Many rural areas still short of doctors; UK's health VP says recent federal funding hike for med-school resident slots was inadequate

Photo from The Lane Report

Just like the rest of the nation, Kentucky needs more doctors, and people and institutions in the state are working on several initiatives to address the challenge. 

The U.S. faces a projected shortage of between 37,800 and 124,000 physicians by 2034, including upwards of 48,000 primary-care physicians and upwards of 77,100 specialists, according to The Complexities of Physician Supply and Demand: Projections From 2019 to 2034, a report released by the Association of American Medical Colleges.

The report cites several reasons: demand for services increases as the population ages and grows larger; many physicians are nearing retirement age; and the demands of the pandemic will accelerate retirements.

The pandemic has also raised awareness of the disparities in health care, emphasizing the need for more access to care, meaning we need more doctors.

For The Lane Report, a Lexington-based business magazine, Jeff McDanald reported how Kentucky's medical schools are stepping up to meet the challenge. 

Kentucky ranks 40th among the states in primary-care physicians per 100,000 people, with only 2,696 practicing statewide, McDanald reports.

“There is certainly a maldistribution of primary care providers, with four of our counties (Ballard, Metcalfe, Owsley and Robertson) having no primary care physician and eight others (Bath, Carlisle, Edmonson, Hancock, Hickman, Nicholas, Spencer and Webster) having only one,” Dr. John Lee Roberts, vice dean for graduate and continuing medical education at the University of Louisville School of Medicine, told McDanald. “And 75 of our 120 counties are classified as primary-care health-profession shortage areas.”

One way U of L has worked to improve these numbers is offering scholarships to help offset medical-school debt.

“The average student-loan indebtedness of a graduating medical student is now well over $200,000,” Roberts told McDanald. “A partnership with the Greater Louisville Medical Society has been generating five or six scholarships per year for University of Louisville students.”

U of L and the University of Kentucky have also secured more Medicaid support for graduate medical education in the state, which has led to more resident and fellow positions in the past few years, which is key to alleviating the doctor shortages, McDanald reports.

However, Dr. Mark Newman, executive vice president of health affairs at UK, told Kentucky Health News that while the Centers for Medicare and Medicaid Services has increased funding for residency slots, it is not enough. 

"UK welcomes this important funding; however, we estimate that it will likely result in just five additional slots for UK over five years," Newman said in an e-mail. "We will continue to work with our national associations on the need for additional funding for graduate medical education." 

McDanald reports that the state’s three medical schools combined graduate about 500 students each year, but there are only about 400 entry-level residency positions in the state.

“Kentucky is a net exporter of doctors,” Roberts said. “We need more entry-level residency positions in Kentucky, and that starts with funding. . . . This is important because we have good data that shows 45 percent of the students who go to medical school in-state will ultimately practice in the state. Similarly, 45% of the residents and fellows who do their residency and fellowship in the state will ultimately practice in the state. But if you have Kentucky medical students who stay in Kentucky for residency and fellowship training, the numbers increase significantly to 74% of them who will end up practicing in the state.”

Role of economic development

Dr. Brent Wright of Glasgow, who has spent his career at a rural family medicine training program, told McDanald that while it is medical schools' responsibility to train residents, it is the responsibility of hospitals and communities to recruit them. Wright is associate dean for rural health and as an associate professor of family and geriatric medicine at U of L.

“Some communities do an extremely good job of referring physicians and are well aligned to their local government, but I think some places struggle,” Wright told McDanald. “When you recruit a physician you recruit the spouse, who may also want to work in the community. And if they have children, they’re looking for a good school system.”

“The ultimate placement of a physician in a community is really a team sport,” Wright said. “Communities need good infrastructure. This gets back to economic development, and if you have areas that start to become depressed, it’s really hard to reverse that.”

Geographic challenges

Dr. Charles H. Griffith, acting dean of the UK medical school, talked to McDanald about the need for physicians in rural parts of the state, especially when it comes to mental-health care. 

"Kentucky is one of the worst states for under-served areas," Griffith told McDanald. "In some areas like Lexington and Louisville we probably do have sufficient doctors, but in our rural areas—which is a lot of the state—there is a dire need. We need primary-care doctors everywhere, but to be honest, there is a need for some of the general specialists out in rural areas.”

Griffith added that there is a great need for more psychiatrists in Kentucky.

“It’s especially evident with the mental-health crisis that’s been exacerbated by the pandemic,” he said. “There are just not enough psychiatrists to meet the mental health needs of children and adults, too.”

Griffith also noted that other health care providers, like nurse practitioners and physician assistants, are meeting some of the need to provide health care in Kentucky, noting that they "can do quite a bit." 

