OSF’s Expansion Continues
I noticed in the Journal Star today that OSF is working on “two smaller expansion endeavorsâ€. The two projects include a $2 million dollar hangar for LifeFlight and a $15 million dollar medical building.
“It is part of our dedication and commitment to having facilities that can take us into the next decades,” said spokesman Chris Lofgren. “It positions us to provide appropriate level of services for decades to come.”
Being transported by air when one is sick or injured makes good intuitive sense. However, in Rosen’s Emergency Medicine, 6th edition, the following paragraphs describe their view of Air Medical Transport (AMT):
“Traditional research in air medical care has identified what can be done in the AMT setting. Work has shifted the focus from simple observational studies to measurement of the value of the interventions. The most basic consideration is if AMT makes a difference to patient care. Older, subjective studies show a benefit to AMT in only 10% to 20% of patients flown. Where AMT appears beneficial, the advantage seems related to the provision of on-site advanced life support care rather than to a unique advantage of the helicopter.
AMT has long been assumed to save additional lives in trauma; however, it is now recognized that improvements in outcomes are more likely related to the provision of on-site ALS care within a comprehensive trauma system rather than to the aircraft itself. Studies have challenged the benefit of AMT in interfacility transports in urban areas. Although the speed of the aircraft is undoubtedly greater than that of any ground vehicles, small gains in transport time may be offset by higher costs without significant changes in patient outcome.
It is interesting to see that highly skilled care at the scene with advanced life support seems to be the crucial issue rather than the “unique advantage of the helicopterâ€.
Remember, the Peoria Fire Department (PFD) can’t give advanced life support or transport the patient. Seems to me that OSF, with their deep pockets, could help the PFD advance their status to advanced life support so immediate on-site care could be given to the patient. According to Rosen, that is key to improving patient outcomes…not building $2,000,000 helicopter hangars.
John A. Carroll, M.D.
www.peoriasmedicalmafia.com
Billy Dennis is a former reporter and editor at small daily and weekly newspapers in Illinois and Missouri. He comments on media, news and politics. He also owns and operates 
Why do you hate AMT ambulances so much
AMT, in the above post, means Air Medical Transport.
But then again, John, you know that the “advanced life support” that the helicopter can provide is much more than the “advanced life support” that a Paramedic provides. More equipment, nurses, doctors, etc. Things that the PFD couldn’t provide even IF they wanted to be an ALS agency.
You also know that over 90% of the work done by LifeFlight is in hospital to hospital transfers (and the majority of transfers are kids coming to the Children’s Hospital) and NOT in responses to the scene of an accident. So, your argument on this post is pretty much invalid.
Once again, John, you post without telling the whole story, the entire truth, and twist a few facts into something that looks different than it really is.
Helicopters are also very effective for massively overcharging patients and making hospitals lots and lots of money. Then again, so are aspirin, pillows, and toothbrushes.
But then again, Tony, you know that the excellent LifeFlight nurses, not doctors, at OSF provide the vast majority of the advanced life support for air transport patients. They use the same medications, breathing tubes, etc., that are conventional for paramedics. And they are taught these skills by PAEMSS, AMT, OSF who could and should be teaching the Peoria Fire Department (PFD) to obtain these skills.
Contrary to what you say, the PFD could provide these same skills because they are in the same Peoria EMS System.
Hospital transfers require skills that frequently use advanced life support also. This is a money maker for OSF.
But the guy that collapses or gets stabbed on Peoria’s near north side gets only Basic support from the PFD. No helicopter with well trained nurses come rushing for him.
When I quote from Rosen’s, and you reject that, there is not much anyone can do to change your mind.
John
Doctors fly to the scene of vehicle accidents quite often.
PAEMS is available to teach any agency at any time, all you have to do is call the EMS office and set up a training date. The PFD, of course, would have to be the one to make this call. The PAEMS office doesn’t cram their training down your throat.
