Board of Supervisors vs. Good Men and Women- August 16, 2005
- From: "LatinoManager" <beltran@xxxxxxxxxxxxxxxxxxxx>
- Date: 15 Aug 2005 20:00:29 -0700
Physician Leadership and Integrity
Posted 04/26/2004
Robert A. Beltran, MD, MBA
The principles of leadership and integrity addressed in Dr. Solyom's
commentary[1] are being challenged at the King-Drew Medical Center
(KDMC) in Los Angeles, California.[2] This academic medical center is
part of the county hospital system run by the Los Angeles County
Department of Health Services.
Los Angeles County has one of the largest uninsured populations,
numbering nearly 3 million, in the nation. The ethnic diversity
reflects the demographic challenges that will change the face of
medicine for the 21st century. Approximately 50% of the uninsured in
the county are cared for by the county hospital system.
KDMC has had a 14-year history of operational and periodic
quality-of-care issues. Most recently, 5 of 18 residency training
programs are experiencing accrediting deficiencies. Of the 5
residencies with deficiencies, 2 have lost accreditation (surgery and
radiology). On top of this, state and federal health agencies have
identified quality-of-care issues surrounding the deaths of 5 patients
and patient safety issues concerning another 11 patients.[3]
Physicians and the care they deliver at KDMC are being examined under a
microscope to ensure quality of care, patient safety, and community
confidence in the institution. The academic medical center is the only
minority academic hospital west of the Mississippi and was established
after the racial turmoil that occurred in 1965 in the black community
of Los Angeles.
At issue are the "standard" measurement and evaluation tools being
utilized to review the institution. The hospital serves primarily
uninsured poor Latinos and Blacks as its target population. Physicians
have raised the question whether a "one-size-fits-all" measurement
standard will appropriately capture the unique circumstances of their
patients vs utilizing specific quality and cultural/linguistic
competency measures for underserved and vulnerable populations that
will produce a clearer picture of the population that utilizes the
hospital.
The "moral and ethical fortitude" Dr. Solyom requests in his commentary
is being demonstrated by the physicians at KDMC in fighting to
resuscitate the institution as well as public confidence and integrity
of this minority academic medical center.
The minority community served by the hospital has some of the worst
health status measures in the Los Angeles county region and in the
nation. The current dismantling of the medical institution that serves
this community brings to light the need for "radical transformation and
emergency measures" called for in the conclusion of Dr. Solyom's
commentary.
Two quotes come to mind when reading Dr. Solyom's commentary:
"All that is necessary for the triumph of evil is for good men and
women to do nothing." -- Edmund Burke
"The greatest form of injustice is the inequality in healthcare."
-- Dr. Martin Luther King, Jr.
The sentinel question arises: are there any good men or women left in
medicine to champion social justice, fairness, equity, and equality for
all Americans?
References
1. Solyom AE. Leadership responsibilities and integrity of
physicians in healthcare. Commentary. Medscape General Medicine.
2004;6(1). Available at: http://www.medscape.com/viewarticle/471135.
Accessed April 9, 2004.
2. Calderon J, Beltran RA. The phoenix has risen but has failed to
thrive: hope on the horizon for King-Drew Medical Center. J Natl Med
Assoc. 2004;96:160-162.
3. Ornstein C, Hymon S. Repeated drug errors cited at King/Drew. Los
Angeles Times. March 17, 2004.
Related Links
Clinical Articles
Leadership Responsibilities and Integrity of Physicians in Healthcare
Leadership Responsibilities in Healthcare
Robert A. Beltran, MD, MBA, President, Latino Med Policy Institute, Los
Alamitos, California; email medicalquality@xxxxxxxxxxxxx
Disclosure: Robert A. Beltran, MD, MBA, has no significant financial
interests or relationships to disclose.
Medscape General Medicine. 2004;6(2):e29. ©2004 Medscape
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