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  #21 (permalink)  
Old 08-24-2004, 06:14 PM
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acgme

Quote:
Originally Posted by jim
am unaware of the sdituation about kings, but as it seems people dont understand the "green book" I will do my once evry 2 months lecture on use of the green book. it is actually rare to find hospitals listed in the green book by name. usually they are listed by affiliation or by corporate name. just because you dont see the hospitals actual name, doesnt mean its not ACGME. you have to actually look at every listing for a city, and read the small print to find the names of the hospitals. In chicago, st anthonys is a ross hospital. but is not listed by name. it is listed by the name "catholic health partners"...just an example.
http://www.ama-assn.org/vapp/freida/...350109,00.html

Scroll down to affiliated programs. FREIDA is the first place you should do an "institution" search, if you are concerned about a hospital.

And, Jim, Larkin is still not officially affiliated with University of Miami as a teaching institution - I don't care what you or anyone else says.

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  #22 (permalink)  
Old 08-24-2004, 06:56 PM
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In fact...

In fact, go to University of Miami's website search engine and enter "Larkin" and see what comes up:

http://search.med.miami.edu/query.html?qt=&submit=Go

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  #23 (permalink)  
Old 08-24-2004, 07:02 PM
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Or...

Go to Larkin's website and do a search:

http://search.freefind.com/find.html...ery=University

You get two results concerning University of Miami. First, you get some mention of a vague affiliation on their Podiatry residency page that mentions the University of Miami Medical School "Department" (as well as Ross). In the second link, you get some mention of a service offered through the "Mammography University of Miami Orthopedic Clinic".



I believe that maybe they let podiatry residents rotate through University of Miami as an externship, but this doesn't create a teaching affiliation at Larkin. Second, their patients probably have some access to U of M services that they don't offer at Larkin. Again, this does not create a formal teaching affiliation.

To rehash the old argument that you alluded to, I wouldn't do my FP core at Larkin if I was an up-and-coming clinical student who just left the island, no matter what ******* **********(who should have remained fired a couple of years ago when he was fired by the school, but somehow got his job back) tells you.

-Skip

Edited by moderator for use of proper names. *** Identifies edited text.
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  #24 (permalink)  
Old 08-24-2004, 07:12 PM
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Then again...

This pretty much tells you all you need to know about Larkin...

http://www.usdoj.gov/usao/fls/Larkin.html

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  #25 (permalink)  
Old 08-25-2004, 11:17 PM
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Then again...

For those of you who didn't see it a few weeks ago, here is an update on the Larkin Community Hospital lawsuit:

Larkin Hospital Hospital Wins Landmark Case

Miami, FL, July 25, 2004—In an unprecedented legal victory over the Agency For Health Care Administration (AHCA), Larkin Community Hospital made history by winning an injunction against the Agency. The Department of Justice (DOJ) filed civil charges against Larkin Community Hospital on 6/29/04 claiming that the Hospital and its Executives were engaged in fraudulent practices under the False Claims Act from 1997-1999, AHCA subsequently, withheld Medicaid payments to the facility. AHCA provided the Department of Justice with what they termed to be “Reliable evidence” of unnecessary medical care provided at Larkin Community Hospital from 1997-1999. These allegations were the basis of a Federal Lawsuit against the Hospital which made headlines approximately two weeks ago.

Larkin Community Hospital, in turn, filed suit against AHCA citing lack of credible evidence of fraud. The Federal Investigation is based upon evidence supplied by AHCA that such credible evidence exists. However, during a four hour civil hearing on July 16, 2004, before Circuit Judge Jonathan E Sjostrom, AHCA was unable to produce “reliable evidence” to support the allegations.

The following is a brief excerpt of the proceedings:

THE JUDGE: Okay. What did the records that you sent -- that AHCA sent, what did they show?

MR. STIVERS (AHCA’S BUREAU CHIEF): Medical records.

