HCFA administrator-nominee Thomas Scully apparently was no shrinking violet when it came to pursuing a job that promises to be fraught with challenges. "He aggressively sought it," says HHS Secretary Tommy Thompson, who will be Scully's boss should he be confirmed as chief of what Thompson describes as the government agency "everybody loves to hate."
Thompson ticked off his reasons for choosing Scully at a breakfast with reporters last week. The 43-year-old hospital association executive's unwavering interest in the post made the list, as did his broad experience. Scully served in the White House Office of Management and Budget under former President Bush and has been president and CEO of the Washington-based Federation of American Hospitals since 1995.
Thompson says Scully impressed him during their interview "because he was not satisfied with the status quo." The former Wisconsin governor also says he found Scully full of ideas on how to improve the giant healthcare payer, which Thompson says uses a computer system installed in 1970.
Finally, though, it didn't hurt that Scully has friends in high places. Thompson says he places a premium on Scully's strong rapport with policymakers. "If we are going to make the necessary changes for HCFA, I need somebody who is going to be able to go to Capitol Hill and articulate my vision, his vision and a vision to improve the overhaul of (HCFA)," Thompson says.
Cellular interference. As anyone who has been subjected to the private details of a cellular phone conversation on a crowded train or elevator can attest, the wireless world has intruded into public places in annoying ways. In hospitals, however, the ring, beep or buzz of a cell phone is not just a minor irritation but also a potential safety hazard, according to recent studies. Although evidence is not conclusive, hospitals are increasingly concerned about cell phone use, especially around sensitive medical devices.
At 250-bed Kalispell (Mont.) Regional Medical Center, administrators last month opted to ban cell phones entirely.
John Hyslip, the hospital's risk manager and safety officer, says he made the recommendation to the hospital's board after reading a January Mayo Clinic study. Researchers conducted 526 tests of 17 medical devices. The study found cell phones caused interference in seven of the devices in more than half of the tests.
Hyslip also said there have been three recent instances of unexplained interference with ventilators and infusion pumps at Kalispell Regional, although patients were not harmed in any of the incidents.
Jim Keller, director of the health devices group at Plymouth Meeting, Pa.-based Emergency Care Research Institute, which conducts independent tests of medical technologies, says hospitals are turning more frequently to his organization for advice.
"Our general recommendation is that they don't need to be totally banned," he says. "They can be used with restrictions." The ECRI recommends not using cell phones around critical-care areas in a hospital, which have more monitoring and life-support equipment.
Black residents boycott hospital. Evoking the racial grievances of his forefathers, John Marshall, M.D., a black family-practice physician living in the deep South, says he's been caught in the middle of a 21st century civil rights struggle.
Marshall's suspension in mid-February from practicing at 143-bed Sumter Regional Hospital in Americus, Ga., has led to a boycott by residents demanding the reinstatement of the popular doctor and the dismissal of hospital President Jerry Adams.
Black residents of Americus, a rural town of about 17,000 in southwest Georgia, have been picketing and boycotting the hospital since March 20.
Marshall, 55, the president of the local chapter of the National Association for the Advancement of Colored People, says his suspension was triggered by his complaints to hospital administrators about "unfair hiring practices" and racial discrimination at Sumter, where he has had privileges since 1986.
"They have gotten tired of me and my complaints," Marshall says, adding that the NAACP's campaign against alleged discrimination at the hospital began about the time he took over as the group's leader in 1995. He says hospital officials gave him only "very vague" information about the charges leading to his suspension. But he says they have nothing to do with issues of patient care.
Hospital spokesman Willie Faust declined to comment on Marshall's suspension, but he discounted allegations of discrimination at the hospital, saying that about 41% of its 760 employees are minorities. However, only four of the 52 doctors on staff are black.
"The hospital's policy does not tolerate discrimination. We're an (equal employment opportunity) organization," Faust says. "We support diversity within our organization, and we're committed to working in the best interests of the community."
A local newspaper, the Americus Times-Recorder, obtained hospital documents stating that Marshall was suspended because of "willful disregard of hospital policies and because (his) conduct requires that immediate action be taken to reduce the substantial likelihood of immediate injury or damage to the health or safety of any patient, employee or other person present in the hospital."