letter oct 19

Dear Everyone

Jasper is asking everyone to play with Chess with him. Lucas and I each gave him a game this weekend, but Jasper needs to be occupied every minute of the day - - playing Spore, watching TV, etc. He already read over an hour today, and wants to save the rest of his book for bed time. Too bad he doesn’t have swim practice on weekends!! His meets will start in a few weeks.

I watched the Bears win a bizarre game against the Vikings this afternoon. Both teams scored in the 40s! At least the Bears won this time. Last week they appeared to eek victory out from a better team (Atlanta), and then lost in the last 11 seconds of the game. The Bears offense is doing well, but their defense is showing age and injuries, especially the secondary. Still, they have out-performed Roger and Barbara’s expectations! The Steelers won too!

This morning I took Lucas to his tennis class and stayed for a swim - - and early voting; I have fulfilled my obligations towards the republic. Afterwards I went to get groceries to make chorizo noodle soup: main ingredients chorizo, broth, vermicelli and zucchini. Nicola had her first driving lesson with her instructor, who the high school kids refer to as the ‘hamster-walrus’ (or maybe ‘walrus-hamster’) Nikki drove on 55th street and Ogden Avenue, so I guess I can make her drive to more interesting places then the residential streets around here. She must have been kind of tired because she got back from a cast and crew party for the freshman play last night at 1:30am. Nicola, obviously, was on the crew as a sophomore. Going out to these parties is kind of annoying for us, since the students don’t really consider their parents’ desire for sleep, and Nikki seems to be on a lot of these plays. She was going to have her first lesson last weekend, but it was homecoming, and the poetry club was helping at the concession stand for the game to get money for the club. Jasper and I missed the game, but we saw the parade. The Latin club was in it, but their slogans and speech was in English. Whatever happened to the days of ‘veni vidi vici’? Anyway, this Saturday afternoon Cindy and I took the boys out to Johansson farms in Bolingbrook to get three pumpkins. I will probably have pictures of the carving in the next posting. In the evening we all (except for Nicola) watched cartoons, and later Cindy and I saw Tina Fey’s impression of Sarah Palin while Palin played her self on Saturday Night Live.

Last week at work we had a big meeting of the LUPF, which is the physicians’ practice plan. There are two big, separate yet related issues that are coming towards us. One is integration of the physicians into the hospital as employees. This will let us get around the Stark laws (http://en.wikipedia.org/wiki/Stark_Law ) that prevent self-referral and kickbacks. Of course, the docs lose some independence. The administration is trying to prevent this by making practicing MDs a large component of the governing board. Now instead of fighting against the administration, we will be fighting amongst ourselves. I guess this is a good thing.

The other issue is the implementation of the ‘XYZ’ plan. This is code for a plan where there is about a 20% hold back on salary to make MDs ‘incentivize’ their practice. Each department has their own method for making the ‘X’ part of their plan, referring to national and geographic practice patterns, and these plans need to be approved by the Dean. Eva’s plan, as far as I understand it, was to use the lowest reference for work performed against the highest amount of average salary. Of course, it is all very well to parrot the need for higher efficiency, but is this to be achieved when only the MDs have this incentive to work harder? Yes, we could have clinics late at night, when you have more insured patients, but who is paying the nursing and ancillary staff? What incentives can we use to have the ORs staffed more hours, and have them turn around faster? How can we admit more patients to the hospital when we already run full? Dr Whelton, our CEO from Tulane says that this plan worked there post-Katrina, and that it works at major medical centers that are making money (Mayo, Hopkins, Pittsburgh). He is “staking his professional reputation” that it will work at Loyola. Of course, the plan that Loyla has now looked brilliant about ten years ago. In any case, later this month I will have some piece of paper that indicates how I will do under the new plan, which will not start until next July. It will be interesting to watch the turnover in personnel that occurs over the next eight months!

Otherwise, work is going surprisingly well. We finally have two new pathologists, so we have enough staff for everyone to get some time off for academic and administrative activities. We are finally instituting grossing templates on Monday after a five year fight within the department (grossing templates are set ways to describe tissues and organs). This should make our reports easier to dictate, type, and read. We finally started up a little ‘dog and pony show’ to take around to clinics who give us material to tell them how they can help us by labeling specimens properly and legibly.

Love, H.