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Nursing Union Buster or Bête Noire?

Imagine finding flyers posted all over a hospital sounding the “alert that a professional union buster was on site”, and that flyer used to identify a nearly 70 year old great grandmother who has to use an electric scooter to get around.  What power this person must have to send the California Nurses Association (CNA) in paroxysm’s of fear and panic and to engage in their usually tactics of lies and misinformation.  I was met with just such exhibitions fear-mongering and hysteria by CNA recruiters, representatives and supporters when I made a recent visit at the invitation of a fellow nurse from Cy-Fair Hospital in Houston.
Their flyer identified me as a professional union buster, which I guess is a recognition of how much they fear my presence; but truth be told I’m not a professional union buster, and in particular I’m not a nursing union buster.  The CNA and many other pro-union people love to use the word union-buster since it tends to invoke images of a Simon LeGreed character replete with requisite black hat and clock and evil laugh.
I have nothing against unions for the blue-collar worker, but I’m far from convinced that professionals such as registered nurses need unions to represent them.   So when nurses contact me for my opinion and advise about how to speak for themselves I am always happy to help my fellow RN in advocating for our profession and for themselves.  I’m happy to help in the effort of showing nurses they can and do have a strong voice as both an individuals and as a group without paying a nursing union dues of upwards to $80.00 a month for the favor.
In the case of two recent nursing union attempts, one nursing staffs attempt to stay free from the CNA and one nursing staff attempt to decertify from the CNA.  As fate would have it, I was in a position where I could help both in spirit and in person so I did.  At the first hospital my fellow nurse and I found CNA representatives playing shenanigans with hospital elevators so that the floor where a “No to the CNA” nurse had been given a meeting room was locked out.  This malfunction only affected the one floor that we had to reach on both days, what a coincidence.  You may wonder why I think CNA representatives capable of such underhanded techniques.  Simple, I still haven’t forgotten a CNA strike in the San Fernando Valley where pro-CNA nurse locked out much need medical equipment, hiding/destroying manuals, etc., so that the relief nurses were hard pressed to provided nursing care to patients many of whom were in intensive care; and the CNA strike was suppose to be all about their concern for patient safety  — go figure!  And at the second hospital I got treated to the experience of being stalked by not one, not two, but upwards to three CNA representatives at a time.  The situation became of such concern that hospital HR and security had to become involved; but I guess I should feel honored that the CNA felt the need to have so many people watching my every move.
Whether or not nurses chose a union to represent them or not should be up to the nurses themselves but this seems to rarely be the case these days.  As in the case of the Tenet Healthcare/CNA neutrality agreement Houston nurses that had opposing views to the CNA material, propaganda or message had no one to turn to; at least that’s what the CNA representatives thought, except they overlooked a grassroots network of informed RNs that were available for these nurses to reach out to; which they did and we responded.  One would think that the CNA representatives would be excited to learn that nurses were empowering one another, oh that’s right it only counts if the nursing unions are doing the empowering.    So sorry, we didn’t get that memo. One would also think that the CNA would invite and encourage an open and lively discussion about the benefits of a nursing union, but they couldn’t be bothered to even accept the invitation extended by one group of nurses to present their viewpoint in an open debate.  Instead they skulked about passing out flyers full of misstatements and lies since it so much easier to insult the intelligence of nurses rather than respect them.
In the case of the flyer they suggested that the nurses ask me a set of questions, and I responded with an open letter.  One pro-CNA nurse chose to mark up my open letter with graffiti instead of addressing me nurse to nurse.  But then again it’s become common practice for pro-nursing union nurses to engage in such childish behavior.  It’s a sad day when our honorable profession is marred by such immature behavior.  However, I see these as indicators of how much the organizational structure of the CNA fears nurses who chose to take back or carry on with their own voice.  In the past several years their membership has been declining (their last official report in 2008 has their membership at just over 72,000 almost a full 8,000 or 13,000 drop depending on which CNA official report you read).  I think it’s this drop that has them scrambling for new members in the other 49 states.
But in some parts of our country nurses don’t want anything to do with them, and even when Tenet handed the CNA the proverbial keys to the kingdom providing CNA organizers unfettered and unprecedented access to RNs on the floor, scheduling information and even home addresses and telephone numbers; the CNA has found resistance to their siren song.  They couldn’t even gather enough cards at Park Plaza and Northwest Hospitals in Houston to even call an election and they slunk out of Houston so quietly that few even knew they had abandoned their organizational efforts.  They accused one, that’s right ONE, nurse of trying to take away the union at Cy-Fair Hospital.  What power this one nurse must have, I guess the well over 30% of eligible nurses that signed decertification cards meant nothing, it was all that one nurse’s fault.  And this morning we learned that Hahnemann Hospital (another victim of the nefarious Tenet/CNA neutrality agreement) had rejected the union.  The CNA had such access to the RNs at Hahnemann that nurses that opposed the CNA had to get the NLRB to intervene just so they could get a meeting room in the bowels of the hospital and finally a table in the cafeteria (shortly before election day) and the union spokespeople whined that this was unfair.
So if our network of nurses, and me, in particular can help our fellow nurses when confronted with such behavior and that makes us professional nursing union busters in the eyes of the union then I guess that’s a cross we’ll just have to bear.  I see it as the desperate actions of an organization that knows that people have begun to look behind the curtain that is the California Nurses Association/National Nurses Organizing Committee and they don’t like what they see.  The more they howl about RNs empowering each other the more I know that I’m their bête noire and that’s a role I think I shall relish.
Geneviève Clavreul RN Ph.D is President and Founder of the National Nurses Professional Association.  She also blogs at The Nurse Unchained.
Published
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on July 13, 2009
in Geneviève Clavreul RN PhD, Healthcare, Opinion and Reform
. 0 Comments

