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Amazing Nurse Story

Posted on December 5, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Nurses are amazing and they are often the unsung heroes of healthcare. When I think about the times I’ve spent in hospitals I have almost zero memories of the doctors, but I have a lot of great memories of the nurses.

I was reminded of this fact when reading this pretty untraditional nurse story that @rn_critcare shared. I wonder how many times healthcare IT developers think about these kinds of unique situations that nurses face. Ok, they aren’t all this large, but they are just as nuanced.

As told by @rn_critcare:
Today in my role as nurse I wore many hats. Let me tell you a story about how the day went… #NurseLife
#medtwitter

Came in this am to discover my pt from yesterday had imaging overnight that revealed catastrophic injuries, along with her sepsis and multi-system organ failure

Within 1/2 hr her fiance approached me about calling in a chaplain, which I assume is to do final prayers. He informs me that he wants to marry her. Today.

I’m not sure b/c pt is sedated and fully ventilated, with no hope of waking up.

Spend next few hours calling chaplains/priests/ministers. Keep in mind it’s Sunday AM and church is happening soon.

I find out that if we can show “intent to marry” that a ceremony can be performed. Photos of pt trying on dress are used. A minister agrees to come after church.

Preparations are being made. Family is happy that we can do this for their loved ones.

Except Pt starts to deteriorate. Cushing triad. Call family in and discuss options. They have a family member willing to perform ceremony, if only for symbolic reasons now…

Hair is washed and braided. I give the sisters some sheets and scissors for a makeshift wedding dress (new) while I go collect flowers from other rooms around the unit. (borrowed)

Flowers are placed in braids along with headband & veil. A blue blanket is draped at end of bed.
Everyone lines up outside the unit and begin the parade into the room. So. Many. People. Can hardly make my way around but secure a post at the med pumps and monitor.

Music is being played, someone has a guitar and another has a drum.

The chaplains words are brief but loving. Asks him does he take her… I do. Asks does she take him, bridesmaids all reply “she does”

Everyone in tears

They are now all in song with only the drum being played, which I feel is shaking my entire soul
Everyone singing Stand by Me and I’m in tears.

Pt stabilizes somewhat. I realize it’s now afternoon and I haven’t had a break or worse, my coffee! I decide to step away for a few minutes. Go outside for air. Find myself at grocery store across the street…

Purchase cake and have 2 hearts drawn with their initials, some bubbly (sparkling juice), and plastic champagne flutes. There was a wedding after all… New groom takes bottle outside with fam, pops the cork & comes back for mini reception.

So much love

I decide to get some charting done. Post-op comes back across the hall and I’m called to help. CRRT machine beeping next door and tend to that. Realize I still haven’t eaten. Grab a cookie from the desk (weekend tradition from consultants)

Pt begins to fail again.

Family called back in, this time the air has changed. It’s heavier and somehow feels hotter than hours before.

The guitar is being played and everyone is singing Amazing Grace. Am I singing along? Maybe. Not sure with this lump in my throat.

Have to turn away and pretend like I’m tending to something very important, which turns out is the wall, but it’s holding me up now, and the singing and drumming is getting louder and I’m just trying to keep it together, keep her comfortable… Won’t be long now…

Her children are at her side now telling her they love her, how wonderful she is, how much they love their step-dad, don’t worry they will take care of him.

A tear falls down her cheek and now everyone is sobbing. My sobs are internalized and I keep my eye on the monitor…

New groom is by her side and I whisper in his ear that she has passed, as this sacred news is shared with a spouse first.

The new groom is now a widow.

One by one the people exit the room, each one reaching out for a hug. Each hug brings me a little closer to the inevitable spill over of tears. My heart aches for them. There are no words, my eyes pleading with them to accept my sincerest condolences…

They need help with funeral home. Explain of course I can help guide them, this is unchartered territory and I do this all the time. My insides are screaming ALL THE TIME!

