witch hunt : OTD Professor Thomas Kossmann

Discussion in 'Australian Medical Council (AMC) EXAM' started by IMG, Nov 5, 2007.

  1. 0TD guest

    0TD guest Guest

    regarding the article :
    Doctor Looks For His Cure
    Witch Hunt: Investigation Seriously Compromised
    Herald Sun
    Editorial
    April 19, 2008 12:00am
    http://www.news.com.au/heraldsun/story/0,21985,23562501-24218,00.html

    An enquiry should be launched to probe Alfred Hospital management and administration to establish:

    *Who leaked the allegations?
    *What are the motives of these persons?
    *Which newspaper(s)/entities are the leaks going to?
    *Who are the anonymous detractors?
    *What are the motives of the detractors?
    *Has the Professor perhaps upset other surgeons in implementing a new type of
    treatment for pelvic fractures as mentioned earlier in this forum by an earlier poster. See/refer to post: Tue Apr 15, 2008 4:31 pm?
    *What has been the role played by visiting surgeons who feared their hospital surgery time would be cut back
    as part of his plan to overhaul the trauma centre by employing more full-time staff, as previously stated by Professor Kossmann in The Age
    report dated December 3, 2007
    http://www.theage.com.au/news/natio...ce-being-denied/2007/12/02/1196530480973.html

    It has emerged in other reports that TAC billing procedure was never adequately explained to the surgeon.
    Why not?

    It is obvious that Professor Kossmann has stepped on toes.
    The leaking of the allegations indicate that there are person(s) determined to
    undermine him.
  2. Guest

    Guest Guest

    The way I see it is that this man has been set up by his detractors who definitely felt insecure in regard to their future employment at the hospital. I read somewhere that they were orthopedic surgeons. On another occasion one surgeon had already previously not had his contract renewed after an altercation with Kossmann. This must have sent out an alarm bell to others.
    Because these persons were of one accord and senior persons, Jenny Williamsm manager of Bayside Health had to take notice of them. It is four doctors against one and she clearly has to support them or take it on the nose from other faceless persons in the crowd who support the philosophy of the four - perhaps all the 35 surgeons who had part-time employment at the hospital. After all, there is nothing that kills private health than a jolly good public system. They were feeding off the public system by their odd operation at the Alfred. Not good for continuity of patient care though.
    The Alfred appears to have become a one man show as regards the trauma area. That would have been far too much for others to stand especially if they had ego problems which many of them do.
    The process has been unjust from start to finish but is the way of many employment scenarios, not just this one. It is not uncommon for a rooster to end up as a feather duster in Australia.
    Not that Kossmann wasn't a very glorious rooster, one who should have sat on the perch for many a long year yet before ultimately falling off from sheer exhaustion. He must have done on average two to three surgeries a day. That is a lot of scrubbing up. He had a seven day week which would have miffed many another surgeon who valued some free time with family. To have had little in the way of a serious outcome from all that is a testimony to his dedication and single-mindeness to have a finger in as many operations as possible so that they all went off all right and were prioritised correctly.
    He and his wife are a wonderful asset to Australia and it is shameful that they have been treated badly.
    I am sure billing must be a very ad hoc thing these days. A goodly portion of his money would have gone into the Alfred coffers anyway to better serve the hospital.
    Unorthodox methods of management will end up in trouble even if the results were well intended and had a good result at the time. That is the thanks one gets for putting one's heart and soul into a place as though it was one's very own. If he had played by rule, he would not have the incredible impact that he did on the image of the Alfred which was raised beyond expectation into a world class facility under his guidance and involvement.
  3. Guest

    Guest Guest

    Somebody complained about him because he was treating patients who would have been treated by these surgeons if he had limited his cases. Apparently the motive of the complaints against professor is due to business competition. Getting rid of him would limit competition. Don't forget surgeons love to see long surgical waiting list.
  4. Guest

    Guest Guest

    Down goes another tall and exceptional poppy. When can Australia learn to be more civilised and less criminal (especially health bureaucrats and the medical profession)?
  5. OTD

    OTD Guest

    Embattled surgeon faces new allegations

    The AGE

    April 19, 2008 - 5:38AM


    The surgeon who quit his role as head of The Alfred Hospital's trauma unit in controversy is facing fresh claims of mismanagement.

    Embattled surgeon Thomas Kossmann was warned by The Alfred two weeks ago it would consider sacking him for failing to hand over hundreds of thousands of US dollars in patient fees and allegedly pressuring a junior surgeon to falsify a patient's records, Fairfax newspapers reported.

    The new allegations are believed to be detailed in a letter from The Alfred to Professor Kossmann's lawyers in early April, Fairfax says.

    They are in addition to the findings of a panel which first began investigating allegations made against Prof Kossmann last year.

    Prof Kossmann has rejected the fresh allegations, saying they only support his claims of a witch-hunt.

    The April letter from The Alfred to Professor Kossmann accuses him of breaching an income-sharing agreement from his hospital-based private consulting practice to the hospital, Fairfax says.

    Prof Kossmann has also been accused of failing to pay The Alfred more than $250,000 in patient fees he had earned by billing the Transport Accident Commission and the WorkCover Authority between January and March last year.

    The letter further alleges that hundreds of thousands of US dollars in subsequent payments have not been paid, and questions whether information about money Prof Kossmann was earning from billing publicly-funded insurers has been withheld.

    Prof Kossmann has denied the claims. He said an oral agreement with The Alfred Hospital's chief executive, Jennifer Williams, for all financial questions would be dealt with after he had responded to an inquiry headed by Dr Robert Dickens. Prof Kossmann has until May 5 to respond.

    Prof Kossmann has also rejected allegations by a junior surgeon that he was asked to falsify a patient's records to conceal damaging material from the Dickens inquiry.

    In resigning yesterday, Prof Kossmann accused colleagues of destroying his career in a witch-hunt.

    "Those who have fought to destroy my career have not been able to come up with a single patient or loved one to support their claims," he said.

    Prof Kossmann was suspended from work last November after allegations he performed unnecessary surgery, undertook surgery he was not qualified to do, and billed patients for operations he didn't perform.

    Following complaints by four surgeons, the hospital ordered a review of his surgical and administrative practices which has reportedly accused him of misrepresenting his surgical experience and performing flawed surgery.

    COMMENTS:

    This is highly irregular.....Thomas Kossmann's previous contract with the Alfred appears to have retrospectively moved goal posts....

    It is impossible for a Dr to bill Medicare and receive this type of money and then later only to be asked it by his employer! There must have been an irregular arrangement in the privatisation of the services at the Alfred (a public hospital). But then also, is this not called cost shifting? (a method of billing the Commonwealth government for services delivered within a public hospital)

    From my knowledge of Victoria, privatised arrangements in Vic public hospitals end up with the practitioner receiving the monies - and he has to pay the hospital rental for use of the premises.

    All fee splitting arrangements are deemed unethical as per the Hippocratic Oath (note QLD practises this in option B schemes for specialists)....and, NSW also practises this in Level 2-4 Staff Specialist awards.

    Does Dr Kossmann have a VMO or Staff Specialist post?

    The mystery deepens. Can anyone shed light on this?
  6. Galileo

    Galileo Guest

    What is really needed is a judicial review of the Investigation into Prof Kossmann.

    This can be via the Supreme Court or through some anti corruption body (after all a trumped up charges scenario is really an expression of corrupt conduct)

    I wished Victoria will now conduct a Special Commission of Inquiry into its Public Hospitals as what NSW is going...this may do Thos K some justice as it will do to me during this time....watch this space!!

    G
  7. Guest

    Guest Guest

    An inquiry into the mechanics and logistics and conduct of the Investigation into Prof Thomas Kossman's case should be assembled as soon as possible. It is likely to reveal gross dysfunction and corruption and maladminstration.

    The Opposition has called for it and this should not be ignored. This will become the downfall of the present Vic government just as the current Garling inquiry will hugely embarass the Iemma government in NSW
  8. Guest

    Guest Guest

    A read through the following article is a reminder of a week in the day of Prof. Thomas Kossmann. How many people could stand week after week of these sorts of events? The second time around too. He had a similar experience in Europe. One would have to have nerves of steel.
    Are the persons who were treated by him in this instance complaining?
    Do they want to sue the hospital and the Health Department?
    How is it that the same paper that wrote this report in 2002 are now setting about telling the world he is a fraud, dishonest, greedy, incompetent and a host of other things. As he was to say in interview on TV, it simply does not make sense.
    Was anyone around when the events described beneath happened?


    The healers
    Author: Liz Porter
    Date: 20/10/2002
    Words: 2900
    Publication: The Sunday Age
    Section: Agenda
    Page: 1

    Last week Thomas Kossmann spent hours in theatre operating on burnt skin and comforting the distraught relatives of the six Bali bomb victims in his care. As head of the Alfred Hospital's trauma unit, Kossmann has just endured the week from hell. Liz Porter spent the day with him.
    It's 7.25am as Professor Thomas Kossmann turns his silver four-wheel drive off Commercial Road and into the car park adjoining the Alfred Hospital's helipad. Within moments he is striding through the emergency department entrance. It's Thursday and the six victims of last Sunday's blast have just begun day five of their ordeal, lying bandaged in the hospital's intensive care and burns units. The next few days will be crucial for them. Between day three and day seven patients who have previously seemed to be doing well can go into a dramatic decline when septic complications set in and stressed vital organs begin to fail. "People feel well in the first one to two days," the surgeon says. "They have been resuscitated, they feel fine, and then after three to four days, they deteriorate and they can die due to septic complications."

    Kossmann, 43, has been in a state of high alert since the moment he heard the news last Sunday. At midnight on Monday he was on the phone organising a list of surgeons for the following day.

    At 6.30am on Tuesday an ambulance carrying Canadian national Richard Gleason, 38, the hospital's first Bali burns patient, arrived after being flown in on a Lear jet fitted out as a mobile ICU. Gleason, a business analyst, had made a last-minute decision to holiday in Bali instead of Mexico and was walking around the island with his backpack on after the blast. The adrenaline and shock kept him going, but now he is critically ill with burns to half his body.
    Later that morning another four patients flew in via RAAF Hercules from Darwin. By Tuesday afternoon, along with burns unit director Heather Cleland, Kossmann was moving between four operating theatres, supervising the "debriding" (the excision of dead and infected tissue) of burns and shrapnel wounds. Six surgical teams had been ready and waiting for the arrivals and 50 minutes after being taken into the hospital, the victims were in theatre.

    "That was a tremendous time because we had to re-evaluate them, resuscitate them and X-ray them," says the surgeon. "They did a tremendous job in Darwin. We knew exactly what we were getting."

    All Wednesday, Kossmann was in and out of the hospital's operating theatres, working on one severely injured burns victim for a four-hour session of tissue-debriding and reconstruction work. Finishing surgery at 7.30pm, he then sat down for a long discussion with the relatives of another patient.

    The German-born surgeon, who was head-hunted from Zurich, joined the Alfred last September. Although he describes himself as psychologically "robust", the Bali victims are a vivid reminder of an experience that has proved to be the best possible preparation for the demands of the past week - and the difficult weeks ahead.

