A Better Next

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by Maren Cooper


  “That’s a sweet thought.” Jess wondered if he missed her or whether he mainly missed having someone there to cook. “I’m sure your lovely housekeeper left something for you to put together. She seems like a gem—you should keep her happy.” She laughed softly. “By the way, thanks for joining me for the puppet show the other night. I hope you weren’t too bored.”

  “Actually, I enjoyed it and also liked meeting your friends. Interesting people. I think Claire has a tough road ahead. Raising a child alone is a big responsibility. You never really know how big it is until you get into it.”

  “Yes, but she’s strong and resourceful, and she has me to help her. She went into it with a clear head.”

  “Well, anyway, they were all very nice.” He paused, then continued, “Jess, you haven’t committed to the Symphony Ball yet. Are you planning to attend with me? It’s coming up pretty soon.”

  “I’m glad you reminded me. I had a thought about that, and I hope you don’t mind my making a suggestion. I know this was an event that was very important to Sally, and to you, and that you’ve always gone with a particular set of friends. It occurred to me that since this is the first one you would be going to after Sally’s death, perhaps your daughter would want to accompany you, in honor of her mother.” Jess paused for a moment, then continued, her voice soft and kind, “Remember how Joanna felt on Sally’s birthday and how you went to be with her?”

  “She always helped her mom get ready. The two of them would barricade the bedroom and get Sally all gussied up. It was a real family event for those two. For us three, I should say.” He paused. “Do you think she’d really want to go with her dad?”

  “Fathers are so important to girls and young women. And this is still not long after her loss—after your loss. I think it would mean the world to her if you asked her to attend in honor of her mother. And what a nice memory you two could make for each other.”

  “Wow, I should have thought of this. It seems like a natural thing to do. What a great idea! I’m going to call her now.” Then another pause. “Hey, you didn’t suggest this because you don’t want to go, did you?”

  “Well, fancy balls aren’t my thing, but I do stand by my suggestion.” She chuckled. “And will you invite me to your lake place for Memorial Day weekend, please? I’m dying to spend some time relaxing with you somewhere you love.”

  Jess was waiting for Larry Personne at Gabe’s when he arrived. She remembered how he had needed to loosen up a bit before admitting his failings to her the last time, and had thought meeting for a drink might work again, although the stakes were clearly higher now.

  He looked much cheerier this time as he walked to her, putting his hand out to shake hers warmly. “So, Jess, I’m hoping we’re ready to wrap this up and move forward. Are we?” As he sat down, he asked the server to bring him a gin and tonic and a refill of coffee for her.

  Jess swallowed hard. “We’re finished with our preliminary work, and before we close it out, I wanted to meet with you to make sure we’re not missing anything or misinterpreting any of our findings. It’s a courtesy we routinely extend to the heads of groups before we finalize our reports, in order to keep them in the loop and make sure they want to proceed.”

  “Well”—he exhaled and loosened his tie—“if that’s all you need, I can tell you right now that I certainly want to proceed. I can hardly wait to get this deal done.”

  Jess wasn’t sure how she could prepare him, so she opted to go for the truth, to get it out on the table and deal with his reaction then and there. “Larry, I’m afraid we’ve found some irregularities in the billing. They’re quite serious—they’re material, beyond the threshold of normal errors, and reportable to the authorities. They have consequences for your group and may have consequences for you, or for anyone else who knew that these practices were in place. And, unfortunately, they will stop us from recommending a business relationship between your group and Midwest Health.”

  Larry Personne’s face lost all expression; his body sagged in his chair. He looked at her, soundlessly mouthing, “What?”

  She gave him time to regain his composure by repeating the message again, this time a bit more slowly.

  He drained his drink. “What does this mean?”

  “It means that you should prepare yourself to understand the legal aspects of the situation your group is in and go from there. My colleague Cindy Newton is ready to meet with you about the specifics of the various infractions and how to report them. She’ll be happy to refer you to an attorney after you understand a bit more about the situation.”

