Tuesday, February 20, 2024

Some Steward they turned out to be

Steward Health Care is a for-profit system that runs nine hospitals in Eastern Massachusetts, most of them disproportionately serving poorer segments of the population. 

Steward has fallen on hard times. Needless to say, the profiteers have been profiting, but there are threats that the system will be shuttering its Massachusetts hospitals, which will throw hundreds of thousands of largely elderly (Medicare) or indigent (Medicaid) patients into a situation where they don't know where to turn for help.

In a state where the major (non-profit) healthcare systems are pretty prestigious: Mass General-Brigham, Beth Israel - Lahey, UMass Memorial, Steward is composed of a bunch of St. Elsewheres: rundown, generally urban, nothing-fancy operations.

On of those St. Elsewhere's is St. Elizabeth's, which was back in the day, the big Catholic hospital in Boston - and not lacking in a modicum of prestige, if that prestige was somewhat parochial.

I've had limited experience with St. E's.

One summer when I was waitressing, I lived in Brighton, where St.E's is located, and I fell and broke my elbow. Once I realized I couldn't straighten out my arm, it was off to the ER at St. E's. 

The X-ray tech told me I needed to straighten out my arm. I told her that not being able to straighten out my arm was why I came to the hospital. So she just straightened my arm out for me. More than 50 years later, I can still recall the pain as she pulled my arm down and held it there for the x-ray. Yowza!

Whoever read that x-ray declared that nothing was broken, and issued me an ace bandage and a sling.

Since it was too painful to work, I went home to Worcester to hang out there for a few days while my arm repaired itself. 

A few days later, I got a phone call - in Worcester - from St. E's. They'd somehow gotten in touch with my roommate, who gave them my mother's number (PL3-5811). They called to tell me to come back in to the hospital, as I had a hairline fracture that needed to be set. So back I went.

This was the day of plaster casts, and after a couple of weeks, I decided I'd had enough - for one thing, it was summer, and my arm in that cast was sweaty and itchy; I remember shoving a wire hanger down to scratch - so I just went ahead and cut the cast off. Without ever availing myself of any further services from St. E's.

A few years later, my Uncle Ralph died in St. E's. I was in the process of moving from Worcester to a dump of an apartment in Boston, and had driven in with my mother and sister Trish to bring a few things into my new dump of an apartment. On the way back to Worcester, we dropped in to St. E's to visit my uncle, who had been admitted there for some heart problems he was having. There, the folks at the reception desk had to relay the grim news that Ralph had died a few hours earlier. 

Fortunately, we weren't far from his nearby home in West Newton, so we were able to immediately drive over there to visit with my Aunt Margaret (my father's sister, Ralph's wife). I can still remember when she opened the door to greet us. Her first words to us were "Isn't it awful?" 

So both of my experiences with St. Elizabeth's Hospital were, yep, pretty awful.

But nothing like the experience of Sungida Rashid, who gave birth there last October, only to bleed to death the next day. 

The 39-year-old’s heart had already stopped once. Medical teams revived her, but the clock was ticking. Doctors soon identified the problem: a bleed deep within her liver. In the operating room, caregivers had a plan to quickly treat it, but the staff there soon discovered something alarming — the embolism coil that doctors could have used to stop the bleeding wasn’t available.

Weeks prior, the hospital’s inventory of the devices had been repossessed, according to hospital staff. A company rep from the manufacturer, Penumbra, explained to staff that Steward Health Care, the parent company for St. Elizabeth’s, hadn’t paid the bill.

Some of the staff members at the Brighton hospital had feared this would happen, raised the alarm with executives, discussed it among themselves. But the warnings hadn’t reached all staff. Now, as the emergency unfolded before them, they did not have the coils. (Source: Boston Globe)
Repossessed equipment, eh. Well, small shame on the manufacturer, but Steward - across its multi-state system - did owe them in the millions. So let's reserve the big shame for Steward for not paying their bills. (They're not paying a lot of other bills, including those for from contract employees and other medical device and equipment vendors. Some vendors are continuing to provide products/services because they don't want to put patients at risk.)

By the way, while Steward serves a largely indigent population, this wasn't the case with Sungida Rashid and her husband Nabil Haque. They both hold/held PhDs and had just moved to Boston where Haque had taken a position as a researcher at Boston University. Both of Haque's parents are physicians. The family is from Bangladesh, and Haque and his infant daughter have (understandably) moved back there.

Back at St. Elizabeth's Rashid was eventually transferred to Boston Medical Center, but it was too little, too late. 

Stunningly, Sungida Rashid died, leaving her grieving husband and a perfectly healthy day-old baby. 

The Steward financial situation is pretty convoluted. Steward is the largest physician-owned healthcare system in the country, and there's been private equity in and outs, and complex real estate leasing goings-on. What hasn't escaped notice is that the system's founder, Dr. Ralph de la Torre owns a $40M

superyacht. While his system has patients dying because it doesn't pay its bills.  

I am by no means anti-capitalism, but there are certain services where it might be better if there weren't pressures to be make profits. Like education. And prisons. And healthcare.

Isn't stewardship supposed to be about trusting the steward to do what's right for those under their care?

Some stewards Steward's turned out to be.

1 comment:

Ellen said...

Sickening in the true sense of the word.