New Suburban Veteran’s Hospital for Louisville

On Veterans Day, 11-11-11, the Courier-Journal reported on the status of plans to build a new Veterans Hospital for the region of Louisville Kentucky.   The community has been waiting with decreasing patience for the results of all the promises and hearings.  The update did not, however, announce that a final site had been decided, nor that financing was in hand, nor that a start date was known.  Instead, the big news was that the site selection process had decided against leaving the hospital where it is on Zorn Ave, and against moving to the downtown medical center of metropolitan Louisville.   Subsequent notice of new road work near the intersection of the Watterson Expressway and Route 42 suggested that the new VA would be located there.  On Dec 14, we received further official verification from United States Secretary of Veterans Affairs, Eric Shinseki, that indeed the 4906 Brownsboro Rd  address is the first choice for the new medical center.  The second choice site is the one Factory Lane near the Gene Snyder Expressway.  It was estimated that from the time financing is secured, construction will take a little more than three years.  The letter from the Secretary appears to be in response to a request from Sen. McConnell for a realistic timeline for the project.  The Veterans’ Day update quoted 5 veterans, 4 of whom expressed disappointment and a preference for staying at Zorn, one of whom was relieved that at least it would not go downtown. Continue reading “New Suburban Veteran’s Hospital for Louisville”

Let Them Eat Cake! (In somebody else’s hospital.)

I have been reviewing all of the letters sent to the Courier-Journal by members of the community.  So far, without exception, all have been employees, faculty, or associated with one of one of the proposed partner institutions, or capital venture company that benefits from the University’s commercial research program.  One of these letters is particularly painful to me.

It was written by a medical student who has not yet even begun his clinical training.  It begins by parroting an assortment of the arguments that have been made by the University and Jewish Hospital & St. Mary’s almost as if the letter were from a University official.    Nonetheless, even a medical student deserves to have their voice heard, and perhaps especially a medical student, whose training will be very much affected by the proposed change in business structure.  The last sentence however broke my heart.  When speaking about the women’s health policy regarding tubal ligations, the writer concludes, “patients who don’t want to deal with it can always choose to go elsewhere.”  This is one of the most unfeeling  comments I have seen with respect to this proposed merger/acquisition.  I hope someone has taken the student aside and counseled them. Alas, perhaps not the two faculty leaders who also wrote regarding end-of life care, “When the stipulations of the Catholic Church make it difficult to follow the patients’s and families wishes, the patient can be transferred to another facility where the desires of the patient and family can be met.”

I hope the student above can bring more sympathy to the patients he may have the privilege of attending to in the future.  Perhaps as he learns to take a medical and social history from those patients he will learn that in fact these patients do not have a choice of going elsewhere.  That is the whole point!  Shame on the University of Louisville School of Medicine, its leadership, and its faculty for creating an environment where such a statement is thought justifiable by your student.  The privilege of caring for the indigent must be earned.  In past months, the University of Louisville has in my opinion abused that privilege.  The majority of the patients, students, trainees, and employees of the proposed merged entity are not Roman Catholic, yet their most intimate personal decisions are now subject to review by somebody else’s bishop.   How can that stand?

Peter Hasselbacher, MD
Dec 5, 2011

Still Another Hospital “Merger” in Louisville Kentucky

Potential Questions and Issues Related to the Proposed  Acquisition or Merger of University of Louisville Hospital with Catholic Health Initiatives.

I am very troubled with the way this vaguely defined proposal has been revealed to the public.  I cannot avoid the impression that important elements of the deal have been intentionally hidden.  There is a lot to cover and these initial thoughts just scratch the surface.  If I had an opportunity to ask clarifying questions, I would start with these.  I ask them from my perspective as a life-long medical educator, physician to both the rich and poor, and a lobbyist for higher education.  What do you think?

Nature of the Proposed Arrangement:
Is a true merger of hospitals planned, or simply an acquisition by another hospital chain?  For example, will the new entity have a single Medicare Provider number?  If a true full merger is not planned, why not?  Which, if any, hospitals will be truly merged, or is University Hospital just being put in play once again by another hospital chain?  What will be new?  For what is the University of Louisville, its Hospital, and the Commonwealth of Kentucky giving up precious independence and control?

University Hospital has been managed by at least 5 outside corporate chains or partnerships of hospitals in the last 25 years.  All failed.  Other existing or contemplated partnerships, programs, or mergers with Louisville Hospitals have also failed.   What were the reasons for those failures?  What plans have been made to ensure a better outcome?  Where can we see those plans?  Why not? Continue reading “Still Another Hospital “Merger” in Louisville Kentucky”

New Site for Louisville Veterans Hospital?

Pending Sign at Bronsboro Site

Actually, this is just my guess, or perhaps wish. Nonetheless, something is happening at one of the finalist sites for the new Louisville Veterans Hospital in Louisville. Over the past few weeks, ground preparations were made for the sign above. Today I noticed that the blank sign itself was erected. I am willing to accept a bet for a drink at your favorite bar that soon there will be a VA Hospital sign there.

Certainly if the Vets themselves had any say in the matter, the deal would have been settled long ago. I attended two major public hearings early in the selection process. Both were heavily attended by veterans and officers of veterans’ organizations. Except for a veteran or two who came with the official party from the University of Louisville and its Hospital, to a person they vigorously opposed a downtown location for the new hospital. One or two representatives of major organizations said they personally had no objection to a downtown hospital, but that their members were overwhelmingly opposed. The most common reason I remember was that they did not want to deal with the parking and traffic of downtown Louisville. They also like the thought and culture of a dedicated facility and staff of their own. They feared being farmed out to other downtown hospitals– indeed this possibility was part of the original planning.

The University and its hospital, and perhaps a partner hospital or two, lobbied very heavily and at the highest levels for a downtown location. They were able to convince the Mayor’s office to take their side. It was and still is big-time politics. The University’s reasons are pretty apparent: the VA is important to them. They desperately need the patients for their various teaching and residency programs. The University likes the faculty salary money that it gets from the government. VA salaries are “hard” money that can be used largely at the discretion of clinical chairmen. The University can place faculty there who cannot qualify for a regular Kentucky medical license. It likes the VA research money that has traditionally been easier to get than NIH money. It likes like having the captive veterans around on which to do commercial drug studies and other research. Like other hospitals in town, University Hospital would like to more easily subcontract for specialty services at its own hospital, or even take over some traditional Veterans Hospital programs. University Hospital by itself does not attract enough of some types of patients to support its training programs. It and the University would clearly benefit from another closer and captive group of patients. No matter where the hospital ends up, I expect to see some maneuvering for access to its patients. Continue reading “New Site for Louisville Veterans Hospital?”