  He seemed to take that in. Still, he sat silently.

  “Larry, this is beyond my purview, and you don’t have to answer me, as you will no doubt need your own counsel to help you with these decisions, but were you aware of the billing issues and what was happening? Did you know what Floyd was doing?”

  At the mention of his name, Larry lifted his head up and smirked. “Ah, Floyd. Good old Floyd.”

  Jess said, “I’m so sorry about this. I know you’ll need some time to process it and to determine your next steps. Shall I have Cindy give you a call to schedule a meeting?”

  Larry just looked at her and started on his second drink.

  “Is there anything I can help you with right now, anyone I can call for you?” She wasn’t sure she should leave him.

  “No, just go.” He made no attempt to engage further and wouldn’t meet her eyes.

  As she prepared to depart, she realized meeting him in a bar probably hadn’t been the best idea after all. She guessed his reaction would have been the same anywhere, but perhaps at least she could have kept him away from booze for a while. She beat herself up about it during her evening run and tried to forget about it while she ate dinner. Finally, three hours after she had left him at Gabe’s, she called the bar and asked to talk to the manager. “Oh, yes, we remember that gentleman. He was quite belligerent. We asked him to keep his voice down while he made a few phone calls, and he was not happy. He did agree to let us put him in a cab awhile ago, after it was clear he was in poor shape.”

  She felt no remorse for having given Larry the message that he and his clinic were in real trouble, but she did feel relieved that he hadn’t hurt himself or anyone else driving home. Now what would he do?

  She saw she had missed a call from Jim while she was on the phone. Too late for that now.

  Chapter 43

  Jess woke with a general sense of dread. Once it was light enough, she headed to the garden. She needed to divide hostas before they got too big, so she graphed her plan but stopped short of any digging, wondering instead how Larry Personne was feeling this morning after his night at the bar. Had he had a chance to think in a constructive way about what she’d said?

  Suddenly, she found herself remembering her parents’ divorce hearing. Where did that come from? she wondered. She thought that had been long buried, just as her family relationships had been. Both had expected her to testify against the other parent. She would have been willing to tell the truth, but that hadn’t been what either of them wanted.

  Sometimes the truth was hard.

  The sun was still gentle and warm when she left the garden. As she got inside, she took a call from a very excited Jim. “Jess, you’re amazing. I can’t thank you enough for suggesting that I take Joanna to the Symphony Ball. She’s on cloud nine. Evidently, there’s a dress of her mom’s that she wants to wear; the two of them both loved it. Joanna thinks it may need a bit of altering, but she’s totally into this. You’re truly wonderful.”

  “I know I am. I’m glad my hunch was on point.” Jess laughed. His enthusiasm was catchy.

  Almost as quickly as he’d begun gushing, he signed off. “Gotta go into a case. Just wanted you to know you’re a special woman and I appreciate your intuition. Thank you.”

  As she hung up, she saw that she had missed a couple of calls while she’d been in the garden, one from Dan and one from Cindy. Rather than taking th
e time to call back, she texted them that she would be in shortly, took a quick shower, and arrived at the office forty minutes later.

  Cindy had a meeting in progress but left it briskly and followed Jess to her office, closed the door, and skipped any preliminaries. “Personne has gone wild. He left a raving voice mail on Dan’s line that he’ll be suing us, that we’re all quacks and don’t know what we’re doing.”

  Jess sat down at her desk and frowned as she emptied her briefcase. “I’m not surprised.” After a brief pause, she said, “You know, I really did screw up on this. I should’ve had a communication plan ready so that things didn’t stop with him. I knew his world was about to cave in. I was so eager to unload the bad news that I didn’t think past that.”

  Jess gazed out the window for a moment and then continued, “Anyway, if he goes into a corner somewhere, we have to be able to communicate with his group. They shouldn’t be left in the lurch because of the actions of a crooked business manager and a complicit physician leader. As it is, he may go off on a bender, or worse.”

