I have received correspondence concerning my previous letter to The Forum, which I would like to share.
Thank you to both parties for their review of my concerns.
As of this date, my wife’s and my schedules have not allowed us to make personal contact for an appointment with Ms. Heismeyer, though we do hope to do so in the very near future.
Again, thank you to both for responding.
Gene Gardner
Moran, Kan.
ACH strives to please
Dear Mr. Gardner,
Please allow me the opportunity to respond to the letter to the editor that was printed in last night’s Iola Register. First let me say that I’m sorry you have had less than optimal experiences with Allen County Hospital. It is always my goal to exceed your expectations.
We staff our Emergency Department 24 hours per day with a provider (either a physician or a “mid-level” provider). Allen County Hospital’s mid-level pro-viders are either a physician’s assistant or registered nurse practitioner. The medical records of all patients seen by a mid-level provider are reviewed by an Emergency Department physician to assure the appropriate standard of care is delivered. I asked Dr. Tim Spears to review your matter from a medical care perspective; his letter is attached. Additionally, I wanted to share that federal requirements are such that we must have physician to physician communication and acceptance before a patient may be transferred to another facility. Furthermore, mid-level providers are required to speak to the patient’s primary care physician prior to transferring a patient. While we always comply with federal requirements we strive to assure that this process does not delay a patient transfer.
I asked our Patient Accounting Department to investigate the billing issues you addressed in your letter. They were not able to find where a bill was sent after the account was paid, nor could they find where there was a gap in billing of two years. I would invite you to meet with me so I can investigate this issue further. I want to better understand your issues and how we can prevent this from occurring in the future. If you would like to meet, please call me at 620-365-1021 so we can find a time we can get together.
Our mission at Allen County Hospital is to provide top quality healthcare to our community and to exceed the expectations of our patients. I want to always address issues as they are identified and work to assure they do not occur again. Thank you.
Sincerely,
Joyce Heismeyer,
chief executive officer
Allen County Hospita
Staff follows guidelines
As medical director of the emergency room at Allen County Hospital I would like to respond to the recent letter to the editor.
I have had the opportunity to work in multiple emergency rooms throughout my career. I do feel that the emergency room at Allen County Hospital provides excellent medical services. Our ER is staffed 24 hours a day, seven days a week by an ER provider, which is either a physician or a mid-level provider, which includes a nurse practitioner or a physician assistant.
As an ER provider, we are required to receive permission to transfer a patient from an accepting physician, and cannot transfer a patient without this acceptance. Most emergency rooms in rural communities are at least partially staffed by mid-levels. Prior to any transfer of the patient a mid-level is re-quired to obtain permission by the attending physician. We are fortunate in this community to have excellent providers with a lot of ER experience who give superior care.
I can certainly understand the concern of patient and their family when they feel that they have not had adequate care. We take these concerns seriously as we strive to continually improve the care that is given to our patients. Although I was not personally involved with this particular case, as with any patient care concern, I have reviewed the information.
When a patient presents to the emergency room with chest pain, even though these symptoms may sound like classical signs and symptoms of a heart attack or angina, there are multiple other medical problems that can present with similar symptoms. Typically if the symptoms are suggestive of a cardiac problem, this is treated as a cardiac issue and a workup is pursued. If the cardiac work-up, which typically includes an EKG, chest X-ray, and blood work for cardiac enzymes are normal, then, a decision has to be made.
Not all patients that present with chest pain are transferred to the cardiologist or kept in the hospital for observation. It is not unusual every day for multiple patients to present to the emergency room with chest pain, and it is not possible for every patient with a normal workup to be transferred to a cardiologist.
In retrospect, the right decision is always easy to make. We do wish as medical providers that we can always make the right decision, but we try to make the best decisions at that time with the information that we have. We do always suggest that the patient follows up with their primary care doctor and if they have further problems, that they follow up for re-evaluation. I do wish that we could satisfy every patient and have a good outcome with every visit but this is impossible for any emergency room. I do feel that we give excellent care at Allen County Hospital and will continue to strive to give excellent care.
Sincerely,
Tim Spears, D.O.