    On August 28, 1988, three Italian fighter jets collided mid-air at an air show at Ramstein, a a US airforce base in the former West Germany. One plane plunged into spectators, killing 45 people immediately, and injuring a further 700. Kossmann, then a trainee surgeon at a teaching hospital only 15 kilometres away, was on duty when, 90 minutes later, 47 critically injured and badly burnt people arrived. The scene, he recalls, was one of "unimaginable" horror, with so many victims with combined burns, shrapnel and blast injuries - the same ghastly combination he has been seeing again this week.

    "Of those 47, 16 were in the same condition as the people we have at the Alfred now," he says. "And of these, we lost five. There was at least one where we didn't expect that he would die. The others were critical, with up to 90 per cent (of their bodies) burnt."

    Many were able to talk when they arrived at the hospital, which made their later lapses into unconsciousness - and the deaths - even more upsetting for staff.

    The arrival of the Bali victims has brought all the horrific memories back.

    "It is the same smell, the same physical smell of the patients," he says. "It is a very specific smell of burnt flesh. And it's the same circumstances with the relatives. They are very distressed."

    His Ramstein experience, says Kossmann, makes him feel confident of giving better advice to relatives. In particular, he tells them not to "burn out their batteries" too early. Relatives tend to be hyperactive, he says.

    "It makes no sense for eight or 10 of them to be here and to have sleepless nights on a couch in the hospital when you can do nothing. They will be needed afterwards. The most difficult phase, for the patient, is not at the moment. It will come later, when the support from the media and relatives and friends is slowing down.

    "It is important (for relatives) to be there when the patient wakes up. There is a very important phase when the patient goes to rehab. Even more important is when they come home from rehab, because normally no one is at home. Everybody goes to work, and the media isn't interested any more."

    Kossmann also worries about the potential lung damage to his patients caused by inhalation injuries. "Toxic fumes might have burnt the lungs. We just don't know this at this point."

    Rehabilitation from burns can take years.

    "Some will heal well from their injuries, but it will be a long process before the soul is healed.

    "If somebody has a burnt face, he will be a different person. If someone has lost a limb, his life has changed. Even if we can repair them, they will be different people."

    The experience of watching patients die is traumatic for staff, too. Counselling is already being offered to Alfred staff, but not forced on them.

    "(In Germany) psychologically the staff felt betrayed by the patient when he or she died, because they were making so much effort. And it was seen as a decision, which was unfair to the staff. You know: 'It's unfair. I am caring for you. For the last three days my whole heart is with you - and you die."'

    7.55am: The daily 30-minute X-ray meeting is drawing to a close. It is a meeting that must go on, Kossmann says, regardless of what else is happening in the hospital. The Alfred's six Bali burns patients are on every front page and in every news bulletin. Even so, the surgeon must also find time for the other 32 patients in the trauma unit.

    8.05am: Hotly pursued by a group of colleagues, registrars and students, Kossmann strides off on his ward rounds . He moves at a tremendous clip, his white coat flying out behind him. His first stop is the intensive care unit where trolleys stand stacked high with dressings and instruments. Each green-curtained cubicle houses a patient hooked up to a small electronic forest of monitoring equipment. There are respirators and machines measuring heart and lung function and blood pressure. Devices monitor the infusion of fluids and medications. Gloved and aproned nurses, one per patient, move smoothly around their charges, gently raising a bandaged hand from a pillow over here, checking the flow of liquid through a tube over there.

    One of the Bali patients is being wheeled off to surgery for debridement and skin grafts as Kossmann arrives.

    "All the best, see you later," he says. The patient raises a weary salute by way of reply.

    The condition of the burns patient in the next cubicle has deteriorated in the past 12 hours. Yesterday he was reading the paper. Today he's breathing with the aid of a ventilating machine. "Have his relatives been informed?" the trauma unit director wants to know. The patient will "make it", he says. But it's important that the families know exactly what's going on.

    Lay people, he says, misunderstand burns.

    "One of the surprises (for them) is that many of these patients were walking round, and they initially thought that their problems weren't great. Some of them walked on to the plane, but then they just deteriorate due to the fact that they have this infection, they have not been resuscitated in the right way, they are starting to have organ failure.

    "Also with third-degree burns you don't feel pain because the ends of the nerves are just dead, so they don't function."

    The Bali victims missed the "golden hour", Kossmann explains - the first hour after injury when medical intervention is needed most. The best possible outcome would have been immediate treatment with fluids, bandaging and pain relief.

    "Pain is a stimulant and you need to calm the body down. And if you don't have enough body fluids, your organs are not sufficiently suffused with blood."

    Part of the assault on the burns victims' bodies comes from outside. "Our skin is the highly developed protection barrier against all this bacteria which would harm our body. You breach this barrier and suddenly everything can come in." With the warm temperature in Bali, the burn surface becomes the ideal "microbiological chamber" for bacteria growth. With body fluids exposed, the bacteria can multiply quickly. But organ failures are also a result of the toxins produced by the body itself in its fight against the massive insult of burn injuries.

    "Our evolution never foresaw that we would survive burns. Our defence mechanism is not sufficient - and the toxins, the bacteria are just taking over. The body has to discharge them through the kidney and the liver and the strain on organs is too great."

    Most of the other cubicles in intensive care are occupied by road accident victims. The driver of a car who went into a tree. The survivor of a head-on collision. Each cubicle reveals a new tragedy - like the woman who was attacked with a stool, one leg of which has penetrated her brain.

    8.30am: Kossmann gallops up a flight of stairs to the hospital's second intensive care unit. After a quick conference with the burns unit boss Heather Cleland about skin grafts for one Bali victim, he moves on to check another blast victim. "He is starting to get cold," he murmurs to a colleague. "There's a zoo of organisms growing on his back," mutters another doctor.

    This unit has the same preponderance of road accident victims as the one downstairs.

    "The day we took the six Bali patients, we took in another eight local victims," says the hospital's trauma coordinator Louise Niggemeyer, one of group of 12 colleagues following Dr Kossmann on his round.

    9.45am: He pauses for a brief chat with Dr Stephen Salerno, from the hospital's medical services department. He wants to line up a theatre for a debridement operation he needs to perform on a burns victim, before Cleland carries out some skin grafts on the same patient.

    Kossmann is also worried about a possible serious infection inside another patient's belly. "We will do a laparoscopy (a procedure in which the smallest possible cut is made, so a mini-telescope can look inside the body). He has ongoing infections so we have to see what's there. If there's nothing, we don't open it. If there is something, we will open it. You have to always figure out what is beneficial for this patient. Is it beneficial to have the risk of laparoscopy, or do we wait until he is so sick that he might die. We are always on a very small pathway - what is the best for the patient."

    Another Bali patient is having another head CT scan. "Just to check the head, to see if there is a change. If we don't address this, we have a huge problem.

    "With all these patients, we are a little bit behind (because of their lack of immediate care in the initial hours). We want to stay one step ahead of the complications."

    Some of the Bali patients will also have sessions in the hospital's hyperbaric chamber, because it is believed that the enhanced oxygen levels in the tissue help healing of difficult open wounds.

    10.40am: In the sixth floor burns unit Kossmann shares a joke about bowel movements with one Bali victim, checks another and then heads downstairs for a brief visit to the trauma out-patient's clinic.

    "Trauma patients are so highly motivated," says the surgeon, who originally planned to specialise in plastic surgery until he did a stint as a trauma unit nurse and found himself captivated by the variety of the work.

    "I saw you on telly last night," says one outpatient. "You looked great." Kossmann looks uncomfortable.

    11.20am: The surgeon makes a flying visit to the Australian Orthopoedic Association conference. He would have been there every day in a normal week.

    1.10pm: Back in the hospital, he is talking on his mobile in Italian. It's his wife, Cristina Morganti-Kossmann, a neuroscientist and acquired brain injury expert, who's in the cafeteria with two other colleagues. The couple came to the Alfred as "a package deal", which involved them moving their previously Zurich-based acquired brain injury research program to Melbourne.

    1.20pm: Cristina Morganti-Kossmann is sitting with trauma care coordinator Michelle Srage, who spent Monday organising a major clear-out of trauma unit patients, to make room for an expected influx of 10 or 11 critically ill Bali blast victims.

    "Every family has been given a social worker," she says. "Theatre staff allowed me to take one victim's mother into the theatre so she could see her son (who had just arrived from Darwin) before they put him to sleep. That never normally happens in an adult setting."

    2.30pm: Kossmann is in the second-floor intensive care unit to meet Dick Gleason, father of the Canadian burns victim Richard Gleason. Dick has come straight from the airport after the long journey from Whitehorse, a small town in the Yukon district of Canada. His ex-wife will be arriving in the next day or so. Kossmann takes the worried father into the cubicle where his heavily bandaged son is lying, and begins to explain the operation, a laparoscopy, that will take place soon.

    2.55pm: Kossmann is scrubbing up for a spinal fusion operation on an elderly man who has had a bad fall. He's sharing the operation - a delicate and tricky procedure - with consultant neurosurgeon Greg Malham. A bone graft is being done with bone from the hip, so the theatre fills with the typical orthopoedic surgery sounds of bones being hammered and sanded down.

    4.10pm: Back in the operating theatre suite's office, he checks Friday morning's theatre schedule. His operation on one of the Bali victims is booked in for the morning and burns unit boss Heather Cleland will follow with her skin grafts.

    4.15pm: Richard Gleason is wheeled past on a trolley on his way to theatre. Cleland, in her blue operating scrubs, is taking a quick breather between two surgery sessions.

    4.25pm: Out of his scrubs and back in his suit, Kossmann makes another quick round of the two intensive care wards. An anxious relative stops him on the way in. "I'm told you're the best in the world," she says.

    In one cubicle, a Bali burns patient's face is covered in a special foil-look dressing. "To avoid bacterial colonisation," Kossmann explains.

    6pm: He leaves the hospital to go home and dress for a black tie dinner for the Orthopedics Association conference. How long will he last? "Until dessert," he says wearily. "I'll drink water only." Of course he'll have his phone and pager with him. It wouldn't be the first time he'd turned up at the hospital in black tie for a late-night check. And he'll be on call from Friday morning until Saturday at 6pm.

    6.15pm: Dick Gleason is sitting on a bench in the foyer. He's just had the results of his son's laparoscopy procedure. It's good news. His son's internal organs are OK. There is no need for surgery on his bowel.

    He sighs. "It's just another ordeal he doesn't have to experience.

    "I'm less worried than I've been since last Sunday. This will be very tough on his mother. I was in Korea, and I've worked in the ambulance service. I know about burns. But it's different when it's my own son. It's shocking. It rips you apart."

    BALI VICTIMS AT THE ALFRED

    â€Â¢ Jason McCartney, 28, has extensive burns. He is in intensive care.

    â€Â¢ Lynley Huguenin, 22, of Wantirna. She is in a stable condition.

