1994 ended with an explosion of union activities in most hospitals in St. Louis area. The health care workers are angry at the bad and dangerous situations in their respective hospitals due to staff reduction which has amounted to disasters for patient care and pressurized employees to hectic frustration. They have complained to hospital administrators with no sensible response. These workers are not against cutting cost to increase the revenue but are opposed to such action when it compromises quality of care and endangers employees lives. Cost containment is a battle ground for hospital business managers and medical staff. It is  difficult for business managers to comprehend the dangers inherent in hospital staff shortage.  Their main concern is increase profit thereby increasing their own salaries. The medical staff want to preserve the quality of care which is eroding very badly in many hospitals causing patient care to suffer. One St. Louis nurse said in response to dangerous staff shortage in hospitals, "The way they're cross training everybody to do everything, some hospitals may hire butchers to operate on patients instead of surgeons and house keepers to pass medicines instead of nurses as part of their cost containment measures."

Staff shortage and poor working conditions motivated many health care workers to join the unionization of their hospitals to protect them from the tyranny of abusive hospital managers. Mike Oniel, one of the co-founder of Association of American Health Care Professions said, "Many hospital workers are joining the union movement and the association is getting bigger everyday." The organization has expanded its activities by launching media campaigns on radios, newspapers, televisions and some have written books to educate public about disasters in hospital managements and the dangerous impact on patient care. This national outcry of nurses from St. Louis might have claimed its initial C.E.O casualties.

Before the C.E.O casualties, some angry physicians are speaking out about the management problems in hospitals and how it has negatively impacted their practice of medicine, some are seeking union representation while others are too afraid to talk. Many have complained about hefty salaries given to some C.E.Os with the highest recorded over twenty million dollars per year for the head of a health care delivery system. One St. Louis County surgeon complained, "How can we reduce cost of health care when some greedy C.E.Os are making millions per year while the insurance companies and government continue to reduce physicians' reimbursement?"

In the Commentary section of St. Louis Post Dispatch of September 9th, 1994, Dr. Lawrence Kahn, a professor of pediatrics from Washington University School of Medicine supported the single payer system of health care which is not socialized medicine but put more control of medicine in the hands of Physicians. He echoed the same problems by other physicians about seeking permission from insurance companies to treat patients under the present systems control by business managers. He believes the decisions about patient treatment should be left to a patient and his doctor not controlled by any managed care system or insurance companies.

Another article from St. Louis Post Dispatch of January 15th, 1995 by Ralph Dummit reported the frustration of Dr. Edmond B. Cabbabe, the president of St. Louis Metropolitan Medical Society that insurance companies, hospital net-work and other entrepreneurs threaten the medical profession. He indicated that physicians are given financial incentives to do the impossible task of reducing cost while trying to give quality care to their patients. Dr. Cabbabe revealed that in the past, good physicians get referrals, today withholding care could mean a hefty bonus at the end of the year.

A female physician in Boston had ovarian cancer. While in treatment, she tasted some of the horrible experiences some patients have endured. Her heart was touched on seeing the callousness with which some physicians related to their patients. On one occasion, she was supposed to spend thirty minutes in Xray department, she ended up spending two hours and was in tears when she left. Although she was terminal, she went back to medical school teaching medical students how to put humanity back in the treatment of their patients. Her story is not new, patients have complained about long waits in hospitals due to staff shortage.

Is it possible to put humanity back into medicine when care is already gone out of health care and replaced with a need for increase profit and the ego mania of business managers? We are in the age of mechanized and computerized medicine, the human touch is probably dead. Can it be resurrected?

Hospitals' C.E.O. Jobs Terminated

In the first week of January this year John T. Farrell, the C.E.O of St. John's Mercy Medical Center, one of the biggest hospitals in St. Louis located in Creve Coeur was let go. Two weeks after this, Paul Wunderlich a C.E.O. of St. Luke's Hospital, another big health care institution in St. Louis with almost 500 beds was let go and replaced temporarily with Dr. George Tucker for reasons not disclosed.

The cause of the abrupt termination of these C.E.O is not clear, but may not be unrelated to some physicians' anger and the serious management crises in some hospitals in St. Louis as depicted in a book "Overcoming the Invisible Crime" published by Lara Publication of St. Louis. The book discusses the serious crises in hospital managements, abuse of power by hospital business managers, health care workers driven insane with stress, callousness of some departmental heads, and decrease in the quality of care raising a national outcry! How many more patients will die?

A sick health Care System

Many health care consumers with insurance may be deluding themselves thinking they are saved within the systems that continue to shrink their options of care while making more money at the expense of people's welfare. In the opinion section of Riverfront Times of October 5th, 1994, Jake McCarthy implied that the health care system is sick and the major opposition to President Clinton's health care reforms are the big corporations and insurance companies who want the system to remain the same so they can continue to make their big buck. While opposing the President's proposal some health care institutions have already implemented their own reform by dangerously decreasing hospital stay after major surgery or child birth.

The real issue is, patient care is no longer in the hands of physicians, the business managers have taken over. This is a very dangerous trend public is unaware of. Nation magazine indicated that the accelerated corporate takeover of health care management in America from doctors and nurses and making medical decisions for profit is the extinction of both professionalism and medical altruism and the depersonalization of care.

"Overcoming the Invisible Crime" defines the abuse of power by corporate managers in health care industry. It also implies solutions by calling on physicians, health care workers and business managers to listen to each other and come up with ways to improve quality of care and reduce cost without endangering patients' and employees' welfare. We have technology to fix broken cars or machines, but none so far can fix a dead person. The recent demise of two C.E.O jobs in major hospitals in St. Louis may be the beginning of a come back for real physicians to take over medicine from hospital's business managers. How many more patients will die before changes are implemented in hospital management?

With all the bickering about poor quality care in some hospitals in St. Louis and across the nation due to staff shortage, JoAnn Ridgeway, a former hospital worker herself enjoyed a dose of a good medicine when she visited St. Mary's Hospital in Jefferson City, Missouri. She was very impressed at the excellent professionalism of the staff, their kindness and the joy with which they served their patients. "The hospital was immaculately clean, employees were happy and well staffed, it was a well run hospital," she said. JoAnn was so impressed about the service in the hospital being a St. Louisian, she therefore asked some of the workers the secrets of their excellent service. She was told they have an excellent hospital administrator who listens and works with the employees.

From my experience working in many hospitals in St. Louis, such administrators described in JoAnn's story are either very scarce or are yet to be born. Today's health care industry is dominated by big egos of callous managers where care is dead and money is king.

Report by 'Yinka Vidal, OUTCRY Magazine (first reported in March, 1995)