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Martin & Me
by Lee T. White
Friday Jun 19th, 2009 8:25 PM
A TV station's investigation of a hospice owned by California Pacific Medical Center reveals what's really wrong with an institution that wants to build a new hospital at Geary & Van Ness
KPIX-TV, CBS 5, did a rather shocking piece about a hospice nurse who admitted under oath that she administered drugs to a patient against a physician’s orders. The patient died and a pathologist hired by her daughter determined that the elderly woman had enough of the drug Atropine in her system to kill seven horses. The licensed vocational nurse, Betsi Bilyck, was still working at Coming Home Hospice as of June 8. A check of the California Board of Vocational Nursing’s license database indicates no disciplinary action. Bilyck still had a valid nursing license as of this writing.

Coming Home Hospice is owned by California Pacific Medical Center, a Sutter Health affiliate. CPMC and Sutter are controlled by a very anti-union board of directors and management. In fact, two members of the Sutter Health board of directors contributed to Mitt Romney’s presidential campaign.

CPMC issued a statement calling its employee’s actions “appropriate.” So a major medical center – the one that wants the San Francisco Board of Supervisors to sign off on its fancy, new hospital at Geary and Van Ness – says it’s appropriate for a nurse to give a patient enough Atropine to kill seven horses even without a doctor’s order. Consider that the next time you need health care in San Francisco.

Covering corporate ass is of paramount importance at CPMC and Sutter Health. An incident that occurred in April illustrates how a culture of deceit permeates these organizations from top to bottom.

My wife, Sherri, was a registered nurse at CPMC until becoming disabled from multiple sclerosis in 2007. Our experiences at the medical center have been overwhelmingly positive. We remain in California chiefly because of her neurologist, Dr. Amy Akers. We also remain friends with many of Sherri's former co-workers. That said, an incident in April certainly called into question the level of trust one should have in CPMC's management.

Sherri needed a new primary care physician because hers left for Kaiser. We went to see Dr. May Yau, who is a partner in Pacific Internal Medicine Associates. Another practice partner is none other than Dr. Martin Brotman, now-former CEO of CPMC and current president of the West Bay Region of Sutter Health facilities. Dr. Yau refused to treat Sherri because Sherri refused to sign a medical malpractice arbitration agreement. Dr. Yau stated that it was the policy of her practice group to require patients to sign such a form.

In response to complaints I made about the incident via e-mail and CPMC's Beyond Medicine blog, I received an e-mail from CPMC Media Relations Manager Kevin McCormack.

"I would also like to point out that while Dr. Brotman may share an office with Dr. Yau he is in no other way affiliated with her," McCormack wrote. "They have entirely separate practices."

Sherri requested and received a refund of the co-pay to Dr. Yau. Attached to this story is a copy of the check that clearly lists Dr. Brotman and Dr. Yau as members of the same practice group.

It is said that there are lies, damned lies, and goddamned lies. I'll leave it to you to discern into which category McCormack's lie should fall.

I sent the Sutter Health board of directors a letter in April in which I discussed McCormack's assertion that Dr. Brotman's practice is entirely separate from Dr. Yau's. I received a nice reply from one of the members stating that Sutter Health couldn't dictate how its physicians operate their practices. Yeah, well, Sutter sure as hell can decide who its regional presidents are.

What happened at the hospice is unacceptable and entirely inappropriate. The fact that CPMC would publicly assert otherwise – even in a pathetic attempt to mitigate its culpability in a wrongful death lawsuit – should frighten the living hell out of current and future patients.

California Pacific Medical Center needs an enema. Brotman and McCormack should both be summarily fired. If Sutter CEO Pat Fry doesn’t have the balls to do this, then he needs to go, too.

Meanwhile, I have warned the San Francisco Board of Supervisors not only to get everything in writing from CPMC regarding the new hospital, but to make the institution face real consequences if it fails to make good on any promises its managers make. A new hospital comes with many hidden infrastructure and transportation costs. For example, have you ever ridden the Muni 38 or 38L? If so, you can imagine what it’ll be like with yet another hospital on the route.

CPMC, long a miser when it comes to charity care, needs to give something back if San Francisco allows it to open a profit center along one of its busiest thoroughfares. How ‘bout starting with a little honesty?

by kevin McCormack
Friday Jul 17th, 2009 3:26 PM
Dear Mr. White
I'm sorry you don't believe me when I say that just because Dr. Brotman has his name alongside Dr. Yau's that it doesn't mean he has any dealings with her. However, it is true. The two may be members of the same group, as is CPMC's Physician Chief of Staff Dr. Damian Augustyn, but they have nothing to do with each other's practice. The group is so they can share administrative costs, not common policies on how to handle patients.

