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Board not meddling in hospital's management

Editor: I disagree with your editorial of Oct. 8, lambasting Frank Fleischer, Jay Wolfson and me for voting our belief with regard to putting out a request for proposals for a search firm to assist Tampa General Hospital in searching for a chief operating officer. Please consider the following. The board voted unanimously in 1989 to have the management audit done at a cost of about $220,000. This audit, known as the Lash report, had basically one main recommendation: Find a strong COO to assist Newell France. I believe that a proper function for a board is to insist on the creation of a table of organization that will promote success and hopefully provide for succession. Newell France is a competent hospital CEO. However, he is 62, we would like him to delegate, and we would like to think we have someone who might fill his shoes is the future. I think these are all good policies and not meddling in management as you suggest. This summer the board voted, again unanimously, to make a search for a COO per the Lash report recommendation. The board voted to issue a request for proposals, and Newell France concurred. The request for proposals had not been put out as of the last board meeting. Mr. Fleischer, Dr. Wolfson, and I were trying to insist on doing what the board had voted unanimously to do earlier in the summer. I would further point out that the board was specific in stating that all candidates were welcome to apply, including current hospital employees. Further, we were specific in stating that Newell France would have ample opportunity to "pick and choose," but that we wanted to find out what was available in the marketplace. We were not going to just ignore the major recommendation of the $220,000 Lash report.

I have confidence in Newell France. I do not sense that the HCA is even considering a Newell France "no confidence" vote. We do want our CEO to put in effect the policies and instructions the board lays out for him. I also have confidence in the opinions of Frank Fleischer and Jay Wolfson. Our various backgrounds offer more than your statement that we are not intellectually honest. Unlike newspaper editors, we are not perfect. Neither is Newell France. We are trying to make some changes for the better. We hope this is appropriate policy-making, not meddling in management as you suggest. Some may disagree, but we did what we thought was appropriate.

You are indeed correct in stating that we must find a solution to Tampa General's financial dilemma if possible. As you are well-aware, a number of the board including me believed that privatization was a solution for the financial dilemma at Tampa General. The press, some politicians, and about 100 of the 850,000 citizens of Hillsborough County successfully defeated this concept, although it has worked successfully all over the state and nation.

Tampa General's finances need three things. First, TGH needs operating capital _ about $20-million worth. This could be created by getting out of the Florida Retirement System. We are investigating how to do this without privatization. Second, TGH must be paid profitably (or at the very minimum in full) for services rendered to all. At this time, the only hope that seems adequate is restoring an indigent care sales tax. TGH's finances looked great with such a tax and terrible without it. Third, we need to increase our primary-care physician and surgeon base so as to sell our inventory of facilities. Our present operation without a strong COO has problems with this part of the solution.

Your reporter sat through the last meeting and heard the CEO from Grady Memorial in Atlanta say that local government puts almost $100-million per year into Grady and pays the bond issue. The CEO from Jackson Memorial in Miami told us a similar story. Send your reporter to Memphis, talk to Jim Root a long-time county commissioner in Shelby County, and look at the Med Center. The Memphis Med Center is a real success story. I challenge you to go, look, report and compare _ Memphis, Miami and Atlanta. Then look at TGH again honestly and intellectually.

Robert E. Vaughn

Tampa

Facts about mental illnesses

help abolish persistent myths

Editor: Understandably, the public is hungry for information about mental illness. Public misconceptions and fears about this very personal condition necessitate that the psychiatrists and the hospitals maintain a close connection with the community through the media, in research update publications and other available means.

The Department of Psychiatry has nationally recognized leaders in the treatment and research of psychiatric illness, and we, the Friends of Research in Psychiatry, provide the public with timely, accurate information about mental illness through the mass media. We routinely meet with and invite the media professionals for tours and information sessions to initiate productive discussions about mental illness.

As a result of psychiatric research over the past 20 years, people hospitalized with mental illness are recovering and are able to lead productive, enjoyable lives. Some will never need treatment again.

Basic research scientists such as those working with the Department of Psychiatry at the University of South Florida will discover some of the fundamental biochemical and genetic structures and functions of the human brain. Identifying the biochemical and physical causes of some forms of mental illness will greatly reduce the stigma as people begin to view mental illness in no more of a judgmental fashion than cancer or diabetes.

Community education programs and casual information sessions at the USF Psychiatry Center in the past years actively involve people in learning about mental illness and offer members of surrounding communities an inside look at modern psychiatric care. Additional ongoing communication with the community will help to underscore that mental illnesses are real, treatable diseases.

Changes in perception come slowly. But thanks to enlightened families who are courageous enough to discuss these intensely personal issues with their relatives, friends and others, the false impressions of public stigma are slowly changing.

Jane A. Mass

executive director,

Friends of Research in Psychiatry

at the University of South Florida

Water restrictions don't control

problem of long-term shortage

Editor: No doubt we're facing an even more pressing water problem than usual given the recent burst pipe in Pinellas County. Even so, one has to think the current restrictions need rethinking. The inequities seem obvious. Businesses and farmers that use tremendous amounts of water can continue to operate, but those who live in a certain area can't use water reasonably and sensibly.

The argument goes that the commercial car washes or farmers depend on income generated from their water use. No doubt. However, a vegetable garden that grows my food doesn't give me similar rights, even though I now have to buy from a grocery things I formally grew? Or my lawn and shrubs, paid for from my income, aren't as valuable as a nursery's? I'm sorry. That kind of thinking just doesn't wash.

The facts are, residential water usage counts for very little of the total water usage in Hillsborough County, much less than one-fourth as I recall. But outside residential water use is visible, and residents aren't organized to lobby against inequities. So now we have inequitable restrictions and rely on our authorities and neighbors to be secret "water police" and report violators. Swiftmud is telling us to solve our water problems simply enough: Don't use water. I'm sorry. It just doesn't make sense. Especially when we haven't supported reasonable restrictions all along. Swiftmud waits until things take a bad turn to act. For example: There should have been a standing restriction on 9-to-5 watering for years. And everyone needs to practice sensible water use at every opportunity. Don't flush toilets unless it's really necessary: Just two fewer flushes a day saves 500 gallons a month for the typical household. Sensible.

What else is sensible? Why not use the water meters already in place to determine equitable water usage? A certain number of gallons per household per month. This addresses inside and outside water use. And while I'm not wild about being limited in the amount of water I use, at least I have choices with this method. People can decide whether they want longer showers or want to water their lawns to barely keep them alive. If someone exceeds the limit, no secret "water police" are needed, simply a stiffer rate is levied on excess use, plus an even stiffer fine. (Because yes, there are people with more money than good sense.)

Currently no verifiable limits exist on inside water use, a testament to the fact that the restrictions are targeted at visible uses of water. And do you avoid breaking the law by bringing in your dying potted plants and watering them inside? It really comes down to just what is fair and reasonable.

Don E. Thompson

Tampa

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