bishop Sheen center with a smile and a hand shake which made me worry that the end of Haitian Hearts was near. The meeting was run by Monsignor Rohlfs and Patricia Gibson. Others in attendance were my brother and sister-in-law, Dr. Gerald McShane (wearing his golf shoes), Sister Diane McGrew from Corporate, Sister Judith Ann Duvall, President of OSF, and a friend of mine who had lost her husband to a heart attack after a bungled ambulance experience.

Monsignor Rohlfs stated the meeting by saying that I needed to accept the financial offer from the Sisters. I told him again that I needed to know the other “details” of the contract constructed by OSF and the Diocese. He would not tell me any of the details, but Dr. McShane gave us a hint that they were "significant". One of Haitian Hearts concerns was that if a Haitian child’s bill ran over the what was allotted by the Sisters, Haitian Hearts would be blamed (in the media like they had in January) and OSF would demand that it be paid. Rohlfs had said that the Diocese was not going to contribute anything for the Haitian children. Joe Piccione and McShane said that the debt would not be carried over each year but, amazingly, Sister Diane stated that Haitian Hearts would be responsible for any debts, that the debts wouldn’t be forgiven at the end of each year, and that there would be no “caps”. This was what I was worried about, along with the safety of the Haitian kids. Thus, I could see that the OSF people and the Diocese had not really prepared for this meeting and Sister Diane was driving a hard bargain. She was definitely not a happy lady and poor Sister Judith Ann did not say anything again. As President of OSF Corporate, I would have thought that the secular leaders would have let her say something.

Monsignor Rohlfs was adamant that no details be discussed until I accepted the plan as it was. We obviously could not accept this. If I accepted the offer and the rest of the contract was bogus, I was cornered and the Diocese and OSF could say that I refused all help for my Haitian kids. The trap was being set. My brother asked for another meeting so OSF and the Diocese could better understand what Sister Diane was saying. Rohlfs said we had just 7 minutes left to make our decision. I showed a framed picture of a little Haitian girl named Pamela needing heart surgery and Rohlfs chided me and called Pamela “my advertisement”. Joe Piccione, OSF Corporate Ethicist called me arrogant and told me that I was “not going to back the Sisters into a corner.”

Rohlfs ended the meeting in one hour. No other meetings were scheduled and my friend whose husband had died got into a wreck on the way home she was so upset with the outcome of the meeting.

The Diocese had aligned themselves with OSF and the big money in Peoria. Catholic social justice was not discussed by anyone except Haitian Hearts.

I left for Haiti the next day to begin working again. The director of communications for the Diocese called me in the Miami airport. She is a friend of mine and sadly informed me that the Diocese was pulling away from Haitian Hearts. Elaine Hopkins of the Journal Star interviewed Dr. William Albers, a pediatric cardiologist at OSF. Even though Dr. Albers was not there, and not on the Haitian Hearts committee, he blamed me on the front page of the Journal Star for failing to “negotiate” with the Diocese and OSF. Monsignor Rohlfs and OSF wouldn't negotiate at all with their mandate to accept OSF's offer, or nothing will be discussed. (OSF usually picks someone peripherally involved in an issue who is well known by the community, to talk to the media when necessary. I had actually expected they were going to pick Dr. Albers to slam me and told my family months before...but it hurt because he was another mentor of mine that I really looked up to as a physician.)

I was really sad during my first couple of days in Haiti that so many people had turned on the program and that Haitian kids were going to suffer greatly for decisions made in fancy offices in Peoria.

With the background as presented, the Catholic Diocese of Peoria came out with the press release as follows:

July 18, 2003,

Catholic Diocese of Peoria’s Statement on Haitian Hearts

Peoria—It is with enormous regret that Bishop Daniel R. Jenky, CSC, is announcing today that the Diocese of Peoria was unable to successfully facilitate an agreement between OSF St. Francis Medical Center and the Haitian Hearts program. The Diocese originally became involved in the process at the request of the Sisters of the The Third Order of St. Francis. From the beginning, all parties involved were fully aware that there were many obstacles that needed to be overcome for this undertaking to succeed. Despite good will on everyone’s part and many hours of hard work, the parties were unable to come to an agreement. The Bishop would like to publicly recognize the zeal and goodness of the many supporters of Haitian Hearts. He would also like to commend the ongoing generosity of the Sister of The Third Order of Saint Francis for their willingness to make a significant financial contribution had this program been successful.

The Diocese will be making no further comment at this time.

-----------------------

My 87 year old mother wrote Monsignor Rohlfs the following letter after the Diocese's pathetic effort regarding helping Haitian children:

Msgr. Rohlfs:

I am quite sure you read Dr. Albers' misinformation in the Journal Star that said that "Dr. Carroll would not negotiate." You know that the reason John could not negotiate was that you would not allow him to do so. You emphatically told everyone at the meeting that John must accept or reiect the sisters' offer of$200,000 before discussing the list of stipulations that accompanied their proposal. You also know that no clear thinking adult would even consider accepting or rejecting without first discussing and negotiating all of the terms that would have to be met first. How could you issue such a senseless ultimatum that is in direct opposition to good business procedures? Why would you not allow negotiations before commitment? Give me one good reason!

I have talked to Dr. Albers and have learned that he was given the false information that John didn't try to negotiate -- Msgr. Rohlfs, you know that even John's written attempt to negotiate (counteroffer) was never responded to. You also know that he asked you verbally at least three or four times and my son Tom also asked for discussion/negotiation before committing to accepting or rejecting the Sisters' proposal. You emphatically refused. In your letter to John announcing the date and time of the fateful meeting, you stated that many things needed to be discussed -- John, of course, totally agreed. Why then did you not encourage discussion and negotiation rather then forbid it?

