Covert attack mounted on trauma center plan

July 12, 2008


Physicians and officials at French and Arroyo Grande hospitals have mounted a concerted but furtive effort to halt plans for an advanced (level-two) trauma center at Sierra Vista Hospital.

The behind-the-scenes maneuvering to torpedo Sierra Vista’s plan started only days after representatives of all three hospitals voted publicly to approve it. The proposed level-two trauma center is the centerpiece of a program prepared by a county consultant who contends the facility would save lives and attract more physicians to the county.

Last year, every trauma patient in the county (those with life-threatening injuries who were not transported to out-of-county trauma centers) ended up at Sierra Vista. Most of those were first routed through other hospitals, resulting in delays ranging from 90 minutes to 19 hours. Nevertheless, according to one French Hospital nurse, French and Arroyo Grande physicians and hospital officials do not want to forego the large fees collected for stabilizing those trauma patients before being transferred to Sierra Vista.

“We know for a fact it (a level-two trauma center) does save lives,” said the consultant, Diane Akers. “There is also a component that many permanent disabilities could be prevented by having a trauma designation.”

Lag time between a severe injury and treatment can mean the difference not only between life and death, but may be the factor determining if a patient will be permanently disabled.

To prevent delays, the designation of a level-two trauma center would create a system in which emergency personnel transport trauma patients directly to a trauma unit and summon the appropriate surgical and support staff.

In early 2008, the San Luis Obispo County Emergency Medical Services Agency (SLOEMSA) board voted to hire a trauma system consultant to provide an objective assessment of the county’s trauma system needs. Akers and her partner, Richard Narad, presented their assessment to the board in May.

While personnel from both Catholic Healthcare West’s (CHW) non-profit hospitals, French and Arroyo Grande, have shown interest in being designated level-three trauma units — a step down from a level-two unit — only Sierra Vista signed on to become a level-two trauma unit. The consultant concluded that multiple level-three facilities would have higher fixed and regulatory costs, while providing a lower level of care than a single level-two trauma unit.

During two board meetings, skeptics of the plan, all affiliates of French and Arroyo Grande hospitals, voiced concerns that Sierra Vista’s proposed designation might result in staffing shortages at their hospitals, and wondered if trauma centers improve mortality rates. Following discussions regarding those concerns, board members voted unanimously to recommend the county adopt the consultants’ recommendations.

Although representatives of CHW voted to approve the recommendation, French Hospital CEO Alan Iftiniuk and Arroyo Grande Hospital CEO Rick Castro immediately expressed concerns to Health Agency Director Jeff Hamm.

“Alan Iftiniuk and others have advised EMS to proceed cautiously and make sure a single level-two trauma center is the best for the county,” Hamm said. “If it pulls physicians away from their emergency rooms, it could have a negative impact. We are moving forward with our eyes open.”

Following his vote in favor of the consultant’s recommendation, French Hospital’s emergency department director and SLOEMSA board member Paul Christensen sent a letter to Hamm, with copies sent to three county supervisors, which articulates his opposition to a single level-two trauma center.

“My goal in writing this letter is to cut through the rhetoric and the politically charged arguments that develop when there are market share and financial issues on the table,” Christensen says in the July 2 letter.

Arroyo Grande’s emergency department director Carsten Zieger sent a letter to EMSA chairperson Rob Reid July 3 asking him to reject the level-two proposal.

“Should a plan for a single level-two trauma center be adopted by the SLO County Board of Supervisors, our ability to care for our patients will not only be eroded, but appropriate patients will be siphoned away from our facility for financial gain, regardless of the assurances of the EMSA medical director,” Zieger says in his letter.

Some proponents of the trauma unit claim those who oppose Sierra Vista’s plan are placing financial motivations above patient care.

“What the ER doctors do not want to give up is that without Sierra Vista receiving a level-two status, the patients go to the closest hospital, then are transferred to Sierra Vista, hence the emergency room docs and the CHW hospitals get to collect large fees to stabilize the patients,” said one French Hospital nurse who has asked to remain unnamed.