Home-grown rural doctors

Another approach to get more physicians to practice in rural areas is to recruit rural medical students and provide rural residency programs, which is what the UK's Rural Physician Leadership Program aims to do. 

“The program is based on the idea that it’s sometimes difficult to transplant someone into an underserved or rural area who is not familiar with the community,” Dr. Rebecca M. Todd, who heads the program in Morehead, told McDanald. “So instead, we go with the opposite approach of recruiting young men and women right out of these communities to go to medical school. Therefore, they are in tune with that patient population, they love the community, and they want to live and work there. It’s been a phenomenally successful program." 

So much so that UK has now opened two larger regional campuses in Bowling Green and Northern Kentucky, McDanald reports. 

The University of Pikeville's Kentucky School of Osteopathic Medicine has also helped to supply primary-care physicians to rural areas. 

“Pike County used to be a medically underserved area and is no longer such because of the number of physicians who have come back to the area or have been attracted to the area partly due to the medical school being here,” Dr. Joe Kingery, dean of the osteopathic school, told McDanald. 

Kingery told McDanald that  83% of UPike osteopathic graduates practice in primary care and stay in Kentucky, which exceeds the percentages for UK and U of L medical-school graduates.

“We have 57% of our graduates who are practicing in a rural area in Kentucky,” Kingery said. “It speaks to our story that we’re placing primary care physicians into underserved areas and the Appalachian region.” Kingery said. “That being said, our graduates can go into any specialty they want. We have orthopedic surgeons, neurologists, neurosurgeons, you name it. In a given year, we usually graduate about 125 to 130, with 65% to 70% of our graduates going into a primary care residency program. And for us, primary care is defined by only three specialties: family medicine, internal medicine and pediatrics.

In January, Campbellsville University welcomed the first class of students to its School of Chiropractic, the first in Kentucky and the only one within a 300-mile radius. It's in Harrodsburg.

“We’re responding to the doctor shortage by graduating doctors of chiropractic trained much like any physician as a port-of-entry care provider," Dr. Trevor Foshang, dean of chiropractic education, told McDanald.

Rural Ky. needs more community health workers and medical-school residents, legislators and UK hospital executive say

Charles Aull of the Kentucky Chamber of Commerce, upper left, moderated the webinar.

By Al Cross
Kentucky Health News

Improving health care and health in rural Kentucky will take more people in the health-care workforce, specifically at the top and bottom of the pay scale, two key legislators and one of the state's top hospital administrators said Tuesday, June 8.

Kentucky needs more health-care workers overall, because it may lose some to the pandemic, Mark Birdwhistell, vice president for health services administration at the University of Kentucky and chief of staff for UK HealthCare, said during a Kentucky Chamber of Commerce webinar on rural-urban health disparities.

"Coming out of Covid . . . many of our clinical workforce are fatigued, and they're second-guessing: 'Is this the career path that I want to go on?' They've been in combat for a year and a half now," Birdwhistell said.

State Rep. Kim Moser, a Republican from Taylor Mill in Northern Kentucky, agreed. "Burnout is real," she said, noting that her husband is a pulmonologist who has treated Covid patients.

The need for more community health workers, who are not health-care providers but can educate people about care and help them get it, came up as Birdwhistell, a former state health secretary, discussed the 2014 expansion of the federal-state Medicaid program for lower-income Kentuckians.

"Just because you've got coverage doesn't mean you've got access" to the health care you need, Birdwhistell said, because "Many providers don't take Medicaid." He and Baptist Health Louisville President Larry Gray said health insurance tends to cost more in rural areas due to lack of competition, so people buy policies with high co-payments and deductibles.

The expansion of Medicaid made clearer how the "social determinants of health" leave rural areas with lower health status, Birdwhistell said. It's twice as likely for someone in an urban area to finish high school or college as someone in a rural area, he said, so health literacy is lower in rural areas. And that extends to health insurance, he said, giving one example: "Deductible. That's hard to explain in English."

Moser, a retired nurse who chairs the state House Health and Family Services Committee, said expanding the limited government and commercial-insurance reimbursement for community health workers' services would help. "That is one policy that we're looking at possibly expanding," she said.

Birdwhistell said that would be "very, very cost-effective," because "In a lot of communities, people don't know how to access care, and they show up in the emergency room. And that is probably the worst place for anybody to show up with a high fever, strep throat, whatever. They don't get a continuum of care. . . . They will listen to somebody that they grew up with, somebody that they go to church with, somebody that they see on the soccer field with their kids."

Service area of Kentucky Homeplace

Eastern Kentucky already has the third largest concentration of community health workers in the nation, trailing only Alaska and northwest Mississippi, according to the Bureau of Labor Statistics.