    â€Â¢ Jodie Cearns, 35, has burns to 55 per cent of her body and shrapnel wounds to her stomach. She has had her left leg amputated above the knee, may have lost sight in her right eye, and her right leg and pelvis are broken.

    â€Â¢ Dale Atkin, 27, of Hallam, is in a stable condition.

    â€Â¢ A Victorian man whose name has not been released.

    â€Â¢ Richard Gleason, a 38-year-old Canadian is in intensive care with burns to 50 per cent of his body.
  9. Guest

    Guest Guest

    I wonder why did not claim that Prof Kossmann had no training in plastic surgery? The above description depicts the skillful use of these skills.
  10. Guest

    Guest Guest

    It is not only the skillful use of surgery that is described in this article. There is the amazing level of multi-skills. The organization that went into catering for a disaster, the seeing to others to help, the ringing around to all those part-timers who like to come to the hospital only when it suited them. Even his wife helped - presumably as a volunteer. There were reasons why the airlift to the Alfred worked in this instance that resulted in a successful outcome for the patients.
    He also managed to visit a conference inbetween times which he had previously planned to go to and was expected to attend.
    Could anyone imagine the level of thought and work that went into this entire exercise and related activities? So he mismanaged did he?
    What sort of energy must a person have and how quickly he must think to achieve all of this without any apparent hitches?
    Somewhere along the way, he must have tried to find time to do the paperwork. It seems, either the paperwork is perfect and the patients die, or, it is the other way around.
    I think the patients have judged Thomas Kossmann by not filing any complaints and neither have their families. That is, really bad complaints.
    After fiddling with 4,000 plus surgeries, that is not too bad. What is a mere $250,000 in all of that and a dozen or so discrepancies, the one percent of his 'dishonesty' in the whole process of his work for six years at this pace?
  11. Guest

    Guest Guest

    one way to see it is that he worked hard and honestly in a busy and increasingly dysfunctional system. No doubt incorrect charging could have occured and he was accused of fraud! outrageous and ludicrous!

    Now the dysfunction has manifested itself in his being suspended and put through an internal investigation which will also result in this report being passed to the medical board....is it not stupid? The threat to sack him was to frustrate him and force him into a position to resign - another underhanded tactic - always used by bureaucrats all over oz
  12. Guest

    Guest Guest

    Prof. Kossmann is apparently born in Germany and he is married to a Cristina Morganti it appears. The couple both come from Switzerland in recent times.
    I note both Kossmann and Morganti appear elsewhere as Ashkenazi Jewish names. The religious affiliations of both husband and wife have never been discussed elsewhere but perhaps someone has made an assumption. Not all Jews living in Switzerland are pure Jewish, they are often descended from a Jewish marriage to a Swiss person at some time. The Jews in Switzerland have been noted in the past for having considerable wealth.
    I just wonder if someone may have twigged on this one and then went for the jugular because of some anti-Jewish feelings.
    I would be very interested to know if anyone has heard anything in regard to that one.
  13. Guest

    Guest Guest

    The company from which Prof. Kossmann is allegedly collecting kickbacks appears to have Jewish names as the principals. Stryker and Zimmer.
    The deal they were involved with was allegedly giving kickbacks to Prof. Kossmann and his wife for trauma research in exchange for the Alfred Hospital giving preference to their products. With the Australian dollar worth a few cents less than the American one these days, such a deal could make business sense to some Americans with their economy losing ground all the time.
    It is possible that such a deal could have upset others who could see that the Alfred and its offshoots e.g. the Research into Trauma was possibly looking like another vehicle for Jewish businesses abroad at the expense of other concerns/products, possibly cheaper from non-Jewish/non-American based interests. I believe even New Zealand is producing its own artificial joints these days. They could not compete in such a situation.
    His professor who gave him all the references from Zurich, Otmar Trenz, also has a Jewish name.
    This point may not be worth pondering at all as many Jewish professionals are by no means orthodox and are not necessarily aligned to any group in particular. It is just that many of them are involved in medicine because that is what they are good at.
    It is somewhat co-incidental though. I note his leading accuser Robert Dicken does not have a Jewish name. Does that have any meaning?
    Does race/ethnicity matter when they are talking about money, incompetence, dishonesty etc? I have seen similar accusations against others whose most outstanding characteristic were that they were a European from a country not usually liked by Britain and its allies for historic reasons. Some Russians and others have fitted into this category as well as some South Africans. Incompetence and dishonesty had nothing to do with it. Australians are far more careful with persons who look and are obviously Asian or African. That would look like real racism even if those persons were doing deals and behaving inexactly the same way as Kossmann. The event here looks and probably is far more complex than it appears at first sight.
  14. OTD

    OTD Guest

    Medical board ponders surgeon Thomas Kossmann probe
    Article from: Herald Sun


    Michelle Pountney

    April 22, 2008 12:00am

    THE Medical Board of Victoria will decide next week whether to begin its own probe of trauma surgeon Thomas Kossmann.

    Prof Kossmann steadfastly denies allegations that he performed unnecessary surgery, did surgery he was not qualified to perform and submitted bills for surgery that did not take place.

    The board was considering its own investigation when it received a letter regarding the surgeon from Bayside Health, responsible for the Alfred hospital, where Prof Kossmann worked.

    A decision will be made on Thursday next week, when the board meets.

    Epworth Hospital, where Prof Kossmann still holds practising rights, revealed yesterday it had written to Bayside Health CEO Jennifer Williams three times, asking for a copy of the report. It has yet to receive it.

    "We have written . . . asking for a copy of the report to see whether there are any issues we need to be aware of in considering Prof Kossmann's credentials at Epworth Health Care," said group chief executive Alan Kinkade.

    "We haven't suspended him. There's nothing that has been made available publicly to us in an official report that would enable us to do so."

    A spokesman for the Alfred, Corey Nassau, said the Epworth could get a copy of the report from Prof Kossmann.

    "We are unable to provide a copy of the report to the Epworth due to continuing litigation," he said.

    Prof Kossmann has not been suspended from Epworth, but has not done any surgery at the hospital "in recent times".

    Hospital management will meet Prof Kossmann within a month to discuss the allegations.

    Prof Kossmann last week quit as head of the Alfred hospital's trauma unit. He has also launched legal action against the Alfred.

    COMMENT:

    This was much expected. In a day or two, the result will be likely that Kossmann will be suspended from practising pending investigation by the Medical Board. If he is lucky enough not be be removed, he will have conditions imposed. This is how the Australian medical profession treats people who are not their own. To dress it to make it impartial, they will put several OTDs in the committee which makes the decision. These are just there for the window dressing - they do not have any power.
  15. Guest

    Guest Guest

    In response to comments by OTD. Yes. It does look as though everything to do with the allegations against Thomas Kossmann are a foregone conclusion.

    There are problems though. One is that there are apparently no patients at this time who show huge dissatisfaction with their treatment from Kossmann.

    There were no unnecessary deaths also. It is all a puzzle.
    His billing procedures have been the same as other people's. It seems that all the doctors were out for as much as they could get and they will now face investigation. So he is not the only one.

    So what is different? He is an outsider yes. Who are his friends and associates now from the Alfred Hospital? Are they all cowards as he indicated in a public statement?

    More is going to come out I am sure. There is going to be dirt flying all over the place and the public will lose confidence entirely with the medical system. Not that they had much confidence in it to begin with. It seems doctors size up a patient in terms of how much he is worth as live or dead meat. I can now understand the American attitude of going jogging, taking supplements and trying to stay as healthy as possible. Anything is better than ending up in a hospital where one is simply money for the doctor.
  16. OTD

    OTD Guest

    I agree absolutely!

    That is why I have left practice in Australia some time ago....that is also why I am encouraging International Medical Graduates not be be seduced to come to Australia unless they are convinced that they will not be unfairly treated and allowed to engage themselves in dodgy practices.

    If ever, my return will only be to join the dole queue or to study law to do payback on the profession and the bureaucrats
  17. OTD

    OTD Guest

    More faecal material will surface....

    sounds like another cause of steatorrhoea

    - bungling bureacracy and obsessive protectionism only the public could fix it by voting in a decent State government eg NSW
  18. OTD

    OTD Guest

    Kossmann faces new queries

    The Age


    Nick McKenzie and Richard Baker
    May 2, 2008

    THE Medical Practitioners Board of Victoria will investigate whether trauma surgeon Professor Thomas Kossmann is safe to practise, after a separate inquiry accused him of surgical incompetence.

    The decision yesterday by the board to launch an investigation into the former chief of The Alfred hospital's trauma unit comes after Professor Kossmann's recent resignation from the hospital and claim that he was the victim of a witch-hunt.

    The board's examination was sparked by a written warning from The Alfred's chief executive, Jennifer Williams, that Professor Kossmann posed a potential safety risk to patients.

    When he resigned, Professor Kossmann said he planned to begin practising elsewhere in Victoria and that he had scores of patients who were waiting for his return. He remains accredited to practise at the Epworth hospital and is still a fellow of the Royal Australasian College of Surgeons.

    Last month, a medical panel headed by respected orthopedic surgeon Bob Dickens and appointed by The Alfred found that Professor Kossmann had performed spinal and pelvic surgery that was flawed or harmful. It also found he had billed the Transport Accident Commission and WorkCover for procedures not performed.

    Professor Kossmann has denied the allegations and his spokesman said last night that the surgeon was "confident that any review by the Medical Practitioner's Board will find that he has the requisite skills to continue to perform surgery in Australia". Any future adverse findings by the board may lead to restrictions on the type of medical work Professor Kossmann can do in Victoria.

    The Age has previously reported that the Kossmann saga has prompted the TAC and the state Ombudsman to launch their own inquiries into how public money is used in the state's health system.

    Questions have also surrounded the move by the college of surgeons to accredit Professor Kossmann without extended oversight. It has also been alleged that state health bureaucrats pressured the college to fast-track his accreditation.

    Comment:

    As expected and predicted.
  19. Guest

    Guest Guest

    Professor Kossmann is in for a grilling it appears. How can one person defend himself against all these institutions? It certainly looks as though it is a foregone conclusion that adverse findings will be echoed even by the Epworth Hospital where he has been working.
    If he becomes a persona non grata here, where will it all end?

    Surgeons' college may probe Kossmann

    Richard Baker and Nick McKenzie
    May 12, 2008

    THE Royal Australasian College of Surgeons could soon begin an investigation into controversial trauma surgeon Thomas Kossmann.

    College president Andrew Sutherland said a review of the surgeon's status as a college fellow may be held if The Alfred hospital made available the final report of its probe into his conduct. Professor Kossmann has played a significant role at the college since coming to Melbourne from Switzerland in 2001, including being secretary of its academic surgery committee.

    "We will not review Dr Kossmann's college status until we have the (Alfred) report or other official information such as from the Medical Board," Dr Sutherland said. "If the report is made public or if we are asked officially to respond to specific issues, we will do so."

    Professor Kossmann resigned as director of The Alfred's trauma centre last month after a medical panel commissioned by the hospital found him to be incompetent in key aspects of surgery and to be billing publicly funded insurers for operations that never happened.