Surely you know John's reasoning for insisting on discussion and negotiation before accepting the proposal: he would be held responsible if Haitian Hearts could not cover its St. Francis' bill. Had this been you, Monsignor, would you (or the diocese) have agreed to accept the Sisters' offer and take the risk of going bankrupt? Of course you would not! Of course John could not!
Regarding Dr. Albers' unwarranted statements to the newspaper concerning negotiations and meetings that he was not a part of: apparently one or more persons have given him inaccurate information -- how unfair! and I believe in some cases dishonest.

Regarding the only two Diocese/St. Francis Haitian Hearts meetings that were held: meeting No.1: you appointed the useless and never-called-upon-to-report committee chairmen and you announced that the Diocese did not intend to "end up with egg on its face." Meeting No.2: you issued the edict that John should blindly accept or reject .... Sounds like a pre-planned charade to me!

Sue Wozniak stated at the meeting that she did not read John's written attempt to negotiate (his counteroffer)--why was this? Had any others on the committee read it?

Over the past two years, John has made numerous attempts to resolve these and other serious concerns regarding OSF St. Francis Medical Center. Nothing has been resolved. As you know, John did not want to sue the sisters, so he and Tom thought a tribunal was the logical, sensible solution. When they discussed this with you early on, you did not appear to object to a tribunal. In fact, you know that you and Patricia helped John write the letter informing Sr. Judith Ann that he was considering it. Why would you then suddenly, three or four months later, get so upset about the tnbunal that you threatened John by saying that you would go to the media if he went ahead with it?

Who/what changed your mind? Did either of you ever tell the bishop that you had known about the tribunal for three or four months and had even helped write the letter? I am sure you know that when John talked to the bishop, the bishop was quite upset regarding the idea of a tnbunal and said that he had just heard about it during the previous 24 hours. Since this is true, why hadn't you or Patricia told him long before and, at the very least explained to John why you so adamantly switched views on the tribunal approach?

John was told by a very well known Peoria attorney that the diocese would never help him-we didn't, for a minute, believe it. Also, he was told by another attorney that the diocese would destroy his reputation. Now, what are we to believe?

Surely your conscience, as well as Dr. Albers', tells you that you have an obligation to do whatever it takes to right this temble injustice to someone who tries to live as he believes. I sincerely implore you to do so.

Mary Carroll

cc: Bishop Jenky
Sister Judith Ann
Patricia Gibson
Dr. William Albers
Dr. McShane
Sr. Canisia
Diana Couri
Joe Piccione
Monsignor Campbell
Monsignor Watson

---------------------------

Addendum: March 17, 2006--

Even though the Diocese walled away from Haitian Hearts in 2003, as many people predicted they would, my wife and I continued with Haitian Hearts spending 5 months per year in Haiti. We have now brought 122 Haitians to the United States. In the past 4 days, two little girls have had life saving cardiac interventions in Ohio and Missouri. Below are two articles from 2005---

Chicago Tribune

Haitians get priceless gift
Illinois doctor helps open the door for heart surgeries

By Deborah Horan Tribune staff reporter
December 6, 2004

When the pain came, as it often did, attacking Katia Cesar's heart with a breathtaking, debilitating cramp, the young Haitian woman would squeeze a pillow to her side, wait for the spasm to subside and count herself among the lucky ones.
Rheumatic fever had damaged her heart years ago, causing the skin on her throat to rise and fall with each heartbeat and leaving her unable to climb the hilly streets of Port-au-Prince, the Haitian capital.

But a chance meeting in Haiti between her uncle and a Peoria doctor led Cesar to a Joliet heart surgeon who could put an end to the painful episodes and ultimately save her life. It's a journey she attributes to a higher power.
"It was God's hand," Cesar, 21, said of the day she saw Dr. John Carroll, a Peoria internist, at a clinic in Port-au-Prince. "The Haitian doctors had told me that I had no hope to live. I was so discouraged, every day I cried."

On Friday, Cesar successfully underwent a three-hour operation in Provena St. Joseph Medical Center in Joliet, where doctors replaced her aortic heart valve with a man-made prosthetic valve.

She became the 111'th patient to receive care in U.S. hospitals since 1995 under the auspices of Haitian Hearts, a charity founded by Carroll that is devoted to helping patients fmd treatment for heart disease and other serious maladies. The treatment is unavailable to people in the crowded and violent shantytowns of Haiti, the poorest country in the Western Hemisphere.

"She's a very serious case," Carroll said, days before Cesar's operation. "She would likely die without surgery."

Cesar's uncle, a waiter, met Carroll while at work at the hotel where the doctor stayed during his visits to Haiti. The two struck up an acquaintance. Then one day, the waiter told the doctor about his niece's "sickness of the heart." The conversation catapulted Cesar from the crowded and anonymous ranks of Haiti's gravely ill onto a select list Carroll uses to track heart patients he knows are in dire need of care.

He shopped around for a hospital that would perform the surgery free of charge and found St. Joseph. He persuaded the U.S. consulate to grant Cesar a three-month visa to America.

"I was nervous when they told me I was going to America" Cesar said in a recent interview at the Franciscan Sisters of the Sacred Heart convent in Frankfort, where she stayed while she awaited surgery. "I was so happy."

Two other Haitian patients who arrived with Cesar on Nov. 13 will also undergo surgery arranged by Haitian Hearts, including Suze Lapierre, 26, scheduled for heart surgery at St. Joseph. Caleb Derestil, 16, who suffers from a rare cancer, will be treated at St. John's Mercy Medical Center in St. Louis.

In a little less than a decade, Haitian Hearts has raised $1.2 million from individuals and companies to bring patients, mostly children, to U.S. hospitals for surgeries unavailable in Haiti, including heart bypasses, Carroll said. Cesar and Lapierre are the first adults sponsored by the group.

Most of the funds raised went to the Children's Hospital of Illinois at OSF St. Francis Medical Center in Peoria where Carroll worked in the emergency room until 2001. The children's hospital took in some 60 children before it ended its support for Haitian Hearts in July 2002, about six months after Carroll and St. Francis parted ways following a dispute regarding hospital policy.