Representatives from French and Arroyo Grande hospitals did not return numerous requests for comment.

Christensen also asserted the consultants’ report is “largely misleading and out of date.” He claims that the number of patients who would benefit by the program, “167” per year, would be at the detriment of the remaining “99,833 patients.”

Selected by the board because of her qualifications, lack of conflicts of interest, and previous experience, Akers has created similar studies for eight other counties in California. Akers asserts she relied on current trauma theories while compiling her report.

“The bottom line is the current practices are from the American College of Surgeons’ most recent 2006 edition,” Akers said.

Akers’ report suggest the county investigate concerns that a level-two designation could negatively affecting area hospitals, though she says that she has “never seen that happen.”

“The ferocity of this is not commensurate with the issue,” Akers said. “It’s not that many patients.”

Akers added that health care is very complex, and that when hospitals focus on specialized care, patients ultimately benefit.

“Everyone can’t be everything,” Akers said. “When you see trauma again and again, you get experience and expertise.”

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By: Anonymous on 7/20/08


By: Anonymous on 7/19/08

Keep posting! I learn more from you than any other.

Please tell us the connection that congalton's wife has in all this. If there is a cover up we need to start another site to investigate this one.


By: Anonymous on 7/19/08

Remember Dr. Cristensen was in charge of the EMSA when they hired the consultant, the same consultant that he now wants to trash.

By: Anonymous on 7/19/08

French's spin team does two things, knock anyone who doesn't bow at their feet and throw lots of money at the media to sway opinion.

Congalton's wife has no financial ties to this story. Alan probably thinks that as Congalton’s wife, she should worry about ads for his show. He uses his ad dollars quite affectively to manipulate the press. Two years ago, when the New Times ran a story about French, he pulled ads. He then throws money at those not writing negatively about French. It is so narcissistic of him to think his power over the media is a financial conflict for Congalton's wife.

After the last article UNCSLO did, the French team made false claims on blogs about Karen and Dan's past history. Trash the messenger when the facts stand alone.

The story is that French hospital staff voted one way then did another thing behind the backs of the public. Trying to change this to be about a conflict of interest is the usual French Hospital underhanded spin.

Please, someone from French address the issue.

By: Anonymous on 7/19/08

congalton's wife was a advertising grunt for Cuesta and got fired. What the hell qualifies her to be the counties EMS director.

There is a hot story for USLO if I ever saw one. But then she is under the same blanket of protection of USLO that they bitch about others being under in the issues they DO investigate.

Something is very very fishy here. Who will investigate this story? A nickle to your dolalr says nobody will. Scam!

By: Anonymous on 7/18/08

How does the story cover up for Congalton's wife? Is she behind the vote than the change of attitude? How is that tied into UNCSLO? More.

By: Anonymous on 7/18/08

SLO-EMSA Executive Director (Dave Congalton's wife)

Please tell me anonymous is wrong! If this is true the scandal is with USLO covering up for a pal.

Oh! This is so wrong…

By: Anonymous on 7/18/08

The Tribune Editors should have credited for breaking this story days ago!

By: Anonymous on 7/18/08

OK, thankfully, it turned out to be computer glitch time at The Trib. Rest of the article is now online. Check it out.

Key question raised again in this article: If French and AG hospital were so opposed to a trauma center, why did they vote to support the designation at the meeting? Very suspicious.

By: Anonymous on 7/18/08

I was reading the Tribune web site a little after midnight on Friday morning and I noticed they had a story about the trauma center debate. Of course, they're a few days behind the UncoveredSLO story, but better late than never. Perhaps they have new information, or a different take.

I kid you not. Here is the entire story they posted. The whole story:

"SLO County Health Care

Hospitals fight trauma center plan

French and Arroyo officials say a recommendation for the designation sought by Sierra Vista is flawed; now they’re being accused of undermining the rival

By Stephen Curran

Read French Hospital's formal response to the proposed trauma center

French Hospital Medical Center and Arroyo Grande Community Hospital have challenged a report that urges the county to pursue plans for a consolidated trauma center, prompting accusations that they are trying to undermine a competitor’s expansion plans.

