DJP Update 10-10-2005 re Where is our Leadership? And Grants


ITEM ONE: Response to "Where is our leadership? letter

ITEM TWO: RELIEF FUNDS AVAILABLE FROM AMA, LSMS, AND PARISH MEDICAL SOCIETIES TO HELP PHYSICIANS REBUILD THEIR PRACTICES


ITEM ONE: Response to "Where is our leadership?" letter

A hero of mine, James E. Brown, MD, who has been a mentor to me throughout my medical career, recently wrote an email letter that he distributed to about 40 friends and family members.  I called it the "Where is our leadership letter?"  The names of the recipients were given.  He was commenting on another doctor's observations about the problems that practicing physicians were having in the Katrina devastated areas.  This letter was then reproduced by another physician, Dr. Michael Ellis, a famous news clipper and a good friend of mine, and the letter was distributed to his "undisclosed recipients" list without Dr. Brown's name on it. (Recipient number: Dozens? Hundreds?)

Because my name was mentioned in the distributed letter to known individuals and then re-circulated to an unknown number of undisclosed recipients by Dr. Ellis, I believe it appropriate to respond about my activities post-Katrina and also offer a sampling of my rules of engagement in a crisis and leadership.  The critical issues raised in the letter deal with allegations that hospitals that remain open in Katrina-hit areas and surrounding areas are refusing to allow displaced physicians from destroyed hospitals in the area to join their staffs and an allegation that "our leadership" is not fixing this alleged problem.

Here is what he said:

Exactly my observations. What a pathetic and miserable showing from a profession that is devoted to relieving human suffering. Where is our leadership? Again, I suggest that an emergency declaration by the Governor be done giving temporary privileges to all physicians in good standing at their previous hospitals that have been closed. The LSMS should have taken the lead weeks ago in this matter. Where are you, Pat Breaud? Where are you Don Palmisano? Where are Floyd Buras? Where are you chiefs of staffs? At our hospital, which has been closed--Methodist, temporary privileges were given within hours to known, accepted members of the medical community who had proper credentials. We were not lawyers who needed time consuming documentation and arcane affirmations. If we knew the people and they were respected members of the medical community, privileges were extended.
 
It is not too late to rise to the occasion. Please let us not embarras ourselves with bureaucratic indifference, and yes, perhaps a bit of greed.
 
jim brown

(Note by DJP: The "Pat Breaud" is no doubt Dr. Pat Breaux, the president of Orleans Parish Medical Society.  Dr. Floyd Buras is the president-elect of the Louisiana State Medical Society.  Both practice in New Orleans and were hard hit by the devastation of Hurricane Katrina.  Dr. Buras will be installed as president of LSMS this Friday at LSMS headquarters as the annual meeting of LSMS was cancelled.  The writer of the email, Dr. Jim Brown, is a great Greek and Latin scholar and an expert in grammar so any inaccuracies in his letter are, in my opinion, the result of a quick email response.)

DJP observations:
First, Don Palmisano is no longer in the elected leadership of AMA, LSMS, or OPMS.  I consider myself in the inactive reserve.  I have remained in contact with our parish, state, and AMA leadership throughout this crisis and given my advice and offered to help in any way they thought I could help.  I went to the command post in Baton Rouge where FEMA and the other Federal and State leaders coordinate and gave them my contact information.

Also, throughout this Katrina and Rita crisis, I have worked hard to make sure that our elected leadership and other key individuals such as the Jefferson Parish Coroner, Dr. Robert Treuting, and the New Orleans Parish Coroner, Dr. Frank Minyard, had a way to communicate to their staff and each other during the inability for phones calls to get through the "congested due to Hurricane" recording.  I personally delivered these devices, including going through the barricades on the perimeter of New Orleans immediately after Katrina to get one to Dr. Brobson Lutz, featured on the front page of the Wall Street Journal, and visiting the morgue facilities set up at Saint Gabriel, just outside of Baton Rouge.  