I rejected no such quote, because the quote from Rosen’s is correct. Its just that you manipulate the quote to mean something that it doesn’t. Rosen’s is an EMS book, not a hospital manual. LifeFlight is primarily used for hospital transfers, not EMS. The benefit of a helicopter is much greater when you are talking about flying to Quincy to pick up a little kid who needs to go to a children’s hospital.
But then again, that would require you to use the truth objectively, something that we have yet to see you do.
Is this a site of activism against a local catholic hospital and for Haitians? Am I getting this right?
The doctors that you refer to are young resident physicians who have little experience compared to the LifeFlight nurses. So you are snowing us here, Tony.
Rosen’s is NOT an EMS book. It is the “bible” of Emergency Medicine. EMS is part of Emergency Medicine. The paragraphs I sited just state that the final words on efficacy of Air Medical Transport have not been written.
Flying a sick kid from Quincy is great. Each medical situation is different, weather conditions are different, and many factors play a role.
And PAEMSS, which you mention, gives their nod to Advanced Medical Transport in Peoria. I am sure you know this.
Several years ago, the Journal Star wrote, “For years AMT has balked at the fire department entering this arena (paramedic and transport)”. Andrew Rand, Director of AMT, stated that AMT is willing to help the fire department advance to the Intermediate level (just below Paramedic), but Rand did not want the fire department to transport patients. Rand stated, “They (PFD) can provide more comprehensive care than they do now.” However, AMT did not obtain the contract they wanted from the city of Peoria, and the PFD stayed mired in their Basic level of care.
Now, Tony, we all know who supports AMT and Andrew Rand. Why was Rand calling the shots regarding whether the PFD should advance their services for the people of Peoria? AMT and their supporters in the medical and business community know the money is made in TRANSPORT. So do you. But lives can be saved with immediate state of the art care and the PFD should be supported in their efforts to advance their services. Whether the PFD advances to a higher level should not depend on whether AMT gets a 10, 20, or 100 year contract with the city.
Are residents not Doctors? Twisting the truth again, are we?
OK so Rosens is an Emergency Medicine book, not an “EMS” book. Everyone else got the point except you, I guess. Either way, LifeFlight is primarily a means to transfer patients from hospital to hospital, which has NOTHING to do with Emergency Medicine or EMS.
I would agree that from time to time AMT is held out to the EMS system as being “great” or a “model” agency. I have seen great care from AMT medics and I have seen crappy care. I would call AMT average.
Andrew Rand does not call the shots for the PFD. The City does. When they decide to make the step it will happen.
The money to be made in the ambulance business is in transport, but not the emergency kind. AMT makes their money from scheduled stuff like hauling grandma in to the hospital from the nursing home for her dialysis. Again, using the whole truth would help the readers.
I agree 100% with you that the PFD should be able to upgrade their service, and as long as they don’t transport AMT should have nothing to worry about.
Unfortunatley, you chalk the lack of upgrade up to a conspiracy. I chalk it up to the FACT that the PFD does not want to upgrade, evidenced by the fact that they have never tried to do so and at this time do not employ enough EMT-Intermediates or Paramedics to do so.
1. Yes, resident physicians are doctors, Tony. See my first sentence. You are off to a bad start.
2. Sure, AMT makes a lot of money transporting grandma. Do you think Mr. Rand and OSF would care if the PFD just transported emergency calls and let AMT transport grandma? I bet they would care. And who really cares what AMT has to “worry about” when the people of Peoria call 911 except the people making the money?
3. And how can Mr. Rand say that if the PFD WON’T transport, they SHOULD be able to upgrade to a higher level of care. How does that work, Tony? You say Mr. Rand “does not call the shots”. Sure sounds like he and his supporters DO call the shots if you read the newspaper and follow this debacle over the last decade. And when AMT is backed by the Project Medical Director (who happens to be on AMT’s salary), and tells the City Council that there would be “duplication of services” if the PFD performed at a higher level, what is one to believe? This could get confusing.
4. Tony, do you believe obstacles have been thrown up to limit what the PFD can do when they talked about upgrading? Ask Dr. Hubler, an ex-Project Medical Director.