In a letter sent Tuesday to the county Emergency Medical Services Agency, executives and physicians from the two hospitals strongly criticized a trauma assessment released in May by Bay Area consultant Diane Akers. They say her recommendation supporting a level II trauma center relied on flawed data that did not adequately reflect local demographics.

Proponents say the trauma center would provide more streamlined access to critical care for victims of severe car wrecks, fires and other events."

Three paragraphs. That's it. There's got to be a glitch in the Tribune computer system and the rest of Curran's article is missing. This can't be it — three paragraphs and a link to the letter that French sent to the EMSA.

It would be extremely disturbing to the community if this turned out to be the entire article — for what is says is that the Tribune is letting one of its biggest advertisers have complete editorial control and publicly make accusations unchallenged by the reporter. If all they're going to do is post the French letter, then the Tribune has hit a new low point.

So let's hope when we wake up in the morning, the rest of the article is there.

By: Anonymous on 7/17/08

The CHW gang is attempting to be oh so clever here, hiding behind Anonymous postings and bringing up this excuse and that excuse.

However, the main facts of the story can't be denied or dismissed away:

(1) The outside expert consultant, with no ties to any local hospital, recommends a Level II Trauma Center for the county.

(2) All the local hospitals and doctors who were at the EMSA meeting agreed to accept the report. There was not a single dissent.

(3) Paul, who really should consider retiring, suddenly goes on a personal jihad and tries to sabotage the proposal with a petty, vindictive writing campaign, no doubt on marching orders from Little Napoleon himself.

CHW is playing politics with people's lives. Pure and simple.

So Paul, my friend, how do you sleep at night? My how you have changed.

By: Anonymous on 7/17/08

Since Karen is so interested in naming names, I wonder why she didn't name these folks?

SLO-EMSA Medial Director (Sierra Vista ER Doc)

SLO-EMSA Executive Director (Dave Congalton's wife)

Print those names and their financial ties to the situation Karen.

By: Anonymous on 7/16/08

We should all give thanks to Uncovered SLO, French and Dr Cristensen all gave a public position then they were sneaky and went behind the EMSA's back to blast the project. Without Uncovered SLO we would have never heard about any of this only what we read in the Tribune and we all know who they bow down to.

By: Anonymous on 7/16/08

ho does the Seep think they are kidding. Why didn't this argument come up during the meetings where it could have initiated a dialogue amoung the professionals and the consultants? Nice Spin but take it someplace else. We the people are smarter than yu politians.

By: Anonymous on 7/16/08

Hey ER Doc, you are a poor hourly paid Doc, Did you forget to mention that as an independent contractor you are paid by the hour to just show up in the ER but you also bill the patients for all of the services you provide.

You said that all the hospitals have the same docs on call but you did not mention only one hospital Sierra Vista has the specilists on paid call so they are garrenteed to be in the ER within 20 minutes of being called, your on call Docs come in if they want and usually only if the patient has insurance.

This is why the 2 not for profit hospitals account for only 28% of charitable care in the county.

By: Anonymous on 7/16/08

Put down the Kool-Aid!

By: Anonymous on 7/16/08

What the Seep doesn't explain is why Dr. Christensen hasn't been consistent on the trauma center issue. If he was that concerned, if he was that much against it, why did he not speak up at the public meeting, when the reporter from the Tribune was there? And why didn't the CEO of French speak up?

I suspect because the media was covering the meeting, no one from French or AGH wanted to appear to be anti trauma center.

Instead, they're mounting an intense letter writing campaign under the radar.

How ethical is that? If you're opposed to a trauma center and you think you can make the argument, THEN DO IT IN PUBLIC, BE CONSISTENT, AND SHOW SOME MORAL COURAGE.

This is not about protecting one's turf. This should be about providing the best system of emergency care in the county.

There is no reason to beat up on Karen and Dan for reporting this story, accusing them of merely trying to stir things up. They're doing the job the Tribune refuses to do and I'm thankful they're doing it.

