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Location: Central Bay Area, CA as of Jan 2010...but still a proud Texan from Houston!
7,484 posts, read 10,448,062 times
Reputation: 8955
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MOD CUT
Quote:
Originally Posted by TVC15;28162840[B
Ok so you want to go with your rankings link[/b]. Top American Hospitals - US News Best HospitalsFine makes no difference to me. So in doing that you will find that out of the 16 Adult Specialties the TMC ranks higher than UCSF and Stanford in most of those specialties. Here are the rankings from your link. TMC is looking good!
MOD CUT
Remember when you said this...
Quote:
Originally Posted by nullgeo
I posted rankings ... you posted P.R. and pom-poms.
So using your link (the rankings link ^) vs. my so called "P.R. and pom-poms". I was able to demonstrate that UCSF and certainly Stanford don't measure up to the TMC. And that the TMC does indeed out rank both UCSF and Stanford.
That's a no brainer but nice try! At least try to understand the rankings link thatyou posted before trying to use it to one up someone.
Hang it up old man you seem to be very confused.
Also hang it up in trying to project your image onto me...it is not me but you who clearly can't even follow the most basic standards of research and reporting. Also it is you who can't even follow posts to keep a coherent thread flowing.
Thanks TrueTimbers...you and I both agree that CA certainly needs the help to clean up the 3rd world hospital lab standards...thank goodness that not all of us are blinded by the hype!
BTW Null what about these links do you not understand
Here we see a third-world ambulance on its way to the third-world hospital. Just like California, yep. Such drama.
If anyone ever called me to request authorization to transfer a patient into those conditions I'd deny it no questions asked.
I find no reasonable reason to find that CA is 20 years behind Texas in any category (much less lab standards), nor doing 3rd world medicine, even adjusting for the hyperbole of a Texan.
I would be beyond interested if we actually were practicing 3rd world medicine as we pay the bills and want the best outcomes possible to limit the size of any potential settlement. Pay now or pay more later basically.
I can find plenty of hits on fines in Texas as well, just to lazy to post em up.
And using a statewide network (kinda sounds like Kaiser to me) to compare to 2 fine institutions in Northern CA is also unreasonable.
As a sidenote I found out that Fresno Community Hospital (county contract) has a charity that covers low income people. They work hand in hand with the county people who administer medi-cal.
If you are in Fresno Community Hospital and can't pay your bill they send around a social worker to determine what you qualify for and make the appropriate referalls. I imagine they do similar things in the bay area.
Now then, to comment on best industry standards in labs which TVC claims to be an expert on. If they are so bad, work harder as we seem to be paying you for that. We pay the lab bills which the labs and hospitals might use some cashola on to pay your consulting fees if ya wonder how I came to that conclusion.
So, these hospitals have labs. And they have to comply with state, local and federal regulations on their way to establishing these standards that lead to reliable testing results. Industry typically tries to adhere to best industry standards and even gain additional certifications to show their adherance and reliability. I find it impossible that Texas would be 20 years ahead or that we practice 3rd world medicine in a general sense given these general regulatory requirements and industry standards.
I'm still kinda lazy and not going to point out all the CA hospitals that rank ahead of TMC network hospitals across multiple categories. Which also includes hospitals that are generally part of the UC system, such as UCLA medical center.
By and large, people can choose where to live. Chicago, New York and many of the big cities in California offer more to the people who want to live there so competition for space is tougher and people are willing to pay more. When did the Obama haters start being so anti-free market? South Dakota has plenty of jobs and low cost of living but who the hell wants to live In South Dakota.
Location: Central Bay Area, CA as of Jan 2010...but still a proud Texan from Houston!
7,484 posts, read 10,448,062 times
Reputation: 8955
Quote:
Originally Posted by Senno
I find no reasonable reason to find that CA is 20 years behind Texas in any category (much less lab standards), nor doing 3rd world medicine, even adjusting for the hyperbole of a Texan.
When you are going to address what I say at least get it right. I said the Bay Area hospitals that I have come across in my Consulting are 20 years behind the TMC in compliance standards.
Quote:
Originally Posted by Senno
I would be beyond interested if we actually were practicing 3rd world medicine as we pay the bills and want the best outcomes possible to limit the size of any potential settlement. Pay now or pay more later basically.
Sorry you're not up to what is happening in the hospital labs in CA. The internet can be your friend
Quote:
Originally Posted by Senno
And using a statewide network (kinda sounds like Kaiser to me) to compare to 2 fine institutions in Northern CA is also unreasonable.
What is unreasonable about it? You guys are screaming up and down like children that UCSF and Stanford are so far above TMC and I used the current rankings to show that they are not even in the same league. There should have been no debate about this...it is a given. Neither of these two Bay Area hospitals holds a candle to the TMC. It’s a no brainer. I am amazed that this even has to be explained...but hey you Californians really don't know much about the rest of the US especially TX.
Quote:
Originally Posted by Senno
So, these hospitals have labs. And they have to comply with state, local and federal regulations on their way to establishing these standards that lead to reliable testing results. Industry typically tries to adhere to best industry standards and even gain additional certifications to show their adherance and reliability. I find it impossible that Texas would be 20 years ahead or that we practice 3rd world medicine in a general sense given these general requirements and industry standards.