    Health Minister Daniel Andrews has continued his seven-month silence on the Kossmann case, one of the biggest medical scandals in recent Victorian history. With the deadline for Professor Kossmann to respond to The Alfred's inquiry expiring last week, The Age submitted questions to Mr Andrews' office. The minister declined to answer most of them. A spokesman said Mr Andrews did not want to pre-empt "ongoing processes".

    The spokesman would only say the minister was first informed of the allegations against Professor Kossmann on October 11 last year. He was briefed on the medical panel's findings on April 3.

    Mr Andrews' silence led Opposition Leader Ted Baillieu to accuse him of being "missing in action" on an important issue and committing a "monumental abrogation" of his responsibilities.

    Professor Kossmann is also under investigation by the Medical Practitioners Board of Victoria, the state Ombudsman, the Transport Accident Commission and Medicare. The college is under pressure to review its role in the controversy after leaked findings from The Alfred probe revealed it used a special provision to grant Professor Kossmann orthopedic status swiftly.

    The Age recently revealed the college committee that accredits overseas doctors had twice decided against granting him automatic orthopedic status due to doubts about the extent of his training. It preferred to observe him for 12 months, sources said.

    Government and college sources say the committee changed its stance after pressure from senior state health bureaucrats.

    Dr Sutherland said the college did not respond to external influences when assessing credentials. "Professor Kossmann's accreditation was undertaken as per the policy for assessing overseas-trained surgeons that was in operation at the time," he said.

    The Age can also reveal Epworth hospital has requested a copy of The Alfred's peer review report and asked Professor Kossmann to state why it should not revoke his credentials to operate there, given the adverse findings.

    Professor Kossmann has rejected The Alfred panel's findings and sued Bayside Health over his suspension in November from The Alfred.
  20. Guest

    Guest Guest

    Someone or a group of people have vested interests in completely getting Thomas Kossmann out of the Australian landscape. This vicious and uncivilised behaviour is not new. But, let the process take its course. Their objective of course is to make as much stick as possible and Kossmann's strategy will be to undermine their methods as much as possible
  21. Guest

    Guest Guest

  22. Guest

    Guest Guest

    For the most part the letters to the Herald Sun are very positive about Prof. Kossmann's performance and skills as a surgeon/physician.
    It would be nice if someone on this forum could download any of the comments on Facebook. Apparently, he has at least 600 supporters mentioned there. Some of us cannot access those comments.
    That is where the puzzle is. How can people be so grateful to someone who has apparently operated on them needlessly? What were their impressions about what happened to them?
    The persons who appear to feel that he has done no good are fellow surgeons.
  23. Guest

    Guest Guest

    Thomas K has more than 600 supporters. Only a few jealous members of the Victorian medical profession are 'unhappy with him' for whatever reason. It is all related to money or the lack of it.

    This is just very unprofessional behaviour of the members of the 'medical profession' in Victoria.

    But, I am sure that in every country there are these characters around.
  24. wc

    wc Guest

    After having met Dr Sutherland, I do not consider he will be helpful to Thomas Kossmann. They will all protect each other to make Dr Kossmann look guilt.

    One way for Dr Thomas Kossmann to change this system is to go public with the radiology films and the incorrect and incomplete reports of those films.

    Who has the right to tell a doctor NOT to operate because it will cost too much money in insurance payouts and medical treatment?

    How many more OTD will be blamed if this corrupt system is left to continue?
  25. Guest

    Guest Guest

    A favorite term used by medicare for allegedly fraudulent claims - when they decide not to prosecute - is to label the claims 'incorrect'

    They may then ask the claimant 'repay' these and they get scot free....but then again, in Australia, the far majority of the white descendants are from criminal stock: and, if they get found out in their scams by an OTD, or, if they do not like the fellow, they usually close ranks and 'fix' the poor bugger.

    This has happened more than once and I know of several cases which are ongoing.
  26. Guest

    Guest Guest

    Surgeon attacks Alfred Hospital review

    The Sydney Morning Herald
    21 May 2008

    The professor resigned last month amid allegations he performed unnecessary surgery, undertook surgery he was not qualified to do and billed patients for operations he did not perform.

    At the media conference on Wednesday, the hospital will be releasing a summary of recommendations following an independent peer review of the professor's work practices.

    But Prof Kossman was scathing in his comments on Wednesday, branding the review a witch hunt and the press conference a show trial.

    "Even by the extremely low standards set by The Alfred Hospital to date in handling this matter, today's so-called press conference is a low act," Professor Kossman said in a statement released to the media.

    "This orchestrated stunt is designed to present the summary of a report that has already been leaked in full to two newspapers.

    "It is a public relations gimmick aimed at glossing over their embarrassing mishandling of the process that has demeaned me and my family, as well as undermined public confidence in the administration of The Alfred hospital.

    "However, I guess a witchhunt would not be complete without a show trial."

    He maintained his innocence and rejected any accusations of improper conduct contained in the panel review report.
  27. Guest

    Guest Guest

    Kossmann put lives at risk, panel finds



    Richard Baker
    May 21, 2008 - 12:48PM


    Former Alfred hospital trauma chief Thomas Kossmann conducted surgery that had the potential for "catastrophic outcomes", the lead investigator of an expert medical panel investigating the surgeon has concluded.

    Speaking out on the Kossmann saga for the first time, the head of The Alfred-commissioned panel, Bob Dickens, said there were instances where patients' lives were put at risk in the 24 surgical cases his panel reviewed.

    Releasing the executive summary of the panel's final report, Dr Dickens said Professor Kossmann conducted unnecessary surgery and procedures in areas where the panel judged him to be deficient.

    He said some cases reviewed "had the potential for catastrophic outcomes and it was fortuitous that they didn't".

    Dr Dickens said the panel could observe no adverse long-term outcomes for the patients reviewed.

    The Alfred's chief executive Jennifer Williams said she was shocked by the magnitude of the panel's findings and would be contacting up to 12 patients operated on by Professor Kossmann to offer a review of their surgery. Ms Williams added that a small number of Professor Kossmann's patients had contacted the hospital themselves to request a review of their surgery.

    The findings in Dr Dickens' report are damning for Professor Kossmann, who resigned at the hospital's trauma chief last month. The panel recommended his accreditation for spinal and pelvic surgery be revoked and that he not be permitted to supervise younger surgeons in these procedures.

    The panel also found he submitted bills to publicly-funded insurers such as the Transport Accident Commission, WorkCover and Medicare for procedures that never eventuated or for surgery not done by him. It recommended all three bodies conduct their own audits of Professor Kossmann's billings.

    Dr Dickens said the episode had been "disastrous" for the German-born surgeon and his family. However, he defended the panel from accusations it had been involved in a witch-hunt against Professor Kossmann, saying it had made every effort to ensure fairness and natural justice.

    Professor Kossmann this morning issued a statement in response to the release of the panel's findings.

    "Even by the extremely low standards set by the Alfred Hospital to date in handling this matter, today's so-called press conference is a low act," Professor Kossmann said.

    "This orchestrated stunt is designed to present the summary of a report that has already been leaked in full to two newspapers.

    "It is a public relations gimmick aimed at glossing over their embarrassing mishandling of the process that has demeaned me and my family, as well as undermined public confidence in the administration of the Alfred Hospital.

    "However, I guess a witch-hunt would not be complete without a show trial.

    "I maintain my innocence with respect to any accusations of improper conduct contained in the panel review report."

    COMMENT:

    This is how the Oz system fixes an OTD who is a brilliant surgeon whom every other Vic surgeon may be professionally jealous of. It is not difficult to fix anyone, whoever it is by erecting a set of goal posts and then moving them and also tilting the level of the playing field.
  28. Fair Go

    Fair Go Guest

    All medical interventions have the potential of becoming catastrophic. To not acknowledge this thinking is naive

    The fact that doctors offer patients bolder treatments often leading to potentially better outcomes is shown by advances in clinical trials (for medical interventions) but in complex trauma work, this is just impossible.

    So, leeway has to be given to the 'art of surgery' and the skills of the artisan.

    To label Kossmann's work as having the potential of becoming catastrophic is like being unwilling to take a patient with a perforated appendix to surgery 'as there is a potential he may die' and leaving him in the ward with some IV fluids and antibiotics.

    What kind of logic is this? Only petty witch hunting Australian bureaucrats (and doctors) could think of such lowly and ungentlemanly schemes.

    Thomas, the country really does not deserve you - like many of the great Australians who have blossomed abroad, you may as well do the same, collect your pension and then return to Oz in your retirement to enjoy the spoils (and collect the dole)
  29. Guest

    Guest Guest

    The Alfred Hospital deflects blame for surgeon Thomas Kossmann

    The Australian
    May 22, 2008

    THE Alfred Hospital has absolved itself of legal responsibility for the botched surgery of disgraced surgeon Thomas Kossmann, despite a review finding that his work as the Melbourne hospital's head of trauma put lives at risk.

    Although patients were subjected to unnecessary and bungled operations, Bayside Health chief Jennifer Williams said yesterday she did not expect to pay compensation.

    "From the information I have about the nature of the complaints, I would not envisage an insurance claim, but that would be a matter for future consideration," she said.

    About 20 patients have contacted the hospital expressing concerns about operations Dr Kossmann performed on them, and the hospital has written to about another dozen.

    Slater & Gordon lawyer Paula Shelton said the hospital appeared to have breached its duty of care to the patients, and she encouraged them to come forward to discuss potential claims.

    "There's very good authority to say the hospital is responsible for the behaviour of Dr Kossmann," she said.

    But Ms Williams refused to accept any responsibility for the hospital employing Dr Kossmann or for his bungled surgery, although she admitted the Alfred did not check the exaggerated claims in his CV and relied on the Royal Australasian College of Surgeons' assurances about his competence.

    Orthopedic surgeon Bob Dickens yesterday released the findings of a damning peer review into Dr Kossmann, which were first revealed in The Australian last month.

    Mr Dickens, who headed the review panel, found Dr Kossmann had exaggerated his experience on his CV, conducted risky and unnecessary surgery and rorted government insurance agencies, including the Transport Accident Commission.

    He called for a sweeping audit of the Alfred's audit procedures, as well as the billing of Dr Kossmann and all other Alfred trauma surgeons.

    The review has sparked a row between the college of surgeons, which blamed the hospital for not detecting the professor's surgical failings, and the hospital, which accused the college.

    Mr Dickens's panel investigated 24 cases involving Dr Kossmann and found problems with 13, including grave errors.

    "Lives were put at risk. There were examples of catastrophic bleeding where there was difficulty getting control of the bleeding," he said.

    He cited other examples where a poorly placed screw in a heart had to be removed in a second operation, and how Dr Kossmann caused a hemorrhage in one of the main arteries supplying the brain during another procedure.

    He said no one died as a result of the bungles, but patients were exposed to unnecessary risks, including infections. He questioned the college's decision to allow Dr Kossmann to practise without sitting the examination for foreign doctors.

    But college vice-president Ian Dickinson said the college had not erred in exempting Dr Kossmann from the exam. He blamed the hospital for failing to detect the failings through its audit and peer-review processes, and accused Dr Kossmann's previous employers of providing "glowing assessments" of his work.