5. Conspiracy is your word. This has been called many worse things.
You keep passing over the simplest of facts. The City of Peoria doesn’t want to be in the ambulance business. The Peoria Fire Department has not tried to upgrade service and doesn’t have the personnel to do so.
What can be done with someone who can’t handle the simple facts?
John,
The current Project Medical Director is not on the AMT payroll. I think you have him confused with a former PMD who was the AMT medical director.
Bob,
I don’t have the current PMD confused with Dr. George Hevesy who I referred to in paragraph #3 above. Dr. Hevesy was the PMD and on AMT’s payroll when he addressed City Council regarding the Peoria Fire Dept.
Do you think it is important that the current PMD not accept a salary from AMT?
John
Ok let me guess…. Now that Dr. Jackson is the PMD and he doesn’t also happen to be employed as AMT’s medical director, this is just more evidence of a conspiracy?!?
Tony, I think you need a little time off… put your feet up and relax.
Isn’t that what you are insinuating John?
And BTW, Drs. Hubler and Hevesey are both still on the payroll of AMT according to their website. I would guess that the reason Dr. Jackson is not working for AMT is that the others still want to.
So Dr. Jackson is free to make his own decisions about the PFD since he is not working in any way for AMT.
Either way, the PFD has not tried to upgrade their service. Still can’t get by that fact John.
Tony,
Please send the website that says that both Drs. Hubler and Hevesy are on the payroll of AMT. I have never seen that. I don’t think there is one, to be quite honest. AMT has an old website if I remember right, but Dr. Hubler is long gone after he became too friendly with the PFD. But correct me if I am wrong.
Why do you think that Sue Wozniak, Chief Operating Officer at OSF told me she thought it was good that Dr. Hevesy stepped away from his job as Project Medical Director when I pointed out that he was on AMT’s salary? She knew it of course since she sits on the AMT Board of Directors.
You never seem to answer the question that I have asked multiple times: Do you think obstacles were thrown in front of the PFD when they wanted to upgrade? Why do you think the PFD sold the one ambulance they owned? Do you think any obstacles were put in front of them?
You should probably stick to global warming.
Dr. Carroll:
While you asked this of Tony, let me add my couple of cents regarding the ambulance purchased by the PFD.
First, the ambulance was purchased from the slush fund called the Foreign Fire Insurance tax (or something like that) that is controlled by the Fire Union (with a token representative from management sitting on the board). The funds come to the Department from the state based on insurance policies written in Peoria. The funds must be used for fire/medical care within the community. The ambulance was purchased by this board without input or direction from the City Administration or City Council. It was done in a closed meeting and few were aware of it until it was ordered. I believe the Fire Chief voted against the purchase of this item.
Second, the ambulance was purchased without first asking for or requesting that the Department be authorized to provide services at the paramedic level. What good is an ambulance without the ability to staff it appropriately?
Thirdly, what benefit is ONE ambulance in a City of 115,000? If the PFD desired to get into the ambulance business (either for ALS or transport service), they would need to purchase at least 5 or 6 to adequately cover the geographic area of the City. They indicated they were going to use it for rehab at fire sites and as standby at community events. I think a basic truck or van would work for those purposes.
Fourthly, the ambulance was sold by direction of the City Council (after a formal vote) based upon their determination that there was no need to add an ambulance to the City’s fleet and that they did not desire to enter into that line of business- at that time.
Fifthly, the ambulance was sold by the City (not the Fire Department) because the City had ownership of it once purchased. As I recall, the PFD lost money on the transaction because they purchased the ambulance – paid to have it repainted with their name/logo prior to having sought authorization (either from the City Council or the PAEMS) to put it into service.
I could go on but I think you get the picture. They never requested authorization to enter into the ALS or transport business but on a folly bought an ambulance – putting the proverbial horse before the cart.