Pharmaceutical Giant Charge Critics with Genocide

When the survival of South Africa’s (SA) mining industry now appears to hinge on their ability to blame their laborers’ costly mine-related lung diseases on irresponsible sex, the financial connections between South Africa’s mining industry, government regulators and university researchers is becoming clear.

Because strategic mining operations depend upon our ability to cheaply mine defense materials like gold, platinum and uranium, the US government shares a powerful incentive to promote the “irresponsible sex/HIV” mythology rather than support the historical claims against the SA mining industry.

The latest evidence comes from Farber lawsuit defendant James J. Murtagh MD who recently posted this email about possible criminal prosecution of the so-called AIDS denialists:

Starling new evidence that AIDS denialist Peter Duesberg and his supporters may be liable for vast human tragedy. I hope that other denialists including Gil and Ullberg will read this carefully. I hope Gil and his gang will repent. Time may already have run out.

Attached to Murtagh’s email was this commentary by AIDS Truther Nathan Geffen, which reads in part:

From 1999 to 2007, (Thabo) Mbeki and his Minister of Health Manto Tshabalala-Msimang obstructed and then undermined the implementation of highly active ARV treatment (HAART) and prevention of mother-to-child transmission of HIV in the public health system. Two studies, conducted independently of each other, conservatively calculated that over 300,000 people died because of Mbeki’s AIDS denialist policies.

Edward Mabunda was one of them. These studies could not account for additional deaths due to the promotion of quackery, often with the health minister’s support. They also did not consider the number of infections that occurred because of the confusion generated by the insipid state-funded prevention campaign and the messages by some outspoken Mbeki supporters dismissing the link between sex and HIV infection. The Mbeki era also fostered a profound mistrust of scientific medicine, the consequences of which also cannot be quantified.

What, if any, repercussions should be there for those responsible for this tragedy?

Geffen ponders various possible criminal charges and venues citing studies, all written by South African researchers who just happen to also be directly or indirectly funded by the SA mining industry, US pharmaceutical companies, investors and/or consultants to those industries. Some of those reports are published by the National Institutes of Health.

As I described last month, RMIT professor Jock McCulloch used portions of the Leon Commission Report (1995) to explain the incestuous relationships between the SA mining industry and research community which:

… shared the same research focus and a common source of funding through mine revenue. They also shared the same personnel, as key researchers moved between one sector and the other. The same men served on state commissions and departmental committees, and represented the Chamber at public inquiries. That made it difficult for an individual to confront the mining houses over the dust hazard…

While the slippery relationships between the genocidal post-Apartheid groups AIDS Truth, Treatment Action Campaign and the pharmaceutical industry and investors were exposed last month, Murtagh’s latest email and Geffen’s report produce one more financial/pharmaceutical connection.