    Dr Kossmann, who resigned from the Alfred last month but denies wrongdoing, branded the review a "witchhunt" and said the press conference was a "show trial".


    Absolutely, this is just disgraceful on the part of the Australians with their witch hunt on a brilliant surgeon whom they were jealous of.
  30. mc

    mc Guest

    PM - Questions raised over trauma surgeons accreditation

    http://www.abc.net.au/pm/content/2008/s2254273.htm]


    PM - Friday, 23 May , 2008 18:54:00
    Reporter: Jane Cowan
    MARK COLVIN: In the wake of this week's ruling that one of Australia's leading trauma surgeons was unfit to enter the operating theatre, questions are now being asked about the accreditation process that allowed Professor Thomas Kossmann to take up his position at Melbourne's Alfred Hospital.

    Letters have emerged showing that the Alfred pressured the Royal Australasian College of Surgeons to fast-track the surgeon's accreditation so he could start work.

    The college has confirmed that pressure was indeed applied.

    Two days ago both the hospital and the Victorian Health Minister denied knowledge of any such pressure.

    Jane Cowan reports.

    JANE COWAN: What a difference a few days makes.

    This is what the chief executive of the Alfred, Jennifer Williams, said on Wednesday when asked if she was aware of any pressure being applied to fast-track the accreditation of the doctor the hospital now deems unfit to practice.

    JENNIFER WILLIAMS: No, I'm not aware of that. He was appointed in 2001. I've been in the hospital three-and-a-half years. I've certainly read all the files and I've not found any evidence of that.

    JANE COWAN: The same day the Victorian Health Minister expressed full confidence in hospital management.

    Daniel Andrews told reporters he knew nothing about any contact between health bureaucrats in either the Department of Human Services or at the Alfred and staff at the Royal Australasian College of Surgeons regarding the accreditation of Professor Thomas Kossmann.

    DANIEL ANDREWS: I think it is, it is simply wrong to put the view or to claim that the conduct that you've referred to occurred.

    JANE COWAN: But now it's there in black and white. In a leaked letter the then chief executive of the Alfred clearly asks the college to waive the usual rules of accreditation.

    Dr Michael Walsh argues it's "unduly excessive" for senior surgeons whose qualifications have already been heavily scrutinised to be subjected to 12 months of supervision before being accredited.

    MICHAEL WALSH (read by actor): The logic of this rule is fairly obvious when we consider surgeons coming to Australia to take up posts. However the appointment of very senior surgeons to senior positions is getting caught up in this ruling.

    JANE COWAN: The Alfred Hospital declined an interview with PM but issued a statement saying the request to expedite the process simply shows the hospital's effort to fill the vacancy in a timely manner. It says the hospital assumed that the college's processes would be followed.

    But the vice-president of the Royal Australasian College of Surgeons, Dr Ian Dickinson, says there was pressure.

    IAN DICKINSON: Yes, there's no question that that's true. The hospital was clearly very keen to avoid some of the processes.

    JANE COWAN: And Dr Dickinson, an orthopaedic surgeon himself, admits the college agreed to shorten the supervision period from 12 months to four.

    IAN DICKINSON: That only happened after the oversight had started to occur and on review of the two surgeons who were reviewing Professor Kossmann, who found at the time in their letters that they thought that Professor Kossmann's work was exemplary and that he was held in high regard.

    JANE COWAN: So the college would have to share some of the responsibility for that decision along with the hospital, wouldn't it?

    IAN DICKINSON: Absolutely not. The hospital clearly was trying to pressure the college just simply to give Professor Kossmann the fellowship and the college did not do that.

    The college can only be responsible for giving the fellowship. It cannot be responsible for ongoing performance, either satisfactory nature or unsatisfactory nature. That is a matter for the hospital.

    JANE COWAN: But the head of the independent panel that made such adverse findings against Professor Kossmann that he's unlikely to work again in Victoria, Dr Robert Dickens, has foreshadowed a tightening of the accreditation process.

    ROBERT DICKENS: And in the future, it may well be that they'll be even more insistent upon persons coming from overseas being required to either do some training before getting their accreditation or alternatively that they sit the exam at least.

    JANE COWAN: A handful of other investigations are still underway into Professor Thomas Kossmann as the doctor maintains his innocence.

    And one source has told PM the doctor might be a sacrificial lamb when it comes to the rorting of the billing system he's also accused of.

    There are rumblings his alleged billing habits might be much more widespread among other orthopaedic surgeons.

    As the source put it, Professor Kossmann may well have done the wrong thing - but the feeling is he's not alone.

    MARK COLVIN: Jane Cowan.





    [/quote]
  31. Galileo

    Galileo Guest

    I fully agree with some of the comments posted above. The case of Thomas Kossmann is that it appears that he was toeing the line of rorting the system with his mates - that is why he lasted for a while before they fell out.

    In my NSW case, I did not toe the line in rorting the system but reported it to Medicare Australia and I was instantly fixed by NSW Health on a barrage of distorted and false allegations which they thought would not only get me out of the system but to ruin my career for good.

    However, Mr Garling did listen to my case in private and I hope he will instruct ICAC to investigate the bureaucrats of NSW Health for unauthorised cost shifting and other forms of abuse and corruption.

    OTDs, if you have been following these postings, you will realise by now that Australia is in a total mess with health care delivery and together with College politics. You need to make an informed decision whether you want to work in Australia or not! Do not be blinded by the big rush for the AMC exams or for the short circuiting of registrations: you are landing yourself into bigger troubles at this time.

    Galileo
  32. Dute.

    Dute. Guest

    So it is all about money. Kossmann appears to have charged as he did in order to keep the trauma unit running and to offer fellows a chance to work within it. The hospital refused to hire a business manager to make the situation more 'official'.


    Kossman told hospital chief of billing to boost revenue

    * Richard Baker and Nick McKenzie
    * May 29, 2008

    CONTROVERSIAL trauma surgeon Thomas Kossmann last year told a senior Alfred hospital executive that he was billing publicly funded medical insurers on behalf of other doctors to boost hospital revenues.

    A leaked February 2007 email shows Professor Kossmann told The Alfred's director of operations, Andrew Stripp, that he had also "generated additional funds through the billing system" to make up for shortfalls in the trauma budget to help cover the cost of junior doctors working on fellowship programs.

    "I have also to discuss the future of the present arrangements for the billing system since I am experiencing significant costs (administration, accountant, tax office) by billing for the fellows … after discussion with my accountant we have to discuss a facility fee for this service," The Alfred's then trauma director wrote.

    The contents of the email will put pressure on The Alfred to explain what senior management knew about Professor Kossmann's billing arrangements with the Transport Accident Commission and other publicly funded insurers.

    An Alfred spokesman last night said it was normal practice for senior doctors to bill on behalf of trainees under direct supervision.

    Last week, the TAC referred Professor Kossmann's billing to Victoria Police for a fraud investigation. The police referral came after an expert medical panel commissioned by The Alfred released a report that found Professor Kossmann billed the TAC for operations he had not done or had been performed by other doctors.

    Earlier this year The Age reported that a secret 2006 TAC audit of The Alfred's trauma unit could not verify whether doctors who had submitted bills had performed the surgery they claimed. Professor Kossmann was one of two doctors named in the audit.

    Professor Kossmann, who resigned as The Alfred's trauma director last month, last night told The Age the hospital was well aware of his billing arrangements because his contract stipulated he direct a portion of fees from each TAC-funded case to the hospital.

    "There were no secrets between me and the hospital in respect to my billing," he said. "There is no secret that the hospital profited because it received $3.6 million through these billing arrangements over the course of my time there.

    "Without this money the hospital would not have been able to fund a number of junior doctors or the activities of the National Trauma Research Institute, which the board and management saw as critical to the hospital's international reputation."

    An Alfred spokesman said the hospital was aware of the billing arrangement referred to in the email from Professor Kossmann to Mr Stripp.

    But he stressed there was a difference between Professor Kossmann billing on behalf of junior doctors under his supervision and the medical panel's finding that he was billing for work he was not clinically responsible for and not entitled to bill for.

    "Andrew Stripp and the hospital were aware of the billing process being employed as outlined (in the email) but did not see Professor Kossmann's bills and did not have a detailed knowledge of the billings. These were forwarded directly from Professor Kossmann to the insurers," the spokesman said.

    The Age believes Mr Stripp was responsible for a review of The Alfred's trauma department in 2006. Professor Kossmann has claimed that only one out of 20 recommendations made by the reviewers has been implemented by The Alfred. It is believed one recommendation not acted on was to appoint a business manager to handle the trauma department's billing arrangements.
  33. Guest

    Guest Guest

    "For the love of money is a root of all kinds of evil. Some people, eager for money, have wandered from the faith and pierced themselves with many griefs."

    1 Tim: 6:10


    "For the love of evil is the root of all money."

    American Proverb
  34. Guest

    Guest Guest

    The truth has not been told in the media as yet.The billing rort is just a way to get rid of Kossmann.

    More questions need to be asked by the media.


    When it is all made public OTD's might have better working conditions.
  35. Guest

    Guest Guest

    From the Website of the Premier, VIC

    MINSTER ANDREWS DISCUSSES ALFRED HOSPITAL
    Wednesday, 21 May 2008
    Summary: Victorian Health Minister Daniel Andrews discusses the Alfred Hospital and Professor Thomas Kossman

    DANIEL ANDREWS: As you’re no doubt aware, the CEO of Bayside Health, Jennifer Williams, has released an executive summary of the peer review panel report into the conduct of Professor Thomas Kossmann in his capacity as the head of trauma at the Alfred Hospital. That report makes very serious findings and makes a number of important recommendations in relation to the way in which Professor Kossmann billed the TAC, WorkCover Authority, Medicare, and it also makes serious findings in relation to…a range of clinical issues in terms of his approved scope of practice and the, sort of, quality of work that he did as a trauma surgeon.

    What I want to do today is outline to you the steps that I have taken since the conclusion of the process run by Bayside Health. It is important, though, at the outset that I make it clear to you that there are some matters that I can speak about today; there are other matters that I cannot speak about – it would be totally inappropriate to canvass some issues – and that’s principally because there are a range of other investigations and inquiries, a range of other important processes that are going on, that are ongoing, and it would be inappropriate to trample all over those by running a public commentary on some of the fine detail of these matters.

    I want to also make it clear to you that right throughout this issue, right throughout this process, I’ve made it clear that I took the fundamental responsibilities that I have as the Health Minister very seriously, and that it was important to allow the process that Bayside Health were running, the peer review process, to run its course so that we had a quality process, we had a proper process to then deliver a proper outcome. So, having done that, I’m…also very conscious of my responsibilities, going forward.

    What I have done, after the Bayside Health came and spoke with me, wrote to me last week, and indicated that Professor Kossmann had…written back to the health service following the final report of the peer review panel having been given to him, he effectively went through a whole range of issues that had been put to him. Given that he had done that and that they had looked at that in detail, they then considered that their process, the peer review panel process into his conduct had basically come to an end.