Call funeral home, with request to leave braids untouched… Veil and flowers too.

I finish my charting. Realize there’s no supper break happening either. Wash my pt up. Gently remove the countless tubes and IVs. Use hushed tones as I explain to her what I am doing, because even in death we deliver honour and dignity.

Take a new nurse down to morgue with me, because it’s a teaching hospital after all. Carry on chatting as though my spirit isn’t weeping inside.
Get back to unit.

Take a long overdue drink of water.

No time for tears.

There’s an admission on the way.

#nurselife

Promoting Internal Innovation to Drive Healthcare Efficiency

Posted on June 1, 2017 I Written By

The following is a guest blog post by Peyman S. Zand, Partner, Pivot Point Consulting, a Vaco Company.

Technical innovation in healthcare has historically been viewed through the lens of disruption. As tech adoption in the industry matures, perceptions on the origin of innovation are evolving as well. Healthcare leadership teams are increasingly leaning on feedback from the front lines of care delivery to identify ways to eliminate waste and drive greater efficiency. Rather than leaving innovation up to third parties, many health organizations are formalizing programs to advance innovation within their own facilities.

There are two schools of thought on healthcare innovation. Some argue that the market’s unique challenges can only be understood by those in the field, leaving outside influencers destined to fail. Others view innovation success in outside markets as an opportunity for healthcare stakeholders to learn from the wins and losses of more technically progressive industries. By mimicking other industries’ approach to promoting innovation (as opposed to their byproducts) in our hospitals and health systems, healthcare can draw from the best of both worlds. What we know is that the process in which innovation is adopted is very similar in all industries. However, the types of innovations and specific models can and should be tailored to the healthcare industry.

Innovation in Healthcare: Three Examples at a  Glance

There are several examples of health organizations successfully forging a path to institutionalized innovation. University of Pittsburg Medical Center (UPMC), Intermountain Healthcare and Mayo Clinic have pioneered innovation programs that merge internal clinical expertise with technical innovators from vertical markets in and outside healthcare. This article highlights some of the ways these progressive organizations have achieved success.

Innovation at UPMC

UPMC Enterprises boasts a 200-person staff managed by top provider and payer executives at UPMC. The innovation team is presently engaged in more than a dozen commercial partnerships, including support for Vivify Health’s chronic care telehealth solutions, medCPU’s real-time decision support solutions and Health Catalyst’s data warehousing and analytics solutions. Each project is focused on the goal of improving patient outcomes. The innovation group was recently rumored to be partnering with Microsoft on machine learning initiatives and the results may have a profound impact on how we use technology in care delivery.

UPMC Enterprises supports entrepreneurs—both internal individuals and established companies—with capital, technical resources, partner networks, recruiting and marketing assistance to support innovation. Dedicated focus in the following areas lends structure to the innovation program:

  • Translational science
  • Improving outcomes
  • Infrastructure and efficiency
  • Consumer engagement

All profits generated from investments are reinvested to support further research and innovation.

Innovation at Intermountain Healthcare

Like UPMC, Intermountain’s Healthcare Transformation Lab supports innovation in the areas of telehealth and natural language processing (NLP), among others. Like most providers, one of Intermountain’s primary goals is controlling costs. The group’s self-developed NLP program is designed to help identify high-risk patients ahead of catastrophic events using data stored in free-text documents. Telehealth innovations let patients self-triage to the right level of care to incentivize use of the least expensive form of care available. Intermountain’s ProComp solution offers its providers on-the-spot transparency about the cost of instruments, drugs and devices they use. That innovation alone net the health system roughly $80 million in reduced costs between 2013 and 2015.

Most of Intermountain’s innovation initiatives are physician led or co-led. The program strives for small innovations in day-to-day work, supported by a suite of innovation support services and resource centers. Selected innovations from outside startups are supported by the company’s Healthbox Accelerator program involvement, while internal innovations are managed by the Intermountain Foundry. Intermountain offers online innovation idea submissions to promote easy participation. The health organization’s $35 million Innovation Fund supports innovations through formalized investment criteria and trustee governance resources. It is important to note that Intermountain Healthcare is interested in all aspects of innovation including supply chain and other non-clinical related projects.