THE JUDGE: Well, I know, but what did they show that you would contend is reliable evidence that circumstances giving rise allegations of fraud, willful misrepresentation or abuse, what did those medical records show that satisfies the 24 (a) standard?

MR. STIVERS (AHCA’S BUREAU CHIEF): (No response.)

THE JUDGE: Do you understand what I'm asking you?

MR. STIVERS (AHCA’S BUREAU CHIEF): I'm not sure I can get where I am to where you want me to be.

THE JUDGE: I just want to know what the 24 (a) reliable evidence is, that's it.

MR. NAM (AHCA’S ATTORNEY): MS. ******* (AHCA’s ASSISTANT BUREAU CHIEF) might know. I don't know, but somebody does.

MS. ******* (AHCA’S ASSISTANT BUREAU CHIEF): Okay. The reliable evidence…….Judge, I think -- I'm not sure…. that I would particularly feel competent to do that, simply because clinically I'm not sure I could explain it to you. I don't have those records and have not reviewed those records…

But I do know I was the one that signed that referral.

Quoting the legal definition of fraud, Honorable Judge Jonathan E. Sjostrom concluded that the State had produced no reliable evidence to support their allegations and issued an injunction for the release of Medicaid monies owed to the Hospital.

Larkin Community Hospital further established that significant irreparable harm would be caused to community and charitable organizations if such funds were withheld. Larkin Community Hospital participates in numerous community outreach programs which benefit the underserved and uninsured population of Miami-Dade County.

The issue of community health was categorically dismissed by State Attorney, Mr. David W. Nam stating that, “it's not Medicaid's job to take care of, I mean, you know, whatever the societal ills may be that result from a lack of insurance coverage for the population.” The judge, however, did not agree, stating that, “the balance of harm in the public interest tips, in my view, heavily in favor of the continuing practice of medicine by these people and they have shown what they need to show, the balance of harm tips in their favor.”

Larkin Community Hospital, a 130 bed medical/surgical/psychiatric hospital, was acquired by Dr. Jack Michel in January, 1998. Since then its rating by the Joint Commission on Accreditation for Healthcare Organizations has consistently been one of the highest in Miami-Dade, receiving 97% and 98% scores for the past six years. As one of the handful of physician owned and operated hospital, Larkin provides prompt medical attention uniquely reflective of its community orientation.
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  #26 (permalink)  
Old 08-26-2004, 12:19 AM
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Then again...

Quote:
Originally Posted by MitchDC
For those of you who didn't see it a few weeks ago, here is an update on the Larkin Community Hospital lawsuit...
Mitch,

I sent you a lenghty PM on this. While it looks official, I believe this post to be a hoax. I'd invite anyone - and will stand corrected, if proven so - to find this "update" anywhere on the Internet. Also, it is highly unlikely that a suit filed only at the end of June would be summarily dismissed at the end of July (e.g., it can take months to do discovery, take depositions, file motions and have them reviewed by the court, etc.), and especially on the sophomoric grounds laid out in this "update". The DOJ just doesn't screw around and enter lawsuits against hospitals on a meritless basis, and then show-up and look like a bunch of keystone-cops during a hearing.

I think this is B.S. The author of it has one post and his name is "jmichel", coincidentally very similar to the name of the CEO of Larkin named in the lawsuit. If I'm wrong, again, I'll eat my words.

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  #27 (permalink)  
Old 08-26-2004, 07:18 PM
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Then again...

Skip,

I'm not here to defend Larkin or anybody else. I just re-posted what was already posted here to make sure that people reading your post had more of the story. Whether you believe what another user posted or not is not my concern. The Larkin case was dismissed on insufficient evidence. You can spend your time doing extra research if it really matters to you.

As another matter of "bunk" busting - another piece of your post was false. The University did not fire anybody in Miami. Larkin dismissed him from his duty because he was supporting the Ross students involved in that whole post-9/11 pseudo-hoax. Instead of being applauded for supporting Ross students, it appears as though you are trying to blame him for doing so. If you want more info on that topic, you may read the article in the Miami Herald to get your facts straight: "Hospital removes MD who tried to place Muslim students".