That is likely due to Kentucky Homeplace, a 27-year-old program of UK's Center for Excellence in Rural Health in Hazard. It says it helps people in the region with "lifestyle choices, environmental factors, inadequate health insurance and general lack of understanding of the health-care system."

Nationally, CHW pay averages $46,000 a year, but in Kentucky the average is $37,320.

The webinar discussion also addressed the need for more doctors in rural Kentucky.

Birdwhistell said a major obstacle to getting more physicians in rural areas of the state are the limits on federally funded residency slots at the UK and University of Louisville medical schools. "Flipping that switch could pretty instantly change the number of professionals we have coming out," he said.

Republican Sen. Ralph Alvarado of Winchester, a physician, agreed, saying that residents tend to set up practices within 80 miles of where they do their residency. Moser also endorsed the idea.

Alvarado, chair of the Senate Health and Welfare Committee, noted that some rural areas have a shortage of health-care providers, which he blamed on state laws that make malpractice insurance expensive.

Gray said the shortage is especially bad in Eastern Kentucky, which needs providers who are willing to come to the region with "a sense of mission and vocation." But even with enough providers, transportation to get some patients to them is still an obstacle in some areas, he said. The expansion of telehealth has helped, he said, but some areas still lack internet access that is fast enough for it.

And even with telehealth, a shortage of specialists blocks care. For example, Kentucky has only 59 child psychiatrists, and half of them "are cash-only, don't take insurance," Alvarado said.

The panel started out by discussing some of the state's poor health statistics. Alvarado said the use of tobacco is heavier in rural areas, leading to all sorts of health issues, and obesity is more common, causing "more negative outcomes."

The news isn't all bad, he said, noting how Kentucky has raised its screening for colon cancer from 47th to 19th in the nation. "That's going to rub off on our death rates . . . in 10 years," he said. "There is some hope." But he also noted that screening rates in Eastern Kentucky remain relatively low.

UK names Dr. Jay Grider its first chief physician executive

Dr. Jay Grider (University of Kentucky photo)

Dr. Jay Grider has been named chief physician executive at UK HealthCare after serving as interim CPE since the position was created in September 2019. It is responsible for the overall strategic direction of performance by University of Kentucky physicians.

Grider oversees the clinical practices of physicians and other health-care providers, including quality improvement and patient safety, and clinical and administrative informatics "to further a culture of data-driven decision making," a UK news release said.

“This is a pivotal leadership position for UK HealthCare,” said Dr. Mark Newman, UK vice president for health affairs. “Dr. Grider has proven to have the right combination of education, experience and talent to be successful in this new role that should prove to be a turning point for our health system as we evolve into a truly integrated medical group known far and wide for clinical excellence.”

Grider is a professor of anesthesiology in the UK College of Medicine, a diplomate of the American Board of Anesthesiology and is board-certified in pain medicine.

A native of Liberty, he received a bachelor’s degree in natural science from Georgetown College; a DO degree from Ohio University in Athens; a Ph.D. in physiology from UK; and an MBA from the University of Tennessee.

He completed an internship at The Ohio State University, then came to UK to complete his residency in anesthesiology, followed by a fellowship in chronic pain management. He also is a graduate of UK HealthCare’s Executive Leadership Development Program through the UK Gatton College of Business.

UK College of Medicine’s Bowling Green Campus welcomes inaugural class, with hopes they will stay in the region to practice

Students of the UK medical school’s Bowling Green Campus
pose in front of Western Kentucky University’s Van Meter Hall.

The University of Kentucky College of Medicine’s Bowling Green Campus welcomed its first class of 30 medical students Aug. 3 during its inaugural white- coat ceremony at Western Kentucky University, Don Sergent reports for the Bowling Green Daily News.

This four-year, regional-campus medical school is the first of its kind in Kentucky. It was created through a partnership between UK, WKU and The Medical Center at Bowling Green in an effort to bring more doctors to the region.

A UK news release notes that the Bowling Green campus is a fully functioning campus, utilizing the exact curriculum and assessments as UK’s Lexington campus.

The 24,000-square-foot portion of the $28.3 million building on The Medical Center's campus where the students will eventually be located won't be ready until mid-September, so they will begin the program using facilities at The Medical Center and WKU, Sergent reports.

At the ceremony, Don Brown, assistant dean of the Bowling Green campus, bragged on inaugural class members for their many accomplishments and told the attendees that the selection process was highly competitive; and Associate Dean Todd Cheever said the class fit well with their goal of addressing the need for more physicians in Kentucky, Sergent reports.