Innovation at Mayo Clinic

Mayo Clinic’s Center for Innovation (CFI) brings in innovation best practices from both healthcare and non-healthcare backgrounds to drive new ideas. The innovation team’s external advisory council is comprised of both designers and physicians to drive innovation and efficiency in care delivery. The CFI features a Multidisciplinary Design Clinic that invites patients into the innovation process as well.

CFI staff found it was essential to show physicians data that demonstrated known problems and how proposed innovations could make a difference to their patients. They emphasize temporary changes, or “rapid prototyping,” to garner physician buy-in. Mayo’s CFI promotes employee involvement in innovative design through its Culture & Competency of Innovation platform, which features weekly meetings, institution-wide classes, lunch discussion groups and an annual symposium. Mayo’s innovation efforts include these additional physician-led platforms:

  • Mayo Clinic Connection—supporting shared physician experience
  • Prediction and Prevention
  • Wellness—promoting patient education
  • Destination Mayo Clinic—focused on improving patient experience

While these innovation examples represent large healthcare organizations, fostering innovation does not require a big budget. Mayo Clinic’s “think big, start small, move fast” approach to innovation illustrates a common thread among successful innovation programs. Here are practical strategies to advance innovation in healthcare, regardless of organizational size or budget.

Four Steps to Implementing an Innovation Program in Your Organization

Innovation doesn’t have to be grandiose or expensive. Organizations can start small. Begin by opening a companywide dialogue on innovation and launching a simple, online idea submission process to engage personnel in your organization. The most important part of this process is educating your teams to understand how to evaluate new innovations against a relatively pre-defined set of criteria.  For example, are you trying to improve patient safety, quality of care, reduce cost, increase patient or physician satisfaction, etc.

Another key element of successful innovation is encouraging collaboration and participation across a wide variety of stakeholders. Cross-functional teams bring multifaceted perspectives to the problem-solving process. Strive for incremental gains in facilitating opportunities for cross-department collaboration in your organization. This is particularly important for the implementation step.

Measure success using performance metrics where clinical efficiencies are concerned. Physician satisfaction, while difficult to quantify, can also pose big wins. You can expect some failures, but stack the odds by learning from other departments, organizations and industries to avoid making the same mistakes.

To work, innovation must happen often and organically. Dedicate funding, establish cross-department teams and build a formal process for vetting internal ideas. Consider offering staff incentives to drive engagement. Not all ideas will succeed. Identify metrics that will help determine ROI (not all ROIs are measured in dollars) on pilot programs so you can weed out initiatives that aren’t delivering early on to protect resources. Also, keep in mind that you can improve these innovations at each iteration.  Make the process iterative and roll out the initiatives quickly. If it fails, shut the process down quickly and move on. If it is successful, improve it for the next iteration and scale it quickly to maximize the benefits.

Whether you’re cross-pollinating internal teams to promote innovation, building partnerships with other organizations or leveraging technology to better connect providers and patients, healthcare’s ability to successfully collaborate is vital to advancing innovation in healthcare.

About Peyman S. Zand
Peyman S. Zand is a Partner at Pivot Point Consulting, a Vaco company, where he is responsible for strategic services solving healthcare clients’ complex challenges. Currently serving as interim regional CIO for Tenet Healthcare, Zand was previously a member of the University of North Carolina Healthcare System, leading Strategy, Governance, and Program/Project Management. He oversaw major initiatives including system-wide EHR implementation, regulatory programs, and physician practice rollouts. Prior to UNC, Zand formed the Applied Vision Group, a firm dedicated to assisting healthcare organizations with strategic planning, governance, and program and project management for key initiatives.