    They then sought my advice on what the next step should be, and I basically provided them with advice last Friday – they would have received the letter on Monday – that the full findings, the detailed report of the peer review panel, in my judgement, should be provided to the Victoria Police, should be provided to the Royal Australasian College of Surgeons, should be provided to any other body that they deemed had an interest in these matters. I should also mention that I also indicated to the Chair of the Board of Bayside Health that the hospital should also provide a copy of the findings of the Bob Dickens review to the Medical Practitioners’ Board, given that they obviously have an interest in these matters also.

    So, having supported this process from its very start, having allowed it to run its course, we have an outcome, a series of findings that are important, that are serious, and what I have done is to take the appropriate action to provide advice to the health service and to make sure that they provided the findings of this particular review, this important review, to the Victoria Police, to the Royal Australasian College of Surgeons, to the Medical Practitioners’ Board, and to any other body that they deemed has an interest in these important issues.

    What I’ve also done today, or what I will do later on today, is I will write to the Chairman of both the Royal Children’s Hospital, the Royal Melbourne Hospital and also Austin Health; those three health services have a strong and important relationship with the TAC and in relation to providing care and attention to trauma patients, and I will provide them with a copy of the findings of the peer review panel, and I will seek from them their urgent advice, or detailed advice from them, as to their thoughts, what learnings can be taken from the findings of this particular report, and then I will seek that advice, and that advice will be provided to me in due course.

    REPORTER: Do you believe…

    ANDREWS: Just prior to taking questions, I should also indicate to you that I not only directed Bayside Health to provide the report to various bodies, as I’ve listed, I also have sought from them detailed advice on what, if any, changes to their systems and processes they envisage making as a direct result of the findings of the peer review panel.

    REPORTER: Could there be more of this fraudulent billing happening in other hospitals? Is that what you’re saying?

    ANDREWS: Well, no, what’s important here is to ensure that other services, other health services, who run similar services to the Alfred look at the findings of this particular peer review panel and then provide me with advice on whether any of those findings would see them change or modify or alter the processes that they have in place. That’s an appropriate step to take, and that’s why I will later on today write to those three health services and seek their detailed advice and their feedback, if you like, on the findings of the Bob Dickens peer review panel.

    REPORTER: Do you think we have a problem with the way doctors and senior surgeons are billing the TAC and other insurers in Victoria?

    ANDREWS: Well, what’s important to acknowledge here is that whilst the allegations, the complaints, the claims made against Professor Kossmann are very, very serious, I have no advice that any other complaints have been made. The only complaints that I am aware of are those that have been made against Professor Thomas Kossmann. They have been dealt with as part of a thorough and a very important process that Bayside Health has run.

    I am aware that, just as Victoria Police will no doubt look at these matters – and, in fact, the Transport Accident Commission have actually asked the Victoria Police; they’ve made a direct complaint to the Victoria Police and asked Victoria Police to investigate these matters – I know that the TAC have also been looking at these matters. So it’s principally a matter for TAC, but they have been looking at this issue and they have asked that Victoria Police look at this issue, but I’ll just go back to the first point I made: the only complaints that I have any advice on, the only complaints that I know of, in relation to this sort of conduct are those that have been made against Professor Kossmann.

    REPORTER: Who, in your view, has to take responsibility for hiring a guy who presented a doctored or a dodgy CV, and then allowed him to go on practising surgery that he wasn’t qualified for?

    ANDREWS: Well, what’s important is that when detailed complaints are made, when official complaints are made, that they are rigorously dealt with, that there’s a proper process to investigate the merits of those particular issues. That’s exactly what has happened at Bayside Health…

    REPORTER: But it’s a bit late, isn’t it? I mean, I think that was the question.

    ANDREWS: No, no, well, I’m answering the question. What’s important is to have a proper process to look at the detailed complaints that have been made, to learn from the findings of that…important peer review process. And that’s exactly what we’ve done: to forward the outcomes of that peer review process, the recommendations and findings, to other relevant – whether it’s the Victoria Police or the College and others – but also to ensure that other health services learn from these issues as well, and that other health services look at the detailed findings and the detailed recommendations that have been made and provide me with detailed advice on what, if any, changes they might make to the systems and processes that they have in place.

    REPORTER: But no one caught the problem at its inception – that’s what I’m getting at. Who should take responsibility for that?

    ANDREWS: Well, part of sending the detailed report…and its recommendations to the College of Surgeons is important, for them to look at the findings and to see whether there are any changes that need to be made in their view…

    REPORTER: [Inaudible] but that’s going forward; he’s looking back.

    ANDREWS: Well, we can only go forward, and what I’m saying to you is that we have…asked that a copy of the findings be given to the Royal Australasian College of Surgeons. I will seek to meet with them very soon to hear from them first-hand about what, if any, learnings they can take from the findings of the peer review panel and, again, what’s important is that we take these findings, that we learn from them, and that all relevant parties have an opportunity to look at the detailed findings of the peer review panel and to provide me with the advice that I need to continue to deal with these issues.

    REPORTER: So you don’t think anyone should take responsibility for hiring a surgeon who, apparently, lied on his CV?

    ANDREWS: Well, there are serious issues in relation to this and, again, I’m not avoiding your question in any way – let me be clear about that – but I did say at the outset there are some issues I can go into. I can’t go into the details of what, if any… The Bob Dickens report finds that Professor Kossmann did not provide an accurate CV. There are other processes that are ongoing in relation to that matter. The College will be looking at that, I’m sure, and providing me with advice on that issue, but obviously Victoria Police will be looking at that and a range of others.

    So, again – I want to be clear with you – it’s just not appropriate for me to canvass the detail of that and, on that basis, what I’m interested in doing is looking forward, learning from this process and ensuring that other relevant parties, others who have an interest in these matters, also learn from these issues, and that’s why we’ve asked for the reports to be circulated, as we have, and that’s why I’ll be sitting down with the College soon to hear from them first-hand about what, if any, changes they can make, what their thoughts on the report are…

    REPORTER: What exactly…will the police be looking at? If he’s to be prosecuted…

    ANDREWS: Well, its not for me – can I say, with the greatest of respect – it’s not for the Health Minister to comment on what the police might or might not look at. That’ll be…

    REPORTER: But you’ve recommended [inaudible] onto the police.

    ANDREWS: No, I have…made sure I’ve taken the action that’s necessary to ensure that Bayside Health provide to Victoria Police – that’s already happened – the full details of the peer review panel, the findings, so that they can look at these matters. It’s important to acknowledge--

    REPORTER: Why, though?

    ANDREWS: --it’s important to acknowledge that the TAC have also made a formal complaint to Victoria Police, and again its not for me to comment on what the police are or aren’t doing, but it would be my expectation that they’d look at the findings of the report, they’d look at the very serious claims that have been made against Professor Kossmann and are the subject of the findings of the peer review panel, and they’d take appropriate steps from there.

    REPORTER: Do you have full confidence in the head of Bayside Health?

    ANDREWS: I have full confidence in the CEO of Bayside Health and I have full confidence in the Chairman of the Board.

    REPORTER: What guarantees do Victorians have that there aren’t other surgeons like this out there performing operations they’re not qualified to do?

    ANDREWS: We have a rigorous quality and safety process, we run first-class services right across our state, in metropolitan Melbourne, in rural and regional areas, and we have proper and appropriate quality and safety frameworks in place, and every Victorian can have confidence of the quality of care that they’ll get when they present for care at any of our Victorian public hospitals, and we have processes in place to ensure that we only provide the highest quality care.

    What we’ve had over the last few months is a proper process to deal with the detailed claims, detailed complaints, that were made against Professor Kossmann. I have allowed those processes to run their course, and now we have an outcome that we can learn from; now we have an outcome that can credibly be used to drive improvements.

    REPORTER: But those processes you just mentioned, clearly, are inadequate.

    ANDREWS: Well, I think we need to be clear about this: the investigation of Professor Kossmann and the peer review process did not come from complaints from patients in relation to care. It came from complaints – this is just a matter of fact; I’m not offering any judgement on this; this is just a matter of fact – came from complaints from other surgeons who had worked with him. They have been properly dealt with; they have been thoroughly dealt with.

    Despite the fact that I’ve been invited to, if you like, trample all over the process many times, I’ve not done that. This process needed to be allowed to run its course, it has been allowed to run its course, we now have a detailed report, we have findings, and you have a government that has taken the decisive action to ensure that the report and its findings are provided to the relevant authorities, to the Victoria Police, and to others, so as we can be sure that appropriate action is taken, as we go forward.

    REPORTER: have you or will you investigate any claims that there was contact between the health bureaucrats either in Department of Human Services or from the Alfred and the Royal College regarding Professor Kossmann’s accreditation?

    ANDREWS: Well, there are…I’m aware…there’s been some media commentary about this. There are unnamed individuals who are of a view that that actually happened. The subject of the claims made by those unnamed individuals has made it very, very clear that she, nor anyone else in the Department of Human Services, had a role in that.

    In my judgement, the Royal Australasian College of Surgeons have proper processes and make independent decisions, and I think it is simply wrong to put the view or to claim that the conduct that you’ve referred to occurred.

    REPORTER: So you’re not concerned that members of the College committee that accredited Kossmann said they twice decided against accrediting, and then…someone got a phone call from the senior health bureaucrat to say, ‘Give the man accreditation’?

    ANDREWS: I am not aware of any--

    REPORTER: Will you look into that?

    ANDREWS: --I am not aware of any person having made the claim you have just outlined.

    REPORTER: Will you look into that?

    REPORTER: Will Professor Kossmann ever work again…

    ANDREWS: Well, I’m not aware… Again, if a complaint is made…and I think what the last seven or eight months has clearly shown is that if a complaint is made in our public hospital system here, it’ll be dealt with in a proper way. I will meet with the College, as I said. I’ve ensured that a copy of the report, a copy of the findings of the report has been sent to the College, and I will meet with them in the next few days, I hope – certainly soon – and I’ll hear from them first-hand what their views are, what their thoughts are on the findings of Bob Dickens’ peer review panel.

    REPORTER: Will Professor Kossmann ever work in Victoria again?

    ANDREWS: That isn’t a matter for me, I’m afraid. I can’t comment on that. That’ll be a matter for him, that’ll be…

    REPORTER: Would you be happy to have him working in the Victorian health system?

    ANDREWS: Well, again, there are a range of issues. It’s important to acknowledge that Professor Kossmann has not worked in the public hospital system since these issues first came to light, since the complaints were made. He stood down, or has been stood down, from his role as the Head of Trauma at the Alfred; he since has given up that post. His professional career and his future is a matter for him.

    REPORTER: What’s to stop him from shopping around his CV any further?

    ANDREWS: I’m sorry?

    REPORTER: What’s to stop him from shopping around his CV any further?

    ANDREWS: Well, again…detailed processes have been run. We’ve forwarded the report for further work to be done. In relation to Professor Kossmann and any future work he may do, that’s fundamentally a matter for him, but again I think that the allegations that have been made against him are very well known.