The report footer indicates that it was published by the newly created Journal of Acquired Immune Deficiancy Syndrome (JAIDS.org), which is managed by co-Editors in Chief William Blattner (who just happens to be the co-founder of Robert Gallo’s Institute of Human Virology) and acclaimed AIDS researcher David Ho.

The website’s domain name registrant is the international investment powerhouse Wolters Kluwers, which generated ~$5 billion in 2008.

According to WK’s 2008 Annual Report:

Wolters Kluwer had 2008 annual revenues of €3.4 billion, employs approximately 20,000 people worldwide, and maintains operations in over 35 countries across Europe, North America, Asia Pacific, and Latin America…

The division is organized into four market-centered business units – Pharma Solutions, Medical Research, Professional & Education, and Clinical Solutions – to serve the information needs of its customers.

Their product Pharma Solutions:

… provides a wide range of data and analytic capabilities, marketing and publication services, business intelligence products, and diversified consulting services to support life science professionals and the pharmaceutical industry, from drug discovery through distribution, as well as government agencies and other healthcare sectors…

… The unit was awarded multi-year pharmaceutical data contracts, including a long-term agreement with the U.S. Food and Drug Administration (FDA)… and a multi-year partnership with Bristol-Myers Squibb to provide Health Insurance Portability and Accountability Act (HIPAA) - compliant prescription sales data to measure business efficiency, control costs, and determine sales force effectiveness.

Bristol-Myers Squibb (BMS) is the manufacturer of  Sustiva (Efavirenz), which is so highly addictive that African children are now smoking it like crack.  Sustiva’s addiction-withdrawal syndrome also appears to produce symptoms that AIDS clinicians identify as the onset of AIDS.

Because BMS faces significant liability regarding the Sustiva snafu, they have good reason to partner with a damage-control publishing company like WK and children of Apartheid like Nathan Geffen who, with the assistance of very creative legal counsel (probably from WK), threatens real scientists like Peter Duesberg with false charges of genocide.

As an investigator, Geffen’s commentary appears to be one more propaganda piece that fits well with the genocidal post-Apartheid organizations that exploit Africa’s cheap black labor force for mining operations, leaving them with mining diseases, false HIV diagnoses and highly addictive and deadly AIDS drugs.

It is also possible that Geffen’s propaganda is the beginning of fabricated documentary evidence that Murtagh and his co-defendants may try to use to defend themselves from Ms. Farber’s lawsuit - even as they try to distance themselves from him.

Either way, Bristol-Myers Squibb has much to explain.

Published
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on July 8, 2009
in Africa, Clark Baker, Corruption, HIV/AIDS, Opinion and Pharmaceutical
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Morality, Courage & SSI Membership

SSI recently received this email from someone who identified himself as a physician and wants to refer SPR victims to Semmelweis:

Please post this to everyone involved in this running feud. I used SSI when I was having my career ruined. Now I don’t know where to send fellow health care providers to when they are getting their lives ruined in a sham peer review. All the clinics and hospitals will use your fued (SIC) against you in court and discerdit (SIC) SSI. Shame on all of you for what you are doing. Both sides of this SSI fued (SIC).

Dear Doctor:

SSI believes that your question is important. As requested, we have posted your email and this response on our website.

If you are mugged and you defend yourself, the casual observer might conclude that you and your mugger are equally and shamefully immoral. Reasonable people know, however, that your morality is not based upon the pedestrian’s casual observations. By raising the specter of shame, you are either profoundly misinformed or are practicing the intellectually lazy doctrine of Relativism. If either is the case, I encourage you to join Dr. Murtagh’s cohorts.

If you read my preliminary investigation and my ongoing investigation you’ll see that “the dispute” began in May 2008 when ex-SSI members James Murtagh and Kevin Kuritzky issued outrageous allegations against UC Professor Peter Duesberg and investigative journalist Celia Farber, with the intent to compel the SSI Board to summarily rescind their 2008 awards without review.