“The vast majority of the students are from Kentucky, which is the mission,” Cheever said. “And the ones from out of state have Kentucky ties. I believe we have the right 30 students.”

Of the 30 new students, 26 are from Kentucky, representing 14 Kentucky counties, including five from Bowling Green or elsewhere in Warren County. The others are from Ohio, Tennessee and Florida.

Mallory Vaughn, a WKU graduate who has known since elementary school that she wanted to be a doctor, told Sergent that the Bowling Green campus “was an absolute dream for me. I get to work in the hospital I was born in. I’ll be able to prepare for my professional career and give back to the community that has nurtured me.”

Connor Donley, also from Bowling Green, told Sergent that he was ecstatic when he was selected for the inaugural class. “The timing couldn’t have been more perfect for me personally,” said Donley, a UK graduate. “I’m excited that I’m going to be getting my education in the community where I grew up.”

Earlier the same day, 136 students received white coats in a ceremony at the UK College of Medicine's Lexington campus.

A similar regional program is expected to open in Northern Kentucky in the fall of 2019, through a partnership between UK's medical school, St. Elizabeth Healthcare and Northern Kentucky University. It will have 35 students in its inaugural class. UK's medical school also partners with Morehead State University and St. Claire Regional Medical Center to offer the Rural Physician Leadership Program.

All of these programs aim to bring more physicians into the rural parts of the state.

Dr. Mark Newman, Owensboro native, taking over at UK HealthCare from Dr. Michael Karpf, who will remain an adviser

Dr. Mark Newman

The University of Kentucky has a new hospital leader. Dr. Mark Newman succeeds Dr. Michael Karpf as executive vice president for health affairs.

Newman, an anesthesiologist, has been president of Private Diagnostic Clinic, the physician practice plan for Duke University’s Medical Center, since 2014. A native of Owensboro, he has been at Duke since 1992.

"Newman grew up in Kentucky as part of a farm family with a strong focus on education," a UK news release said. "He stayed close to home to attend Western Kentucky University to help his family while his father was ill, and began running the family farm after his father passed away." Getting an Air Force scholarship to the University of Louisville medical school, he completed a residency in the Air Force and a fellowship at Duke University Medical Center before returning to active duty. He was deployed for the invasions of Panama, Kuwait and Iraq.

“I will be helping lead one of the nation’s renowned institutions of higher learning, research and clinical care as well as returning to my home state,” Newman said in the release. “The last decade has seen UK HealthCare evolve into a system with the focus and the flexibility to grow and build on its reputation while advancing the health- and patient-care opportunities for people throughout the commonwealth, and I look forward to being part of its continued success.”

Karpf "will continue making his $900,000 salary for the next year as he advises UK President Eli Capilouto on state and federal health care issues," Linda Blackford reports for the Lexington Herald-Leader. "Under Karpf’s 13 years of leadership, UK HealthCare invested almost $2 billion in new facilities, faculty, programs and technology, as well as forging new partnerships with regional health care institutions and expanding the College of Medicine to satellite locations around the state. Capilouto has frequently said Karpf oversaw the greatest success story in academic health center history, a statement he repeated at the UK Board of Trustees meeting Friday," Sept. 15.

"After Karpf’s year of advising concludes, he will make $200,000 a year as a part-time faculty member in the College of Medicine, conducting policy research," Blackford reports. "Karpf’s eventual part-time salary was calculated by taking 50 percent of the salary earned by medical professors who are at the 75th percentile of pay in the Association of American Medical Colleges survey."

Read more here: http://www.kentucky.com/news/local/education/article174155761.html#storylink=cpy"

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UK plans to develop its third regional medical school in Northern Kentucky; others are to be in Bowling Green and Morehead

The University of Kentucky College of Medicine plans to develop its third regional medical school in Northern Kentucky, in an effort to increase the overall number of physicians in the state. The other two are in Bowling Green and Morehead.

"In Kentucky we have a shortage of physicians, especially primary-care physicians, throughout the state,” UK President Eli Capilouto said in a news release. "We are working in close partnership with leading universities in our state and regional medical centers to directly respond to this need. Additionally, this collaboration will allow us to expand college of medicine enrollment in a manner that effectively and efficiently utilizes existing resources throughout the state."

The Bowling Green program is supposed to begin enrolling students in 2018, and the Morehead program sometime thereafter. The Northern Kentucky initiative will be in partnership with Northern Kentucky University and St. Elizabeth Healthcare.

Dr. Robert DiPaola, dean of the UK medical school, said it is at capacity and can't expand enrollment without the help of regional partners. Currently, the College of Medicine enrolls 547 students, including 139 recently admitted into the class of 2020.