When you first raised the issue with me I tried to respond in a helpful, respectful manner. It would be nice if you had returned the favor when you had questions about me. Calling me a liar doesn't help anyone, nor does it resolve any differences we have.

I am always willing to talk to you about any topic, any concerns you may have about CPMC. You simply have to ask.

Kevin McCormack, CPMC Media Relations Manager
by Lee White
Monday Jul 20th, 2009 8:02 PM
You're dancing, Kevin. In a way, I feel sorry for you. If Brotman was as stellar an individual as he believes himself to be, he would have dealt with this issue directly rather than making you his frontman. But that's why you get paid the big bucks, I suppose. I'll bet every physician in that practice has the same malpractice insurance carrier and demands that every patient sign the same form Sherri was handed. They should be honest enough to say, "Hell, yeah, we make our patients sign arbitration agreements. It saves us a lot of money." I might not like that sort of arrangement -- and I wouldn't see anyone listed on that check for treatment even if it was free -- but at least I wouldn't question their integrity and their motives.
by Cathedral Hill Neighbor
Wednesday Jul 22nd, 2009 5:40 PM
Mr. McCormack,

You can't be mad at Lee for calling you a liar. Sutter/CPMC has a long reputation for lying to the community, and you're their mouthpiece, so...
by Lee White
Thursday Jul 23rd, 2009 11:52 PM
The California Board of Vocational Nursing and Psychiatric Technicians today filed a petition to revoke the license of Betsi Bilyck, the nurse featured in the story above. The California Department of Social Services, which regulates Coming Home Hospice (owned by CPMC) issued an order to Bilyck telling her that her presence at the hospice, or any other facility, "constitutes a threat to the health and safety of the clients in care". Bilyck is therefore currently "not allowed to be physically present in any facility." Read the nursing board's order here:
by Clara Bow
Wednesday Sep 9th, 2009 11:07 AM
Dear Lee,

I'm sorry for you and your wife. I found it interesting that you wrote about Sutter's board members donating to Romney's campaign. I believe that Sutter has strong ties in Utah and to the Mormon church and I believe that Sutter's business dealings are designed to enrich other LDS members primarily. In Marin County back in 1995, Sutter took over a lease of Marin General Hospital and the lawyer who designed that lease was named Quentin Cook, an LDS elder. Sutter profited over 150 million dollars over the course of the lease since then and Sutter's CEO at the time was named Van Johnson, another LDS elder.
by Lee White
Friday Sep 18th, 2009 10:11 PM
Interesting that you brought up Mr. Cook. I found some info about him online. By the way, you might also like this story:
by Lee White
Friday May 21st, 2010 7:08 PM
On May 7, 2010, the California Board of Licensed Vocational Nursing placed nurse Betsi Bilyck on probation for three years.
by Tracy Thomson
(thomson.tracyc [at] Thursday Jun 24th, 2010 4:43 PM
My Mother was a resident at Coming Home Hospice from December until February 2010 and I have to say that the reason her last few months were dignified and well spent was all due to the nurses and staff at coming home hospice. This hospice gave my sister and I time to spend with my Mom in a home like hospital. Each nurse cared deeply for my Mom and our family. Taking the time to explain things, call us to share updates with us, and even giving me their personal cell phone numbers at times so I could call them on their day off if my Mom needed something specific. I have never felt more cared for, and I know my Mom's last breaths were felt in a safe and loving environment. I hope that everyone keeps an open mind when reading the articles that are talking poorly of this affiliation.

Monday Feb 28th, 2011 8:55 PM
Sutter Health, only one of many highly profitable "non profits" in the
American Corporate Health Care panoply, is currently imposing a rent increase of up to 60% on primary care physicians at St Luke's Hospital in SF.
They continue to attempt to squash independent practititioners and force primary care docs to work for the 'company store' ie the Sutter Health Foundation, at rates which plumbers and electricians would find laughable (until THEIR unions are shut down, of course)
When is America going to wake up to the fact that Sutter Health, and all the other middle men corporations which provide "Health CAre Management Services" are massive kleptocracies, bankrupting the medical care system, and sucking it dry???!!!!
by noname
Sunday Jun 17th, 2012 4:15 PM
Sutter's billing is coming from Salt Lake City,Utah now.