By: Anonymous on 7/15/08

The report was from a non-biased source. I find it hard to believe the docs in our county are destitute. Even if, is that a reason to risk lives to make more money?

The board meets on Thursday. I wonder what the other board members will think of Paul Christensen voting yes in public than going behind their backs to mount a counter attack?

By: Anonymous on 7/15/08

Lets all be frank here it is about keeping revenue at French to fund the CEO's million dollar salary not about what is good for the county and preventing disabilities and saving lives.

The consultants report is on the EMSA's website I urge everyone to read it.

By: Anonymous on 7/15/08

To One More Reason: I beg to differ with you, but when I had to utilize the ER I went to TCCH because I am in the NC. If happened to be at around midnight, so no wait BUT there was absolutely no personality except for the kind lady taking my information. I was given two pills and I went home. I received a bill from them (even though I have insurance) of $1000.00 for the ER and $98.00 for two Zantac tabs. Yikes!! Unfortunately, I had to return to the ER the next evening and went to French. The care was amazing, I was in and out with extreme efficiency AND the bill I received was l/3rd that of TCCH. I don't want this to be all amount $ but the level of care was so much better. I find no comparison.

By: Anonymous on 7/15/08

I need to point out a few major flaws in the arguments here. For one, Velie's article is clearly meant to inflame people, I would like to know how the 4 letters sent by Dr. Christensen to the Health Agency and the County Supervisors is a "furtive" or "covert" attempt at disagreeing with the consultant's recommendation. It is following standard procedures to try to avert a policy that could be a detriment to patient care.

Another huge problem with the way many people are interpreting the issue is the assumption that it is black and white, that there are "good guys" and "bad guys". Determining whether or not a designated trauma center is appropriate for our community is a complicated problem – there is bias from all sides, even the consultant.

The consultant's job is to determine the best hospital to be a trauma center, not what is the best overall trauma plan for the county, of course she will choose Sierra, it is the only one that has agreed to pay the Neurosurgeons to practice there. Many of us, through training, and experience, feel that the current trauma plan, where all hospitals participate, sharing patient load and specialty coverage, and being geographically dispersed throughout the county to allow for shorter transport times. You may not realize, that the same surgeons are on call for the entire county, and it doesn't matter which hospital you go to, you'll probably end up with the same Dr. depending on the night. Also, the consultant is not a trauma or an ER physician and is not from our area, having little to no insight into our regional challenges. Her views were automatically, although I'm sure unintentionally biased in dealing with the county EMSA, who is headed by a physician from Sierra Vista, the entity that has the most to gain from this plan.

The only "bad guys" in medicine these days are many insurance companies. Hospitals are just trying to stay afloat, local physicians can barely afford to own a house and keep their practiced open, and nurses that train here are leaving for the bay area where they get paid almost double. I find it very disheartening to hear people's thoughts of the medical profession. We are, for the most part, here to help and to heal people, taking care of you in your times of need. Despite being cursed at, spit on, insulted, swung at, doused in bodily fluids, dealing with impatient and rude people who think that they're more important than the next sick person, keeping ridiculous hours, having to wade through bureaucracy, being constantly threatened with lawsuits, and other daily travails, we still return to the fold, continuing to do our best to help the people that come to us. Luckily, much of the population here on the central coast are kind and understanding, and appreciate our care, and these are the rewards that keep us going. Somehow much of the public seems to think that we are "out to get them", that we are greedy, rich, and are always trying to make more money. The reality is, I get paid by the hour just like most of you, and when I'm done paying my school loans (13 years worth), my mortgage, bills, and taxes, my wife and I don't have much left, just like everyone else.

I don't care if French or AG hospitals lose patients to a designated trauma center at Sierra and I don't have any "talking points", what I do care about is the patients of this community. If I didn't, I'd pick another job. From my 5 years here and my Emergency training, my conclusion, which is independently the same as Dr. Christensen, Dr. Zieger, and many other specialists, is that a level II trauma center at Sierra is a bad idea. Although it may help a handful of neurosurgical patients a year, it will be a detriment and possibly a lethal decision for dozens of other patients that will be subjected to longer transport times and delayed care. I flew on New England Lifeflight for 3 years as a flight doc and know that helicopter transport, although the gold standard for some situations, can actually be slower and more cumbersome in certain regions depending on your population distribution and where your hospitals are, much like SLO county.