No these labs are required by law to follow CLIA and FDA regulations but the problem here is that they don't. Sadly most in the lab don't have a clue about the actual laws....yes that is unbelievable! My training at M.D. Anderson and in the TMC included all of these Laws. Labs are supposed to be structured around these laws.
Yes third world to the max!
Here are a few examples: And every single one of these in written in CLIA. Look it up online.
Poorly written or out dated or completely missing SOP's. i.e. They were never written.
CLS's that don't know how to analyze a CBC blood smear.
CLS's that fail to understand that you are to make a slide of the CBC and review it under the microscope if the CBC analyzer flags you to do so. I have witnessed a CLS that did not make a smear on a flagged specimen and just released the results to the ER. The patient had a normal looking CBC but a flag for suspect Immature Neutrophils. They did not make a smear and released what appeared to be a normal CBC to the ER doctor. I pointed it out to a senior CLS who performed a smear and guess what she found? 70% Immature Granulocytes! She had to send a corrected report to the ER doctor. Imagine how long this has been going on at this hospital? How many missed diagnoses due to this poor level of laboratory standards? Doctors make 60-70% of all medical decisions based on lab reports.
This is UNHEARD of where I come from! You would not have a job at M.D. Anderson or any good hospital lab if you did this.
CA hospitals are full of CLS's that went to school in other countries...thus English is their second language. They have zero technical ability and zero critical thinking skills. I was told by one Lab Director that they have to write their SOP's with an 8th grade level of English due to all of the ESL CLS's Again UNHEARD OF!!! Most technical words are not 8th grade level words.
CLS's that don't understand proper maintenance of the analyzers or handling of the reagents.
CLS's that don't check the expiration date on a reagent or understand the opened expiration date. It is simple to just read the package insert to understand how to handle reagents...but not here. I have never once come across a hospital CLS that has ever read a reagent package insert. I have found expired reagents being used. I have found open reagents with no opened date written on it.
One large reference lab last year received 37 citations. This lab was almost shut down...actually half of their instrumentation line was shut down by the inspectors....guess why? The person performing the high complexity testing was a GED from Jamaica!!! No college degree and no CA CLS license...actually having a CLS license does not mean much here in terms of you being qualified to perform your job correctly...but is required to work in the labs. And you can't imagine what the other 37 citations involved!
I have observed improper cell counting and spinal fluid counting techniques. Unbelievable!
I have found equipment that has NEVER had maintenance performed on it or properly cleaned.
Pipettes and centrifuges in use that have never been calibrated.
Labs that don't require CLS's to read the User Manuel for every single test that they perform as well as every analyzer they work with. Or understand the principal behind the test. That is what they supposedly were taught in school. Not sure what they teach them in the Philippines
I can list pages of what I come across...this is just barely scratching the surface. However it is the same story in every single lab that I consult with. CLS's from 3rd world countries that appear to have no technical background performing high complexity testing in the labs.
I have never in my entire life observed anything like this. It was the most shocking thing to have come across in my career. I never thought I would find third world standards in the Bay Area labs. But sadly it is rampant here.
Everything I have listed can be found in the CLIA Law which is online. You would think that these poorly run labs would make it a requirement for all of the CLS's to read before they can work there...but CLIA is not written with an 8th grade level of grammar...so most of it will not be understood by those with ESL. Besides they don't require them to even read the Manufacture Package Inserts or the Instrument User Guides.
And about working harder....my job is to consult it is the Labs job to do the work fixing their mess. Some of them just flat out don't listen and it results in this CDPH Issues 12 Penalties to California Hospitals
I do an outstanding job but even some of these labs are being run by the same folks that held 3rd world standards 20 years ago and then moved up in rank to the Lab Director...see this horrible cycle that has occured in CA. There is a very shocking story as to how this all came about in CA and you can thank LFS for it. Also ask some of the Lab Directors why the standards are so low here in CA...most know the story. And you know what they say when the cat's away the mice will play. When I am not standing there most go back to third world ways.
BTW I only get the call to help them once they are cited.
I never in my wildest dreams thought that I would see these types of standards. It is going to take 20 years to undo what has happened here in CA. It is only in the beginning stages.
As someone who currently lives in the lone star state, I can say good for the California Gov. Rick Perry is a man who is not to be trusted. For instance, the man is toll-road happy. He and his administration have created numerous toll roads in the Austin and Houston areas without the consent of the locals.
It has been speculated that he has done this due to the fact that Austin is the "bluest" city in Texas. Personally, I believe it. Yes Texas' economy is doing fairly well, but it is NOT because of Rick Perry.
The fact that Perry is trying to poach jobs from California confirms to me what kind of man he is: A dirtbag who is trying to make a pathetic last ditch effort to try and get a 4th term as governor of TX, which IMHO, isn't going to happen.
I personally want to see California's economy get better and not because I plan on moving back there soon!
Ive never cared for Rick Perry, he's always seemed a bit dumb and a bit sleezy to me. The economy was in fine shape under Bush, long before Perry came to office and the state did fine through the recession in spite of Perry.
I dont like the poaching campaings by Perry one bit. It just doesnt sit right with me. If Texas is doing well, it will do well on its own and by the strength of its people not the governor.
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Give it up Senno. Look at this UCSF AGAIN...they just don't learn do they? 
