The Bishops are coming!
The Bishops are coming!
The saga of the corporate takeover of the University of Louisville Hospital and most of the clinical operations of the University’s Medical School by Catholic Health Initiatives and KentuckyOne Health has been going on for so long that I have plumb run out of clever tag lines! Today’s report by Laura Unger of the Courier-Journal reminds us that March 1 is the official “integration day” on which KentuckyOne Health formally takes the reins from the University.
Thinning the herd.
Of course, the Ides of March are historically March 15 so my title is premature, but then again KentuckyOne Health has been running the show for some time now. University Hospital employees were enrolled in KentuckyOne’s health insurance plan at the beginning of the year and have been dancing to the tune of drug and background checks. Employees are naturally apprehensive about what’s going to happen and have interpreted the new University Hospital’s activities as an attempt to “thin the herd.” The new Interim President of University Hospital, the long-serving and competent Ken Marshall, seeks to lend an egalitarian cast to the proceedings by pointing out that he too underwent the new employee screening procedures. However, to my knowledge, KentuckyOne employed physicians or medical staff members have not been asked to undergo drug tests. The public can judge for itself the extent to which past mistakes and indiscretions should be permitted to influence full participation in society, but I suggest that if KentuckyOne and the University of Louisville wish to give the appearance of fairness and equity, that they screen all of their current employees, physicians, and faculty to the same standards. (In fact, given the history of what was in my medical opinion unexplainable use of OxyContin by University employees, such screening might be in the best interests of both employees and the public. Perhaps that problem has already been solved.)
Skeptical– Who, me?
Our readers will not be surprised that I am quoted as being skeptical that the new partners will be able to deliver on their promises– clinical or financial. While the concept of a “hospital-within-a-hospital” may provide the necessary doctrinal camouflage to allow the enterprise to slip under the radar or be winked at by critical bishops, it is a medical absurdity and intellectually dishonest to pretend that the sexual and reproductive organs of men and women can be detached from the rest of their bodies for the comprehensive practice of modern medicine on any floor of a hospital. The failed policy of “don’t ask, don’t tell” used to gloss over the issue of sexuality in the military was both intellectually and morally dishonest. “Don’t ask, don’t tell” is equally repugnant in healthcare which must above all, be based on honesty and trust.
I practiced once at University Hospital. My feeble grasp of logic tells me that the statement that medical professionals in the hospital are being asked to respect the Ethical and Religious Directives of the Catholic Church, and the statement that policies on reproductive and end-of-life care will remain the same at University Hospital are mutually incompatible! Either that, or the Roman Catholic Church has taken a bold step out of peoples’ bedrooms and into the 21st century: that it will now give us control over our own deathbeds, including allowing the withdrawal of artificial hydration and nutrition if so directed by a living will, medical surrogate, or humane medical practice. A KentuckyOne Health Vice President for Mission would no longer be needed to make sure that religious doctrine is enforced. If the religious directives have been withdrawn, and physicians and trainees are free to practice modern medicine unencumbered by somebody else’s’ religious dogma, I will sing the praise of the Church in these pages. For now, as far as the federal government goes, there is only one University Hospital, regardless of what it is named. Even God cannot finesse that one away. CHI and KentuckyOne Health are responsible for everything that goes on in that hospital. In my opinion, to attempt to claim anything else is scandalously hypocritical.
Changes in leadership.
Ms. Unger also reported last week about changes at the top at both Jewish Hospital and University Hospital. KentuckyOne Health recently released a public statement confirming the changes. Both organizations now have interim presidents. At University Hospital, James Taylor was replaced by Ken Marshall. I have long liked and admired him. Mr. Marshall has been associated with the hospital for nearly as long as I have, beginning as director of public relations. He well knows the thorny thicket in which the hospital operates and his institutional memory and people skills will be valuable.
At Jewish Hospital, former President and CEO Valinda Rutledge was replaced, at least in an interim capacity, by Doctor Charles Peck. Most recently working for a company in Colorado, Doctor Peck had been serving as a consultant to the hospital’s clinical effectiveness team. He has much experience in many areas of medical enterprise, but not, as far as I can find, as a senior hospital administrator. His professional emphasis in recent years has been in ambulatory surgical centers and in creating effective and profitable hospital partnerships with physicians. These skills are very much compatible with what I perceive is KentuckyOne’s presumed strategy of growing their clinical activities in the eastern suburbs, and dealing with a medical staff town/gown problem on steroids.
What is happening? Do we have a right to know?
KentuckyOne Health, at least in Louisville, appears in my opinion to be in internal turmoil. With its UofL partner, they seem to be making-it-up-as they-go-along. I fear the partners wanted their deal so badly that they promised things they will not be able to deliver, and that there will be no recourse from the Governor’s office or anyone else for failures. This deal cannot be rolled back no matter what happens. I hope to be proven wrong because our community deserves better.
Should we beware the Ides?
The Ides of March occur on a day dedicated to Mars, the God of War. Classical history tells us that on that day Julius Caesar– he who would be dictator– was assassinated, plunging the Roman Empire into a round of civil wars that destroyed the Republic forever. We are now witnessing hospital wars of immense destructive potential. We the citizens of Louisville have a vested interest in the outcome and therefore in the terms of engagement. If we fail to both inform and assert our opinions, then we will deserve what we get.
I invite KentuckyOne Health to break their silence regarding their plans. If your plans are as good for our community as you promised during the prolonged merger and RFP processes, why not share them. What have I said that needs to be corrected? For any others out there who read this Policy Blog, what do you think? Louisville needs all of you to help Identify current or future issues that impact our community. Feel free to leave a comment below. Your eMail will not be published, nor is it even necessary to leave one but you get more credibility from me if you do. You may also contact me confidentially from the right sidebar link.
Peter Hasselbacher, MD
President, KHPI
Emeritus Professor of Medicine, UofL
February 28, 2013