Our Vanishing Right to Patient Privacy.

On March 20, I submitted the following letter to the Courier-Journal. Others have offered similar views and I gather that my contribution was not accepted. Since I buy my ink by the gigabyte, I have the opportunity to publish the letter anyway! Here it is.

Bullying not allowed in school.
Kentucky education Commissioner Wayne Lewis has demanded that 10 different school districts in the eastern half of the state send him records and documents for teachers who did not show up to work this legislative session. Enough teachers did so, that at least some schools had to close. The demand specifically includes doctor’s notes confirming illness. The first thought of the physician in me is that federal patient privacy law (HIPAA) prohibits the sharing of patient information except to other health professionals or entities sharing in medical care of a given patient. These protections are quite strict. Specific permission from a patient is
required to discuss matters even with a family member, or to even to disclose whether an individual is a patient or not. A note from a doctor– even without a diagnosis– conveys information simply by virtue of the physician’s practice. A note from an obstetrician might suggest a pregnancy. An individual may not wish to disclose that they are seeing a cardiologist, psychiatrist, or any other specialty that might announce a pre-existing condition. Even if Kentucky law or regulation allows Frankfort or a school district to demand a doctor’s note, it is not clear to me why federal law would not supersede state law. I will leave that to legal experts.

Given the obvious animus of the Bevin administration towards Jefferson County and its public-school system in general, and towards teachers and the teacher’s union specifically; a reasonable person might conclude that Commissioner Lewis’s demands represent an attempt to intimidate teachers for standing up for what they believe is right for their schools. The Commissioner’s more recent promise not to punish anybody if there are no further work stoppages converts a veiled threat into an operative one. Commissioner Lewis reasonably suggests that students can ill-afford to miss even one day of school when avoidable. How can one disagree? I would ask, however, what would be the response of the public if Commissioner Lewis asked for the names and the medical records of students who skipped school in order to protest for the need of gun control following the aftermath of school shootings here in Kentucky and elsewhere? I am confident that our public would be outraged! We should be outraged today. Teachers did not make the decision to travel to Frankfurt lightly. They deserve public support– indeed public protection against what is in my opinion, and that of others, an attempt to bully teachers into submission.

Peter Hasselbacher, MD
Louisville, KY
March 25, 2019

University of Kentucky Dental Professor Forced Off Faculty for Criticizing Gov. Bevin’s Medicaid Cuts Gets $620,000 in Court Settlement.

Yes.  But, behind them I suspect is the Emperor.
                                            Paul Atreides, in “Dune.”

More than a year ago I wrote about the capture of the academic process by the Kentucky Governor’s Office where some unnamed individual with clout became “pissed-off” when Dental Professor Dr. Raynor Mullins exercised both his faculty and first-amendment rights to suggest that cutting back on dental and vision services to Medicaid beneficiaries was a bad idea. Everyone involved seemed to know who in Frankfort held the power to intimidate the leadership of our “Flagship University,” but the Governor’s office denied any involvement in the matter.  (We have encountered that scenario before, right here in River City!)  The University rolled over and dismissed Dr. Mullins.

In response, and to both hold the University accountable and presumably to shine a bright light on what actually appended, Dr. Mullins filed a lawsuit against the persons of the Vice President for Administrative and External Affairs and the Dean of the University of Kentucky College of Dentistry.  In my earlier commentary, I opined that perhaps under oath that the truthfulness of the allegations would come out– or not!  It is not clear to me that any such disclosure happened. The University requested of Federal Judge Robert Wier a summary judgement (dismissal) of the case against it which was denied.  As I understand it, before the case was to go to a jury trial, a private settlement was reached without any admission of guilt.  I do not know how much pre-trial discovery was done. Today’s reports in the Lexington Herald and Courier-Journal do not refer to any information from depositions taken under oath.  Often such settlements include clauses of confidentiality that hide embarrassing findings from public view. Is it conceivable that court records might be sealed?  Is it possible that we may never know to whom the UK officials caved?

What is just as disturbing as not ever knowing the identity of the bully is the claim that communication within the University and with the Governor’s office in this matter was conducted using personal e-mails.  The use of personal electronic devises and emails to skirt open-meeting and open-record laws is an emerging threat to the ability of the public to hold its government accountable.

