Has Ballad Health betrayed the citizens of NE TN and SW VA?

Published 1:25 pm Monday, June 26, 2023

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To the Editor:
“The only thing necessary for evil to triumph in the world is that good men do nothing.” (Adaption of Edmond Burke – author unknown.)
In the past, hospitals were organized by concerned citizens and physicians for the purpose of delivering healthcare. The primary emphasis was delivery of quality healthcare, without any objective of ”profit”.  Obviously, each hospital had to make enough to pay its bills and expand service, but making money was not the main objective.  With the complexities of health insurance, “big pharma”, government regulation, etc., many hospitals found it difficult to stay afloat. Enter “the villain” – “corporate medicine”.  Unfortunately, their whole emphasis seems to be “making money”.  Don’t be fooled by them being called “non-profits”.  That just means that surplus money does not go to shareholders or owners.  Instead, it goes to the top executives as salary, so that they get super exorbitant salaries, but consequently they must cut costs to make up for their salaries.  That means that services, personnel, and expansion suffer.  For example (reportedly): Ballad Health CEO Alan Levine’s annual compensation is $4.6 million; salary for CAO Marvin Eichorn is $1,140.425 + bonuses and for CFO Lynn Krutak is $1,026,003 + bonuses.  For that same amount of money, Ballad could hire (assuming “average TN salaries”) 33 physicians or 108 nurses or a combination of the two! Which benefits the community the most?  Since Ballad entered the picture, it appears as though there has been a  progressive decline in the number of physicians, nurses, services and facilities and an astronomical increase in executive compensation.  Do you believe that is a good trade-off?
In a reported short story:  a greedy corporate capitalist approached Michael Douglas and said “I loved your quote in the movie Wall Street ‘Greed is good!’ “.  Douglas reportedly responded, “I think you missed the point, I was theVILLAIN in that movie!”   Also, I believe that the greedy, self-serving capitalists would benefit from reading the story of Lazarus–not the more familiar one who was resurrected, but the one in Luke 16:19-31 and also Matthew 25: 31-46. Note: I am not against free Adam Smith capitalism, but I am against unfair business practices and monopolies.
My next point is that roughly 5-7 years ago, the people of NE Tennessee and SW Virginia went through a very long, protracted process to allow Ballad to become a monopoly.  It was rightfully feared that their having a monopoly would result in increased expenses and a decline in overall quality.  In spite of community protests, and apparent “FTC remonstrance” (Wally Hankwitz, MBA, LFACHE), with political maneuverings and other questionable practices, they managed to wrangle it through. In order to get the approval at the time, they made many promises to EXPAND healthcare services, especially in the rural areas.  I believe they have double-crossed ALL of us and done quite the opposite!!
Compared to about a decade ago, they have been closing down and trimming back services “everywhere” in the system, except  for Johnson City Medical Center.  There are significantly fewer physicians than before. They will claim that they have kept a number of hospitals open, but this is a ruse.  What they have done is taken previously fully functioning hospitals (i.e. with inpatient care, ICUs, ORs, obstetrics, etc.) and turned them into Urgent Care “patch and send to JCMC” stations. Examples are Johnson  County Community Hospital, Dickenson Community Hospital, etc.. Furthermore, Holston Valley Hospital previously was a Level 3 trauma center, but was downgraded and lost their Pediatric unit and NICU.  The operators and supervisors at Bristol Memorial don’t seem to know if they have been downgraded.  It appears as though EVERY facility in the system has been downgraded, except, JCMC. I believe this is unacceptable! Incidentally, the JCMC night supervisor doesn’t seem to know the difference between a Level 1 & 3 ICU and states JCMC is a Level 1!?  Note: loss of services or facilities begets further loss. For example, if a hospital loses an ICU, that limits what surgeries can be done there. Loss of a pulmonologist, cardiologist, neurologist, etc. limits one’s ICU.  Also, every physician wants to have other good, qualified physicians with other specialties around to “back him/her up”, and so forth. Since there has also been a major loss of physicians and nurses, those remaining personnel have to work understaffed and overworked with very high patient to healthcare provider ratios!  I highly commend those remaining behind, for enduring the adverse conditions. I do want to say that there are many very good physicians, nurses and other personnel working in the system in spite of what appears to be adverse conditions, but if they complain, they probably will be fired. The majority are still here because they have local ties to the area i.e. were born and raised here, have family here, spouse has a job here; etc.  A local Milligan nursing professor told me that graduates don’t want to work for Ballad due to their treatment by the administration, the adverse conditions under which they have to work and the pay.
Mr. Levine’s apparent philosophy is that EVERYTHING more than a minor illness or injury, should be sent to JCMC.  He wants to concentrate ALL the “experts/specialists” there claiming that’s the best system.  He ignores the inconvenience of having to travel long distances to go there. What happened to the initial promises of EXTENDING healthcare?  Furthermore, if you have an emergency in Erwin, you will be 2 hr. away, Roan Mountain — 2 hr. 15 min. away, Dickenson County — 95 min. away, Watauga Lake– 1 hr. away, Hampton — 30 min. away.  Don’t forget to add the time it takes to get to the hospital, sign in, fill out “paperwork”, get assessed, contact & wait for an ambulance, transport, more paperwork, vital signs by a nurse, and finally you may be seen by a physician, if readily available and not tied up with another patient. In other words, you very well may DIE!  Also, using Mr. Levine’s philosophy, maybe most of the patients should be sent to Vanderbilt which has many more specialists.