  Cindy put a hand on her shoulder. “This will get sorted out. You couldn’t know how he’d take the news. Dan’s been trying to reach him all morning, and he hasn’t responded. Did he express any interest in meeting to learn more about the legal realities and his obligations?”

  “No, truly, he shut down and shut me out.” Her early-morning sense of dread was back in full force, and now it had a shape. The Midwest Health project was dead before it could really get started: fifteen physicians’ careers derailed and a rogue doctor wreaking havoc on the firm.

  Cindy moved to the sitting area and gestured for Jess to join her. “I’m afraid it gets worse. Larry has made this personal and blames you for all of it. And he didn’t just call Dan; he also called Dick Morrison at Midwest Health.” Cindy paused, then added, “We think he may have called, or intends to call, Jim as well.”

  Jess noticed the voice mail light blinking on her office line just then. She was about to pick up and retrieve the message, when Dan walked into the office.

  “Jess, don’t listen to that.” He guided her to the sitting area, where Cindy was waiting, and they all sat down. “I know Personne called you.” He grinned. “He said some very bad things about you and called you some names that I haven’t heard in a while. He has quite the command of colorful language.”

  Jess couldn’t bring herself to join in the light laughter that followed. “Sorry, Dan. I guess I screwed up.”

  “On the contrary. You and your team uncovered some crazy stuff that this guy either knew about or should have known about, and now he’s striking back. It just so happens that you’re his target. Someone was bound to be.”

  “Dan, I think Amy is trying to get your attention.” Cindy was looking through the hallway glass at his administrative assistant, who was standing with her arms full, waiting for a sign of permission from her boss.

  Dan went to the door and let her in.

  “I’m sorry to interrupt, but these came for Jess. May I bring them in?” Amy asked as Dan peered into the box.

  “Couldn’t be a better time for flowers.” Dan clapped his hands.

  Jess unwrapped the lovely bouquet, and the card fell to the floor. Cindy quickly picked it up and read it aloud: “So grateful that you’re my team leader! I continue to have the highest regard for your integrity. Thank you. Dick Morrison.”

  “He enjoyed the rant last night as well, but when he called me this morning, it was to thank us, not to second-guess us.” Dan looked bemused. “Jess, he knows who you are. You have a voice message from him as well. Erase the one from Personne and savor the one from Dick.”

  “Looks like he’s a true fan,” Cindy said. “He even underlined ‘continue.’ He clearly remembers and is appreciative, for sure.”

  Jess took a moment to enjoy the sweet scent of irises and lilies and to catch her breath. “I’m glad we didn’t have to do a lot of damage control on that end of things. But wow, what a mess otherwise. What have you two been thinking our next steps should be?”

  “Well,” Dan said, “now that we know he was drinking last night and probably made the calls in that state, we should give him today to sleep it off and come to his senses. I have a call in to him, so that’s enough for today. If he doesn’t call by morning, I think we—and that means Cindy—need to figure out how to get to him to explain the specifics.”

  “It’ll be so much better for him and the group if he works with an attorney to sort out how to approach this situation. Who knows—maybe he’ll surprise us and retain someone today and call us. Cindy, if he doesn’t have someone in mind, I assume you’re putting together a list of attorneys for him?”

  Cindy opened the notebook she had carried in. “Yes, I’m on it. I’m already developing a problem list to pass on as well. I’m prepared to meet with him whenever he’s willing.”

  “And what about the group?” Jess asked. “If this goes on for more than a day or so, they’ll begin to ask questions, especially if Personne isn’t around. We should have a good outsource firm ready to refer them to for an interim manager. Many are just hanging on until this assessment is completed before they jump ship if the Midwest Health deal doesn’t come about.”

