New home for UofL Faculty Private Private Practices?

Genealogy hobbyists will tell you that while much information is available on the internet, eventually you have to get your feet dirty and go out into the real world for information. Taking that advice to heart, I played Hardy Boys last weekend and went out to walk the property of the medical facilities at the Jewish Hospital/Norton Suburban medical centers on Dutchman’s Lane and Dupont Circle. There was much to see and insights to gain. It appears to me that KentuckyOne Health already has enough land to build a major new medical facility and/or renovate and construct several smaller ones. A newly acquired office building might house a battalion of KentuckyOne and University of Louisville faculty physicians. A single additional acquisition will give the company a massive piece of contiguous land on which build nearly anything, including possibly another hospital. It is clear to me where KentuckyOne must have its sights set and I am not alone. I prepared a map showing the corporation’s current known holdings. Photographs of the properties can be seen here.

What KentuckyOne Health owns today.
Immediately across the channelized Weicher Creek from Jewish Hospital East Medical Center and connected by a substantial 2-lane bridge, are four contiguous lots on Dupont Circle owned by KentuckyOne or Jewish Hospital-St. Mary’s: street numbers 1108, 1110, 1112, and 1114. Buildings previously at 1112 and 1114 have been demolished. Buildings at numbers 1108 and 1110 are vacant. (A lithotripsy company truck was parked out back.) It is not clear to me where the parking lot between 1108 and the single long building from 3928 to 3944 Dutchman’s Lane is divided. If I were a long-, or even short-term planner for KentuckyOne Health/CHI, I would want to buy that land. I have reason to believe it has not been for a lack of trying. People have told me that it is just a matter of time. Perhaps the deeper pockets of Catholic Health Initiatives will finally swing the deal. The Dutchmans Lane property was purchased in 1999 from Brown-Conti, L.L.C. by BCK Properties. (I understand that some of the principals are the same people.) I was not able to reach the company for comment.

Further along Dupont Circle, KentuckyOne Health recently bought two additional properties at 4001 and 4000. The most recent occupant of 4001 was Oliver’s Billiards. Oliver’s was just evicted from the property with a speed that surprised some surrounding businesses. That suggests to me that KentuckyOne is ready to make some moves.

Directly across the street at 4000 Dupont is the former Vogt Power International Building. This office building looks to be in good shape from the outside and has great parking. It would make a great doctor’s office building. Indeed, it is already a target for deliveries from the “Vice President of Medicine.” Based on my reading of the contracts between KentuckyOne, CHI, and the University of Louisville; and on discussions within these organizations that I personally heard, I believe this building will soon house private practice activities of the faculty of UofL. I am seeking confirmation, but I think we will know soon. It would be a good home for employed physicians of KentuckyOne Health and perhaps independent physicians as well.

Is the future in Ambulatory Surgery and Diagnostic Centers?
All the income with fewer the costs and responsibilities? Growing ambulatory surgical centers is a special competence of Dr. Charles Peck, Jewish and St. Mary’s Hospital’s new President. The building on the corner at 4005 Dupont Cir. is presently occupied by the “Surgecenter of Louisville, an affiliate of SCA.” Louisville’s land records indicate that the site is deeded to the Alabama parent company. Therefore, strictly speaking, the land is not owned by KentuckyOne Health. Because the Surgecenter’s website declares it to be a partner with Jewish Hospital-St. Mary’s, I have colored it in on the map as part of KentuckyOne’s effective domain. If anyone can provide more definitive information about the ownership and partnership situations, I will be happy to clarify this for the record.

What else is there?
The Dupont Circle loop contains many other properties with a variety of owners. The majority of individual businesses are involved in medical care in some way. One major exception is Shenandoah Condominiums, a residential community adjacent to the major Jewish Hospital Medical Center property. The subdivision comprises some 5 major buildings and a small clubhouse with pool. Altogether there are 80 units. Residents were under the impression that overtures had been made to acquire the property, but the fact that negotiations would have to be conducted with 80 different entities fends off any buyer. I do not know enough about real-estate law to know if the residents’ confidence is justified. Some of the medical office buildings on the Circle are also condominiums. At least some have long-term leases.  I suppose the same issues would be operative.

I am unaware at present of additional alliances or loyalties between the healthcare professionals in the area and the three major hospital systems that have a presence there. Surely, those relationships are going to be further strained. It is clear that things are in flux. For an area that must have to feed a lot of people at lunchtime, two major restaurants are closed, boarded up, or for lease. Some of the businesses, offices, or stores have little to do with the healthcare industry. It remains to be seen if they will be able to operate in this changing environment with inevitably rising rent and worsening traffic.

So, is this a bad thing?
The actors involved have chosen not to share their plans with the rest of us, even though the majority of their funding comes from public sources and our healthcare dollars. Since we as a society have not yet arrived at the proper conclusion that healthcare is a common good, they are likely to get whatever they want or can lobby for. I wish I could read the future– I cannot. What I do believe is that the competition in Louisville’s healthcare community is decidedly unhealthy for the rest of us. I lament the fact that our public university has been dragged, not unwillingly, into the thick of it. Cooperation among the three major local hospital systems is long gone, and in an era when the majority of physicians are becoming employees of hospitals, is doomed to become even more hyper-polarized. For example, do we really need three different organ transplantation programs in Louisville? Do we really need more than one children’s hospital. How many more hospital beds do we really need? Do we want our doctors to have to take sides? Will we have to worry about whether our doctor will refer us to the place he or she thinks is best for us, or to the place that decides on their bonuses? What will happen to downtown Louisville as jobs and reasons to come downtown further diminish? More to the point, how will this hyper-competitiveness effect the availability and cost of health care for the medically indigent, the uninsured, the underinsured, or for that matter the rest of us. To this latter point, as the downtown players and University faculty shift their energies to our eastern suburbs, I foresee that the downtown medical center will devolve even further than it is into a segregated place into which the disadvantaged are shuttled for medical care of a discounted brand. Yes, that would be a bad thing!

Peter Hasselbacher, MD
President, KHPI
Emeritus professor of Medicine, UofL
March 13, 2013