If the City Council desired to get into the ALS/Ambulance business, I think they would easily receive authorization from the PAEMS upon appropriate request and training of their staff. This would be similar to how East Peoria did it. However, at this point they are already struggling to fund existing fire stations – let along adding an additional service when the community is already covered by a great EMS system (composed of both PFD first response and AMT ALS response).
John, it was so simple to find I’ll bet even you could look for it, or is this another one of your “challenges” to prove that someone who might disagree with you is just stupid? You don’t think there is one, and I must just be another one of “those” people.
http://www.advancedmedicaltransport.org/aboutamt/board.htm
I’m sure you will be able to find some way to discredit this site though.
I have already answered those questions. I guess I will again.
PFD hasn’t tried to upgrade, officially. Now they might have tried internally, but they never convinced their leaders, which is evidenced by the FACT that they have never filied paperwork with IDPH to upgrade their service. I would guess that they did meet some obstacles, but they were all internal to the PFD and City of Peoria.
Now would be a good time to remind the readers that the ambulance that Peoria once had was not purchased by the Fire Dept but by the Foreign Fire Board which is made up of firefighters from the IAFF local, not the Chiefs or City management. So, it really wasn’t that the PFD was trying to get into the ambulance business. The PFD sold the ambulance because it shouldn’t have been purchased to begin with. Gotta have the whole story, John, not just the part you want to tell people.
Peo Proud:
Please stop, you are making too much sense by pointing out how simple this all really is. John can’t handle that. There MUST be more to the story.
Klaatu
Barato
Nikto
Tony — I’ll try to stop but I have a thing about facts. I like to share them.
How often are those multi-million dollar helicopters used within the city limits to transport patients from the scene of an accident, shooting, etc.? They aren’t. I would love to see one try and land in the near North side to treat a shooting victim. Can you even imagine the amount of FOD (foreign object debris) that would become little missiles as the helicopter tried to land and then take-off?
The helicopter is generally not used for any scene response within a 10 mile radius of OSF. I say generally because there are time it is in the case of extended entrapment in an accident or something. However, in most cases an ambulance trip is quicker than a flight with all the pre and post landing steps they need to take when you are that close.
Dear Peo Proud and Tony,
I know you guys are baiting me and I keep answering you. But I do think that more information that is out there that is factual is important for people to see. This is an important topic for Peoria. There will not be a quick fix.
Peo Proud, I have to be honest with you. I don’t think you composed your comment. You received some major help and then Tony added his accusatory repetitive comments. But you are both doing the best you can to support AMT.
You both are tied in or know people who really know the politics behind Peoria’s EMS. Your comments at other sites on this blog, where you indicate that you have no interest in finding out the other side of the story, really diminishes the perception of your objectivity regarding this topic (EMS) as well.
Tony, you did not answer my question regarding Sue Wozniak’s comment regarding Dr. Hevesy. Do you not want to find out this side of the story?
Tony, the website you linked to is AMT’s. It is old. And the fact that Dr. Hubler is on the website does not indicate that he was on their payroll like you say he was. Dr. Hubler is long gone from his association with AMT and you know that.
Tony, you said that you would “guess†that the obstacles that the PFD ran into are internal to the PFD and the City of Peoria. I disagree with you. What did Dr. Hubler tell you when you spoke to him, when he carried on dialogue with the PFD regarding upgrading their services? Or did you not look into that side of the story? Do you consider Mr. Rand at AMT internal to the PFD and to the City of Peoria?
Peo Proud, the “slush fund†that you refer to (Foreign Firefighters Fund) purchased the first AED’s for the PFD years ago. I wonder how many lives the “slush fund†saved? I really wouldn’t trash out this fund too much if I were you.
Peo Proud, according to the Matrix Consulting report, the PFD asked the Project Medical Director (Dr. Rick Miller) to allow them to equip the ambulance they purchased. This request was denied.
Peo Proud, wouldn’t one PFD ambulance be better than none? I think it would and I bet the Peoria public would think so too. And it wouldn’t have cost them a cent for the actual vehicle since I offered to purchase it and donate it back to the PFD if certain requirements were met by PAEMSS. One thing I wanted to know were statistics from PAEMSS regarding the level of EMS care that you say is so wonderful in Peoria.
