Category: Health Care Reform

More Signs of Cooperation Between Norton and UofL!

Terry Boyd of Insider Louisville has reported rumors of an upcoming announcement by the University of Louisville concerning its Pediatric Heart Transplant Program. If this happens, it would not be totally unexpected. Norton Healthcare and the Department of Pediatrics have been advertising jointly for a pediatric cardiologist with experience in the medical management of these patients. (A former UofL cardiologist with those qualifications left last year to join a program in Texas.) The Division of Thoracic and Cardiovascular Surgery in UofL’s Department of Surgery still lists two cardiac surgeons with pediatric qualifications. The contact person for the advertised search is at Norton, leaving the question open of who will be hiring or paying for the new physician. Norton’s hiring away of UofL faculty has been a highly contentious issue for UofL. It is good to see that there is still some cooperation between the two competing healthcare organizations. Could this be a sign of bigger things to come?

It was noted that such a pediatric transplant program would not be completely new. Although I am told that there has been no heart transplant at Kosair during the last 12 months or so, a look at the numbers from the Organ Procurement and Transplantation Network (OPTN) confirms that Kosair Hospital has had such a program at least since 1988. The table just below shows the number of pediatric heart transplants done at Norton Kosair Hospital for Children. Continue reading “More Signs of Cooperation Between Norton and UofL!”

Why Do We Physicians Still Practice So Much Ineffective Medicine?

How Not to Treat Idiopathic Pulmonary Fibrosis.

One of the first things I wrote about on these pages was the importance of having good evidence backing up what we doctors do to people, and how commercial editorial policies of medical journals have at least the potential of denying doctors and their patients timely knowledge of information that might inform their medical choices. I thought of that article again when I looked at one of the several email news summaries I get from various organizations.

One of the highlighted items that caught my eye was a report that “Combination therapy for pulmonary fibrosis appears to increase risk of death [and] hospitalization.” Several of the diseases I used to treat included pulmonary fibrosis and were notoriously difficult to manage. I clicked the “More…” button and was led to this week’s New England Journal of Medicine. The article provides a stunning example of how we physicians still allow ourselves to be led down the garden path of ineffective medical care. Continue reading “Why Do We Physicians Still Practice So Much Ineffective Medicine?”

Open Letter to Metro Louisville Council Concerning QCCT Fund for Indigent Care

The Status Quo is Not an Option.

In an earlier article, I urged all readers to make their opinions known to Metro Louisville leadership about how to handle the University of Louisville’s request to maintain the status quo for how public money for indigent care is funneled to University of Louisville control.  In that spirit, I sent the following letter to each of the Metro Council members and to the Mayor.  Given that the University’s own internal review process is unlikely to produce detailed financial information relevant to its use of QCCT funds, and that it is not yet known if the Kentucky State Auditor’s office will have adequate access to the University’s books to do its job, how the Metro Council decides to act becomes even more important. Continue reading “Open Letter to Metro Louisville Council Concerning QCCT Fund for Indigent Care”

Fourth Meeting of UofL Hospital Operations Review Committee.

Some good work, but continued disappointment.

On May 9, the UMC Ad Hoc Operations Review Committee held its next to last meeting.  One additional meeting is scheduled for May 23, at which time the final report of the consultant organization, Dixon Hughes Goodman (DHG), will be presented.  Given the level of detail presented at yesterday’s meeting, I do not expect any major new elements to be presented.

The meeting agenda was brief, including an “update” to DHG’s analysis to date, and a presentation of case studies of hospitals deemed similar to University of Louisville Hospital. Most of the committee members appeared to be present as were some half-dozen of the consultants. Reporter Laura Ungar of the Courier-Journal and myself were the only members of the public that I recognized. Continue reading “Fourth Meeting of UofL Hospital Operations Review Committee.”