Say what you will, but realize that this is a very complicated issue that is not helped by inflammatory articles, narrow-minded critiques, and one-sided viewpoints. For the most part, the people involved on both sides are simply trying to promote a county-wide trauma plan that will allow for the best and safest care of all of you.

By: Anonymous on 7/15/08

It is very interesting to read about the problems faced by the county citizens regarding level of care.

I live in El Paso, TX where we are faced with body serches and limited access to county hospitals because police officers shot in Mexico are brought to the hospital because they can not be provided with life saving care and protection in Juarez, Chihuahua Mexico.

Mexico pays for the health care, we pay for the protection. Out of 13 police officers brought to El Paso, 7 were U.S. Citizens??? I found out that their mothers came for delivery in the USA giving their childern US citizenship which they did not care about until it comes to shopping and emergancy medical care.

I am glad to see that you do not have gang or drug crime requiring hospitals to have immediate trauma centers. I wonder what those involved in this issue would do.

By: Anonymous on 7/15/08

There is little doubt that "ER Doc" works at French Hospital or maybe AG. Every single issue he/she raised has been addressed by the outside consultant. All of the hospitals voted to accept the report. All of their attacks have been covert. It's sad to see how medicine gets practiced up close.

By: Anonymous on 7/15/08

Here id a little history, Marion Medical center also owned by CHW had a prop. on the last ballot to add a $35 dollar fee to every piece of property in S.B. county to raise 5.3 million a year to fund a level 2 trauma center. It did not pass but they thought it was good enough for their county to try get the tax payers to pay for it. I guess the patients in SLO county do not deserve the same thing but with a private hospital willing to front the bill for it.

French and Arroyo Grande do not meet the needs of the county, see the Tribune article earlier this year showing the 2 hospitals only only cover 28% of uncompensated care in the county while the for profit hospitals cover 72%

Is there any question of CHWs motivation

By: Anonymous on 7/15/08

Hi ER Doc, you have done very well you have followed the talking points from French to the letter.

By: Anonymous on 7/15/08

Gee, the consultant is wrong, this is a consultant that deal with trauma centers. Hey ER Doc where do you practice, let me guess.

The addition of the heliport at Sierra Vista, see the Monday Tribune article, will certainly improve the speed.

By: Anonymous on 7/15/08

I am slightly intrigued at the comments suggesting that a single level II trauma center in our community would result in any improvement in patient outcomes in our are. First off, studies showing benefit of trauma centers have largely been focused on centers with 24 hour in house surgical care- we do not have this in our county. Secondly, to address the neurosurgical concerns, traumatic bleeds, requiring acute interventions also require an on hand surgical staff and an open OR which usually take at least 1/2 hour to arrang.. transport times from Twin Cities and Arroyo Grande are significantly less than this. Thirdly, ocular and plastics traumas are exclusively taken care of at French hospital which requires transport from Sierra to French. Fourthly, a large portion of the counties traumas are occuring in either the Twin Cities or Arroyo Grande catchment areas, a centralized trauma center results in increased transport times. In reality very few of our county traumas require emergent surgery, and of those that are unstable and require surgery far and away the most important initial necessity is blood transfusions which can be rapidly started at any local facility, chest decompression which can be done at any local department as well, in addition all local facilities have available operating rooms and on call surgeons-most who cover all of the areas hospitals allowing for surgical care to be obtained in an equally timely fashion regardless of the recieving facility. Lastly, the consultants are not farmiliar with our particular areas needs and drawbacks and were hired under the direction of a County EMS director who works primarly at Sierra Vista. In realkize that this article is written in an attempt to stir the pot but obviously is written by an individual with absolutely no insight into the complexities of regional trauma care.