Their complaint called for a competent independent investigation because, if false, their libelous allegations could have professionally harmed both (per se libel) and would have unnecessarily subjected Semmelweis and its Board to unnecessary liability.

As a retired member of the LAPD and licensed investigator who had not heard of the issues, disputants or SSI before 2008, no one was better suited to examine the charges. As soon as I began my investigation however, Murtagh’s camp tried to pressure me into stopping it – going as far as criminal attacks and witness intimidation.

My continuing investigation eventually developed sufficient evidence for this New York Supreme Court lawsuit against and Murtagh and Kuritzky, who are still hiding from process servers. Their co-defendant receives, directly and indirectly, millions of dollars in funding from pharmaceutical and mining companies (and their investors) that avoid billions of dollars in liability by blaming their impoverished black African miners’ silicosis, asbestosis and tuberculosis on “irresponsible sex” (e.g. AIDS). Murtagh, his co-defendants, hedge fund operators, pharmaceutical companies, international mining companies and the UN promote the scam as a “human rights” issue in order to sack Africa’s rich mineral wealth while attacking individuals like Farber and Duesberg who question the arrangement.  Without AIDS, thousands of international mining operations in Africa would close - as they almost did in 1995.

So outrageous were Murtagh’s charges that even his collaborators recently distanced themselves - calling him morally repugnant.

If Murtagh’s allegations against Farber and Duesberg were true, he would enthusiastically respond to the civil charges against him - just as SSI did after Ralph Bard filed his frivolous lawsuit against SSI last December. Because of our fact-based response, Bard’s own neighborhood court will soon dismiss his complaints.

So as you can see, the two sides consist of 1) the current board and membership, and 2) “Murtagh’s camp” which libelously tried to rescind the 2008 awards to Duesberg and Farber without evidence – in what anathematically resembles “sham peer review.”

If you read my bio and investigation you’ll see that I have better things to do than keep the peace between SSI and a tiny group of socially dysfunctional ex-doctors.  But as a victim of retaliation myself, I never targeted others for personal gain. Murtagh’s camp demonstrates that not all peer review are shams: Their behavior only serves to corroborate whatever allegations were once made against them.

My year-long examination concludes that SSI, its membership, mission and goals are too important to turn over to alleged men who attacked SSI on behalf of individuals like Murtagh and Kuritzky.

What also appears to animate Murtagh’s camp is SSI’s refusal to advertise legal services by ex-doctors. The SSI Board stopped this practice last year when they sensed that SSI’s former ex-doctor-lawyer board members were exploited SSI’s website, name and members for personal gain.

Since those lawyers were removed from Board influence last year, SSI has assisted more than a dozen physicians and nurses with free legal consultation and affirmative defense that has saved their careers at a minimum cost.

Because of the complications of HCQIA and peer review, SSI no longer promotes the use of career doctors who become lawyers for the same reason that we would not encourage surgery by a career lawyer who becomes a surgeon. When it comes to peer review cases, experience matters.

If you’re still confused about what you’ve called our shameful dispute, SSI probably isn’t for you. Our mission and goals are too important to waste time with Murtagh cohorts or those who are easily confused by them: Nor do we waste much time thinking about them. Like other benign pathologies, they will eventually slough off or find softer targets.

As a former US Marine and LA cop, I am proud that the SSI Board stood strong in the face of Murtagh and his enablers. Dr. Ignaz Semmelweis knew that courage often exacts a terrible price.  Of courage, Aleksandr Solzhenitsyn wrote:

A decline in courage may be the most striking feature which an outside observer notices in the West in our days. The Western world has lost its civic courage, both as a whole and separately, in each country, in each government, in each political party, and, of course, in the United Nations. Such a decline in courage is particularly noticeable among the ruling groups and the intellectual elite, causing an impression that the loss of courage extends to the entire society.

SSI membership is not for the morally confused or ambivalent. While it takes courage and endurance to fight corrupt multi-billion dollar healthcare and pharmaceutical industries, it would take comparatively little effort to accept the material benefits that would come by surrendering to them in the name of patient safety and Semmelweis.

As long as there are some healthcare professionals who take their Hippocratic Oath seriously, I am proud to remain in that fight.