So how do they get away with all this?  I believe that it is by being sneaky, NON-transparent and using subterfuge. I also have to wonder if COPA is truly looking out for the healthcare of the area.  Recently, Ballad decided to close the ICU at Sycamore Shoals Hospital having previously eliminated all obstetrical services. They were not “transparent”, and tried to “sneak” it by.  They failed to make an obvious public announcement, such as in the paper, on the news, etc. and claimed to have announced it in some obscure location. Furthermore, although Mayor Patty Woodby was apparently aware of their plans, the commissioners were reportedly kept “in the dark”.  In the election, I thought she promised “transparency”?  The news of the planned ICU closure did leak out at the last minute, and Commissioner Angie Odom informed me two days before the Council Meeting.  I wrote a “confidential” (for her and the commissioners ONLY) email to Ms. Woodby voicing concerns and objections to closing the ICU.  I also warned her that if Ballad was communicating exclusively with her and/or making promises about aiding her political aspirations, she needed to be wary, because when they are done with you, they may “throw you under the bus” (based on experience).  In spite of denying any “collusion”, Ballad CEO Alan Levine emailed me withinhours of my sending the “confidential” (“NOT for Ballad”) email to Ms. Woodby.  I believe this was both unprofessional and immoral on Ms. Woodby’s part. Of note is the fact that Ms. Woodby NEVER answered my email.
Next came the TOTAL FARCE – the COPA meeting.  Although Ballad & Ms. Woodby tried to keep the meeting “under wraps”, the word got out and a very large number of people showed up to protest.  Unfortunately, I could not personally attend due to prior commitments.  What I was told, was that the meeting was held at a Ballad facility and directed & controlled by Ballad. (??unbiased??).  Then, reportedly ALL the “pro Ballad” speakers were allowed to speak, but only a “very small” number of “anti-Ballad” speakers were allowed to speak, and their time was severely limited.  Further, one observer felt that the COPA representatives really were not attentive.  A large number of “anti-Ballad” speakers were prevented from speaking, including a physician commissioner. Is the COPA Board TRULY looking out for the citizens? Does that sound fair or democratic?!?!  I don’t think so!
Since the meeting, there have been multiple excellent articles criticizing Ballad in the Elizabethton Star newspaper: May 20–Norma Morrison; June 14–Danielle Goodrich; June 17–Dr. Charlene Thomas.  Of interest is that it was reported to me by a Carter County Commissioner, that Carter County Commissioner Dr. Robert Acuff, who is a surgeon and WAS a Board of Directors member at Sycamore Shoals Hospital voiced some “mild” opposition to the closing of the ICU, and so was shortly “fired” from the Board.  That’s the way “big corporations” work: if you oppose them or voice a complaint, they fire you (ASFAD=A subject for another dissertation). Therefore, you won’t be able to get an honest opinion from any employee, even if they have major, valid healthcare concerns or grievances.  That is another problem: Ballad has been buying up many of the physicians’ practices so that they can “control them” and keep them quiet (ASFAD).  They also use their money to “shut up” the opposition (ASFAD).
I commented that Mr. Levine’s compensation was comparable to the CEOs of the Mayo Clinic, Johns Hopkins, etc. with inferior results.  He stated he apparently thinks that Ballad is “superior”!?  I do not think so! — Do you? He apparently has quite an ego!
Bottom-line: are Ballad & COPA fulfilling their obligations to the community? Take a hard look around!  How long does it take to get an appointment?  How long a wait is it before you can see a specialist, or is a specialist even available?  Although Holston Valley was previously listed in the hospital ratings of US News and World Report, NONE of Ballad’s hospitals are currently listed. The average Ballad facility ratings on Google are in the 2 range out of 5.  None of the hospitals got 3 or above ratings.  So many people I know go elsewhere for elective significant healthcare i.e. to Vanderbilt, Duke, Cleveland Clinic, etc..  I believe we deserve better, but will only get it if the citizens speak up and do not swallow Ballad’s bogus PR. They have a well-funded special PR Department–which is apparently the “Propaganda Department”).  I believe they should put more emphasis on QUALITY medical care rather than pseudo “public image”. I could give multiple examples, including personal experiences, of substandard care at Ballad, but ASFAD.
Citizens should contact:   (See initial quote!!  As pointed out, the employees cannot speak out, so the citizens MUST!  It is your healthcare that is at stake!)
1) COPA at:  tn.health@tn.gov   or mail: Tennessee Department of Health–COPA; 710 James Robert Parkway, Nashville, TN 37243.
2) Your County Commissioner
3) Carter County Mayor Patty Woodby–MAYBE she will answer you; she would not answer me.
Also, in the next election, remember how your “representatives” TRULY represented you. Or did they just look out for their own political ambitions as many – NOT ALL– politicians do (ASFAD).  Reportedly Todd Smith, Angie Odom, Donnie Cable, Ginger Holdren, Danny Deal and Lisa Childress did speak in favor of the citizens, but Ballad prevented Dr. Robert Acuff, Kelly Collins, Julie Guinn and Nancy Brown from doing so.
4) Federal Trade Commission:  https://www.ftc.gov  or mail: 600 Pennsylvania Avenue NW, Washington, DC 20580   (202) 326-2222
5) Send letters to your local newspaper.
6) If you would like to send me relevant information, including negative experiences:  SV.4Truth.GJSB@yahoo.com
Note: This letter will be sent to the major newspapers in the area.  Please make note of which ones publish it and which ones do not.
P.S. After this letter, I don’t think I will be on Mr. Levine’s gift list, and if I “mysteriously” die in a Ballad facility, please notify the FBI.
Steven Vest, MD, FACG, FACP, AGAF
Former member of Norton Community Hospital’s Board of Directors

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