I found a donor for these communication devices, Blackberries with phone, email, and nationwide walkie-talkie capability.  The donor was The Doctors Company (TDC) in Napa, California, under the leadership of Dr. Richard Anderson.  (Full disclosure: I am on the board of TDC.)  Such phones were given to Dr. Jim Aiken and his team (7 phones), Dr. Brobson Lutz, who runs the "French Quarter Medical Clinic in Exile", New Orleans Coroner (4 phones), Jefferson Parish Coroner (2 phones), Mr. Dave Tarver, LSMS executive director (one phone), Dr. Russell Klein, Speaker of LSMS HOD (1 phone), Dr. Jay Busby, current president of LSMS (1 phone), Dr. Keith DeSonnier, of AMA delegation and practicing physician in the Lake Charles area hard-hit by Hurricane Rita, and Dr. Pat Breaux, current president of OPMS, as well as Susan D"Antoni, executive director of OPMS.  I also have one for delivery today for Dr. Mike Ellis.

Meanwhile, Robin and I continue the arduous task of dealing with the home insurance issue, meeting with roofers, contractors, etc. to try and salvage our home and also delivering communicators. We commute from our temporary living quarters in Baton Rouge. (Thanks to Dr. Larry and Sharon Braud for this wonderful help for lodging in a family home.)  We also lament now that 3 of our grandkids have moved to Atlanta post-Katrina. Now that we are home from the 300 day road tour as AMA president and the 249 days of president-elect and 250 days road days of immediate past-president year, we were looking forward to spending more time with our 6 grandkids.  However, because of Katrina, son Donald Jr. has accepted a job with a law firm in Atlanta and moved there with his family and 3 of our grandkids are his kids.

Why spend time writing this letter?  Dr. Brown and Dr. Ellis are dear friends and mean no harm to me.  I write to set the record straight because I am reminded of the words of Cyrano de Bergerac who gave the advice on one's reputation:

I carry my adornments on my soul.
I do not dress up like a popinjay;
But inwardly, I keep my daintiness.
I do not bear with me, by any chance,
An insult not yet washed away * a conscience
Yellow with unpurged bile * an honor frayed
To rags, a set of scruples badly worn.
 (and he goes on to speak of his good name, and making the "sharp truth ring, like golden spurs!)
Cyrano de Bergerac by Edmond Rostand (Brian Hooker translation)

So, if you want the leadership to do something for you, communicate it to them.  Bring them the facts.  Words mean something but documentation is critical evidence in preventing anyone from changing their story and saying "you misunderstood what was said."

As I mention in my "Big A and 25 C's" of risk management lecture ( go to www.intrepidresources.com )
One of the C's is Confirmation: Memories fad, witnesses lie,  and people die.

Get hospitals to confirm in writing they are refusing to allow you on the staff.  That was the reason I always felt comfortable in debates with the best of the trial bar: I always was armed with the facts.  The truth documented is a powerful tool.  Grousing around the coffee pot is of no value.  I gave this advice to Jim and another colleague who called me prior to the email letter.  I certainly understand the frustration of documentation but this can be done quickly.  You also can document the refusal to give you something in writing.  I know this has been brought to the attention of one of the JCAHO commissioners and this should be followed up.  Get the new rules of the game post-Katrina.

Also, if you have a complaint, show up at the LSMS meeting in Baton Rouge this Friday.  The incoming president, Dr. Floyd Buras will be installed as the president.  See ITEM TWO.

 Don't tell me you are too busy.  If it is any important issue, then you will make time.  A lesson of leadership is to have the complainer stand up with the facts and present them.  Don't expect the leader to go into battle without ammunition.  If the medical society is wrong, then try to convince them.  We did that under the leadership of Dr. John Cooksey in 1975 when the medical society initially was against caps saying a cap was unconstitutional.  We asked for a rehearing and convinced them.  The rest is history.  The cap is in place and ruled constitutional.  This double hurricane disaster is of a magnitude that is difficult for those who are not living in the aftermath to understand.

So where is Don Palmisano?  He is right here in Baton Rouge and Metairie, doing his best as a organized medicine leader out of power trying to do what he can do in his own way and making himself available to any leader in organized medicine who wants whatever advice and lessons of experience Don Palmisano can share.  Be assured I willing share my advice to those colleagues in distress.