Clark Baker
Secretary/Treasurer
Semmelweis Society International

Published
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admin
on June 26, 2009
in Clark Baker, Corruption, Healthcare, Hospital, Opinion, Pharmaceutical, Political, Sham Peer Review and Whistleblower
. 1 Comment

Is Healthcare Asleep at the Wheel?

Dateline: Redding California, 2002 - A jetliner carrying 700 passengers crashed into Mount Shasta killing 69 and injuring most of the remainder. Pilot error caused the crash. The FAA ignored the incident.
If this story were true, we would be outraged and demand a full government investigation of the FAA’s negligent failure to investigate. Yet the story is partially true: all the “passengers” were patients at Redding Medical Center in Redding, California between 1993 and 2002. The two “pilots” were Drs. Fidel Realyvasquez, a cardiac surgeon, and Chae Moon, a self-proclaimed cardiologist.
In late 2002, the FBI “busted” this conspiracy of negligence. The two physicians have lost their license to practice in California.  The hospital administrators who helped hide the doctors from public scrutiny have relocated to foreign countries to find work.
But “busting” the “bad guys” for unnecessary heart procedures and surgery on healthy patients was not good enough for my team, or for the people, so we set out to discover how this gross and near criminal medical negligence could possibly be tolerated for 10 years at a well respected, accredited, and licensed hospital.
Based on our investigation and report gleaned from public documents and private testimony, we found that government officials failed to enforce our laws: laws necessary to assure hospitals are safe for the public.
Both State and federal health care officials knew as early as 1999 that RMC and its medical staff could not assure patient safety for cardiac services. These officials knew the hospital and medical staff provided no oversight or review of the quality of care provided by Moon and RV. In fact, both of these physicians were in charge of their own reviews. Moreover, our main hospital accreditation organization, the Joint Commission, also knew in 1999 of the danger Moon and RV posed to patients because their patient care services were hidden from review by their peers. The JC accredited RMC anyway. The first peer review provided for Moon and RV was performed by outside medical experts hired by the FBI in 2002.
Now that we know hospital peer review requirements are not enforced, the California legislature refuses to give our enforcement agency, Licensing and Certification, the power it needs to enforce our laws.
Professional stakeholders, but not the public, oppose law enforcement penalties that would compel effective peer review. L&C does have the power to impose fines of $50,000 to $100,000 against hospitals for allowing imminent danger to patients. But the absence of peer review is not an imminent danger, even though hundreds of patients can be harmed over time.  Patients at many California hospitals are vulnerable to unmitigated medical negligence which can only be prevented by brave conscientious physicians who have the professional courage to voluntarily identify physicians who allegedly endanger patients and hold them accountable through the peer review process. In hospitals where peer review is absent or ineffective, there is no mechanism to cull out negligent physicians until after many patients are damaged.
When peer review is properly performed, suspected physician errors are discovered timely, through analysis of various triggers, such as unexpected return to the operating room or unexpected blood loss. Promoted by these triggers, specific patient cases are reviewed by other physicians at the same hospital. The care provided may be acceptable or problematic. If physician negligence is discovered, corrective action is taken. A physician may be instructed to take more education, limit performance of certain services, or could be discharged from the medical staff for egregious acts. The result is safer care for future patients.
The California Legislature ordered a report on California peer review and hired Lumetra, a private company to write it. Lumetra published its report in 2008. Lumetra found that peer review in California is unacceptable, inadequate, and ineffective: patient safety cannot be assured. RMC is the “poster child” for what goes wrong too often. Now, seven years after the FBI “busted” Moon and RV, and after the Department of Justice and CMS kicked RMC out of the Medicare Program, our peer review laws remain unenforced throughout California. 
In the 2009 legislative session, the California Legislature has taken up the peer review issue (SB 58, SB 700, AB 120, AB 245, and AB 834). But current proposals will not enact penalties L&C requires to enforce our laws. Experts believe L&C needs the power to impose intermediate sanctions against hospitals and medical staffs for repeat failure to conduct peer review. Currently, the only power L&C has is to revoke the license of the entire hospital, which the Agency rarely does. By contrast, intermediate sanctions could remove the license of a hospital for certain elective services only in those clinical departments (e.g. cardiac services) where peer review is not provided or is ineffective on repeat audit. With this power, a negligent hospital and medical staff would face huge financial losses and, therefore, would provide the missing peer review immediately. Without the enforcement power of intermediate sanctions, hospitals and medical staffs can continue to flaunt our laws knowing the State has no power to enforce them.
In other words, currently peer review is self-administered, not audited for effectiveness, and when not done, there is no power to enforce the requirement. Self-administered peer review in hospitals works as well as self-administered regulation compliance did on Wall Street in 2008. Doctors who need help are not identified, and future patients continue to suffer the consequences.
In 2009, patient safety will remain a goal, not a reality; except, perhaps, in a few self-proclaimed centers of quality. To change this unacceptable situation, you must write to your California legislator and demand enactment of intermediate sanctions to enforce the peer review laws in California.
Good luck next time you are admitted to a hospital in California. You will need it because patient safety cannot be assured. It is safer to fly.
Dr. Rogan is a family and emergency physician who served as the Medicare Medical Director in California from 1997-2003. In 2002, he assisted law enforcement with the RMC investigation. Currently, he is an
independent consultant to health services companies.
 
