Conflict of Interest

 Conflict of Interest

During the fall of 2001 many people told me that Dr. George Hevesy was receiving a salary from Advanced Medical Transport (AMT). This seemed unbelievable to me. They usually followed up their statements with, “You know this is conflict of interest”. Another physician in the OSF ER screamed at me in anger about Hevesy’s conflict.

Hevesy was wearing many hats. He was the newly appointed Director of the ER at OSF and had been the Project Medical Director (PMD), for about 10 years. As PMD he was in charge of all the ambulances in central Illinois—approximately 70 agencies. Hevesy was (and is) Corporate Medical Director of AMT. The following year, OSF-SFMC would appoint him as President of the Medical Staff at OSF.

I filed under the FOIA at the Illinois Department of Public Health in Springfield for a conflict of interest statement. The document arrived after many months of trying.

Below are some excerpts from the IDPH statement regarding conflict of interest. It is not signed. It begins,

“In accordance with Section 515.320 j Scope of EMS Service, the Peoria Area EMS System is herein notifying the Department of a Stipend received by the EMS Medical Director from an EMS Provider in the System. Specifically, the Peoria Area EMS Medical Director, Dr. George Z. Hevesy, receives a stipend paid by an ALS provider, Advanced Medical Transport of Central Illinois.The stipend is justly provided to the EMS Medical Director for oversight and consultation provided to this comprehensive EMS provider. This EMS provider accounts for the majority of the System’s EMS responses and interfacility transfers. Additionally, this EMS agency provides a unique regional critical care (inter-facility) transfer service under the direct medical control of the EMS Medical Director.

This stipend does not create an agreement or atmosphere which makes the EMS Medical Director answerable to or directed by the EMS provider. Nor has it influenced the Medical Director’s assistance of other providers.

The Peoria Area EMS Medical Advisory Board and the Ambulance Board of Directors, consisting of representatives of the Peoria area hospitals, have reviewed the stipend and believe there is no potential or actual conflict of interest.”
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The “EMS provider” stated above is AMT. I wonder what the PFD would say about influencing the medical director’s assistance with regards to the PFD? The Ambulance Board of Directors must be the AMT Board of Directors because there are no other ambulances in Peoria.

This is truly an amazing document. (Please see last post in this blog regarding Doug Marshall's comments regarding PAEMSS and IDPH and the confusion that is created by the statement in the Journal Star that PAEMSS is an arm of IDPH. Doug Marshall is OSF attorney and PAEMSS attorney.)

Locally and nationally, people in EMS told me this represents conflict of interest. Firefighters stated that they “tap their toes nervously” and wait for AMT to arrive when they have a patient with severe breathing problems and are unable to help the patient other than give basic life support, even though the PFD had firefighters with advanced skills (Intermediate and Paramedics). Many firefighters in the Peoria area, told me that Hevesy “obstructed” their departments when they attempted to upgrade their services for their citizens. The municipal fire departments are not paying Hevesy; AMT is. AMT is the only paramedic and transport service in the city of Peoria.

Three are two fundamental ethical premises that guide prehospital medical care. The principle of justice implies that the system be fair and equitable. The principle of beneficence requires that actions and intentions are in the best interest of the patient.

In the April 5, 2005 Annals of Internal Medicine a Position Paper regarding medical ethics stated the following: “The physician must seek to ensure that the medically appropriate level of care takes primacy over financial considerations imposed by the physician’s own practice, investments, or financial arrangements. Trust in the profession is undermined when there is even the appearance of impropriety.”
“…Physicians must be conscious of all potential influences and their actions should be guided by patient best interests and appropriate utilization, not by other factors.”

Do you think this constitutes conflict of interest?

In December 2002, my brother and I met with Monsignor Rohlfs and the Canon Law Lawyer for the Diocese of Peoria, Patricia Gibson. We met with them in Monsignor Rohlfs office. We expressed our concern with the conflict of interest regarding our EMS system as described above. They helped us draft a letter of petition to the OSF Sisters requesting a Catholic tribunal court against OSF because of OSF’s association with AMT and Hevesy.

However, in February of 2003, when I met with Monsignor Rohlfs and Patricia Gibson, they told me that if I pursued a tribunal regarding OSF’s role in this matter, the Diocese would withdraw its support from Haitian Hearts. They also stated that they would blame me in the media for the failure of the program. I was stunned to hear Monsignor Rohlfs say this. The Diocese effectively held the Haitian kids who needed heart surgery hostage to protect OSF from a Church tribunal. This was very hard to accept.

I filed the petition anyway with Bishop Jenky, who refused to consider it. (See his written response below.)

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