By: Anonymous on 7/14/08

Been hearing that for….let's see…forever

By: Anonymous on 7/14/08

Please. Do not post using other people's names. It is not only unfair; it is classless. It will not be tolerated.

By: Anonymous on 7/14/08

Thanks Karen & Dan for another good story that SLO County residents should care about. This can have a effect on anyone one of us at any time. I for one find it outrageous that French Hospital would try to block a trauma center over politics and market share. We are talking about the health and well being of our loved ones and ourselves. Keep up the good work and hopefully the board of supervisors are now better informed.

By: Anonymous on 7/14/08

We all need to vote and to get at least 10 other people to vote in this years New Times poll about the best blog in SLO county!

That award will do great things foir the popularity of this site and help Dan & karen get the needed revenues to continue their great work.

Kudos to Dan & Karen and to UCSLO…which will be "Best blog in SLO county 2008!

By: Anonymous on 7/14/08

First, Sierra Vista is PIT, it is a dirty old building, the staff match the lighting, dim. Hospitals here cannot even be laughed at, it is a 3rd world country compared to Boston or New York. As long as this area is rated as rural there won't be any better healthcare. The insurance companies and the government don't pay as much to a Dr. here as they do in a real city. I'm sure as the already aging population here gets older, something will be done. SLO may become an agricultural community once again, only this time harvesting organs.

By: Anonymous on 7/14/08

Getting the right care in the first hour or is vital, not just stabilized. Think about spinal cord and head injuries. Sierra Vista is the only hospital with a neurology team. Almost every populated county has hospitals that specialize in certain medical care, and you are sent to the appropriate hospital, not just the closest. It is widely accepted that their is a substantial decrease in mortality rates from trauma following the designation of a trauma center. I would rather listen to the experts than those with a financial stake in the outcome.

By: Anonymous on 7/14/08

Everyone may be biased on this issue, but if our ER Doc below is correct, (1) why did the outside consultant reach the conclusion she did about a trauma center and (2) why did all the hospitals sign off on it in public? Speaking out of both sides of the mouth is what I find disturbing.

By: Anonymous on 7/14/08

Unfortunately everyone is biased on this one, but the proper decision is what's best for patient care. As an ER doc, we are trained and the literature shows that as a trauma patient, the faster you get to ANY tertiary care center, the better you chances of survival. Once you are stabilized, then you get transfered to a trauma center if need be. The vast majority of traumas in this county are from the lakes to the north or the dunes to the south. The extra 20-30 minutes it takes to get to the proposed Sierra Trauma Center instead of going to a closer Twin or AG is long enough to bleed out from your injuries, or suffocate because they couldn't intubate you in the field. The truth is, that because of our geography and patient populations, unfortunately a dedicated trauma center may do more harm than good. As for me, knowing that prolonged transport times are more dangerous than the lack of a trauma center, take me to the closest hospital, be it Twin, AG, French, or Sierra.

By: Anonymous on 7/13/08

Chip Visci's $400k salary.

There certainly are RICH


I noticed The Tribune is celebrating the GAY marriage/coupling thing in its "news" paper today!

By: Anonymous on 7/13/08

Yes, the Tribune did write a story aobut the original trauma center disucssion. Read the story. Where's the concern from CHW? In publoic, everyone's on board. Then the knives come out. Pathetic.

By: Anonymous on 7/13/08

The Trib ran a story on the vote not the backroom fighting.

By: Anonymous on 7/13/08

The Trib did run the story on the trauma plan on June 21.

By: Anonymous on 7/13/08

an atascadero blog will be coming in the near future.It's in the making and getting ready for the election.

By: Anonymous on 7/13/08

As "Thanks a Lot" points out, a story like this about French would never run in the Tribune. They're too big of an advertiser and the Tribune desperately needs $$$$$ now. Those full page ads help pay Chip Visci's $400k salary.

Good, important story. Hope Adam Hill investigates and demands answers from French. What a bunch of slimeballs. They're playing politics with our lives. That's the bottom line: a trauma center would save lives and French is doing everything possible to stop a trauma center.

