Author: P Hasselbacher

Secret War Against Birth Control in Louisville Now Out of the Closet.

KentuckyOne Health physicians are now on the record about medical practice restrictions.

On June 9, I reported in these pages that agents for KentuckyOne Health (KOH) were enforcing certain new restrictions on their employed physicians, and in particular, on Obstetricians and Gynecologists. I used these prohibitions to demonstrate how in my opinion University of Louisville physicians and trainees would have had to ignore contemporary standards of the practice of medicine had Catholic Health Initiatives (CHI) been able to acquire the clinical operations of the University. I had, in my opinion, reliable evidence that KOH physicians were being prohibited from offering birth control and other standard reproductive or women’s health services, limited in their treatment of ectopic pregnancy, restricted in end-of-life care, and subject to other of the Ethical and Religious Directives of the Catholic Church. Hypocritical “work-arounds” were suggested that in my opinion opened wide the door to medical falsehood by patients and physicians alike. I could not get a single physician to go on the record to confirm what I was being told privately. Neither could I get a reply from Jewish Hospital or their major women’s health program.

As of today we have a different story. Laura Ungar reported on the front page of Louisville’s Courier-Journal that the physicians of Highlands Family Physicians, a major primary care practice employed by the Jewish Hospital Physicians Group, have severed their association with KOH and joined the physicians of Norton Healthcare where they will be allowed to practice to the full standards of modern scientific, evidence-based medicine and their medical license. The major stumbling block reported was a prohibition against birth control and a required documented emphasis on “natural” family planning (a.k.a. the make-love-and-worry-for-a-month rhythm method, or presumably abstinence). At this time, we do not know the full spectrum of related prohibitions. When the physicians of Highlands Family Medicine requested written direction to dispel confusion about rules that “could change,” none were made available. As a matter of courtesy to those concerned, I again offer to publish any such clarification in these pages. I think the public has a right to know, don’t you? You can download a copy here of the “contractual” restrictions that the University of Louisville would have been only too happy to adopt last January 1. From all that I can see, it appears to me that these are the rules that Jewish Hospital and its physicians are now following. I would be happy to publish a clarification that no physician was ever shown such a list. Continue reading “Secret War Against Birth Control in Louisville Now Out of the Closet.”

Latest Public Hearing About New Louisville VA Hospital.

It ain’t over until the cornerstone gets laid.

Background.
The Veterans Administration held its most recent (but certainly not last) public hearing yesterday evening at the Clifton Center on Payne Street here in Louisville KY. The purpose of the meeting announced in the paper the day before was to discuss “concerns or considerations related to design or layout” of the replacement for the existing Robley Rex Veterans Affairs Hospital to be built on land recently purchased by the VA near the Brownsboro Road exit of the Watterson Expressway. The announcement below of the hearing on the website of the Robley Rex Hospital (reproduced in full here) accurately anticipated that there would not be very many specifics to discuss!

“The purpose of this meeting is to provide the general public, interested stakeholders, affected governmental agencies and other interested parties timely information regarding the proposed action of the VA relative to the present progress of the Facility Master Plan for replacement of the Robley Rex VA Medical Center (VAMC). … The master plan is conceptual in nature and will neither establish a design for the construction or implementation of the new medical center nor institute benchmarks for the same purpose.”

Executive Summary.
It became apparent immediately that there was a mismatch between the goals of those moderating the hearing and the audience. The neighbors of the future hospital wanted to know what was going to be built in their backyards, but the presenters were still very much in the conceptual stage and had no details to offer. This was a recipe for a bad-tasting meal. The result was continuing frustration on the part the residents who feel information-starved, and not as much substantive input as the master planners must have wished for. Nonetheless, the hearing revealed a few new twists in what is sure to be a continuing organized campaign to delay and/or to build the hospital elsewhere. I will present these below. Additionally, local and regional VA officials attended the hearing and provided me with additional information. Continue reading “Latest Public Hearing About New Louisville VA Hospital.”

UofL Hospital Cuts Some Clinical Services.

A significant loss to the community or not?

On Aug 1, the Courier-Journal’s hard-working Laura Ungar reported that the University of Louisville was cutting some services available to its hospital patients. The digital version of the report was quickly picked up by national media. Ashok Selvam, a reporter for the industry news magazine, Modern Healthcare, could not elicit comment from the Hospital itself. His story gave the impression that the cuts were a consequence of last December’s failed merger with Catholic Health Initiatives. It seems to me that such an interpretation is exactly the story line that UofL has been using as it maneuvers to finally consummate such a marriage. Additionally, UofL has been forecasting reduced services to the indigent for many months as it argues before the Louisville Metro Council for additional public funding. Without some actual cuts in evidence, such promises might appear hollow. Given its claims of poverty and need for more tax dollars, I am not surprised that UofL might want to provide some kind of evidence that the sky really might be falling in.

Fortunately for Louisville, Ms. Ungar was very successful in eliciting more information. Despite the fact that UofL President Ramsey recently went out of his way to say that he makes it a point not to read the Courier-Journal, the Hospital would have lost much local credibility if it had stonewalled. So, what were the actual services that are said to be cut, and how might they be related to a failure of the merger or to the provision of indigent care? I must say that I agree with the comment from the Louisville Mayor’s office that “it appears these services are not critical.” Lets take a look ourselves. Continue reading “UofL Hospital Cuts Some Clinical Services.”

UofL Required to Trade Sports for Indigent Care!

Well… maybe.

A few weeks ago, Louisville’s Metro Council approved with only few changes the 2012-13 Budget prepared with Mayor Fischer’s administration. The University of Louisville had protested strongly over what it called a “reduction” in the funding of the QCCT fund that goes solely to UofL for indigent care, and incidentally makes it possible for the hospital to transfer large sums to the University for other undisclosed purposes. In reality, the net amount for the University’s benefit was the same as it has been. The Mayor and Council rightly refused to play the same misleading bookkeeping game of payment and rebate. Looming over our local deliberations was a threat by some state legislators to reduce their contribution to the QCCT fund by the same amount as any reduction by local government. This despite the fact that Frankfort has been playing its own version of a shell game with UofL for just as long, and indicates that many in state government are also losing their patience with current University leadership. We are left with having to parse the meaning of the word “reduction.”

Initial reports of the Councils deliberations told of added language to the effect that if the City’s income were better than projected, additional funds might be given to the University through of the QCCT. No demands were made on the University to become more transparent and accountable in its use of the money as others, including Metro Council have requested. It seemed that once again, the University had gotten what it wanted through bully and bluster. I waited to see the final budget language, and now that it has been published, I am quite surprised. Here is the exact language added as it appears in the Public Health and Wellness portion of the approved budget. Continue reading “UofL Required to Trade Sports for Indigent Care!”