Zand holds a Bachelor’s of Science in Computational Mathematics and Engineering from Michigan State University, and a Master of Business Administration from the University of Michigan.

If Restaurants Were Run Like Hospitals

Posted on October 8, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Health Catalyst has created this really awesome video that shows how a restaurant experience would be if it were run like hospitals. I’d say this is funny, but it cuts a little close to home. Either way, it’s insightful.

Come on, hospitals! Put the social media pieces together!

Posted on August 9, 2010 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Today, in the Baltimore Business Journal, we learn that Charm City hospitals are doing a great deal more social media outreach than they had in the past.  Take health system LifeBridge, the paper says:

The LifeBridge Twitter account and Blogspot blog is updated regularly and provides health care information to patients while its Facebook page is used as a job and career board. LifeBridge also has its own channels on YouTube and ICYou, an online health video source.

These all sound like good initiatives which use the various social media channels appropriately.  It’s clear that LifeBridge is trying to reach out and touch consumers; that it wants patients to be healthy;  that it’s making sure people have access to its job listings and that it’s making an effort to keep people up to date on its activities.

All of which means, well, just about zero if I’m a patient hoping to decide where to have an elective procedure.  Nada. Zip. Job listings?  Meh. Tweets?  Well, I’m willing to be called on it if I’m wrong, but I’m doubting they start thoughtful conversations with consumers.  Health information on video?  Well, I’ll add a few points for the video, as it’s a pretty compelling way to educate people, but just a few.

Bottom line?  Even if they are using the right content for the right pieces, these are a bunch of loosely-connected initiatives that can’t do much to make patients feel safe, comfortable and welcome on their own.  Doing that takes not only a change in content, but also in approach.

It’s time to build social media efforts around a central goal, that of making your key audiences feel connected to your facility. Not informed about what you’re up to (most people who read don’t care about your new parking tower), not educated (there’s a place for that and it’s usually called WebMD) but connected.

That would take a bunch of effort, time, study of what patients, clinicians and staffers want and some serious trial-and-error experimentation. But it would be worth every penny. Try it — I dare you!  You won’t be sorry.

Proposition 8: A warning to hospitals

Posted on August 6, 2010 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Sadly, it seems that unless the Supreme Court kills California’s anti-gay-marriage Proposition 8 dead, and that creates a domino effect nationally, hospitals will be slow to treat gay and lesbian families with dignity and provide similar levels of support.  

As far too many sad incidents illustrate, hospitals have treated gay couples as though their relationship gave them no rights — even when they’d signed a stack of legal papers which should have closed the matter.

One recent example is the case of Janice Langbehn, who was barred from seeing her dying partner Lisa Pond because the two weren’t married.  According to Langbehn, who sued Miami’s Jackson Memorial Hospital over the incident, the staff refused to even take a medical history on Pond from her, despite the fact that Pond was unconscious. 

The incident, which happened in February 2007, drew national attention. But it still took Jackson until April of this year to institute an official policy naming same-sex partners as “family” for vistation purposes.

Now, Jackson Memorial may be an outlier —  other hospitals have already clarified their policies to offer equal protection and access to all families — but it’s also a county facility.  Apparently, governmentally-sanctioned discrimination was just fine with the city fathers and mothers until just this year.

That kind of foot-dragging has to stop. Regardless of how you feel about gay marriage, there’s a lot of momentum behind the movement, and it’s not likely to go away.  So even if you’re unmoved by appeals to fairness or the suffering of gay spouses, try legal reality on for size. 

Hey, hospitals are terrified of blowing HIPAA rules, and only a couple hundred violations have been cited since its inception. (Criminal convictions? Counted easily on your fingers.)  Don’t you think gays and lesbians are going to see to it that you get some very serious heat if  you treat them like second-class citizens?  That’s a more serious threat than a possible Britney Spears leak.