Since then, Haitian Hearts, led by Carroll with assistance from other Downstate volunteers, donors and board members, has had some success finding other hospitals to admit needy Haitian patients.

Carroll, 41, has been passionate about bringing Haitians to the U.S. for treatment since he first traveled to clinics in the Haitian countryside with a church group in 1981 and fell in love with the people.

He took an interest in tropical disease and noticed a high number of patients had severe heart problems. But hospitals were poorly equipped and underfunded, and patients were often at the mercy of the political violence that has plagued Haiti, particularly since President Jean-Bertrand Aristide was forced to flee the country in February. Carroll's solution was to find help for as many of the patients as he could outside the country.

"It's just so important that children's hospitals around the U.S. and Canada open their doors to a child or two a year," he said. "We probably have 20 kids on our list that need to come here for surgery."

Poverty and ignorance compound the problem. Both Cesar and Lapierre live in houses without plumbing or running water; neither one knew they had contracted the strep throat that turned into rheumatic fever and damaged their hearts.
As a child, Cesar remembers always being sick with fever. At 14, things got worse: Her legs swelled, she couldn't walk without feeling winded, and she couldn't study or play sports. When her mother took her to a community hospital, a doctor gave her medicine for anemia.
"They never revealed I had a heart problem," she said. "They didn't know what was wrong with me."

Three years later, another doctor discovered her bad heart and told her she probably would not live much longer. She sat without hope in her mother's tiny house in a crowded slum until the day her uncle told Carroll about his niece.

By then, Carroll had become locally famous. Haitians had heard about the American doctor who worked at a rural hospital five hours south of the capital. When he advertised his arrival on the hospital's radio station, patients would flock there and to the Lucella Bontemps clinic in Port-au-Prince to receive help for ailments common to the developing world: typhoid, malaria, tuberculosis and malnutrition.
"We'd get besieged with calls," he said.

All the while, he kept an eye out for severe heart patients, adding each new case to a handwritten scroll on which he logs a patient's medical condition and history of illness. Cesar was No. 43 on the list.

Lapierre was No. 30. She had been referred to Carroll a few months earlier by a Cuban doctor working in Haiti who discovered her damaged heart and knew the American doctor might be able to help.

"My heart was beating faster," Lapierre said. "I didn't know what was wrong."

When the U.S. visas for Cesar and Lapierre came through, their journey began. Carroll's sister-in-law Theresa Atchley met the women at O'Hare International Airport with coats and other clothing. The young women then went to the convent, where Lapierre spent two nights before doctors discovered possible signs of tuberculosis and pneumonia. Rather than expose elderly nuns to contagious disease, Carroll brought her to his home in Peoria for a few days. She is now staying in Minooka until the surgery.

Cesar remained at the convent, in a room usually reserved for friends or prospective nuns.

"I was suffering so much," Cesar said of her medical condition. "When I met Dr. Carroll, I felt I had hope again."
Copyright © 2004, Chicago Tribune
---------------------------------------

A wise use of medical resources?
Caring for sick Haitian children personalizes poverty of developing nations
Sunday,April 24, 2005
BY MARIA KING CARROLL

We are standing on the second floor of the UNICAR hospital in Guatemala City at 7 a. m, listening to about 15 doctors discuss the children on the floor who have recently had heart surgery. A tall, trim man wearing a light blue suit and sporting a full head of neatly combed white hair leads the group from one child's bed to another, asking questions and making comments.

"This is like going on rounds with God," whispers my husband, Dr. John Carroll, the founder of Haitian Hearts, a program that brings Haitian children to the United States for heart surgery. In fact, Dr. Aldo Castaneda, our elegant leader, is one of the gods of pediatric cardiac surgery. We have ventured to Guatemala to see if his program might accept a Haitian child for surgery.

Fifty years ago, as a med student in Guatemala, Dr. Castaneda hooked up dogs to a prototype heart-lung machine to understand how it might be used to help people. It's difficult to operate on a beating heart. The heart-lung, or bypass, machine allows surgeons to stop the heart without killing the patient. Bypasses made open¬heart surgery possible.

After completing his residency and working at the University of Minnesota, Dr. Castaneda spent the bulk of his career at Boston Children's, where he headed the Department of Cardiovascular Surgery from 1972 to 1994. Our host in Guatemala, his young associate, Dr. Juan Leon-Wyss, tells us that most prominent among Dr. Castaneda's many surgical innovations is showing the world that it is not only possible but preferable to operate on newborns with congenital heart defects, rather than waiting until the children are older, as was the practice.

Despite these world-class accomplishments, Dr. Castaneda has saved what I believe is one of his most impressive achievements for his "retirement." He returned to Guatemala, a poor central American country of 14 million where there was no children's heart surgery, and started the Fundacion Aldo Castaneda. Through this foundation, he built the hospital, UNICAR, supplied it with state-of¬the art medical equipment and recruited staff.

In 1997, doctors performed the first pediatric heart surgery in Guatemala. Last year 373 surgeries were completed at UNICAR. The program is managing cases just as complex as those in medical centers in the United States. On rounds, we see three children with hypoplastic left heart syndrome, a condition where essentially the left half of the heart is missing. This severe defect requires three surgeries to correct.

We are so impressed with the level of medical care at UNICAR that Haitian Hearts donates money to pay for the surgery of a Guatemalan child whose family cannot afford it. Guatemala and Costa Rica are the only central American countries where pediatric heart surgery is performed.

After rounds, we gather in the conference room to review some echocardiograms of Haitian children. We show the group echoes of children with complex and simple defects. Watching these echoes sets Dr. Castaneda to musing.

"If you look at this from a public health point of view, given limited resources, we'd like to operate on children who we can cure, who can go on and have a good quality of life and a normal life span. But to view it less coldly, I know when the child is in front of you, it's different; you want to help that child."

Dr. Castaneda says they would like to operate on a Haitian child, but they are not able to do it for free. The team is interested in an 18-month-old girl who has ventricular septal defect, or a hole between the lower chambers of the heart. As heart defects go, VSDs are usually relatively easy to repair. For this surgery and the necessary medical care, the cost would be $6,000.