By: Anonymous on 7/13/08

People can write whatever they want. True, not true, off subject, on subject, whatever!!!! Go Greyhounds!!!

By: Anonymous on 7/13/08

Try keeping to blogging on the article. Maybe Uslo can have another link for blogging about the site or for those who want to have other discissions

By: Anonymous on 7/13/08

We have lots of local blogs and feature type media sources. The watchdog function of media is dead in our county except for UNCSLO.

Those who call writing about the biggest financial mess our county has ever seen as north county gossip are probably tied into someone in the hot seat or a hospital. Bash the messenger and change the subject when no other come back will do.

UNCSLO will make it because of community support and a need for unbiased reporting.

By: Anonymous on 7/13/08

How do you like the new proposed name for this site?

We decided on this name because " was too long.

By: Anonymous on 7/13/08

To 'I Told You So'

You articulate the reason good investigative reporting is dying. You are part of the problem. I hope USLO tells you to suck wind! I think this site's bottom line is truthful reporting. This is not 'hate.' This is not 'attack' reporting. This site will survive and prosper. My prediction.

By: Anonymous on 7/13/08

This site needs to learn from the radical left websites and biased media. Hate does not sell. For me I'd rather have the $20,000 than to be begging for nickels.

Wise up and do what will bring in revenue first. You take care of yourself and the rest will follow or one day there will be some article about the end of this site as Karen and/or Dan got paying jobs from a more established company.

It's all economics…simple and pure.

The sewer man is begging for peanuts this site is doing the same and the Trib et all are raking in the bucks.

This needs a good rethinking with the bottom line in mind.

PS: Yes you can get a national issues blog anywhere. The point is you have to leave this site to do it. Traffic = money! Basic economics 101. Bring the bodies and the rest will fall into line without sacrificing the quality of the reporting.

If all you do is attack…folks will drift away. We have seen it happen.

I hope this wakes up and makes the changes necessary to thrive. If not the old adage still stands…bad news doesn't sell. You are missing a huge opportunity with this upcoming election to launch a well-planned thrust to increase income here. Don't stick your head in the sand on this one.

I have consulted for many companies over the years. You are doomed if you keep doing the same thing. Change is good and you don't have to compromise anything!

Take 15 minutes and discuss this.

By: Anonymous on 7/13/08

I wouldn't expect Sierra Vista to put the trauma unit in for altruistic reasons alone. They are not a non-profit hospital such as French and Arroyo Grande. Those two don't pay taxes and get donations because they are supposed to be focused on doing a public service.

It's not that SV has no want of monetary gain, it's that CHW hospitals would forego human lives to make a buck.

By: Anonymous on 7/13/08

Heh, heh, heh. This story appears on UNSLO Saturday, the Fibune has a full-page ad touting French in today's "newspaper" and earns about $10,000. The same thing happened years ago when Blackburn wrote a New Times article on a doctor named Pilch. Two full page ads in the Fib to rebut. Net? $20,000 to the liars. UNSLO unwittingly helps the Fibber. Irony?

By: Anonymous on 7/13/08

I think that some folks are just trying to point out that SV may not be wanting the trauma center for altruistic reasons. The corporate owners of hospitals definitely have an effect on their business operations.

By: Anonymous on 7/13/08

Arroyo Grande hospital is a joke.

By: Anonymous on 7/13/08

This blog site is here to respond to the article above it, that's it. Uslo is not on a rampage against Hurst or any other entity-they report the news as it develops. That is their mission and we are damn lucky they are doing just that.

Don't forget to donate so they can continue to let us know what is going on around here behind the scenes.

I'm not affiliated with Uslo in any way, I just dig what they do.

By: Anonymous on 7/12/08

I think Anonymous has a particularly valid point here. There are some pretty clear attempts to detract from the real story here by linking Tenet to scandals on the national level. Irrelevant to this story.

The outside consultant says bring in a trauma center. All the hospitals publicly support the idea, then gang up on Sierra Vista in private and try to smear people who get in the way.

Do not lose sight of the real story.