Hospital leaders, it’s time to begin training your staff that discriminatory treatment of gays and lesbians won’t be tolerated, any more than they’d be permitted to kick Latino dads out of their wives’ rooms or refuse to take medical histories from Asians.  Their politics, feelings and preferences are fine, but they have to stay at home (or go elsewhere with them to a different institution).  This is going to be a really tough one, sadly, so be prepared for some blowback. But go ahead anyway.

P.S.  For a little treat, I give you “Summer of Loving,” a sweet and memorable tune comparing the battle over Proposition 8 to Loving v Virginia, the case in which the Supremes struck down laws against interracial marriage.

Let’s turn patients into evangelists; join our beta and find out how

Posted on July 27, 2010 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

We would all love to see great healthcare organizations rewarded by great community support, both on and offline — but the truth it’s rarely that easy.  If you want feedback — even well-earned praise — you generally have to work for it.

The problem seems to be particularly acute for hospitals. Even patients who have had a great experience with labor and delivery, about the most heartwarming,  upbeat experience a healthcare provider can deliver, seldom go online to rave about the lovely setting, the attentive nurses, the modern birthing practices or family-friendly room design. Still,  it’s a problem for providers across the board.

So, what will it take to get patients to share their feelings online? Let’s find out!

nextHealth Media is pulling together  a group of providers who want to build a better community engagement model, specifically by using social media tools.

Our idea is to create a single plan and implement it across a few environments — making it easier to share ideas and make progress — then tell the story of what we’ve learned.

The model will be very simple and the time we invest fairly modest, but we think the returns could be great.  As things progress, Twitter and TweetChat will keep ideas flowing (#engagedpatient).

If you’re interested, drop me a note at engagementproject@nexthealthmedia.com or call me at (703) 537-8105. And if the spirit moves you, please do comment here on what you think it will take to get this project off the ground. Would love to get your input!

Video: Accountable care organizations, the Steve Jobs way

Posted on July 10, 2010 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

This video, by healthcare consultant Anthony Cirillo, offers a neat suggestion — why not sic Steve Jobs on the accountable care organization model?  As Cirillo sees it, Jobs is one of few execs out there who really understands how to build complex things in a lean, functional way.

“When we develop products, we’re about putting as many features into them as possible, and hospitals, as many services as possible,” Cirillo says. “But Steve Jobs…wouldn’t just build an accountable care organization, he’d build your accountable care organization, where you would get just the amount of care you needed at the right time in the right place.”   More below:

Don’t be distracted by the guitars hanging on the wall in the background — they’re just symbolic of Cirillo’s other passions, singing and songwriting.  What he has to say on this subject is definitely worth a listen.

Doctor-patient speed dating: a good idea

Posted on July 6, 2010 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

 At first, I wasn’t sure what I thought about this, but I’ve decided that we’ve looking a  good    idea here. As the following    NPR piece describes, some hospitals have arranged a form of    “speed dating” giving doctors and  patients to meet each other in a friendly, relaxed    atmosphere. God knows this is a more sympathetic approach than the mechanical, soul-less  one already in use, n’est pas?  Both doctors and hospitals appear to win here.

Hospital attracts patients with “speed dating”

“[These programs] aren’t just about marketing to patients. They’re also a tool to reach out to physicians and encourage them to refer their patients back to the hospital.

“Physicians drive health care, period,” says Travis Singleton, a senior vice president at Merritt Hawkins, a physician placement firm. “Ninety percent of the health care dollars that are spent in today’s marketplace are through the physician’s pen, whether that’s patients they admit, whether that’s tests they administer, whether that’s procedures they order, whether that’s insurance they bill.”Do you think this is a good idea?  Why or why not?

The next generation of healthcare social content

Posted on July 5, 2010 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

If you’re like me, you’re tired of hearing about the entire social media mess– Twitter, Twanger, Facebook, Nosebook, StumbleUpon, FallDown, ClimbUp, YouTube, Tubular Bells, Foursquare, FiveSquare, Friends on a Stick, Digg, Dig-Dugg,  PasstheHat, you name it. 

