Mythicaldude

Phnom Penh, Cambodia

March 24th, 2012

TO: The editors of The Phnom Penh Post and The Cambodia Daily

Dear Editors,

I read the letter from Bernard Krisher published on page nine of the March 24-25, 2012 edition of The Cambodia Daily, and I would like you to publish this response. Truth is in very short supply in Mr. Krisher’s missive and he appears to be guilty of the same thing he accuses The Phnom Penh Post of: failing to check the facts!

I categorically deny that I have invaded the privacy of my friend who is a patient at Sihanouk Hospital Center of HOPE (SHCH). Mr. Krisher’s accusation to the contrary is simply untrue. I have, on behalf of my friend and with my friend’s explicit permission, repeatedly attempted to obtain a copy of my friend’s medical records from SHCH because my friend wanted (and still wants) me to do this. In fact my friend gave the hospital a signed letter requesting copies of these records on July 27, 2010 (I have a copy of the signed request right here in front of me). Subsequently the hospital had my friend sign an official SHCH medical records release form in order to accomplish this seemingly trivial and routine task, yet my friend has not received the requested copies to date.

When Mr. Krisher states that “Mr. Goodman expected information that he was not entitled to…”, he is entirely wrong. In fact just this month I received several official SHCH Health Report Summary documents that SHCH sent to me detailing private medical information about my friend. The hospital sent these highly confidential reports directly to me specifically because my friend requested that they do so and because the hospital has a duty and obligation to honor my friend’s requests.

Actually, in point of fact, the hospital, where Mr. Krisher is Chairman of the Board, has flagrantly violated my friend’s medical privacy and confidentiality on several occasions and I have documents that indisputably prove this. SHCH deliberately e-mailed very private and confidential medical information about my friend to people who are not SHCH medical staff and who were not authorized by my friend to receive such private information. This is a true fact!

Furthermore, Mr. Krisher is also completely incorrect when he wrote that “The hospital had no obligation to provide such information…” to me. The fact is that very clear guidelines published by the Cambodian Ministry of Health state in plain unambiguous language that “Clients have the right to choose who, if any one should be informed on their behalf about their health condition.” So in fact the hospital has both a duty and an obligation to comply with my friend’s choice in this matter.Mr. Krisher is just plain wrong.

When Mr. Krisher wrote that my “accusation against the hospital… was improper”, he is absolutely incorrect and I think he and the hospital owe both my friend and I a public apology for his completely baseless public accusations against me.

Finally, Mr. Krisher is completely incorrect when he suggests that these issues have not been a matter of public discussion in the past. The fact is that these issues have been openly discussed on the Internet in several blogs and on Facebook, and they are entirely “fair game” for further public discourse. I believe that Mr. Krisher is well aware of these public discussions, yet he quite disingenuously seems to be in denial of them and his statements are woefully lacking in credibility.

In light of these facts I wonder why it is that The Cambodia Daily did not check to see if what Mr. Krisher claimed and accused was actually true. Is it because he is the Publisher and feels that he can write what he wants without regard to the facts? It appears that, in both his role as the Publisher of The Cambodia Daily and in his role as Chairman of the Board of Sihanouk Hospital Center of HOPE, Mr. Krisher has set a very poor and disreputable example for these organizations and in doing so in such an openly public manner he seems to have violated his fiduciary duty to the hospital, something that I find to be quite irresponsible, offensive, and shameful.

I absolutely stand by the accuracy of my letter that The Phnom Penh Post published last week and by the accuracy of this letter as well. What I said is true, what Mr. Krisher said is not. With all due respect, Mr. Krisher seems to be more than just a little bit out of touch with reality.

Sincerely,

Steve Goodman

Phnom Penh, Cambodia

PLEASE ALSO SEE THESE POSTS:

http://mythicaldude.net/blog/2010/07/22/sihanouk-hospital-center-of-hope-not-even-up-to-cambodian-standards/

http://mythicaldude.net/blog/2010/07/09/sihanouk-hospital-center-of-hope-has-problems/

AND

http://greatnonprofits.org/whitelabel/reviews/sihanouk-hosiptal-corporation

http://greatnonprofits.org/reviews/thanks/108359

http://mythicaldude.blogspot.com/2012/03/sihanouk-hospital-center-of-hope.html

http://mythicaldude.typepad.com/mythicaldude/2012/03/sihanouk-hospital-center-of-hope-in-phnom-penh-does-not-like-complaints.html

http://sideth.com/help-us-build-a-bridge-to-tomorrow-the-sihanouk-hospital-center-of-hope/#comment-3501

http://sarvinakang.wordpress.com/2011/09/09/sipp-brings-cambodian-women-smiles-and-hope/#comment-24

http://blawgirl.julieanneines.com/2010/05/28/phnom-penh-bar-review-and-moto-ride/comment-page-1/#comment-4900

http://vinzlite.multiply.com/photos/album/8/Sihanouk_Center_of_Hope_Cambodia

http://www.expat-advisory.com/forum/asia/cambodia/bernard-krisher-defamed-me#comment-28168