Published
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on June 16, 2009
in California, Corruption, Gerald N. Rogan, Opinion and Reform
. 0 Comments

Why Do Americans Want Government Healthcare?

Senior fellow at the Manhattan Institute David Gratzer MD asks: 

In Canada, private-sector health care is growing. Dr. Day estimates that 50,000 people are seen at private clinics every year in British Columbia. According to the New York Times, a private clinic opens at a rate of about one a week across the country. Public-private partnerships, once a taboo topic, are embraced by provincial governments.
In the United Kingdom, where socialized medicine was established after World War II through the National Health Service, the present Labour government has introduced a choice in surgeries by allowing patients to choose among facilities, often including private ones. Even in Sweden, the government has turned over services to the private sector.
Americans need to ask a basic question: Why are they rushing into a system of government-dominated health care when the very countries that have experienced it for so long are backing away?  http://forums.wsj.com/viewtopic.php?t=6173
Published
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on June 12, 2009
in Healthcare, Opinion and Reform
. 1 Comment

If Bernard Madoff Were a Doctor

Dr. Kate Scannell compares disgraced financier Bernie Madoff to pharmaceutical shill, Scott S. Reuben, MD: 

In an analogous manner, the story of Dr. Scott S. Reuben tells the tale of one man who, in pursuit of personal gain, harmed huge segments of our nation’s health care system. That he could get away with falsifying pharmaceutical research and medical publications on such a massive scale over many years also tells a larger story about our nation’s medical research industrial complex. 

That complex — the enormous, poorly regulated, financially incestuous and opaque system that generates and disseminates the medical information we use to determine health care for patients — is similarly structured to allow individuals and privileged industries to profit through backroom deals. 

A few days ago, it was widely reported that Reuben, an anesthesiologist in Massachusetts and a faculty member of Tufts’ medical school, had falsified at least 21 of his 72 published research studies. He simply made them up. 

Many of those fictional studies promoted the use of painkillers — like Pfizer’s Celebrex or Merck’s Vioxx — during orthopedic surgeries, highlighting yet another layer of his disgrace. Those drugs, known collectively as “COX-2″ drugs, have been suspected of causing severe side effects like heart attacks and strokes, and Vioxx was finally withdrawn from the market in 2004. 

As was reported in Scientific American, Reuben’s work tried to encourage surgeons to abandon use of older and less expensive anti-inflammatory painkillers in favor of newer and more expensive ones called “COX-2″ drugs. 

In addition to faking research, downplaying COX-2 side effects, and jacking up the cost of medical care, Reuben also profited from financial arrangements with Merck and Pfizer. Those relationships are hard to confirm in his publications, but you find evidence of them in odd places. For example, in a conference brochure (Reuben lectured widely to disseminate his “research”) you discover that he not only received “grants” from Merck and Pfizer, but that he was also on their for-hire speaker’s bureau.  

The rest of Dr. Scannell’s commentary is found at Inside Bay Area.

Published
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on March 15, 2009
in Opinion, Pharmaceutical and Reform
. 1 Comment