When I called PAEMSS, they said they kept no aggregate statistics (or something like that). How did you come to your conclusion (or the person that composed your article) that EMS in Peoria is so great? If you have the numbers, please send them along. Matrix did not publish any pre hospital health care indicators for Peoria’s EMS either.
Have a good day.
John
John said: Peo Proud, the “slush fund†that you refer to (Foreign Firefighters Fund) purchased the first AED’s for the PFD years ago. I wonder how many lives the “slush fund†saved? I really wouldn’t trash out this fund too much if I were you.
Finally John, you write something worth reading. I would personally like to thank you. This “slush fund” also goes to buying stuff like Refrigerators, stoves, washers and dryers that the City would have to pay for if this “slush fund” wasn’t available. It also will buy other things too, like extrtication gloves, thermal imaging cameras, uniforms and tools for firefighters and I could go on and on. Peo Proud, before you trash something you know nothing about, consider reading the facts before you post what you think you know. I think if you looked into how many good things come from this “slush fund” and how much money it actually saves the City, I think you would reconsider your statement.
Dr.:
Thanks for the compliment – I think, but all my posting are directly composed by me. Whether that’s a good thing or not, I don’t know. As to my having too many facts — it’s not that hard to come by them if one has an open mind and does a little research.
Sorry if I offended anyone on the “slush” fund comment. Probably a little overreaching. However, my main point was and is: the ambulance was purchased by funds given to this group that are not in control of the City Administration or City Council and a decision was made to purchase the ambulance from those funds.
Dr.- actually, NO I don’t think 1 ambulance is better than none. Especially given the current level of EMS care available in Peoria. If they wish to get into the ALS/transport business it should be done as a comprehensive move – so that the PFD can bill for services. Otherwise, it’ll be nothing but a money losing endeavor from day one.
And Doc, not supporting AMT at all – just trying to get you to acknowledge all the facts surrounding the situation.
Yeah, “slush fund” is probably not a good way to describe it, but Peo Proud’s point is right, that the fact that the ambulance was purchased does not mean that it was part of a plan to actually use the ambulance. It was the decision of the FFT board, not the leadership of the PFD.
T.V. is right, the FFT goes to purchase lots of things that would otherwise come from the City budget, appliances and such for the firehouse, and even emergecy equipment. The volunteer dept I am with just throws it in with the general fund, but of course we need any money we can get to just operate.
For light reading, here is some info on the Foreign Fire Insurance Tax in Illinois: http://www.ilga.gov/legislation/ilcs/ilcs4.asp?DocName=006500050HArt.+11+Div.+10&ActID=802&ChapAct=65 ILCS 5/&ChapterID=14&ChapterName=MUNICIPALITIES&SectionID=44050&SeqStart=250500&SeqEnd=251790&ActName=Illinois+Municipal+Code.
************
And finally, John, most of the questions you “challenge” us to answer cannot be answered, because they are based on private conversations that happened years ago. You know that they can’t be answered, but you use them as a tool to “prove” that we are either biased or just not up to your level. Every time we discuss this subject you set up a straw-man argument against me and whoever else is participating. It is one of the classic logical fallacies and you commit it almost every time.
I don’t know Peo Proud, but as for myself, if you consider being a member in a leadership role of a small volunteer fire department to be a “connection”, then I guess I am guilty. I think you even described me as “well connected” in a previous writing, something which I laughed at.
So, John, feel free to stuff your straw man all you want. Until you address simple facts, Mr. Scarecrow will continue wish for a brain.
Peo Proud is:
1) Not a member of a Fire Department,
2) Is not a member of any EMS/ILS/ALS organization,
3) Isn’t employed by any of the three fine Peoria hospitals;
4) Isn’t involved in fire/ems issues in any way and actually doesn’t have any friends/acquaintenances that really are either;
5) Isn’t married to anyone that would be connected to any of the above (sure you know why I listed this one Doc!)