    REPORTER: Are you satisfied, though, that the Alfred did enough to check his credentials?

    ANDREWS: Well, there are a range of issues, and one of the findings that’s been made against Professor Kossmann is that he did not provide an accurate CV. I go back to the point I made before: it’s not really for me to go into the detail of that because that, I think, will be the subject of other important processes, other important work that’ll be done if not by the police than certainly by others, the Medical Practitioners’ Board, for instance, and it’s just not appropriate for me to trawl through that, and that may well then prejudice the outcome of that important work, which goes directly to the question I was just asked about his future. Those processes need to be…

    REPORTER: You are in charge of hospitals…

    ANDREWS: No, no, absolutely, and…he is not working in the public hospital system now, and I don’t think while ever these issues remain unresolved he will work in the public hospital system.

    REPORTER: So the rigorous process you talked about, that’s basically that we rely on whistleblowers?

    ANDREWS: No, no. If people have a complaint to make, then the complaint is made, and what I’m saying to you and to every single Victorian is that they can have confidence that if a complaint is made, it will be investigated. That’s what’s happened here. Whether it be in relation to processes established by Bayside Health, or whether it be, for instance, if a patient had a concern about the level of care they were provided, under an Act of the Victorian Parliament, they can come forward, they can make a complaint, and the Health Services Commissioner will act without fear or favour to get to the bottom of that. We have a rigorous quality and safety process. It is a very sound process, and every Victorian can have confidence that if they have a complaint to make, they can with confidence come forward, make their detailed complaint and it will be acted on in their interests, in the interests of other patients, in the interests of the best possible health care for every single Victorian.

    REPORTER: Given that the report found that lives were put at risk, isn’t processes that deal with the aftermath a little bit, you know, it’s all good, but does it stop people’s lives being put in jeopardy?

    ANDREWS: What’s important is that the community can have confidence that where complaints are made they’ll be dealt with in a proper way. And that’s what’s occurred--

    REPORTER: What can you say about a doctor…

    ANDREWS: --that’s what’s occurred in the last seven or eight months. There is some further work to do, whether it’s the work of Victoria Police, who ought be allowed to do their job – and I won’t be interfering in that process; it’s simply not right to do that – the College of Surgeons will look at this, the Medical Practitioners’ Board will look at this and, indeed, the other health services, including Bayside Health, that I have written to, will look at these matters as well and provide me with advice on what, if any, improvements, what, if any, learnings can be taken from this important process.

    REPORTER: What can you say about a doctor at that level, the irresponsibility of it, of cooking up your CV and lying on it?

    ANDREWS: Well, again, I go back to the earlier answer I gave you. It’s not appropriate for me to comment on the detail of that issue. What is appropriate is that I take the action I’ve taken, and once I was informed by Bayside Health that their process, their peer review process was finished, they sought my advice on what the next steps ought to be and I have provided them with that advice, and that is why a copy of the report, a copy of the findings have been provided to Victoria Police, that is why copies of the findings have been provided to the Medical Practice Board, that is why copies of the findings of the report have been provided to the College of Surgeons, that is why Bayside will come to me with detailed advice on what, if any, changes they seek to make. And, as I said to you before, I’ll also make sure that the other three services who, again, do similar work and bill the TAC in a similar way also look at the findings of the report and provide me with their thoughts on the findings of that particular report.

    REPORTER: Morally, do you believe the victims of his botched surgery have a claim to compensation?

    ANDREWS: Well, I can only go back to the point I made before: if any individual has a complaint about the quality of care that they have received in any of our public hospitals, then there’s a well-established framework under an act of the Victorian Parliament that will allow them to come forward and have their complaint dealt with. I have confidence in that system; I have confidence in those processes. Beth Wilson, the Health Services Commissioner, or indeed the Ombudsman can deal with those important matters and, again, it’s not a matter of this particular incident – it’s across the board: if anyone has a complaint, then they can, with complete confidence, come forward and that complaint will be dealt with.

    REPORTER: But it’s likely to go beyond the…complaints process to include actual legal action against the hospital…

    ANDREWS: And that’s a matter for…I wouldn’t comment on legal action that people may take. What I would say, though, is that you need to establish the facts of a matter first, and there are processes in place to do that.

    REPORTER: That’s what we’ve done, isn’t it, through the [inaudible]?

    ANDREWS: No, no. I can only go back to the point I made before: the complaints against Professor Kossmann have come from fellow surgeons. They are not complaints made by individual patients. If, however, any patient of this particular doctor or any doctor or any patient across the health system, if they have a complaint to make, if they have concerns about the quality of care they were offered, then they can come forward with absolute confidence and make a complaint, and that complaint will be dealt with properly. And the Health Services Commissioner will deal with that, and I have total confidence in the work that the Health Services Commissioner would do, and does do each and every day, to support those who have a complaint.

    REPORTER: Will the Government or the TAC attempt to recover the money that Kossmann is alleged to have rorted from the Government?

    ANDREWS: Well, again, there are claims, there are findings about various billing issues. The TAC are looking at that issue, the Victoria Police are also looking at that issue, and it wouldn’t be appropriate to foreshadow that. That is an ongoing process, and I’m very confident that the police and the TAC will look at that issue. WorkCover have an interest in this matter as well, and indeed Medicare may have an issue as well. But those processes need to be allowed to run their course so that we can properly and appropriately determine what, if any, of that sort of conduct has, in fact, gone on, what, if any, monies are owed, and we can move forward from there.

    REPORTER: Has this whole saga concerned you, worried you?

    ANDREWS: Well, look, what I’m always concerned to do is to ensure that if there are complaints made, if there are allegations…

    REPORTER: But the nature of the complaints – has that concerned you, worried you?

    ANDREWS: Well, what I have been keen to do is to ensure that these issues were taken seriously and dealt with seriously. That’s what Bayside Health has done, that’s what I’ve done, and that’s why we have a process that’s run its course and we now have findings, we now have a detailed set of findings from the peer review panel, and we can now use those findings to check and to make sure that our systems and processes are as good as they possibly can be, to learn from those findings and to go forward.

    I’m concerned to ensure that every single Victorian gets the best possible care and, what’s more, I’m concerned to ensure that every single Victorian has confidence in the services that we offer.
  36. Guest

    Guest Guest

    There seems to be this repeated political rhetoric of concern of "every member of the public to get the best possible care"

    Clearly this is not achievable as health care woes even during good times are present and care always maldistributed: it is a reality.

    Is this obsession to deliver this rhetoric impacting on the abuse of OTDs nationwide? This seems to have become more so after the Patel saga.
  37. Guest

    Guest Guest

    Alfred may face costly repayments to TAC

    The Age
    * Richard Baker and Nick McKenzie
    * June 7, 2008

    THE Alfred hospital is likely to have to repay hundreds of thousands of dollars to the Transport Accident Commission if a series of external investigations confirms its former trauma chief rorted the motorist-funded insurer.

    The Age believes The Alfred's chief executive Jennifer Williams was warned by a staff member in a recent briefing that the hospital could face accusations of accepting "dirty money" if it kept all the cash it received through Thomas Kossmann's TAC billing.

    Hospital sources said Ms Williams had replied that the hospital might have to reimburse the TAC for some of the money it received through a deal it had with Professor Kossmann under which it got a cut of every TAC fee he earned.

    Professor Kossmann, who denies any wrongdoing, told The Age last week that the hospital got at least $3.6 million from the deal to split his TAC earnings. The hospital is pursuing Professor Kossmann for $700,000 it claims the controversial surgeon owes it through the TAC deal.

    If investigations by Victoria Police, the State Ombudsman and the TAC confirm Professor Kossmann rorted the system, the hospital could face the painstaking task of identifying which of his TAC bills were inappropriate and would require reimbursement.

    Neither the TAC, Health Minister Daniel Andrews nor The Alfred would comment yesterday on the prospect of the hospital having to repay the TAC. But The Age believes the TAC recently passed information gleaned from its own inquiries to fraud squad detectives.

    A report released last month by an expert medical panel commissioned by The Alfred to investigate Professor Kossmann's clinical and billing practices found he billed the TAC for operations that were not done or for procedures not done by him.

    The panel also found major flaws in Professor Kossmann's clinical practices, recommending his accreditation to perform spinal and pelvic surgery be revoked. It also identified problems with his accreditation by the Royal Australasian College of Surgeons.

    The prospect of The Alfred having to repay the TAC emerges as new documents reveal the hospital's National Trauma Research Institute (NTRI) was effectively bankrolled by the TAC.

    Documents obtained by The Age under the Freedom of Information Act show a TAC subsidiary called the Victorian Trauma Foundation contributed as much as $5.4 million to the NTRI, which was the brainchild of Professor Kossmann.

    Professor Kossmann was a member of the Victorian Trauma Foundation board at the time it decided to fund the NTRI. Both he and the TAC maintain that procedures were in place to ensure no conflict of interest arose in board decisions.

    Bayside Health board minutes from April 2003 show the board had noted that "the close links between the NTRI and the Victorian Trauma Foundation are important".

    The documents also show The Alfred decided to increase its commitment to the institute by $770,000 to make up for a shortfall in capital costs. It had previously pledged $2.07 million to "fit out" the NTRI.

    The NTRI also received substantial donations from medical device companies, insurers and family trusts.

    Professor Kossmann also contributed almost $290,000 of his own money to the institute, which The Alfred says is not required to produce an annual report to account for expenditure.


    COMMENT:

    It may be group rorting and Thomas K was not fully aware of this as he was new to the system. Why should he bear all the blame if all this mates are rorting Medicare and TAC?
  38. Guest

    Guest Guest

    It a common practice to bill Medicare and insurer. I note Kossmann gave his money back to the Hospital and research. What did the other Surgeons do with their "extra" payments?

    This system is wide spread across Australia.

    Thomas Kossmann continued to do the best for his patients which was costing the TAC more in medical costs and compensation payouts to the accident victims.

    Kossmann's patients have recovered well, what about the patients of the other surgeons? Are they the patients who are still complaining they are not getting the medical treatment because they are on workcover and TAC claims?
  39. Galileo

    Galileo Guest

    This is a lovely case for the Commonwealth Attorney General to explore prosecution under the Doctrine of Collective Intent - a well established principle in law.

    The Alfred (and its band of surgeons) has a vicarious liability - not only Thomas Kossmann - who, as you said, returned (? some of) the money as a charity.

    Galileo
  40. Guest

    Guest Guest

    It is again time to call for the Commonwealth take over of all public hospitals: enough corrupt clowning has been happening everywhere especially NSW
  41. Guest

    Guest Guest

    $1.4m lure for trauma surgeon Thomas Kossmann to stay

    Geoff Wilkinson

    June 10, 2008 12:00am




    SURGEON Thomas Kossmann was offered a rich new five-year contract at the Alfred hospital shortly before he was discredited and removed.

    The deal proposed by the hospital in 2006 offered Prof Kossmann a pay rise of up to 40 per cent and potential earnings of $1.38 million.

    In other developments in the case that has divided the medical community, the Herald Sun can reveal:

    AN email by one of the surgeons whose complaints triggered the review that ended Prof Kossmann's Alfred career confirms his opponents were "aiming for dismissal".

