Author: P Hasselbacher

Why Do We Physicians Still Practice So Much Ineffective Medicine?

How Not to Treat Idiopathic Pulmonary Fibrosis.

One of the first things I wrote about on these pages was the importance of having good evidence backing up what we doctors do to people, and how commercial editorial policies of medical journals have at least the potential of denying doctors and their patients timely knowledge of information that might inform their medical choices. I thought of that article again when I looked at one of the several email news summaries I get from various organizations.

One of the highlighted items that caught my eye was a report that “Combination therapy for pulmonary fibrosis appears to increase risk of death [and] hospitalization.” Several of the diseases I used to treat included pulmonary fibrosis and were notoriously difficult to manage. I clicked the “More…” button and was led to this week’s New England Journal of Medicine. The article provides a stunning example of how we physicians still allow ourselves to be led down the garden path of ineffective medical care. Continue reading “Why Do We Physicians Still Practice So Much Ineffective Medicine?”

Maneuvering for a New VA Hospital Site in Louisville Continues.

Resistance up to the last minute!

The Courier-Journal’s lead front-page article today continues to report on the “VA Hospital Site Controversy” with a headline ” Older Vets had More Say In Survey” and that some younger ones argue their voices aren’t being heard. Fair enough.

The survey being referred to was professionally conducted in 2009 by the VA as part of their decision-making process about if and where to replace the current VA Hospital on Zorn Avenue in Louisville. It is pointed our for us that three quarters of those polled served in the military before 1990 and that most of those were Vietnam veterans. Should this be a surprise? Aren’t most of the 21.8 million Veterans older by definition? It is said that some younger veterans are criticizing the VA for not taking their views into account before deciding on the new site off Brownsboro Rd. at the Watterson Expressway.

Only two younger veterans are mentioned in the article. Both spoke out at the public hearing on April 18.  Their criticism appears to have been the stimulus for the article.  One of the men lives adjacent to the favored Brownsboro Rd. site. [It is hard to imagine a more convenient hospital site for that particular soldier!]  Two soldiers or veterans do not in my mind a groundswell make. Continue reading “Maneuvering for a New VA Hospital Site in Louisville Continues.”

Open Letter to Metro Louisville Council Concerning QCCT Fund for Indigent Care

The Status Quo is Not an Option.

In an earlier article, I urged all readers to make their opinions known to Metro Louisville leadership about how to handle the University of Louisville’s request to maintain the status quo for how public money for indigent care is funneled to University of Louisville control.  In that spirit, I sent the following letter to each of the Metro Council members and to the Mayor.  Given that the University’s own internal review process is unlikely to produce detailed financial information relevant to its use of QCCT funds, and that it is not yet known if the Kentucky State Auditor’s office will have adequate access to the University’s books to do its job, how the Metro Council decides to act becomes even more important. Continue reading “Open Letter to Metro Louisville Council Concerning QCCT Fund for Indigent Care”

Fourth Meeting of UofL Hospital Operations Review Committee.

Some good work, but continued disappointment.

On May 9, the UMC Ad Hoc Operations Review Committee held its next to last meeting.  One additional meeting is scheduled for May 23, at which time the final report of the consultant organization, Dixon Hughes Goodman (DHG), will be presented.  Given the level of detail presented at yesterday’s meeting, I do not expect any major new elements to be presented.

The meeting agenda was brief, including an “update” to DHG’s analysis to date, and a presentation of case studies of hospitals deemed similar to University of Louisville Hospital. Most of the committee members appeared to be present as were some half-dozen of the consultants. Reporter Laura Ungar of the Courier-Journal and myself were the only members of the public that I recognized. Continue reading “Fourth Meeting of UofL Hospital Operations Review Committee.”