6) Is simply a proud peoria resident that is for good decisions being made by our elected officials based upon FACT and not emotions, hysteria, or what “feels good”.
But you HAD to have help writing your post on 1/24/2007. You just HAD to. There is no way you could come up with that on your own. How dare you even try to fool us into thinking you could…
Honestly, for all the sniping going on here, I’m happy to see that folks are using facts and figures to bolster your arguments, and the insults are beign kept to a minimum.
One of these days, I’d like to see Ton and PeoProud put some of this energy into creating their OWN posts, on their own blogs or even b makign a post of two here on Peoria Pundit.
Bill,
Don’t be too impressed with the quality of the comments and their warm and fuzzy nature. Have you been reading them? I told Tony a long time ago, that he gets no beer.
Peo Proud should not believe that I was impressed with his facts and figures. I am not. He and Tony produce no figures at all if you actually read their comments.
No, I take that back. Peo Proud said that one ambulance run by the PFD would be worse than having no ambulances. So he did use a statistic after all.
As I mentioned, neither will ask key questions to people at PAEMSS or OSF. They both refuse to do so out of fear…and on other comments they have made, they say they just don’t care to hear the other side. So they really DON’T have the monopoly on facts as they try and make us believe.
These two characters tell us who they are not associated with but won’t tell us who they are. They seem like such purists about topics close to their hearts, but they won’t give their names.
I wonder why?
John
Because it really sticks in your crawl.
Billy,
I’ve been promising you one for a while and I’ll try to come through this weekend. Just been busy. It’s SO much less time to comments than to prepare a full posting (plus there’s a different – or should be – level of facts, cohesiveness, and logic that goes into original posts. Comments can come off the top of your head.
We are all holding our breath….
Oh, how we wish that were so true in your case.
I would not be just a nuffin’
My head all full of stuffin’
My heart all full of pain.
I would dance and be merry
Life would be a ding-a-derry
If I only had a brain…
Dear John said : Don’t be too impressed with the quality of the comments and their warm and fuzzy nature. Have you been reading them? I told Tony a long time ago, that he gets no beer.
Hey man, I’d buy Tony a beer any time. Also Billy, I would love to see Tony start his own posts too, because all he is doing when responding to Dr. Carol is waisting his time. Those who read this site know who is right and who is full of hot anti OSF air. I notice that as time goes by the people posting in response to your nonsense is getting fewer and fewer. Billy posted something about his hits and views, and I am pretty sure that the fact that you are on here because your sites are not getting the attention you wanted is not the reason for his hits.
I personally don’t believe that there are any questions to be asked at OSF and PAEMS, if there are, let the people who “should” be asking them ask them.
Here here, T.V.
Did you have any help writing that? So logical and concise that I’m sure the good Doc won’t believe you were capable of doing it on your own.
T.V., maybe someday I will be in the position to owe you a few beers.
TV’s comment was written by him. No doubt about it. Wasn’t full of facts and figures either, but he definitively wrote it without help…
You must have physic powers to know from Haiti who writes what!
And i started tying my own shoes without help today too, progress is slow but sure.
In conclusion,
1. OSF is spending 2 million dollars on a helicopter hangar. The PFD remains Basic and non transport for 113,000 people in Peoria.
2. The final verdict is not definite in the medical literature about the efficacy of air transport for emergency cases. Advanced Life Support (not Basic) seems to be the most important issue.
3. Pre hospital health care statistics seem to be missing in Peoria. The Pundit’s anonymous commenters talk about EMS in Peoria in glowing terms, but offer no proof.
4. Obstacles have been placed in front of the PFD regarding upgrading their services. The anonymous commenters don’t seem to be interested in talking to OSF and PAEMSS about this topic.
5. Conflict of interest in Peoria is alive and well.
See, I TOLD you there was a conspiracy. This just PROVES MY point.
Comment by Dr. John A. Carroll
2007-01-27 08:32:39
“In conclusion…”
I sez: Oh, don’t tease us with a line like that.