Author: P Hasselbacher

Conflicts of Interest in Continuing Medical Education Yield Probation at UofL.

On May 2, 2014 Laura Ungar of the Courier-Journal reported that the Accreditation Council for Continuing Medical Education (ACCME) had placed the University of Louisville Program of Continuing Medical Education (CME) on probation. Given that UofL’s School of Medicine itself had just been placed on probation by other accreditors, this second failure of external review is yet another indicator that something is very wrong at our academic medical center.

UofL’s CME program oversees the integrity and scientific merit of postgraduate medical education offerings attended by medical students, interns, residents, faculty, community physicians, and other healthcare professionals. As a nationally accredited program, UofL also sponsors and certifies CME programs in other states, internationally, and on the Internet. Since the majority of CME is now paid for by pharmaceutical and medical device companies, the need for unbiased information is greater than ever. It is in this arena of avoiding commercial intrusion on its academic affairs that UofL stumbled. Continue reading “Conflicts of Interest in Continuing Medical Education Yield Probation at UofL.”

Prohibition of Same-Sex Marriage in Kentucky Declared Unconstitutional.

The other shoe has fallen in a pair of court challenges from Louisville seeking to overturn Kentucky’s statute and constitutional amendment that prohibit same sex marriages or the recognition of the same as unconstitutional. The case began as Bourke v. Beshear demanding that Kentucky government and businesses apply law and regulation pertaining to marriage equally to legally married couples regardless of gender-mix. Judge John G. Heyburn, II found no fault with the Plaintiffs’ claim and ruled that Kentucky law’s on recognition of otherwise legal same-sex marriages to be unconstitutional. Kentucky’s Attorney General Jack Conway agreed and declined to appeal Judge Heyburn’s opinion which was ultimately stayed pending appeal and review by higher courts.

Seeking to rip out both vine and root, and ignoring the advice of other advocates who argued that the time was too soon to take on the basic issue of the prohibition of same-sex marriage in Kentucky proper, additional plaintiffs jointed the Bourke case which appropriately is now renamed Love v. Beshear. On July 1, 2014, Judge Heyburn found that Kentucky’s prohibition of in-state same sex marriages is unconstitutional under the equal protection clause. That order was also stayed pending expected review by the Federal Sixth Circuit Court of appeals in Cincinnati this August.

The finding.
IT IS HEREBY ORDERED THAT to the extent Ky. Rev. Stat. §§ 402.005 and .020(1)(d) and Section 233A of the Kentucky Constitution deny same-sex couples the right to marry in Kentucky, they violate the Equal Protection Clause of the Fourteenth Amendment to the United States Constitution, and they are void and unenforceable. Continue reading “Prohibition of Same-Sex Marriage in Kentucky Declared Unconstitutional.”

Catholic Health Initiatives Reports Increasing Financial Losses in Kentucky.

Last Thursday, Chris Otts of WDRB News may have been the first to report on Catholic Health Initiatives’ (CHI) most recent quarterly report to its creditors covering the 90 days ending March 31, 2014. Meant to be read in conjunction with last November’s audited annual report, the current unaudited update covers the first full year that CHI has controlled “substantially all of UMCs operations” at University of Louisville Hospital (ULH). The news report focused on the fact that KentuckyOne Health, the manager of CHI’s multiple hospital-related operations in Kentucky, had lost an additional $134 million on its “faith-based” hospital operations over that 90-day period. This stunning loss comes on the heels of an earlier report that KentuckyOne had lost $100 million in the six months ending December 31, 2013.

More than just financial data is provided.
The full report is in the public domain. My reading confirmed what was reported by others. However, I was struck more by other tidbits of information that confirm or add to our knowledge of what is happening behind the surgical drapes hung to to keep the rest of us from assessing the health of this hospital system of which a public asset is part. Continue reading “Catholic Health Initiatives Reports Increasing Financial Losses in Kentucky.”

Patient Access Data at Veterans Hospital Medical Centers.

Mixed results at Robley Rex Hospital in Louisville but mostly better than average.

I recently commented about the reaction in Washington to revelations that veterans trying to get appointments at VA medical centers were facing long waits and that utilization data for at least a handful of centers had been altered to make them look better than they were. I was subsequently asked how our local Robley Rex VA Hospital in Louisville stacked up against others. While I have heard good things in support of the Louisville VA from veterans at public hearings, and while the hospital has done well in national accreditation and quality surveys, I had no specific information about waiting times. The release of national patient access data from the Veterans Administration in Washington gives us something to go on and will be presented below. In brief, our hospital has little to be ashamed of, but the data as presented are not easy for me to interpret.

One of the pitfalls in analysis of data-dumps like this one is that without knowledge of exactly what is being counted or measured, how items are defined, or the operational measures used to assemble the data; the robustness of any conclusions may be compromised. My lack of day-to-day working knowledge of how appointments are actually made at VA hospitals or how the various lists of waiting times were compiled for this report limits my confidence. Nonetheless, assuming the data from the various medical centers has been collected in the same way, an overview and some rough comparisons seem reasonable. Continue reading “Patient Access Data at Veterans Hospital Medical Centers.”