  Jess was fidgety and couldn’t stay seated. She walked to the window and then turned to face Dan. “If the practice can’t be saved, Dan, we should be thinking about how to steer those who leave to Midwest Health.”

  Dan sat taller in his chair and smiled broadly. “God, yes. We should. Good thinking. That still works for Midwest Health’s strategy, and you’ve already learned that the clinical quality of that group is very high. That could be the best solution for those physicians, as well as for their patients. Could save a lot of heartache for everyone.”

  “As long as the legal issues don’t bog them down individually,” Cindy added. “Remember, we did an assessment that will now be turned over to . . .”

  “Yes.” Dan stood and nodded in agreement. “And that legal process will take months, if not years. At least we know we did the right thing and can make the handoff with a clear conscience.” He checked his watch. “I love problem solving with you two. So let’s continue thinking along these lines and see where we are in the morning.”

  Jess worked on other projects through the next several hours, trying to keep her mind occupied. But later, when she left the office and headed to the parking ramp, she searched for her car for ten minutes before she realized she was on the wrong level.

  Chapter 44

  Jess took a glass of wine out to the patio to try to unwind. She breathed in the earthy smell of freshly cut grass and felt the gentle touch of a light breeze on her bare arms. She was tempted to go fiddle more with her garden, when Jim texted and said he was going to stop by on his way home.

  As soon as Jess got a look at his face, she knew something was wrong. “Hi there. How are you? Tough day?” She poured him a glass of wine as he joined her near the patio table. His rigid body language did not invite a touch, nor did he reach for the wineglass, so she sat and waited.

  “Not so much for me.” He seemed to search her face. “Must have been a rough one for you.”

  “Did you get a call?”

  “Yes, and it wasn’t pretty.”

  “I bet not, and you weren’t the only one to get one.”

  “Are you OK?”

  “Yes, I’m fine. This isn’t the first time I’ve been subjected to someone’s misplaced anger.”

  “I can’t believe it. Of course, I don’t believe any of what he said about you personally. But I also can’t believe that they’re in legal trouble.” He was pacing the length of the patio, lost in his own world.

  “You know I can’t talk to you about this stuff, right?” she asked, but received no answer.

  “You know this clinic was important to my practice, right?” His tone was soft, a bit condescending.

  She paused, trying to decipher that comment. “Jim, this isn’t a good conversation
to start.”

  “You know these guys are MDs just trying to do their thing, and without a manager to do the business piece . . . they’re not trained to know this billing stuff. I’m not trained to know this billing stuff.” His voice was getting louder, and he now stood stock-still, facing her. “That they could be held accountable for billing irregularities and face legal consequences—it’s crap!”

  How dare he bait me? she thought. She wouldn’t go there.

  “I’m sorry that you got a phone call, and I’m sorry that this whole situation may be difficult for your own practice. But I’m not sorry to have been involved in assessing the practice and following the facts. That’s my job.”

  She rose to walk the edge of the patio and give him a moment to settle down. When she returned, he was in full smolder.

  “Do you realize that Personne has probably lost his livelihood? Here’s a guy in his midfifties facing legal trouble when he should be winding down to retirement. This isn’t fair!” He started to pace again.

  She silently counted to ten, then sat and poured herself more wine. “Overbilling Medicare is not a victimless crime,” she said coolly. “And physician leaders have a fiduciary responsibility for overseeing their management. If they want to be business owners, they cannot default on that.”

  He stopped an arm’s length from her, his voice now steely and low. “How could you see it only that way? How can you throw him under the bus? How can you live with yourself, having done that?”

  Jess stood and walked away, trying to keep her trembling under control. She could hear the crunch of the gravel as he left the patio and headed for the front of the house.

  Dusk had fallen, and it was chilly. She finished her wine, headed into the house, drew a hot bath, and soaked in it until she stopped shivering.

  Was it really just this morning that he called me to tell me how amazing I am? she wondered. That certainly wasn’t what he was thinking about me tonight. But how much do I care?

 

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