"You should know," says Dr. Casteneda, "that our success rates don't match the big programs in the U.S., like at Boston Children's, but we achieve rates as good as those at second-tier U.S. programs."

We all agree that this little girl would be a good candidate for surgery at UNICAR. Our next step is to arrange for the child and her mother to travel to Guatemala City, which will necessitate flying to Havana, Cuba, as there are no direct flights between Haiti and Guatemala.

Given the widespread health problems in developing countries, is the extensive cost and effort of providing Haitian children with heart surgery a good use of resources? After all, bringing individual children from Haiti to the United States or Guatemala does not alleviate Haiti's crippling poverty. What it more immediately does is help some children and their families.

In a broader sense, though, I think having these children in our communities helps "raise the voice of the poor," which economist Jeffrey Sachs states in his book "The End of Poverty" is one of the nine steps to exactly that goal.
Because of the power the United States wields, we need to be especially aware of the conditions of people in poor countries. We were in Haiti last November. Haitians were paying close attention to the U.S. presidential elections. Arguably, the U.S. president affects the lives of average Haitians more than the lives of average Americans.

The children we bring for surgery personalize the problems in developing countries. We hope people will want to help them and the millions they represent in places like Haiti. Children in developing countries, like all of us, deserve first-class medical care.

Individual stories can move people to action. For despite the moral calculus those in deprived countries are forced to use to determine who gets medical care, Dr. Casteneda says that sometimes even when the surgical risks for a child are high and the outcome uncertain, they have taken a leap.

"When we've seen the child, we've broken down and operated."

Maria King Carroll lives in Peoria and spends part of the year working in Haiti. Her husband, Dr. John Carroll, founded the Haitian Hearts program in Peoria in 1995 and continues to run it.

Tom Carroll's Letter to Bishop Jenky---September, '2003

2006-03-14T07:15:00.000-08:00

Sunday, 21 Sep 2003
To: Bishop Jenky
Cardinal George
Monsignor Rohlfs, Monsignor Campbell, Monsignor Soseman, Monsignor Watson
Diocese of Peoria Parish Pastors

(Other recipient names were not included.)

An update on Haitian Hearts and OSF:

As most of you know, Paul Kramer, Executive Director of Children's Hospital of Illinois, contacted the American Consulate in Port Au Prince, Haiti, last December to inform them that OSF would no longer approve medical visas for Haitian Hearts' patients. After John Carroll and others picketed OSF administration in January reminding them that "Respect for Life Includes Haitians", the hospital, in decidedly un-Christian fashion, responded by officially suspending the Haitian Hearts program.

The program's suspension and the accompanying ban on visas for John's Haitian patients have never been lifted. Despite my brother's many attempts in the ensuing months, including his offer to pay 100% of Haitian patient's hospital bill, and the intervention of the Diocese of Peoria, John has been unable to obtain permission for any medical visas from St. Francis.

In July, the Haitian Hearts program was dealt another severe blow when the Diocese of Peoria withdrew its support and OSF subsequently announced that it, too, had officially dropped Haitian Hearts. The Peoria Journal Star reported that OSF claimed its medical staff was supportive of and had participated in the decision to abandon the Haitian Hearts program. Dr. William Albers, retired chief of Pediatric Cardiology at OSF, was quoted as saying that the program failed because John Carroll was "unwilling to negotiate". In this letter, I will question the reasoning and the motivation behind the decision to drop Haitian Hearts and the hospital's accompanying public statements.

The hospital's refusal to accept more Haitian patients last December was a severe blow to the patients and families who were waiting prayerfully for our help in a country that lacks the medical facilities to care for them. John, at that time, had identified 18 patients, 16 of them children, all of who would be candidates for heart surgery at OSF. They are not allowed to come because the hospital will not approve of their visit. It's sad to realize that, despite the critical medical problems these patients represent, there were only two meetings in the last six months involving all three organizations (Haitian Hearts, OSF and the Catholic Diocese of Peoria). Haitian Hearts members were surprised and disappointed when Monsignor Rohlfs announced at the February 7 meeting that the next team meeting would likely be scheduled for May. There was no need or reason to wait three months before meeting again.

As it turned out, our next meeting didn't take place until July. Before discussing the meetings, let me point out that Dr. Albers did not attend either meeting, was not on the committee, and has not communicated with John in the last six months. He would have, therefore, no first-hand knowledge of John's "willingness to negotiate". (Dr. Albers: I would still like to know what basis you had for saying John was not willing to negotiate on behalf of his Haitian patients. Do you believe that your statement is consistent with John's past behavior regarding his program? Has John typically been willing to sacrifice his patients by refusing to negotiate on their behalf or would you regard him as a good advocate for them? Please give these questions and your answers to them some careful thought before making any more public judgments regarding my brother.)

One of the tasks John was assigned by Monsignor Rohlfs at the February meeting was to obtain assurances from various members of OSF's medical staff that their support for Haitian Hearts would continue. Haitian Hearts has, of course, always received an incredible amount of support from the surgeons, cardiologists, intensivists, etc. who have donated their services without charge. John asked for promises of support and, without exception, was assured by the doctors of their willingness to continue working for the program. Why then would OSF state that the doctors involved with the program participated in and supported the decision to cancel it? Several doctors intimately involved with Haitian children care over the years have since told us that they were informed that the program had been cancelled but definitely were not involved in the decision to cancel it. Could it be that OSF administration wanted to portray the false impression that their decision to cancel a charitable program was actually made by "the medical staff" because it helps justify that decision in the public's mind?

The hospital's dissemination of misinformation is very injurious to the Haitian Hearts program and to my brother. It reflects a mean-spirited attitude that is contrary to the Sister's mission statement which calls for open and honest communication. I maintain that OSF and Dr. Albers have a moral obligation to correct any misinfonnation they have allowed to propagate. I would hope that a Catholic institution would never choose to propagate false or misleading information and I expect that Dr. Albers would certainly not either. My family and I are waiting for a public correction or retraction from both parties.

