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Shaw: Tough to monitor Cook County’s docs

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Updated: September 15, 2013 6:13AM



Is there a doctor in the house?

It’s often hard to tell in Cook County’s sprawling health care system, which is one of the largest government-run networks in the country with two hospitals, 16 neighborhood clinics, about 1,100 doctors and, in any given year, roughly 300,000 mostly indigent patients.

That’s a lot of vulnerable people.

A quarter of the system’s nearly billion-dollar operating budget comes from Chicago-area taxpayers, with state and federal funding covering much of the rest. That’s a lot of our money.

But a lengthy Better Government Association investigation raises serious questions about whether patients and taxpayers have been shortchanged, mainly because of grossly inadequate staff oversight.

We’re not talking about the hacks and slackers who perpetrate most of the county scandals.

This one focuses in large part on doctors who earn up to $500,000 a year and qualify for lucrative public-sector pensions but don’t necessarily give taxpayers or patients a day’s work for a day’s pay.

Over the past year, the BGA tracked the comings and goings of several county doctors — all with outside practices in addition to their public jobs — and found one of them was at his side job or at home on various occasions when he was scheduled to be working at the county’s Stroger Hospital on Chicago’s West Side.

Another physician rarely swiped a county identification card as required, so it was hard to determine whether the doctor was working a requisite number of hours.

And this, we’re told by reliable insiders, is just the tip of the iceberg.

County physicians are paid to work a set number of hours each week. Some are full-time, others part-time. Some have private practices or privileges at other hospitals. Some do rounds at a county hospital one day and at county clinics another.

But unlike most of the 6,000 staff members who have to swipe in and out daily on electronic keypads, doctors swipe their ID cards only once, so there’s no easy way to monitor their comings and goings.

And on days the docs forget to swipe or are in the field and can’t, they’re supposed to fill out “no punch” forms with the hours they actually worked.

But frequently the forms aren’t completed, and hardly anyone cracks down, so absences often don’t have consequences.

Sources also relayed stories about other medical personnel, including nurses, swiping in for one another to cover their absences.

During our inquiry, county officials launched a parallel investigation, which led to the firing of one doctor, the reprimanding of another and the distribution of memos reminding all employees to swipe and all supervisors to start accounting for subordinates.

County board president Toni Preckwinkle also added a BGA board member to the system’s governing commission.

Those are commendable steps, but we don’t know of a single supervisor who was held accountable for past oversight failures.

And county medical officials are still talking about a new timekeeping system with biometrics to halt the mass swipe-ins — thumb, palm or facial recognition — but so far it’s just talk.

So the proof of Preckwinkle’s commitment to actually reforming such a large, unwieldy bureaucracy will be down the road, when we can ask: “Is there a doctor in the house?”

And feel relatively confident the answer is “yes.”

Andy Shaw is president and chief executive of the Better Government Association.

He can be reached at ashaw@bettergov.org or at (312) 386-9097.



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