    THE coroner has still not conducted an inquest in the case of a 60-year-old woman who died in questionable circumstances at the Alfred during surgery that did not involve Prof Kossmann.

    PROF Kossmann believes at least three deaths there in recent years should have been investigated and has accused his critics of "total hypocrisy".

    THE German-born trauma surgeon rejected a major job offer in 2006 from a hospital where he had previously worked in Zurich.

    Prof Kossmann yesterday said he believed there had been a conspiracy against him.

    He said a small number of visiting surgeons who complained about him were motivated by a threat to their incomes by changes he proposed to hospital staffing.

    "It's a turf war. It's about power and money," he said.

    An email seen by the Herald Sun shows that one of the surgeons whose complaints prompted the Kossmann review contacted another surgeon interstate two days before the review started.

    The Melbourne-based orthopedic surgeon asked the interstate surgeon to review one of Prof Kossmann's cases and send his report to the review chairman, Prof Bob Dickens.

    "It would be preferrable (sic) if . . . it appears that your desire to make comment is spontaneous," said the email of November 16 last year.

    "Could you also add that you have seen several other cases that you have been concerned about the management of.

    "(Another surgeon) heard about the review and has spontaneously forwarded information about another case to the reviewers. We are aiming for dissmissal (sic)."

    The author of the email, which was anonymously left in Prof Kossmann's letterbox, could not be contacted by the Herald Sun for comment.

    The three-man peer review panel appointed by the hospital to investigate Prof Kossmann found he put patients' lives at risk by performing harmful and unnecessary surgery with the potential for "catastrophic outcomes".

    It also accused him of rorting the Transport Accident Commission and other public insurers by billing them for surgery he did not perform.

    A new contract discussed with Prof Kossmann in 2006 would have significantly increased the hospital's income from facility fees and donations paid to it by him as a condition of his contract.

    It proposed a sliding scale to increase the earning potential of the hospital and Prof Kossmann if he lifted his billing total.

    Bayside Health public affairs manager, John Heselev, said the contract was negotiated in good faith.

    "It was only upon the (review panel's) report being delivered that the hospital's view changed," Mr Heselev said.

    Prof Kossmann's formal response to the review included accusations against other surgeons of falsifying time sheets, delaying patient treatment to gain financial benefits, and working in private outside Melbourne while being on call.

    "I believe the complainants were concerned and unhappy about proposed changes to the hospital's operating rosters, which would have restructured the way the hospital allocates certain spinal cases and reduced their income," his response said.

    Mr Heselev said the motivation of the complainants was not relevant and the independence of the panel has never been under question.

    The review panel conceded that Prof Kossmann's clinical practices had not led to any patient deaths or long-term adverse outcomes.

    Prof Kossmann said yesterday the review panel's assertion that he had put lives at risk was "total hypocrisy".

    He said at least three deaths at the hospital which could have been due to the intervention of surgeons had been "swept under the carpet".

    Prof Kossmann said a lack of supervision could have been a factor in the death of the 60-year-old woman, whose case was to be investigated by a coroner.

    "The surgery was started by a junior doctor from overseas, and the consultant was still operating in private at another hospital," he said.

    The Coroner's Court has confirmed it is investigating the death of a patient in surgery at the Alfred in March 2005.
  42. Guest

    Guest Guest

    The plot unfolds: where else do you not see this type of 'professional' behaviour amongst doctors in Australia?

    I would suggest, 'nowhere'
  43. Guest

    Guest Guest

    a lot of this seems to be from performing procedures on virtually braindead patients. When is it the anesthetist's responsibility to say no? arent they ultimately under control when it comes to surgery and assessing the patients viability for procedures?
  44. Guest

    Guest Guest

    When power is unchecked, it becomes corrupted.....those who wield it acquire the mentality of gangsters and have the ability to abuse this power.

    Top level health bureaucrats have a big role in this mess and they are trying to shift the blame to Thomas Kossmann and appear clean.

    Do not think the Colleges are immune (they like to think they are) but when they are charged with 'assessing' OTDs, they automatically become de facto statutory health bodies - even under the Commonwealth health funding acts (eg the Health Insurance Act) if they are registered interstate.

    They are thus subject to the law despite their 'registered company limited by guarantee' status. This also includes the AMC.

    Let us hope this will lead to big leaps in reform which include College abuse of OTDs
  45. Guest

    Guest Guest

    Alfred Hospital faces negligence lawsuit

    The Age
    June 24, 2008 - 5:31AM


    The Alfred hospital in Melbourne and its former trauma chief are facing legal action following allegations of negligent surgery.

    Professor Thomas Kossmann was stood down last November while an independent three-member panel headed by child orthopedic specialist Bob Dickens investigated patient complaints.

    The panel said last month it found that Professor Kossmann lied about his surgical experience in his CV when he applied for the position of trauma director and that he carried out inappropriate and unnecessary operations.

    Mr Dickens said there was no evidence of patients dying as a result of any procedures undertaken by German-born Prof Kossmann, who resigned in April, but lives had been put at risk.

    Law firm Slater & Gordon said it was preparing several cases against the hospital, and possibly Prof Kossmann, over the alleged negligent surgery.

    "They are all people who have got significant problems," Slater & Gordon medical negligence specialist Paula Shelton told The Australian.

    "There are certainly a couple of them that I think are serious.

    "It's fair to say they relate to poor (surgical) outcomes."

    Comment:

    The ambulance chasers are in - or, is Natural justice beginning to wield is head?
  46. Guest

    Guest Guest

    The Alfred Hospital surgeon Thomas Kossmann facing negligence lawsuit


    Rick Wallace, Victorian political reporter | June 24, 2008

    MELBOURNE'S The Alfred Hospital and its former head of trauma, Thomas Kossmann, are facing legal action alleging medical negligence.

    Law firm Slater & Gordon hastold The Australian it is preparing several cases against the hospital, and possibly Professor Kossmann, for allegedly negligent surgery performed on trauma patients.

    The cases come in the wake of a damning peer review into Professor Kossmann's surgical and billing practices, which were first revealed in The Australian in April.

    The review alleged he had exaggerated his experience on his CV, conducted risky and unnecessary surgery, and rorted government insurance agencies, including the Transport Accident Commission. It also alleged he had put lives at risk with bungled surgery that involved grave errors in more than half of the 24 cases that were examined.

    Professor Kossmann has denied any wrongdoing and attributed complaints from doctors about his surgery to competitive jealousy. He condemned the peer review, led by orthopedic surgeon Bob Dickens, as a "witch-hunt", and several of his former patients have come forward to praise his surgical performance.

    When the review was released last month, Jennifer Williams, the head of Bayside Health, which operates The Alfred, absolved the hospital of any legal responsibility. But Slater & Gordon medical negligence specialist Paula Shelton said her firm was preparing several cases involving allegedly unsuccessful or unnecessary surgery performed by Professor Kossmann at The Alfred.

    "They are all people who have got significant problems," she said. "There are certainly a couple of them that I think are serious. It's fair to say they relate to poor (surgical) outcomes."

    For the cases to succeed, the victim must prove at least 5 per cent physical impairment and that the surgery done was poorer than could be reasonably expected at the time.

    Slater & Gordon is still investigating the cases and expects to obtain the medical records from the hospital and launch action within a few months if independent advice confirms the alleged negligence.

    A spokeswoman for Professor Kossmann said the surgeon was not aware of any claims against him and therefore could not comment. Ms Shelton said she was unable to give details of the cases, but The Australian has spoken with one of Professor Kossmann's patients who is not among the existing cases, but is considering joining any action against the hospital.

    The patient, who declined to be named, claimed he had complications after Professor Kossmann operated on him in 2004 following a car accident.

    He claimed he suffered a post-operative infection following the original surgery. "At the time I found him to be very professional and thought the complications which arose both in the short term and long term just came with the territory; however, reading the reports coming out now makes me wonder about that," he said.

    "About a year or so later, my leg played up again so I went to a doctor to have a look at it and they found deep-vein thrombosis, which he attributed to the original injury ... X-rays showed that a titanium screw placed in my knee ... had snapped during that surgery and had been left there."


    COMMENT:

    Will the truth ever be exposed? See how gullible Australian patients can be and how they can be truly opportunistic? One does not need to comment on how some Colleges and Australian doctors treat their OTD colleagues and get away Scot free. See how easy it is to ruin an OTD's career? OTDs, if you want your life ruined, go to Australia in 2008. I can comfortably inform you that things have become messier and OTDs are getting a continuing raw deal
  47. Guest

    Guest Guest

    People are looking at final outcomes on technical devices which can be faulty: how can one conclude that a screw had broken during the procedure when it is highly possible that this could break later on?

    They will never be able to proof this in the absence of serial radiography - but then, if these were ordered, then, where is the evidence supporting their use? Again, they can nail the doctor on overservicing. Either way he loses.

    Are they going to sue the manufactuers of the screw too? Silly bug&*s
  48. Guest

    Guest Guest

    Thomas Kossmann did the best for his patients which was NOT cost effective for the Government or insurance company. This is what they do to the OTD.
    We need to do something to stop them doing it again!

    The following written by a lawyer is part of a submission to the Federal Government inquiry on Workcover, accidents, insurance.


    The complete submission can be found on this link

    http://www.aph.gov.au/house/committee/ewr/wkc/subs/sub62.pdf
  49. Guest

    Guest Guest

    i highly doubt he left a screw in someones operation just lying there for no reason before stitching it up. he always used a radiographer on those cases.
  50. its all about culture...

    listen guys, the problem lies within the different culture of medicine in germany and the anglo saxon world, and more specifically within the totalitarian culture of german medicine.

    kossman seems to be the archetype of the old german Chefarzt (department head) who usually think of them as beeing god. in the past those guys were allowed to bill from all the private patients treated in their department, even when they had not performed the procedures themselves. this was on top of their base salary from the hospital. they also held sway on all hirings of doctors in the department, their promotion and their ability to do research.

    Today this is basically the same with ONE big exception, the department heads are no longer allowed to bill the private patients any more, those revenues go to the hospital so the Chiefs are left with his base salary, and more or less disgruntled. this might very well be the reason kossman came to australia in the first place for he could now only expect a salary as department head in germany or switzerland in the range of 200000 to 300000 € wheras in the past that might have been up to 1 or 1.5 million €. that is the reason he came to australia, to make money and for nothing else. the guys in the hospital had seemingly allowed kossman to bill for his own pocket so I am not at all surprised that he operated patients even if there was no chance for them to survife, just to get the procedure billed.

    he wanted to destroy the anglo saxon consultant model in the hospital and replace it with a Führer like leadership style of the all knowing all mighty Chefarzt, who bills everything and is not touchable for the other doctors.

    considering this model is getting out of style even in germany, I would recomend you not to implement it in australia and kick the medical dictator out of you country.
    now its up to you if you want to allow yourselves to be ripped off any longer by this newborn Hitler or if you want to stick to you well working consultant system without totalitarian structures in hospitals.

    regards.

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