The letter below was published in the Khmer edition of The Phnom Penh Post last week. Bernard Krisher, the Publisher of The Cambodia Daily and the Chairman of the Board of Sihanouk Hospital Center of HOPE (SHCH) published a letter in the Sat/Sun March 24-25, 2012 edition of The Cambodia Daily that contains false accusations against me and other absolutely untrue assertions. I have written a response letter for publication to the editors of both The Cambodia Daily and The Phnom Penh Post detailing, point-by-point, my response to Mr. Krisher’s missive. Should The Cambodia Daily not publish my letter I will do so myself on blogs, on Facebook and elsewhere. Stay tuned…

Phnom Penh, Cambodia

March 19th, 2012

TO: Mr. Alan Parkhouse – Editor-in-Chief, The Phnom Penh Post

Dear Editor,

By definition, complaints in a clinical hospital setting have a legitimate and proximate intent to help improve healthcare quality, but at Phnom Penh’s Sihanouk Hospital Center of HOPE (SHCH) complaints have sometimes been forcefully discouraged and their handling is often rude, unprofessional, incomplete, unethical and decidedly sub-standard to internationally accepted best practice standards.

Because I and a poor sick friend who is treated at SHCH have been repeatedly told by the hospital’s current Director, Dr. Gerlinda Lucas that SHCH “operates to an international standard” our expectations for the best possible care are well-founded and our dismay and dissatisfaction with SHCH’s poor procedures for complaint handling and quality improvement (or lack thereof) are equally well-founded. Our dissatisfaction with the way SHCH handles complaints stems, in part, from this “expectations gap”. The discordance between what we want and have every reason to expect from the complaint process and what we routinely receive is large and quite troubling.

We believe that SHCH should take a significantly more humane, empathetic, flexible and expansive approach to providing remedies when a patient is injured, harmed or otherwise unhappy with a doctor’s care. In many respected studies, patient complaints correlate highly with other adverse outcomes that obviously should be avoided at any cost.

“Complaints and other sources of feedback from patients in the form of compliments, comments and concerns represent an important opportunity to learn lessons about possible service failures, which can then be translated into improvements in service quality. An important factor in judging the quality of a health service should be how quickly and effectively complaints are resolved and embedded into service improvement. Patients want to see their concerns taken seriously, their complaint investigated speedily, fairly and using appropriate mechanisms such as mediation and investigation, with an apology, a clear explanation given, and follow up action taken.”
(From page 251 of Donaldson’s’ Essential Public Health by Liam J. Donaldson and Gabriel Scally)

Dr. Wayne Cunningham of the Department of General Practice, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand wrote in an article called “Complaints, shame and defensive medicine” published on March 15th, 2011 in the BMJ Online Journal of Quality and Safety (http://qualitysafety.bmj.com/content/early/2011/03/23/bmjqs.2011.051722.full) that:
“The emergence of defensive medicine suggests that an unintended outcome of the complaints process can be reduced patient care. We propose that the profession institutes a rapid collegial response to complaints that is mindful of both emotional and intellectual responses, and seeks to minimise the maladaptive learning that is characteristic of defensive medicine.”

On numerous occasions the hospital has responded to very serious complaints about problems that are completely preventable in a most unenlightened way – with aggression and mean-spirited actions; defensive denial of a problem, trying to prohibit a patient’s loving caregiver and legitimate advocate from coming to the hospital to provide comfort and care (a right enjoyed by all the other patients), making threats to both the caregiver and the patient, and ignoring the complaint altogether and thereby ignoring a valuable opportunity to improve the doctor-patient/caregiver relationship and missing a chance for meaningful and lasting quality improvement and learning that could benefit all patients.

Young doctors at SHCH are being trained and educated in what appears to be a highly toxic culture where complaints are seen as discouraging, unhelpful, destructive, and are treated in a hostile and unwelcome fashion. Senior SHCH doctors (as well as Mr. Bernard Krisher the chairman of the hospital’s board) who ought to know better have instructed doctors and staff to ignore patient and caregiver complaints and have even gone so far as to instruct hospital doctors to “refer out” a patient who has made entirely reasonable complaints.