MitchDC

A REMINDER TO ALL USERS: The use of personal names without the permission of that person is not allowed on the forum. Personal attacks, insults, or other defamatory comments will also not be tolerated.
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  #28 (permalink)  
Old 08-26-2004, 08:33 PM
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Then again...

Quote:
Originally Posted by MitchDC
As another matter of "bunk" busting - another piece of your post was false. The University did not fire anybody in Miami. Larkin dismissed him from his duty because he was supporting the Ross students involved in that whole post-9/11 pseudo-hoax. Instead of being applauded for supporting Ross students, it appears as though you are trying to blame him for doing so. If you want more info on that topic, you may read the article in the Miami Herald to get your facts straight: "Hospital removes MD who tried to place Muslim students".
This is simply not factually correct. Obviously I have stepped on your toes, Mitch. And, I'm going to leave others to decide who's more likely right here. Don't get me wrong; I'm an active Ross student. I want to see the University grow out of it's "Mom and Pop" mentality. A large part of this is a more active commitment to its students to tell the truth and bring things out in the open. Instead we are often stuck with the "mushroom syndrome" (i.e., how one grows mushrooms): being kept in the dark and fed a lot of crap. Personally, I'm sick of it.

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  #29 (permalink)  
Old 08-29-2004, 11:11 PM
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king's county

I saw that the post is about King's county and somehow ended up with postings about Larkin. Hmmm makes you think? Someone trying to change the subject??
Let me say this, I am not a Ross student but I have good friends and colleagues who go/have gone there. I feel very sorry for the Ross students who rotate at King's county. It is in NO WAY appropriate for a 3rd yr medical student and frankly I'm surprised your administration has continued its affiliation.
In 3rd year of med school you should be clerking patients and following them through the admission to learn clinically. However, this should not be at the expense of didactic learning. You should have enough time to READ and reinforce what you see clinically. It's the only way you'll really learn. The best IM rotation is the one that gives you a 50-50 between the books and the patients and I try my best to do that with the students I supervise. I give them solid medicine cases (COPD, PE, CHF etc etc) and no more than 2 patients at any given time. This is the way it should be in 3rd yr. I have personally gone to the ward where Ross students rotate as patients are frequently transferred from that service to a REAL medical service (ours)when the crap hits the fan. The students are absolutely LOST. They have no clue what they're doing or why and I give them no blame for this.
King's county is way too busy for a 3rd yr student. It's great for a 4th yr student doing a subI in medicine but not at all appropriate for 3rd years.
Whenever I go over to the A ward I try to teach the students a bit before their patient is transferred (usually to ICU) but it's tough. PA's should NEVER be supervising/teaching medical students...NEVER period!!
The attendings there are incompetent at best and thats all I can say about them.....

sorry guys... but whoever advocates for students at your institution should tell the school to NOT place 3rd yr students there...but it's a good place for a 4th yr subI rotation.......

later...
HG
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  #30 (permalink)  
Old 08-30-2004, 12:01 AM
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king's county

Quote:
Originally Posted by helpfulgrad
I saw that the post is about King's county and somehow ended up with postings about Larkin. Hmmm makes you think? Someone trying to change the subject??
No, not really. It was more to illustrate, in response to something Jim alluded to, how Ross doesn't always give its students all the information they need to make an informed decision.

Thanks for your great post, by the way. I didn't rotate at King's, but that pretty much sums up what I've heard from those who did.

And, to "flip the script", I'd give Ross the following grades on how they are currently running things that are the most important to students:

Pre-Clinical Sciences (i.e. Dominica): B
AICM (i.e., Miami): D-
Clinical Sciences (i.e., U.S. Clerkships): C-
Financial Aid Department: C

Overall, this rounds out to a solid "C-". So, as you can see, they'd have to take the "Comp".

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