I’m not going to deny that many of these channels (the ones I didn’t make up to be silly, of course) have some uses. I’ve been known to follow a Twitter conversation via hash tags, enjoy a few threaded conversations on Facebook, connected with some very useful businsess contacts on Linked in and promoted many a blog item on StumbleUpon and Digg. These are good, useful  activities which can sometimes offer real communications value.

But what’s the point of using any of them if all your organization does is pump out the least valuable information it has to offer? Neigborhood events. Cutesy press releases.  Links to clinical research done by your faculty (which is, of course, valuable, but hardly unique to your stream if a true discovery is involved.)  As I noted previously in an item on useless Twitter feeds, social media doesn’t matter if the society you want isn’t listening.

So, enter the notion of “social content,”  information written by pros — sometimes professional journalists in your field — who mine your organization for information that really matters and help present it in ways that build your healthcare organization’s brand. 

Facebook pages, for example, can become places for serious dialogues about health issues, hosted by your organization but run by people who are focused on real substance.  Social content involves real research, study and preparation, like the research and editorial efforts you see turned out by Modern Healthcare or Press Ganey.

Rather than issuing happy-talk nonsense statements, healthcare leaders can develop social content that shares their key concerns and team messages using the social media infrastructure.  These messages don’t involve some sort of tricky, gadgety approach to using social media channels;  they’re just stronger, clearer and far less shallow than what you might have done in the past.

The bottom line?  Creating social content isn’t a Big New Thing — it’s just a method of squeezing far more value into a smaller space and coordinating it with what you say elsewhere.  It’s confident , it promotes your mission, and it’s too damned important to ignore.

If we can help you begin a social content audit — to find out what kind of great content you’ve already got — just let me know.

Video: How public reactions rip hospital buyouts apart

Posted on June 17, 2010 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

   In theory, selling a hospital should be a fairly routine matter, at least if no unusual legal issues are involved. Often, the acquisition solves some serious problems by bringing in much-need capital.

But just as often, things get extremely messy. Communities like things the way they are, and go nuts.  Nurses strike. Regulatory issues mire down transactions for years and political debates get very ugly. In fact, after 20 years of watching hospitals get acquired, I can’t tell you how many times I’ve seen such deals go down in flames.

Just how bad can it get?  Well, consider this video , a slickly-produced political statement challenging the sale of Houston’s Memorial Hospital Southwest to a county entity. The deal involved fell apart late last year, but the way it went down is worth a look.

When Harris County announced plans to buy Memorial Hermann,  at least 200 doctors vowed to walk off the job if the facility changed hands. Their grievances were many, but the CEO’s position really cheesed them off. From the text accompanying the video:

 [CEO Dan Wolterman says] that Memorial Hermann has exceeded profit expectations for nine straight years, but the system still laid off many of the system’s top people this year. Now they want to dump Memorial Hermann Southwest and are asking for a $165 million taxpayer bailout from the Harris County Hospital District, whose history of Medicare/Medicaid fraud should be a source of concern for all taxpayers. Can we really trust these two greedy executives?

And then they get to what seems to have been the real issue. “They want to get rid of urban hospitals and build palaces in the suburbs. And they want us to pay for it!” the announcer warns sternly. So this particular battle had a “haves vs. have-nots” feel.”

OK, I’m going to get cruel here. I’m not convinced that doctors were really worried about saving an urban hospital.  They don’t make much money there and their patients are often indigent. But sometimes power struggles don’t need any real  justification.

The bottom line is that this kind of protest plays out in some community every day — and can get even hotter if a for-profit company rolls into town and starts shopping.

In fact, during Columbia Hospital Corp.’s acquisition spree in the early 90s, I attended a closed-door meeting on a proposed buyout in south Miami. One doctor said that he’d better drop his pants now because of, uh, what would happen next. Bear that in mind as you’re shopping, investors. And watch this video once or twice.