By: Anonymous on 7/12/08

Just another day in politics. Say this out of one side of your mouth and then that out of the other side of your mouth. Then go behind the scene and do all of your dirty work.

By: Anonymous on 7/12/08

Because Sierra Vista's parent company was found guilty of misdeeds, your saying it's ok for local CHW officals to say one thing in public and another behind closed doors, to make false statments, to attack anyone who does not agree with their plan, and to act unethically. What does one have to do with the other?

By: Anonymous on 7/12/08

In 2006, Tenet settled some of their fraud lawsuits involving overcharging Medicare (taxpayers like you and me) and paying kickbacks to physicians in California. Total settlement = $900 million.

That was just 2 years ago and it was the second largest Medicare fraud settlement in the history of the United States.

By: Anonymous on 7/12/08

It sure didn't take long for Alan Iftinuik's people to stick their heads out and do the predictable: (1) attack Karen Velie and (2) attack Tenet.

Attack, attack, attack. That's all they can do. When New Times ran an article critical of French Hospital, all the advertising was pulled in retaliation.

Make no mistake — these CHW folks are bullies and they'll stop at nothing.

By: Anonymous on 7/12/08

I Googled Tenet fraud and Catholic Healthcare fraud, they both come up with a handful of charges.

By: Anonymous on 7/12/08

Hey Karen Velie,

I'm not exactly sure why you suckle from the teet of Sierra Vista so much (this is your second non-story about CHW facilities), but why don't you have your readers Google "Tenet fraud" for once and see the track recond of the owners of Sierra Vista and Twin Cities.

Of course this is about money and the administrators at Tenet have been the greediest of the bunch – just look at their track record.

By: Anonymous on 7/12/08

French markets themselves as the county's leading heart care specialists. I don’t remember Sierra Vista complaining that they were getting more patients because of the specialty.

It’s ironic that their web site talks about the importance of getting care within the first hour after a heart attack.

By: Anonymous on 7/12/08

What do you bet we will see an ad in the Tribune from French or Arroyo Grande within the next few weeks. Money talks.

By: Anonymous on 7/12/08

This story is one more reason to avoid Arroyo Grande Hospital, the worst hosppital in the county. French isn't much better. If you're injured, just make damn sure the ambulance takes you directly to Sierra Vista.

Will we ever see this story in the Trib? Doubtful, given the way they fawn over French. Disgusting.

By: Anonymous on 7/12/08

This is an extremely troubling article. I intend to forward it to the county supes, Mr. Mecham and Mr. Hill.

Can you believe this? An expert consultant is brought in, proves the need for a certain level trauma center. All the local hospitals publicly applaud the idea because no one wants to be seen being against a trauma center and saving lives.

But once the media spotlight is turned off, these heartless S.O.B.'s mount a vicious, immoral, and unethical campaign to undercut Sierra Vista and keep them from getting a trauma center.

Unbelieveable. Unethical. Disgusting. So much for French Hospital specializing in issues of the heart. Now we know better.

By: Anonymous on 7/12/08

Why would Paul Christensen send the letter to only three supervisors? Is it not unethical for a board member to vote yes on something, then send another opinion to those that have the final say. A bit underhanded. Shame on you Paul.

By: Anonymous on 7/12/08

We can get national blogs else where. This is the only invesigative news source in SLO county.

Keep digging things up.

By: Anonymous on 7/12/08

You think our hospitals fighting over revenue while foregoing patient care is north county gossip?

Did you read the story?

By: Anonymous on 7/12/08

This site started off with a bang but has slowly sunk to a gossip site for north county.

Some guy had an idea about a local and national issues blog. I now thing it was a good idea.

We don't need some investigative article to shate out opinins. That would open this site to anyone south of Atascadero.

We'll see, I guess.

But, whatever you do please no more "send me money" articles by the sewer man…ok?

By: Anonymous on 7/12/08

It's all about greed and the almighty dollar-nothing else.

By: Anonymous on 7/12/08

So how does EFI, Hurst and Gearhart fit into the picture here, I thought this website's sole purpose was to bash those three?