At the February 7th meeting, Bishop Jenky emphasized the importance of both OSF and Haitian Hearts working together to arrive at an agreement or contract so that Haitian Hearts could continue. He said that it is sometimes difficult for friends to agree to a contract, but that a contract was exactly what was needed.

In March, OSF submitted a proposal for a contract. This proposal included no financial contribution to Haitian Hearts from the hospital, no "cap" or maximum amount Haitian Hearts could be charged, a return to Haitian Hearts paying 45% of medical charges, and a list of restrictions that seemed designed to make it very difficult for John to obtain the hospital's permission or approval for the patients. The hospital's proposal also stated that the Diocese of Peoria would be responsible for any unpaid hospital bills incurred by the Haitian patients. Why OSF would attempt to place this financial responsibility on the Diocese is anyone's guess. Not surprisingly, the Diocese was unwilling to agree to this part of the contract offer.

Several days after receiving the hospital's proposal, John and other members of Haitian Hearts responded by submitting a counterproposal. John's counterproposal asked for:1.) an annual allowance from the Sisters to help defray hospital charges, and 2.) maximums or "caps" on the patients' medical bills.
Patricia Gibson told John that Sr. Judith Ann and Joe Piccione had reviewed the counteroffer and seemed to view it as reasonable. Oddly enough, Sue Wozniak said in July that she had not seen, or read, this counteroffer from Haitian Hearts. Haitian Hearts members were disappointed to learn this. Sue was a critical member of OSF's negotiating team. If the hospital were truly serious about negotiating a contract, it seems that Sue Wozniak should have, at a minimum, read our counteroffer. It seems to me that the failure to do constitutes a reluctance or unwillingness on the hospital's part to negotiate.

In April, Monsignor Rohlfs told John that the Sisters had revised the hospital's proposal to include an annual $200,000 discount on medical bills with Haitian Hearts paying the remaining hospital charges at a 45% rate. We were, of course, very encouraged and grateful that the Sisters were offering a financial contribution to the program. There was still no provision for a cap or maximum amount that Haitian Hearts could owe. At this point, Monsignor Rohlfs told John that Haitian Hearts would have to accept or reject the Sisters financial offer before any other points of the contract could be negotiated. John acknowledged the Sisters' offer was generous but felt that other aspects of the financial package, such as caps and maximum liability, needed to be negotiated and understood by both sides before accepting or rejecting them. It would be irresponsible for Haitian Hearts to prematurely agree to any financial offer without both sides fully understanding the terms of that agreement. Since Haitian Hearts is a relatively small organization with a finite amount of fundraising ability, the issue of caps or maximum liability is, of course, crucial to its financial survival. With no cap, Haitian Hearts would run the risk of financial ruin with every patient. Strangely enough, Monsignor Rohlfs did not agree with the logic of this position and insisted John must "accept or reject" the Sister's financial offer before any other issues could be negotiated.

I can't emphasize enough that accepting a financial offer, no matter how generous the amount, without a cap on medical bills is a major problem for a small organization like Haitian Hearts. Our program's debt and its financial solvency are, of course, critical concerns to us. Last January, OSF administrators announced to the media that they were suspending Haitian Hearts because the program owed the hospital over $500,000 in medical bills. The hospital's announcement prompted a fair amount of public criticism of John and his program. Several days later, the hospital claimed that Haitian Hearts's debt amounted to "over $400,000" and their statements to the newspaper later described the debt as being "almost $400,000." This means the hospital initially overstated the debt by more than $100,000. More than one-fifth of the debt initially claimed as justification for suspending a charitable organization apparently never existed. The hospital administrators did not bother to explain how or why they had overstated our debt by such a large amount. Since the public criticism caused by their initial statement only hurt John and Haitian Hearts, the hospital apparently never felt it necessary to correct or explain their error. Sr. Judith Ann was contacted by a Haitian Hearts member who respectfully asked her to explain the accounting of the debt since our figures actually showed we had a positive balance rather than a negative one. Sister responded by referring her to Paul Kramer.

Sister, I must say I am very disappointed that you did not clear this matter up. If the hospital decides to state publicly that we owe it over half a million dollars, it only seems fair for the hospital to be willing to back up that claim with hard figures. Don't you agree? Please let me know if there is any possibility for reconciliation on this matter. I believe that Haitian Hearts has been dealt with unfairly and that the hospital should publicly correct its previous statements. I would expect nothing less from a Catholic institution. Please prayerfully consider my request, Sister, and let me know your decision.

Without caps providing an upper limit on financial liability, it is easy to envision a scenario wherein John and the Haitian Hearts program would once again be held liable for huge medical bills if one or more of the program's surgical cases developed complications. If that happened, it is possible that OSF administrators would make an honest effort to accurately compute the amount of that debt before announcing it to the media, but, based on their actions in January, I certainly wouldn't expect fair treatment. OSF administrators and spokespeople dragged John's name through the media spotlight in January. I can only assume that, given the opportunity, they would repeat this behavior in the future. Haitian Hearts could be forced into insolvency or bankruptcy in such a situation. Would the Sisters be willing to stand up and protect the reputation of Haitian Hearts and John Carroll in this situation? The Sisters did not stand up to protect Haitian Hearts reputation against the false statements of their administrators last January. Would anyone expect them to in the future?

The Haitian Hearts program has been quite successful at raising funds: we raised over $1.1 million in the last few years, all of which went to Children's Hospital of Illinois. Combined with the Sister's generosity the program has successfully brought over 90 Haitians here for life saving surgeries. However, no small organization should be forced to subject itself to unlimited financial risk without being permitted to even discuss the option of caps. Monsignor Rohlfs, why did you mandate that Haitian Hearts could not negotiate any points of the contract without first agreeing to a financial offer? Would you, as Vicar General, allow our Diocese to accept a financial offer if there were no discussion allowed ofthe resulting financial liability? You don't really have to respond to this question, Monsignor. I already know the answer. Of course you wouldn't.