I do not forget the battle I was in in the late 1970s when a medical building was to be built on a piece of land and it never was built on that site.  The limited partners believed that a fiduciary duty was breached by the general partner in a subsequent sale of that land to a relative.  The other limited partners, approximately a dozen, asked me if I was afraid to get involved in litigation to fight for our rights.  I told them I was not afraid but I wanted to know if they were willing to stay in the battle until the end.  They pounded the table and said yes.  Well, the battle lasted 15 years and over the years all but two 5% owners quietly got out of the fight leaving the two 5% owners alone.  I was one of the 5% owners.  We eventually won at the appeals level with a rare rehearing and it was upheld by the supreme court.  My point is just like my Dad taught me as a kid:  "Son, you will meet people in life who come on like Gangbusters but go out like We The People."

I also remember the words of Joseph Reed who fought George Washington in the American war for independence:

"Your noisy sons of liberty are, I find, the quietest in the field* An engagement, or even the expectation of one, gives a wonderful insight into character."

Also, in the Iliad, Odysseus told his men before the battle: don't tell me what you are going to do with the Trojans before the battle, but rather tell me what you did after the battle.  I find the talk less. (With apologies to Homer for my inadequate memory of the exact words.)

Jim Brown is a seeker of truth and a man of courage.  I will go into battle alongside him anytime so don't misinterpret my remarks.  I know him to be extremely smart and a logical thinker.  I believe in time he will agree with the advice below.

So, get the facts documented.  Then spend the time going to the elected leadership and be prepared to join in the fight until the end.  Win, lose, or draw.

Now I feel better.  I still love Dr. Jim Brown who remains my hero next to my Dad and George Washington.  But, sometimes great people are wrong just as those of us who are not so great are wrong.  Jim Brown is no exception in that, in my opinion, he is wrong about Don Palmisano in this instance.  The leadership of the various medical organizations and medical staffs can speak for themselves and I will not presume to do so.


ITEM TWO: RELIEF FUNDS AVAILABLE FROM AMA, LSMS, AND PARISH MEDICAL SOCIETIES TO HELP PHYSICIANS REBUILD THEIR PRACTICES


www.LSMS.org
The Louisiana State Medical Society will install Floyd A. Buras, Jr., MD of New Orleans as the 126th President of the Louisiana State Medical Society on October 14, 2005 at a special meeting of the Board of Governors. The inauguration will be held at LSMS Headquarters, located at 6767 Perkins Road in Baton Rouge, and will begin at 2:30 pm.
 
Presidential inaugurations by custom take place at the Annual Meeting of the House of Delegates. The 2005 Annual Meeting was cancelled due to the devastation caused by Hurricane Katrina and subsequent recovery efforts.
-------------


Read about the relief funds available from AMA Foundation, Louisiana State Medical Society, Orleans Parish Medical Society, and Jefferson Parish Medical Society to help physicians rebuild their practices/
Visit the following links to learn more:

http://www.lsms.org/Hurricane%20Katrina/Hurricane%20Fund%20Release.htm

http://www.ama-assn.org/ama/pub/category/15610.html

http://www.ama-assn.org/ama1/pub/upload/mm/367/katrina_grant_app.pdf

LOUISIANA STATE MEDICAL SOCIETY AND COMPONENT SOCIETY  RELIEF FUNDS

PRESS RELEASE                            CONTACT:   Anne L. Shirley
                                                                                      Director of Public Affairs
                                                                                      800.375.9508
                                                                                      anne@lsms.org
Baton Rouge, LA * In response to the tremendous outpouring of concern for Louisiana's physicians by the medical community throughout the United States, the Louisiana State Medical Society (LSMS) has established the LSMS Hurricane Katrina Physician Relief Fund. This fund was set up for those who want to directly help displaced physicians re-establish their practices in the disaster area or elsewhere in Louisiana.
LSMS President Jay Busby stated, "Over seventeen hundred of our members have temporarily or permanently lost their practices, and in many cases their homes, due to Hurricane Katrina. The LSMS has received hundreds of phone calls and e-mails from around the nation offering donations as a way to help affected physicians. We are humbled by this expression of support and now have in place a way to help these physicians put their careers back together."
The Baton Rouge Area Foundation, an organization known nationally for its philanthropic work, will administer the LSMS Hurricane Katrina Physician Relief Fund. Physicians' offices are a vital part of the healthcare infrastructure that must be restored in the Southeast Louisiana disaster area.  The relief fund will provide grants to physicians from the designated disaster area that will help them re-establish their practices and begin to provide needed medical care to people returning to the area.  Donations are tax deductible and can be made online at http://www.physicianrelief.kintera.org or by mail to: 402 N. 4th St., Baton Rouge, LA 70802. (Please make checks payable to LSMS Hurricane Katrina Physician Relief Fund/BRAF.)
Dr Busby expressed the gratitude of the Louisiana physician community, "The LSMS deeply appreciates the overwhelming response shown by so many individuals and organizations to help the people of the Gulf Coast region recover from the most catastrophic natural disaster of modern times. This is the Spirit of America once again reaching out with expressions of compassion and hope to lift up a part of this great nation in its hour of need."  
If you have any questions regarding this relief fund, contact Amy W. Phillips, JD, LSMS Director of Legal Affairs and General Counsel, at 225.763.8500 or amy@lsms.org.

GREATER NEW ORLEANS MEDICAL FOUNDATION
A nonprofit foundation of the Orleans Parish Medical Society
 
Contributions should be directed to:
     Greater New Orleans Medical Foundation
     c/o Hibernia Bank Main Office - Baton Rouge
     440 3rd Street
     Baton Rouge, LA  70802
 
The following information should be included on the memo line of the check or in a separate note:
     "Deposit to Greater New Orleans Medical Foundation" 
     Either of the two following #s should be included:
          Tax I.D. #: 20-1650323
          Bank Account #: 2080558964
 
Questions regarding the Foundation should be directed to:
     Susan D'Antoni, Executive Director
     Orleans Parish Medical Society
     Greater New Orleans Medical Foundation
     256.355.4991 or 504.453.8562
 

JEFFERSON PHYSICIANS' FOUNDATION
A nonprofit foundation of the Jefferson Parish Medical Society 
Contributions should be directed to:
     Jefferson Physicians' Foundation
     Jefferson Parish Medical Society      4937 Hearst St., Suite B      Metairie, LA 70001  Donations should be made payable to:      "Jefferson Physicians' Foundation"  Questions regarding the Foundation should be directed to:
     Charlene Baudier, Executive Director      Jefferson Parish Medical Society      504.455.8282 or email@jpms.org
 

 
AMA FOUNDATION HEALTH CARE RECOVERY FUND
 
For immediate release October 6, 2005
The American Medical Association (AMA) Foundation announced today that it is offering grants to help physicians rebuild their medical practices in the wake of Hurricanes Katrina and Rita. Grants will be awarded from the AMA Foundation's newly established Health Care Recovery Fund, an ongoing fund that will also be available to physicians affected by future natural or man-made disasters.
Physicians whose practices were damaged or destroyed in areas declared disaster zones by the Federal Emergency Management Agency are eligible to apply. Applications are available online (PDF, 12.3KB, requires Adobe® Reader®) or by mail through the AMA Foundation, 515 N. State St., 11th Floor, Chicago, IL 60610. Physicians need not be AMA members to apply, nor will their AMA membership affect their application status.
The Health Care Recovery Fund was started with a $100,000 grant from the AMA. The AMA Foundation will accept donations by mail to the fund.
"Rebuilding the health care infrastructure after major disasters like Hurricanes Katrina and Rita is an immense challenge," said AMA Chair-Elect Cecil B. Wilson, MD. "These grants will begin to help physicians get back on their feet and provide much-needed care to their patients on the Gulf Coast. This effort also will give physicians and others around the country a chance to donate to an ongoing fund designed to assist their colleagues who are rebuilding their practices in disaster areas."
###
For more information, please contact:
AMA Media Relations (312) 464-4430