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Sad goodbyes follow layoffs at hospital. Patients left looking for alternatives

Wednesday, May 02, 2007
Chicago Tribune
by Judith Graham, Tribune staff reporter

Tribune staff reporter Mickey Ciokajlo contributed to this report
 
Carolyn Pearson had never seen a doctor cry until a few weeks ago, when her orthopedist broke down and wept over getting a layoff notice from Cook County.
 
"What are my patients going to do?" Dr. Vietta Johnson asked her, between sobs. "Where are people going to go?"
 
"I can't get it out of my mind, how hurt she looked," said Pearson, a patient of Johnson's for 11 years. "It cut me -- right to the heart."
 
As Cook County proceeds with budget cuts to its health system, doctors and nurses who have tended people for years are saying goodbye, many with heavy hearts, and patients are wondering where to turn.
 
Pearson, who is 66 and uses a wheelchair, had been treated for arthritis pain at Provident Hospital's orthopedic and podiatry clinic, which Johnson directs. The clinic was shut down and orthopedic surgeries stopped on April 16 at Provident, one of three hospitals run by Cook County.
 
Patients are being sent instead to Stroger Hospital, whose orthopedic surgery clinic is already full to bursting. But Stroger is a two-hour ride by wheelchair-accessible van from Pearson's house -- too far, she said, to travel.
 
Pearson has called all over the South Side, looking for a physician who can help. So far, she said, she's had no luck.
 
At a meeting Tuesday, the county health system's interim head, Dr. Robert Simon, defended the elimination of Provident's orthopedic division. Only 333 orthopedic surgeries were performed there last year -- a volume that can be handled at Stroger, he said.
 
But Johnson noted Provident's orthopedics and podiatry clinic also treated 6,200 cases last year and performed 900 procedures in January alone, including casts placed on broken limbs, wound care for diabetics and treatment for fractures.
 
"He's not giving the whole picture," she said. "These people have no place else to go on the South Side for this kind of care."
 
Arleen Johnson, 51, a former public defender who has degenerative arthritis, was scheduled for a hip replacement March 6 at Provident -- an operation she hoped would help her stand up straight, walk farther and relieve her constant pain. The South Sider doesn't have health insurance and hasn't been able to work for years.
 
The morning of her surgery, she learned that the procedure was being canceled because the Provident orthopedics unit was slated for closure. "I just fell apart," she said.
 
A phone call to Stroger Hospital revealed it would be at least a year before another hip surgery could be scheduled, she said. Apparently, at least 1,200 patients are waiting for hip and knee replacements there.
 
"It's a total nightmare," said Arleen Johnson, who admits she has no idea what to do.
 
A few weeks ago, Felicia Thomas of Harvey added her name to the list. She'd been scheduled for a March 27 knee replacement at Provident Hospital; that, too, was called off.
 
Thomas, 50, takes pain medicine six times a day for a bad knee and can walk only half a block with a brace. She said her doctor at Stroger told her the wait for surgery there would be two to five years.
 
"I started crying and said, 'Doctor, how am I going to live like this?'" said Thomas, who has no health insurance.
 
On Tuesday, Simon said he thinks "we're going to have to wait until more revenues come in before we can take care of these" joint replacements.
 
But Dr. Johnson, the former orthopedics division chief at Provident, says the county has it backward. "The answer to this budget crisis is not to fire surgeons who do the work that actually brings the money in," she said.
 
Dr. Daniel Ivankovich estimates that the hospital's orthopedic surgeons generated as much as $20 million in billable services last year -- money desperately needed by the cash-crunched county system. But invoices never went out because of what he calls "administrative incompetence."
 
Cook County Commissioner Robert Maldonado shares Dr. Johnson's perspective: "This administration only looked at cuts, never at potential revenue opportunities. That's what's so sad about this situation."
 
"I'll be the first to say Provident Hospital has been mismanaged, but this is going to be a real tragedy for the community," said Commissioner Tony Peraica.
 
Don Rashid, spokesman for the county health system, said the invoicing problems are "a situation that's being addressed systemwide."
 
Dr. Johnson is an unlikely pink-slip recipient. A former president of Provident Hospital's medical staff, she was voted physician of the year at the facility in 2006. She was educated at Princeton University and Harvard Medical School, and her credentials are impeccable.
 
Simon has no plans to keep Johnson on board if he reopens the orthopedic clinic at Provident in a few weeks, as he suggested at Tuesday's meeting. His plans call for bringing over part-time staff from Stroger Hospital to do the job.


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