Some additional comments about the second, and final, Haitian Hearts / OSF / Diocese meeting on July 17th:

At an earlier meeting with two representatives of Haitian Hearts, Sue Wozniak, OSF's Chief Financial Officer, distributed a draft of a proposal wherein Haitian Hearts would be responsible for 45% of hospital charges up to a preset limit, and 30% 'of the charges after that. At the July 17th meeting, we asked about this lower, 30%, charge and were told that the offer did not exist. We were told ''that was only a draft." It seems that we on the Haitian Hearts committee should have known or been able to guess which of the hospital's offers were serious and which were not. Joe Piccione and Dr. McShane stated early in this meeting that "the Haitian Hearts program would begin afresh (or anew) each year", implying that the debt owed by Haitian Hearts would be forgiven at the end of each year. Later on in the meeting, Sr. Diane stated that Haitian Hearts's debt would not be forgiven but would be carried over from each year to the next. Joe and Jerry did a quick reversal and suddenly agreed that our debt would not be forgiven. I stated that the financial "offer" was confusing, had changed at least twice in this short meeting, and I requested that, with only a few remaining minutes in our allotted hour, we schedule a future meeting to discuss finances. My request was refused by Monsignor Rohlfs.

Before the meeting ended, Joe Piccione said that my brother's statements and/or actions towards ''the Sisters" were arrogant. The next day the Diocese and the hospital announced their withdrawal from participation in the Haitian Hearts program.
The stated purpose of the July 17th meeting, as expressed in the written invitation from the Diocese, had been to discuss many issues concerning the proposed agreement between OSF and Haitian Hearts. There was no indication, based on the written invitation, that further negotiations would be contingent on our accepting or agreeing to a not-well-defined financial offer. The time limit for this meeting was set by Monsignor at exactly one hour. It came as a genuine surprise to me when Monsignor Rohlfs began the meeting by saying John must accept or reject the Sister's financial offer before any other issues could be negotiated. When asked why we were being forced to agree to a financial arrangement before negotiating any other issues, Monsignor Rohlfs replied that it was "because I have decided it". He also stated that he did not believe John was ever going to agree to any contract- with the hospital and wanted to save everyone the time and trouble of negotiating. I couldn't believe my ears. This statement came at the beginning of the very first negotiating session between OSF and Haitian Hearts. It took Haitian Hearts almost 6 months just to get this negotiating meeting with the hospital. Monsignor, do you really believe John was not going to agree to a contract with OSF? What possible benefit would there be to Haitian Hearts if we refused to agree to a contract? Monsignor Rohlfs, there were over 30 Haitian patients whose very lives depended on our negotiating a contract with the hospital. Why would you start out the meeting by saying that you didn't think we would ever agree to a contract? Did you think that saying this would help facilitate the negotiations? John has successfully fought his way through bringing more than 90 Haitians to the US for surgery. There are now more than 18 additional patients waiting for surgery. How could it possibly help these patients to refuse a contract with the very hospital that helped so many previous patients? What benefit would there be to spending much time negotiating with and then refusing to agree to a contract with OSF? More communication, not less, is obviously what was needed -- why, near the end of the last meeting, did you turn down my request for another meeting to work on the financial issues? Is your time, or the hospital's, so valuable that you were unwilling to risk spending another sixty minutes on a topic that literally means life or death to Haitian patients? If it were your heart surgery that was in jeopardy would you have been willing to schedule one more meeting to discuss it? What do you think will happen to the Haitian heart patients if other hospitals follow OSF's lead and likewise refuse to help them?

Bishop Jenky, do you approve of the restrictions on negotiations imposed by Monsignor Rohlfs? Is this the Diocese's usual method of fostering agreement between people? Also, why did the Diocese remain silent while John was blamed for being "unwilling to negotiate"? Why did it remain silent in January when the alleged amount of Haitian Hearts debt kept changing in the media from day to day? Is this open and honest communication on the part of the Diocese? I don't think so.

I believe that Monsignor Rohlfs did not conduct this meeting in a good-faith manner.
The meeting appeared to be a formality meant to ease the hospital's withdrawal from a program that it no longer has the moral courage to support. The primary concern was preserving the hospital's image. The people who will immediately suffer from this are, of course, the Haitians. Hospital administrators and ethicists have done a decent job of spinning the public's perception of their cold and calculated decisions. However, I don't have to be an ethicist to know that, in the end, we are all judged on our actions -- not on speech.

For the record, let me say that OSF's actions and statements regarding my brother and Haitian Hearts are deeply disturbing to me and have profoundly affected my opinion of a once-proud, Catholic organization. I have watched as John has been called arrogant and stubborn because he insisted on quality care for his Haitian patients. Those very characteristics are deemed highly desirable in a physician if one happens to be the patient benefiting from the improved level of care. Not everyone has the luxury of being paid to sit in a comfortable office while criticizing the actions or words of others. Mr. Piccione, if you would care to take the time, I will be happy to meet with you and explain the true meaning of the word "arrogant". Let me point out that we in central Illinois are blessed with everything we need to provide care for the least of our brethren: a superb medical facility, physicians willing to donate medical care without charge, foster families who open their homes to the Haitians, and a generous community that has donated a large amount of money to help pay for the childrens' surgeries. The only thing lacking is permission from the hospital administration to provide these surgeries. We have everything else. All we need is the moral strength and leadership to do the right thing.

This is my third letter to the Diocese in the last 18 months. I have not received answers from the Bishop to my first two letters. I will respectfully ask once again and I will continue to ask for a response to my concerns. The issues I raised are very important and will not go away. It's important to note that my brother John has asked Bishop Jenky for a tribunal to investigate a conflict of interest involving OSF Medical Center. His request has also gone unanswered. Bishop Jenky, don't you have an obligation to respond in a timely manner to a request for a tribunal, especially one that deals with a matter affecting the public good? Has the volatile subject matter of this tribunal influenced the hospital or the Diocese's decision to withdraw support for John's program, Haitian Hearts? I believe that it has.
I will await an answer to this letter.