Details of the broad-based initiative are still being ironed out, though UK officials have signed a memorandum of understanding with the partners. The four-year Northern Kentucky program will utilize the same curriculum and assessments as UK's Lexington campus.

The release says the "on-site faculty will have UK College of Medicine appointments and teach in small groups and provide simulation/standardized patient experiences with lectures delivered on-site from Lexington utilizing educational technology. Additionally, clinical experiences will occur at St. Elizabeth Healthcare and surrounding community practices."

University of Louisville School of Medicine no longer on probation, but still not fully in compliance with national standards

The University of Louisville School of Medicine is now in compliance with all educational standards and is no longer on probation, according to a news release from the school.

“During the past two years, we have worked diligently to address the concerns raised by the Liaison Committee on Medical Education,” said Toni Ganzel, the school's dean.

Ganzel noted that the school had changed its curriculum, completed a major renovation of its instructional building, implemented new technologies and strengthened its educational governance and organizational structure to bring the program back into compliance.

The school has been on probation since March 2014, but has remained fully accredited during its probation, according to an article last year in The Courier-Journal. It quoted Ganzel as saying that the LCME actions were based largely on two areas of concern, the pre-clinical instructional building and the pace of pre-clinical curricular changes and curricula oversight.

"In my view, the LCME made a needed wake-up call to the university administration that put educational maters back on track again. In its emphasis on its commercial research agenda, U of L has allowed its educational priorities to recede," Peter Hasselbacher, emeritus professor at the school and president of the Kentucky Health Policy Institute, wrote on its blog. "In that respect, although the experience was both painful and embarrassing for all of us, we are now entering a better place."

Hasselbacher wrote that the LCME survey team found that four standards were not fully in compliance and still required monitoring: "diversity of minority and gender for faculty and students; provision for active and independent study for students, comparability of instruction and evaluation across instructional sites, and inclusion of behavioral and socioeconomic subjects in the curriculum."

Attorney general says UK should hand over records on children's heart surgeries, which have been suspended pending review

Attorney General Jack Conway has ruled that the University of Kentucky hospital violated the state Open Records Act by refusing to give a reporter for the university-owned radio station records relating to the work of the chief of cardiothoracic surgery, who has stopped doing surgery on children. UK refused to let Conway's staff examine the records to evaluate UK's claimed need for confidentiality.

After inquiries by Brenna Angel of WUKY, "UK announced that the hospital had stopped performing pediatric cardiothoracic surgeries pending an internal review," John Cheves writes for the Lexington Herald-Leader. Angel reports that she sought records on Dr. Mark Plunkett, left, who was also director of the pediatric and congenital heart program: "the date of Plunkett’s last surgery, the mortality rate of pediatric heart surgery cases, and documentation related to the program’s review." She sought no patient-specific information.

UK denied her request, citing the federal Health Insurance Portability and Accountability Act and arguing that release of the information could lead to the identification of one or more patients because Plunkett was doing so few surgeries on children. It also cited HIPAA in refusing to let Conway's staff review the records. Conway rejected that argument, noting that HIPAA does not supersede state laws and even make allowances for them.

Because it deals with the Open Records Act, Conway's decision has the force of law. UK can appeal the decision to circuit court within 30 days of March 27, the date of the decision. "UK spokesman Jay Blanton says officials are considering whether to file an appeal," Angel reports. The decision was publicly released Monday, the same day UK held a press conference about "the progress UK Healthcare has made in cardiology," she notes. "Yet the pediatric cardiothoracic surgery program remains under review, and patients from Central and Eastern Kentucky are being referred to hospitals out of state. Dr. Mark Plunkett remains on staff."

When Angel asked Dr. Michael Karpf, UK's executive vice president for health affairs, to comment, he replied, “We’ll have something to say about that in a little while.” Cheves notes, "UK recruited Plunkett, a noted surgeon at the University of California at Los Angeles, in 2007 to strengthen its pediatric heart program. He makes $700,000 a year, one of the highest salaries at UK." (Read more)

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More residency placements will be needed as medical school enrollments rise, perhaps by 30 percent through 2016

Aimed at addressing expected physician shortages, enrollment at U.S. medical schools is on target to increase by 30 percent by 2016, the Medical School Enrollment Survey has found.

But even if enrollment rises through expansion of medical schools and construction of new ones, "This won't amount to a single new doctor in practice without an expansion of residency positions," said Dr. Darrell G. Kirch, president and CEO of the Association of American Medical Colleges.

First-year medical school enrollment is expected to reach 21,376 in 2016-17, a 29.6 percent increase over enrollment in 2002-03. Nearly 60 percent of the growth will happen in the 125 medical schools that were accredited in 2002; 25 percent will happen in schools accredited since then, and 17 percent will come from schools that are applicant or candidate schools.

