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This topic was not a requested topic. Actually, I wanted to write about this because of a post a friend of mine shared from an article she read. It inspired me to write about this because I have first-hand knowledge, and have seen it. There are no facts or data that I will be referring to because frankly, none are kept the two issues I will be discussing. No one in their right mind would ever keep data on this. However, it's real. Many of my readers know my background, but for those who do not, I spent a total of just under 40 years in pre-hospital medicine working as a career firefighter and paramedic. During my career, I cared for 76,251 patients. Yes. I kept my own count. I always say, if I haven't seen it, it's might be because it hasn't happened yet. Yes, I've seen a great deal. Not only from the provider and first responder standpoint, but also the corporate standpoint. Where and who I worked for is irrelevant because this is a system wide problem.


First allow me to state that is a given, and perfectly understandable, that any company MUST turn a profit. No company can survive if they are not making money. Many of these companies, especially in the commercial ambulance services want to do more, but would not get reimbursed by insurance companies and the necessary changes that are required to do this are at best, a nightmare due to the changes that may have to be made at the level of the state legislature. However, whether the best intentions are there, the corporate America mentally id terrible when it comes to workers. Not just in medicine, but in all aspects of corporate America.

For years, our society has been plagued with the corporate America attitude of, and I have heard this said directly, "If you don't like it leave, I have 200 applications on my desk of people just waiting to take your job." One of the first jobs I had in management many years back, they sent me and one other to a country I will not name, for a two-week seminar as to why they had great productivity and an excellent relationship with their workers. My co-worker and I were in shock. What this company was doing was exactly what needed to be done to increase productivity and make the employee want to work and do a good quality job. I witnessed people volunteering to stay late as long as necessary to make production for that day after the production line was down for three hours being repaired. The keyword here is VOLUNTEER.

We brought back many of these concepts in a full written report. Mind you, this was tried and proven to be successful. The response was, "we'll never do that." Again, witnessed first hand. Most companies promote a TEAM environment, yet, do nothing to make employees feel like part of the team. Here's a good example, at a meeting it was said, "I want to run this by you all for your opinion, but I have already made up my mind what I'm going to do." My first thought was, if you already made up your mind, why are you wasting my time?


There are many other examples I could give, however, I think I've made my point. This type of corporate attitude leads to:

1. Unhappy workers,

2. Workers that do not want to come to work,

3. A non-productive work force,

4. Poor employee/company relations,

5. Lack of caring.

These are just a few, there are more. What is leads to is some that will care about the job they do regardless of the conditions, and those that will not. It's that simple. My best-selling book many years ago which is no longer in print, but available on as an educational tutorial, was Management and Employee Relations. Hundreds of students have taken that tutorial and I hope many are better managers because of it. However, it's the main corporate attitude that needs to change in our country. In business, productive change starts but could also end at the top. All the 'at-a-boy' emails from the CEO are meaningless to people that are treated like they are dispensable. Healthcare is just one industry where this occurs. It is a systemic problem. One piece of data I will share is this. In this study by STAFF SQUARED HR, it was determined that 85% of people hate their jobs. Isn't that sad? Now we must understand and also be fair by saying for some folks, no matter what the company does, they will not be happy.


As compared to many countries, and this may be a matter of opinion, one might say we have a good healthcare system. However, our healthcare system is not broke, in my opinion, much of it is destroyed. I didn't spend almost 40 years in pre-hospital medicine and the fire service because it pays so well. IT DOES NOT. For most of those years I had to work two jobs. On my days off from the fire department I worked on an ambulance, and many times, after a shift at the FD was over. I was raising three children. We all do what we have to do to give our children the things and opportunities we may have not had growing up. I did it because I loved taking care of people. However, you see it all. The good and the bad.

I've stopped working in that field two years ago as my writing career flourished, and frankly, it was my time to say goodbye to it. During my career I had 13 surgeries from job related injuries and many broken bones. It is not easy work. It is dangerous, demanding, both physically and emotionally. You miss many events with your family and children, and most, end up in divorce as I did. Many commit suicide, and many just get burnt out. However, I loved when I delivered a baby, which I delivered 13 over the years. I loved saving someone's life knowing that if I, or someone else wasn't there for them, they would have died.

However, I was not fond of the fact that many people abuse the 911 system. Many have state insurance that are fully capable of working, just choose not to because the system does not have the resources to weed out those that really do not need these free benefits. No one can be refused medical treatment, as it should be, but what bothered me the most was this;

Elderly people who worked their entire life just to go on medicare, and I would have to pronounce them deceased because they could not afford to buy and pay for their medicine that insurance either did not cover, or their co-pay was too high.


As I said earlier, there are people on state benefits in many states that actually need to be, and are deserving of these services, but there are also many that are not. These individuals get these services and medications for free, while someone who worked their entire life does not. Here is an example, and this happened numerous times in my career, not only once.

I would respond to a cardiac arrest call, get on scene and sometimes could work the patient to get their heart started, and there were times they were too far gone. In both cases, I would have to pronounce them DOA, dead on arrival, or call a doctor because they were not responding to attempts to resuscitate them and after conferring with family on scene, or by phone, receive permission to terminate our efforts and pronounce them deceased. Well, it doesn't end there. We would have to determine why this possibly happened. The first thing we would do is check their medications to figure out their medical history. On more than one occasion I would find the empty pill bottles with no medications around. The refills were not refilled, therefore, they were not taken their heart or high blood pressure medicines, and others, for some time. Often times if we did successfully revive someone, we would find out they were not taking their medications because they could not afford them. When I would speak to a family member they would have no idea their loved one was not taking their meds for that reason. I would have to watch them be even more upset because if their loved one probably wasn't so proud to say something to them, they would have paid for them. Someone's mother or father might still be alive. I ask you, should anyone dies for that reason?

We all watch the news. We have all seen what has happened to the price on medications such as insulin, and others. These are medications that people need to take in order to live. The pandemic has strained this problem even more. For years, these drugs could be bought that are made by the same manufacturer, in the same packaging, from another country, at a fraction of the cost. Does this sound like a healthcare system that works?


Thank God, if all goes well, President Trump, or any President for that matter, is taking an active role in getting these drugs prices reduced. I understand the expense that goes into research and the pharmaceutical companies need to get their money back, but not through the middle-man that jacks all the prices up. When did we lose the value we have always placed on human life? It's easy to be 35 or 40, sit back and be complacent about this. However, I will tell you what my father used to say when he was alive, and something he taught me from when I was young.

"Remember, you won;t be young forever, and everything you we someone elderly going through, you will be going though one day."

Those are some of the truest words I have heard becuase I have seen it, witnessed it, and unfortunaetly and sadly, saw the results. You will NOT find data and statistics on the examples I gave you because no one keeps them. Therefore, until it happens to you or one of your loved ones, you might not get it. I get it. This is the truth. It's not easy to write about, and it;'s not easy to read about, but it is the truth. Like it or not.

I've seen it, therefore, I do not need data or proof. I've witnessed it, so I know the problem exists. Parts of our healthcare system or not broken, they are destroyed. If we hold any form of value of life, they must be fixed.

Thank you ... Caesar Rondina


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