It appears as though rather than wanting to improve the quality of healthcare that they deliver SHCH simply wants to eliminate having to deal with anyone who has the good sense and heartfelt concern to complain about serious problems. This is a very dangerous, irresponsible and unethical approach, not only in my opinion by according to many scholarly articles and studies that have been internationally accepted. In fact SHCH’s senior doctors and management have even gone so far as to subject their patient (and my friend) to abusive and unethical threats by a gang of hospital employees (including doctors, nurses and counselors) who behaved in a thuggish and entirely uncompassionate manner by bullying and threatening the patient in direct response to a number of completely legitimate complaints.

SHCH’s complaints handling (there seems to be no properly documented procedure or policy) takes too long, offers little satisfaction or appropriate feedback and resolution and does not demonstrate sufficient impartiality or interest in patient satisfaction, comfort, wellness or in quality improvement. The few written responses to complaints I’ve received clearly suggest that criticism is not welcomed as a way of improving the quality of healthcare services the hospital delivers. There is a very clear implication that SHCH’s clinical complaints procedure needs to be carefully reviewed, reformed and improved to ensure true accountability to patients, its donors and to its mission.

Promotion of trust, candor, safety, accuracy, correct diagnosis, effective treatment and good preventative care takes a strong institutional and organizational commitment to best practice medical and ethical standards that SHCH has repeatedly failed to consistently demonstrate. SHCH needs to change this for the good of all its patients and for the good of all the young doctors it professes to train and educate.

I want to encourage SHCH to take all feedback in a positive and constructive manner. Find the truth in feedback rather than focusing on any possible deficiencies that it may contain. SHCH can make health care better, safer and less costly for its donors while strengthening the core values of the patient-doctor relationship that are uniquely human; honesty, integrity, empathy and compassion.

Poor sick patients need the kind of environment where they feel comfortable questioning anything that seems, wrong, strange or out-of-place and where doctors are open to a range of different opinions from others. Please improve both the quality of healthcare and the handling of complaints, concerns and other constructive feedback at Sihanouk Hospital Center of HOPE.

Sincerely,

Steve Goodman
Phnom Penh, Cambodia

PLEASE ALSO SEE THESE POSTS:

http://mythicaldude.net/blog/2010/07/22/sihanouk-hospital-center-of-hope-not-even-up-to-cambodian-standards/

http://mythicaldude.net/blog/2010/07/09/sihanouk-hospital-center-of-hope-has-problems/

AND

http://greatnonprofits.org/whitelabel/reviews/sihanouk-hosiptal-corporation

http://greatnonprofits.org/reviews/thanks/108359

http://mythicaldude.blogspot.com/2012/03/sihanouk-hospital-center-of-hope.html

http://mythicaldude.typepad.com/mythicaldude/2012/03/sihanouk-hospital-center-of-hope-in-phnom-penh-does-not-like-complaints.html

http://sideth.com/help-us-build-a-bridge-to-tomorrow-the-sihanouk-hospital-center-of-hope/#comment-3501

http://sarvinakang.wordpress.com/2011/09/09/sipp-brings-cambodian-women-smiles-and-hope/#comment-24

http://blawgirl.julieanneines.com/2010/05/28/phnom-penh-bar-review-and-moto-ride/comment-page-1/#comment-4900

http://vinzlite.multiply.com/photos/album/8/Sihanouk_Center_of_Hope_Cambodia

http://www.expat-advisory.com/forum/asia/cambodia/bernard-krisher-defamed-me#comment-28168

• I am an American ex-pat living in Phnom Penh, Cambodia where I work as a guitar player, photographer and consultant.

• For more than 20 years I lived a somewhat conventional life with a career in sales, marketing and management of innovative high-tech hardware, software and Internet companies, but for the past ten years I have been traveling and pursuing a career in photography.

• I’m a very lucky guy with lots of solidly successful business experience, but I’m difficult to pin down due to my wide range of interests.

• I spend my time learning, reading, doing photography, playing guitar, listening to music, traveling, meditating and walking around to see what’s going on in our world of inestimable beauty and potential.

• I’m an unusual, fun-loving yet serious and hard-working individual. Private and independent.

• I was fortunate to have studied with the 14th Dalai Lama at his temple near Dharamsala, India some years ago, but that is just one of many exceptional experiences and accomplishments.

• I absolutely refuse to define myself by, or conform to any standard or convention so please don’t get hung-up on labels! Its all up to me… I question authority, break the dominant paradigm, think for myself and I suggest that you do the same! I aspire to do things that are collaborative and outrageously amazing in vast mythical proportions!

• I earned a Bachelors degree from the University of Pittsburgh in Philosophy and English Literature and worked for more than twenty years as a successful software and Internet company executive, but I’ve lived, traveled and photographed extensively in Southeast Asia since 2002.

• I have traveled extensively in the United States, Canada, England, France, Germany, the Netherlands, Japan, Singapore, Malaysia, Thailand, Myanmar (Burma), Laos, Cambodia, Viet Nam, Nepal and India.

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