The United States is facing a shortfall of more than 90,000 primary care and specialty doctors by 2020, the AAMC estimates. With medical schools stepping up, what's key is "an increase in federal funding to expand the number of residency training positions — which prepare new doctors for independent practice," research-reporting service Newswise reports.

"Otherwise it may become more difficult for medical students to complete their training and for patients to get the care they need — as our population continues to grow and age, more doctors retire, and 32 million Americans enter the health care system as a result of the Affordable Care Act," Kirch said. (Read more)

UK opening new operating rooms, including high-tech hybrid

The region's first hybrid operating room, one that adds imaging and robotics to traditional surgery, is opening this week at the University of Kentucky Albert B. Chandler Hospital. The only other hybrid OR in Kentucky is at the Trover Clinic in Madisonville, according to Kristi Lopez of UK Public Relations.

News media are being invited to see demonstrations and tour the facility, as well as eight new operating rooms opening in the next phase of the hospital's construction, on Wednesday afternoon. Those on the 1:30 p.m. tour will include Dr. Michael Karpf, UK's executive vice president for health affairs; Ann Smith, the hospital's chief administrative officer; Dr. Joseph "Jay" Zwischenberger, UK HealthCare surgeon-in-chief; Dr. Bernard Boulanger, surgical services director; Dr. David Minion, a vascular and endovascular surgeon; and Dr. Justin Fraser, a neurosurgeon.

"Advantages to a hybrid operating room include greater accuracy of surgical procedures, reduced recovery time, and reduced risk of postoperative complications," a UK press advisory said. "Vascular and endovascular surgeries will begin being performed in the new OR in the next few weeks."

Journalists wanting to take the tour and watch the demonstrations should park in the UK HealthCare parking garage at South Limestone and Transcript Avenue and meet university public-relations representatives promptly at 1:30. For more information or assistance, call or text Lopez at 859-806-0445.

Beshear must reject hospital merger, C-J argues in huge editorial

Gov. Steve Beshear must say no when it comes to the merger of University Hospital, Jewish Hospital & St. Mary's HealthCare and St. Joseph Health System because it jeopardizes the separation of church and state, contends a lengthy editorial in The Courier-Journal. (C-J photo of University Hospital by John Rott)

The merger would mean the University of Louisville's hospital, a public institution, would be subject to Catholic health directives because St. Joseph is owned by Catholic Health Initiatives. "The result of merger would be that this community's public hospital, built only after voters approved a bond issue for its initial funding and with millions of taxpayer dollars flowing into it for decades, would be bartered away without public input, open bidding or any other formal procedures, to a religious group that limits standard medical care based on religious dogma," the editorial reads.

In order to take place, the merger requires the green light from Beshear, who must not give it, the editorial argues. Instead, he must remember when "he recognized the problem with posting the Ten Commandments in public school classrooms" while he was attorney general 30 years ago. "He needs to recall that brave and principled stance and tell U of L that no, you cannot sell the people's hospital to a religious organization."

The editorial, which took up the vast majority of the Sunday paper's Forum section, not the usual space on the first inside page of the section, also points out there is no other church-state medical complex anywhere else in the county because "it's unconstitutional."

The editorial also contends the merger is discriminatory. If it were to go through, women who have given birth to a baby at University Hospital would have to be taken to Baptist East Hospital if they wanted to receive a tubal ligation, a procedure that is often performed after a birth. "It is a deplorable solution to a problem that shouldn't exist to begin with," the editorial reads. "And it won't exist if Gov. Beshear has the sense and courage to reject this misbegotten scheme." (Read more)

U of L spinal cord center brings in $13.7 million in 2011, $64.1 million since 2000

The University of Louisville's spinal cord scientists attracted more than $13.7 million in outside funding in 2011 alone, and have brought in a total of $64.1 million since 2000.

"This is tangible evidence of our effort to become a nationally recognized premier metropolitan research university," said U of L President James Ramsey. "We have taken the investment that the state has made in our program, brought in the best researchers to work on spinal cord injury, and begun to help people."

One major success story was that of Rob Summers, who played college baseball in Oregon and was paralyzed below the chest after a car accident in 2006. "In May, a team from U of L and two California universities announced that they had used electrical stimulation and rehabilitation to help (him) stand and take steps with assistance — a breakthrough with implications for millions of paralyzed people around the world," reports Laura Ungar of The Courier-Journal. (Read more)

Center for Excellence in Rural Health marks 20th anniversary by adding new program in medical lab science

The University of Kentucky’s Center for Excellence in Rural Health celebrated its 20th anniversary this week and announced the addition of a new baccalaureate degree in medical laboratory science, which will start next fall at the facility in Hazard.