The University of Kentucky does not come off looking good in this matter.  It seemingly admits no guilt at all, but some UK entity now has a 6-figure settlement to pay with legal fees to boot. Dr. Mullins is taken back in to the faculty. Transparency disappears. No one is held accountable. Dr. Mullins may not have achieved all his goals, but in my view, he stood up to the state agency that is the University of Kentucky and won!

Peter Hasselbacher, MD
Emeritus Professor of Medicine,
University of Louisville
Dec 10, 2018

[If anyone has public court documents or other information that might shed light on this sad affair– or for that matter correct any misunderstanding of mine– I hope they will communicate with me confidentially or with the email link found in the side-bar of this website.]

Here is a copy of Judge Wier’s opinion of 9-28-18

Who Should Control the Curriculums at Kentucky Universities?

Lest anyone doubt Gov. Bevin’s inclination, indeed intention to intervene in the academic decisions of Kentucky’s state universities, I draw your attention to his recent speech to the Kentucky Council on Postsecondary Education (which sets Kentucky’s higher education policy and which he largely appoints) in which he “suggests” to our university Boards and administrations that they should shed whole academic programs that do not contribute to employment and economic development as he envisions it. This should not come as a surprise to anyone, because he made the same statement early in his term shortly after he celebrated his intention to open the separation of church and state more widely. Others have already noted how a broad-based general education has not done badly for the Governor personally. I will add that the Governor’s initial public spokesperson in Kentucky did not do very badly with her history major from a Kentucky college. She moved from working for a governor to working for the president of the United States.

It is my impression that a “suggestion” from Gov. Bevin forebodes a more aggressive intervention on his part. I point to the “pressure” brought to the University of Kentucky to fire a professor who was critical of one of the Governor’s healthcare policies, and his “pressure” brought on the University of Louisville Hospital and KentuckyOne Health to sever and not renew its transfer agreement to accept the rare patient from Planned Parenthood or other abortion provides who has a serious complication from surgery. (This latter matter is now in Federal Court.)

Although the Governor’s office denies any intervention on his part, in my opinion, and that of the parties being leaned on, the pressure could only have come from the Governor himself directly or indirectly through proxies. The Governor has not been shy about stating his intention to achieve his economic and religious agendas. Why should be not believe him? In my opinion, such tactics do not deserve the banal description of “pressure,” but meet the definition of bullying. We all know what happens when a bully is not confronted – the result is more of the same. University accreditors at SACS, are you watching? Kentucky elected officials and our general public, are you?  Our Universities cannot fight this battle by themselves.

Peter Hasselbacher, MD
Emeritus Professor of Medicine, UofL
September 14, 2017

Who Will Defend Kentucky’s Academic Institutions Against Political Capture?

[Below is the full text of my shortened Op-Ed piece published on-line by the Courier Journal on Aug 8, and in the print edition of Aug 9.  The complaint by Dr. Mullins and links to background and documentation are also available.]

I submit this as an open letter to the Southern Association of Colleges and Schools Commission on Colleges (SACS) and to the Louisville community. On August 2, the Courier-Journal reported extensively on a lawsuit brought against senior members of the University of Kentucky’s administration and the administration of Governor Matthew Bevin by Dr. Raynor Mullins, a distinguished senior member of the faculty of the School of Dentistry at UK. The lawsuit alleges that Dr. Mullins was fired from his non-tenured faculty position in retaliation for comments that were critical of Gov. Bevin’s plans to reshape Kentucky Medicaid– a plan intended to considerably reduce the number of Medicaid beneficiaries and cut back on benefits, including dental services. The lawsuit names as defendants “Mark Birdwhistell, UK’s Vice President of Administration for UK HealthCare; Dr. Stephanos Kyrkanides, Dean of the UK College of Dentistry; and ‘John Doe,’ described as an official in the Bevin administration.” (Dr. Birdwhistell is a major architect of Gov. Benin’s healthcare plan.) The story was picked up by the Associated Press and is appearing across the country. What is happening in Lexington is relevant to the accreditation status of the University of Louisville and the reputation of our Commonwealth. Continue reading “Who Will Defend Kentucky’s Academic Institutions Against Political Capture?”