Tom Carroll

(My brother never received a response.)

Bishop Jenky Rejects Catholic Tribunal Court

2006-03-14T07:10:00.000-08:00

Bishop Jenky Rejects the Catholic Tribunal Court

A Catholic tribunal court is a “search for the truth”. The church has long endorsed the principal of subsidarity, affirming that decisions should be made and disputes resolved at the lowest possible level of authority, with appeals to a higher authority only when such efforts fail. Thus, the diocesan bishop, and not the Pope, creates disciplinary policies for his local church. According to Canon Law, The bishop needs to get involved in cases where the public good may be at stake. Bishops are bound by canon law. Their actions must be in conformity with canon law. If they don’t follow canon law, their actions are invalid.

I believed that a tribunal court should be petitioned for against OSF for multiple reasons.

I will list some of the reasons below. I wrote 4 petitions for tribunal courts in 2003 and my brother wrote for one. Bishop Jenky answered only one of the five with a typed written letter. Bishop Jenky advised me to take my petition to Rome because the OSF sisters are a "pontificate of Rome". However, in his office, he told me, that there would be no tribunal court against OSF because he was the judge and he would “not judge against OSF”.

If OSF had a system of checks and balances that was functional, I would not have had to request a tribunal court from Bishop Jenky. For example, when I asked Doctor Gerald McShane, Director of the Ethics Committee, to bring up an issue regarding OSF administration to the Ethics Committee, he stated that Keith Steffen, OSF administrator, sat on the ethics board and my complaints would probably go nowhere. I asked OSF Corporate Ethicist, Joe Piccione, multiple times to take serious issues regarding abandonment of Haitian kids to the ethics committee and I never heard back any response from the ethics committee.

The American Medical Association statement on Ethics Committees in Health Care Institutions (E-9.11) state that “ethics committee members should be selected on the basis of their concerns for the welfare of the sick and infirm (which would include the pre hospital patient, the emergency department patient, and Haitian children that need heart surgery), their interest in ethical matters (Keith Steffen?), and their reputation in the community and month their peers for integrity and mature judgment (Keith Steffen?). Committee members should not have other responsibilities with their duties as members of ethics committees.”

The AMA statement was ignored by OSF. McShane, Piccione, and Steffen are all very, very high salaried members of OSF Corporate and Administration. Could they give unbiased, ethical answers regarding OSF’s actions? The governing elite of any organization can eventually think that it is the organization.

So, if Bishop Jenky would have allowed a Catholic tribunal court, in chronological order, these would have been some of the issues that would have confronted him and he would have had to search for the truth, as the tribunal dictates. However, he chose not to.

Reasons for a Catholic Tribunal Court vs. OSF:

1. The public good was at issue, with long waiting times in the ER and lack of bed capacity within OSF-SFMC. Tim Miller had stated that the “main campus had been ignored” (while the Center for Health was being built on the north side of the city). Keith Steffen had told me that there had been serious problems with leadership in the ER at OSF and Sue Wozniak said there had been "poor planning" regarding our dysfunctional Emergency Room. The ER had the lowest patient satisfaction and employee satisfaction in the medical center.

2. In my opinion, my firing from OSF had been punitive and retaliatory for pointing
out obvious problems when I wrote Keith Steffen on September 27, 2001 and copied all of the Emergency Department physicians including Dr. Hevesy. I was to learn that Dr. George Hevesy, Director of the ER and in control of all the ambulances in the Peoria area for many years, was on the payroll at Advanced Medical Transport, and according to the Peoria Fire Department had “obstructed” them as they desired to give better care for people that call 911 in an emergency. I felt that there was a very negative conflict of interest here with Hevesy on OSF’s and AMT’s salary. Also, Sue Wozniak, CFO at OSF, is on the AMT Board of Directors which I did not think was a healthy relationship either.

3. During my first meeting with Keith Steffen in October, 2001, he metaphorically referred to me as a malignancy and an “uncontrolled hemorrhage in the ER at OSF”. He also told me repeatedly that “when this comes out about you, it is not going to be good”. He called me a “bad person” to other people who told me and spoke inside outside the hospital inapprpropriatley multiple times about my termination. This was defamatory behavior on his part and very destructive. His comment that when he sees Haitian children “it makes me want to puke” seemed very wrong. Open and honest communication, and respect for Catholic social teaching, an OSF mission statement, was destroyed by Steffen.

4. Keith Steffen also brought up the concept of fear amongst employees as being a good thing. Fear plays a big role in the medical community in Peoria. Steffen shouldn’t promote this. Even Joe Piccione emailed me in November of 2005, deploring administrations fear concept.

5. Chris Lofgren, OSF spokesman, spun the truth to the media regarding the fate of Haitian Hearts after I was fired. The medical center should be honest in all forums. He also spoke to a hospital employee about my termination and on one occasion laughed and told me that “maybe Sister Canisia started the rumors”.

6. Keith Steffen stated that he was going to stop all funding for Haitian Hearts which he did on July 12, 2002. This seemed to be in opposition to what Sister Judith Ann had stated that “OSF will never turn away a child”. Again, the Sisters Mission Statements were violated as were the Ethical and Religious Directives for Catholic Health Care Services.

7. OSF-CHOI executive director, Paul Kramer, told the pediatric cardiology office to not schedule a Haitian child for cardiac catheterization, thus delaying her surgery. I watched him walk into a cardiology exam room while a 24 year old Haitian lady was being examined by the cardiologist. The host mother was enraged with Paul Kramer and he later apologized. OSF administration seemed to be controlling surgeries and procedures for certain Haitian Hearts children. I believe the pediatric cardiologists are afraid of the administrators at OSF. After I reported Kramer’s actions to the Pediatric Resource Center for negligence, the Haitian child was immediately placed on the schedule.