At a ceremony honoring current and former faculty, staff and students of the center, speakers include UK President Eli Capilouto, 5th District U.S. Rep. Harold "Hal" Rogers and Dr. Wayne Myers, the center’s first director and a former director of the federal Office of Rural Health Policy.

Capilouto, a dentist by trade, said “With approximately 80 percent of the center’s graduates working in Appalachia or other rural communities, it’s a testimony to the fact that this idea worked.” More than 550 people are graduates of the center's academic programs. The center also includes Kentucky Homeplace, a nationally recognized community health worker initiative; the Kentucky Office of Rural Health; and the East Kentucky Family Medicine Residency Program, a UK news release said.

UK surgeons first to do life-saving lung procedures in tandem

Surgeons at the University of Kentucky are the first in medical history to perform two procedures in tandem to bridge a lung transplantation. The procedures were performed first on Wanda Craig, 68, who is now the oldest person to be "bridged to transplant using an artificial lung device, also known as an extracorporeal membrane oxygenation," reports research-reporting service Newswise. (Photo of Wanda Craig and Dr. Enrique Diaz by Julia Meador)

Craig, of Lexington, had chronic obstructive pulmonary disease and emphysema for which she has been treated for the past 10 years. In November 2010, she took a turn for the worse. "I was so out of breath from walking to the kitchen ... I didn't have enough energy to even scoop ice cream out of the carton," she said. Pulmonary hypertension, from which she also suffered, had caused the right half of her heart to fail, which prevented blood from going through the lungs to fill the left side of the heart, explained Dr. Charles Hoopes, director of UK's heart and lung transplant program.

To fix the problem, Hoopes and Dr. Enrique Diaz, the program's medical director, performed a procedure called an atrial septostomy, in which a small hole is created between the upper two chambers of the heart. This procedure, along with the extracorporeal membrane oxygenation procedure, saved Craig's life, the news release says. "These procedures are novel in terms of a bridge to transplantation, and the use of an artificial lung together with an atrial septostomy for cases of respiratory and right ventricular failure have not been performed together until now," Diaz said.

Three days later, Craig underwent a double lung transplant, and has been healing since. "More than anything I am looking forward to doing those normal everyday things like going to the grocery store and watching my grandson's T-ball games," she said. "And scooping my own ice cream." (Read more)

Republican leader and former U of L trustee says university made poor argument that hospital isn't public

The University of Louisville made a “terribly flawed argument” when it claimed that University Hospital was not a public entity, former U of L Trustee Bill Stone told cable channel cn|2's "Pure Politics" program yesterday. "That argument has been central as university leaders try to finalize a merger with two private hospital groups, Jewish Hospital and Catholic Health Initiatives," Ryan Alessi notes.

Stone, a former Jefferson County Republican chairman, said he agreed with Democratic Attorney General Jack Conway's ruling in an open-records case that the hospital is a public entity, and “I don’t know of any lawyer of merit who wouldn’t agree with Jack Conway’s assessment. That has been the weakness in U of L’s selling point. The University of Louisville Hospital is part of the university.”

Alessi reports, "Stone said the university should be highlighting the positives of the merger." Stone told him, “I think this merger can be sold to the public on the basis of how much it will mean to this community economically, what it will mean from a prestige point of view, where it will be an incubator for Nobel Prize-winning scientists.” For the story and video, click here; for the video only, on the image above.

State senator says U of L doctors used Medicaid funds to pay themselves $4.8 million in bonuses, seeks more oversight

State Sen. Tim Shaughnessy has questioned a $30 million transfer of surplus Medicaid funds to Passport Health Plan board members in 2008 and 2009. Shaughnessy, a Louisville Democrat, says doctors at the University of Louisville medical school paid bonuses to themselves using about $4.8 million intended for indigent care and used another $5.2 million to purchase an electronic records system, making them eligible for more bonuses from the federal government, Deborah Yetter of The Courier-Journal reported.

Since Attorney General Jack Conway ruled the transfer illegal, some groups have elected to repay. University Physicians Associates will repay $9 million over five years; U of L, University Medical Center and local hospitals that provided capital to start Passport have agreed to repay, but on different terms. Conway did not indicate whether the $4.8 million in compensation was bonuses or salaries, Conway spokeswoman Shelley Johnson told Yetter.

Shaughnessy said repayment is not sufficient to address the real problem — "that U of L's board wasn't involved in major financial transactions involving groups with which it is affiliated, including Passport, University Physicians Associates and the U of L medical center," Yetter reports. "We need to know how this happened, and we need to make sure it doesn't happen again," Shaughnessy said in an interview.

Shaughnessy is working on legislation for the 2012 General Assembly requiring public university boards to apply more oversight to groups like Passport. He has also written letters to Passport chairman Dr. Gerard Rabalais and U of L President James Ramsey. (Read more) To read Shaughnessy's letter to The Courier-Journal, click here.

U of L prof earns $11.8 million grant renewal; has helped glean $100 million in federal grants in 17 years

A University of Louisville researcher has been awarded a $12.8 million grant to keep his adult stem cell project going.

The funds are from the National Institutes of Health and will allow Dr. Roberto Bolli, right, to continue to investigate how introducing genes into stem cells might improve stem-cell therapies; look at how diabetes affects stem cells; look at how proteins called cytokines affect stem cells during heart failure; and investigate the signaling pathways of stem cells in the body.

Bolli's project was granted $11.7 million in 2006. Since Bolli started working at U of L in 1994, he and his team have brought in more than $100 million in NIH grants. In one project, patients have reached the two-year mark after being infused with their own processed adult stem cells. That project is looking to find a way to use a patient's own cardiac stem cells to regenerate dead heart muscle after a heart attack.

"U of L has a mandate to become a national recognized metropolitan research university," President James Ramsey said. "One gauge is our faculty's ability to attract competitive grant fund from the NIH." Ramsey said the overall mission of the medical school is to improve the health of Kentuckians.

3 universites and federal agency join to improve oral health in Appalachian Kentucky

With money from the Appalachian Regional Commission and some of their own, three very different Kentucky universities will collaborate "to enhance sustainable, collaborative dental health education and care" in the state's eastern coalfield, where both are sorely lacking, they announced in a press release.

Morehead State University, the private University of Pikeville, and the University of Kentucky's College of Dentistry will design the Appalachian Rural Dental Educational Partnership Plan "to train more dentists to practice in rural areas and give them the tools necessary to set up thriving dental practices in Eastern Kentucky," the release said. The funding is $400,000 from ARC, $127,293 from UK, $82,035 from UPike and $47,873 from Morehead State.

“The majority of Eastern Kentuckians have struggled to sustain quality dental health, and one of the barriers to maintaining good dental health is poor access of quality dental care,” state Department for Local Government Commissioner Tony Wilder said. His agency handles ARC matters in Kentucky.

Said new UK President Eli Capilouto, a dentist by trade, “We know that if we can break a cycle of poor health, we can begin to break cycles of poverty. Cycles of despair can become legacies of hope. We also, increasingly, know that partnerships and greater collaboration are the best – and, perhaps, only – way to address major challenges.” He called the project a unique partnership among a federal agency, a governor and “the state’s flagship institution, Kentucky’s public institution dedicated to serving the people of Eastern Kentucky, and a critically important college with deep roots in Eastern Kentucky.” (Read more)

Markey Cancer Center at UK says its patients have higher survival rates than those treated elsewhere in Ky. and the nation

"Patients at the University of Kentucky's Markey Cancer Center who have certain types of cancer have higher rates of survival than patients with the same cancers treated elsewhere in the state or even the nation according to new data released today," Business Lexington reports.

"Markey officials said the data shows that the center's patients have significantly better five-year survival rates than those Kentucky cancer patients who were treated elsewhere for brain, breast, liver, lung, ovarian, pancreatic and prostate cancer, as well as for stage IV colorectal cancer." (Read more)

Free conference on Alzheimer's in Louisville Sept. 17

A Washington-based geriatric researcher will join University of Louisville researchers and clinicians a free conference examining Alzheimer’s disease from 9 a.m. to 3 p.m., Saturday, Sept. 17, at the Crowne Plaza Louisville Airport Hotel, 830 Phillips Lane, near the state fairgrounds.

“The Journey: Alzheimer’s Disease and Caregiving” will provide information on the risk factors for Alzheimer’s disease, the reasons why certain populations are at greater risk for developing it, and current practices in caregiving. Admission, parking and lunch are free to participants at but pre-registration is required by Sept. 15 to info@alz.org or 1-800-272-3900.

Thomas Obisesan, M.D., chief of geriatrics at Howard University Hospital, will open the meeting. His research is focused on finding a cure for Alzheimer’s and "disentangling the overlap of cardiovascular disease with Alzheimer’s disease risk," a U of L release says. The conference is supported with grants from Eisai Co. Ltd. and the Signature Research Institute. It is co-sponsored by the university and the Greater Kentucky and Southern Indiana Chapter of the Alzheimer’s Association.