Also, Haitian Hearts had many questions regarding OSF-CHOI and Foundation handling of funds for Haitian children. Kramer admitted to asking Linda Arnold to ask for funds from Rotary Club North that were not intended to go to OSF…they were dedicated to Haitian Hearts out of hospital expenses for the Haitian children (medication, food, flights, etc.) OSF withholding donor lists to Haitian Hearts also seems very unethical. We have no idea who to thank and how much money is owed to us from OSF. And what happened to the majority of Catherpillar Foundation’s generous contribution in 2001?

8. OSF refused to accept full charges for Willie Fortune who needed his pacemaker changed. He was dying in Haiti and OSF refused him. (He was emergently operated at another medical center in the United States.) This action is in direct opposition to Catholic social teachings, the Ethical and Religious Directives, and the Sisters Mission Statements. (Since, OSF refused Willie, other former OSF patients have been denied treatement at OSF, and at least one has died (Jackson Jean-Baptiste), after 20,000 dollars was offered for his care.)

9. The OSF Corporate Ethicist and the Director of the Ethics Committee (Piccione and McShane) did not seem to respond in an “ethical fashion” to my requests for certain important topics to be brought up to the ethics committee. I never heard from the ethics committee in 5 years over any of my requests.

As a Monsignor in the Diocese of Peoria told me, there is significant “corporate malaise” at OSF. I think the people of Peoria could be much better served by OSF.

Why did Bishop Jenky not give the tribunal a chance? A review board would have looked at the above and made a recommendation to him. I could support everything reported above.

It is interesting that in 1993, the Catholic Diocese with Joe Piccione had devised a way for OSF physicians to prescribe birth control pills from OSF offices. Without the help of Bishop Meyers, this would have been much more difficult for OSF to accomplish. Bishop Jenky apparently agrees with this protocol. According to the Peoria Journal Star, OSF thought they would lose business without the ability to provide birth control pills.

Does OSF donate to the Catholic Diocese of Peoria, and if they do, how much? Do you think the Diocese or OSF will answer this question?
---------------------

April 30, 2006

Pax Christi USA wrote an article in 2005 "Remembering Archbishop Oscar Romero". He had great passion for the poor.

Romero stated, "A Church that doesn't provoke any crises, a Gospel that doesn't unsettle the Word of God that doesn't get under anyone's skin, a Word of God that doesn't touch the real sin of the society in which it is proclaimed--what Gospel is that?"
-----------------------

July 11, 2006

Below is a letter I wrote to the Catholic Post regarding Amy Riedell's April 9, 2006 column in the Post. Her article concerned OSF's new $234 million dollar expansion in Peoria.

It looks like the Catholic Diocese of Peoria and OSF are close when they need to be and that my petitioning for a tribunal court was appropriate. Bishop Jenky was in attendance when Keith Steffen was announcing the OSF expansion.

-----Original Message-----
From: drjohn@mtco.com [mailto:drjohn@mtco.com]
Sent: Monday, July 10, 2006 2:33 PM
To: cathpost@mcleodusa.net; pgibson@cdop.org;
keith.e.steffen@osfhealthcare.org; joseph.j.piccione@osfhealthcare.org
Subject: Peoria's Medical Mafia

Dear Tom,

I recently read Amy Riedell's column April 9, 2006 regarding OSF's new
medical expansion. I'm a little behind in my reading.

It is very well written but also should be very embarassing for Bishop
Jenky and the Catholic Diocese of Peoria. Imagine this planned $234
million dollar event announcement just several months after OSF refused
Jackson Jean-Baptiste and Haitian Hearts financial offer for his life. He
died a very painful and slow death. That, of course, was not reported in
the Catholic Post. We were with him and taking care of him the last two
months of his life.

Imagine Bishop Jenky having to listen to Keith Steffen talk about the
Sisters who founded the hospital and the current Sisters who have very
little to do with the day to day operation of the largest hospital in
downstate Illinois.

Imagine Bishop Jenky listening to Steffen talk and knowing that Willie
Fortune was refused a new pacemaker at OSF with full charges offered by
Haitian Hearts. Steffen laughed out the administrative window as Willie
stood there on the OSF sidewalk as OSF refused to see him. Willie was 16
years old at the time and weighed about 70 lbs. This doesn't sound like
"the greatest care and love" that Steffen professed in his speech, does
it? Bishop Jenky had to be nauseated at that point.

Think of Bishop Jenky's remorse when he heard Sue Wozniak, CFO at OSF, and
Board President at Catholic Charities?, talk about the new expansion as a
"place of healing". Jackson Jean-Baptiste's and Willie's mothers wouldn't
have believed her words.

Think of Bishop Jenky's mindset knowing that his vicar general and canon
law lawyer threatened me to go to the media against Haitian Hearts if I
petitioned to file a tribunal court against OSF with the Catholic Diocese
of Peoria. Bishop Jenky threatened me with the need to come to confession
to him for the "killing of 18 Haitian children" if I pursued a tribunal
court. He knew very well what the problems were, but knew he better blame
me. When I met with Bishop Jenky, I could see that he was very afraid.

Bishop Jenky must have squirmed in his chair when Steffen tied Bishop
Jenky to Steffen and OSF by stating that OSF is a "continuation of the
ministry" of the Diocese of Peoria under Bishop Jenky's leadership.
Another smart move on OSF's part. That of course implied that Bishop Jenky
was in agreement with the abandonment of dying Haitian children and OSF's
oral contraceptive policy. It also implies that Bishop Jenky and Monsignor
Rohlfs should not advise me or any of the Haitian kids to go to Rome to
Pope Benedict for pastoral care issues at OSF. Seems like Bishop Jenky
should have control according to Steffen and deal with these issues in a
Catholic way using Catholic social justice and respecting Humane Vitae
(sp) and the Ethical and Religious Directives (regarding health care) in
the United States.

I wonder how much OSF donates to the Catholic Diocese of Peoria each year?
The laity will never find out.

John Carroll
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