More Negative Press for UK and its Hospital

7/6/2016

Once again, for those new to this blog site, at present there are 21 posts on the blog and each has its own set of comments. To read the comments you have to hit the word "Comments" at the beginning or end of the post. Somewhat confusing is that when you bring up the comments for a specific post it eliminates the other posts from the screen. To bring the other posts back up simply go back to the top of the page and click on Blog. Finally, to understand the development of the blog it is best to read it from the bottom post (Dr. Paul Kearney Case) up. One point of note here, to read the earliest posts you have to click on the word "<<Previous" at the very bottom of the posts available.
* Note: To see PDF Documents cited in this post simply click on the underlined segment

I guess it is time for a new post. In certain respects, this is really an extension, or perhaps in part an explanation, for the horrible Press-Ganey survey results discussed in the previous post. The comment at the end of this post, from “Nothing to hide”, references the most recent Herald Leader article on the happenings in the hospital. To quote Nothing to hide:

"UK and its foundation sue former student in open-records appeal.

http://www.kentucky.com/news/local/education/article87736192.html "

To me, this is absolutely ludicrous, the “public” University of Kentucky suing someone for requesting open records. It is even more ridiculous that they are claiming KMSF, a subdivision of the hospital created by the University Hospital to manage their money, is not a part of the University of Kentucky. This is sort of like saying that the Grants Management division of the University is not a part of the university and therefore these grant funds can be spent in any way Grants Management should so choose, and definitely would not be subject to open records requests. I say that because the university and KMSF lawyers then add to their claims the supposition that because KMSF is not a part of the University of Kentucky, the money and financial matters that they handle for the "public" University Hospital are also not a part of the "public" University of Kentucky and not subject to open records laws, in spite of the fact that these monies were generated by faculty, physicians, residents, fellows, students and staff employed by this “public” University of Kentucky. Add to that the fact that the head of KMSF (Dr. Marc Randall) and its managing board are made up of primarily University of Kentucky College of Medicine Department chairs and Division heads, you have to question what is really going on here?

Well maybe the signed affidavit submitted by the former head of KMSF, Darrell Griffith, offers some insight into why KMSF and the hospital administration are so avarice in their fight to keep KMSF records out of the public eye. That affidavit can be found here:

https://pageonekentucky.com/2016/02/23/juicy-affidavit-hits-in-uk-kmsf-case/

Some of the highlights from this document include:

“During my tenure as Executive Director of Kentucky Medical Services Foundation the Foundation operated as a private non-stock, nonprofit corporation organized under the laws of the Commonwealth of Kentucky. As a non-stock, nonprofit, private corporation Kentucky Medical Services Foundation was not subject to Open Records Requests.

The purpose of the Kentucky Medical Services Foundation is to bill and collect for services of medical faculty members, manage their practices, and arrange for improved salaries and benefits. Kentucky Medical Services Foundation acted as a management services organization on behalf of the University of Kentucky College of Medicine.

During my tenure, the Kentucky Medical Services Foundation engaged in business activities that included, but were not limited to the following:

A. The financing of the Child Development Center’s new building and the annual operating expenses in excess of $l 00,000.00. In connection with the Child Development Center, KMSF loaned the Child Development Center a sum in excess of $5 million; only $2.5 million had been paid back as of my departure.
B. KMSF loaned a pharmaceutical company in excess of $400,000.
C. KMSF hired a management/consulting firm to do a “turn around” on the pharmaceutical company.
D. KMSF leased an airplane together with a separate agreement for the pilot.
E. KMSF purchased buildings on Alumni Drive.
F. KMSF provided matching funds to the University of Kentucky for the “Bucks for Brains” program.
G. KMSF paid for consultants and management staff for Eastern State Hospital.

As the former Executive Director of the Kentucky Medical Services Foundation, it is my opinion that KMSF exceeded its scope. KMSF business activities were outside the purview of the UK Board of Trustees by design and, by design, outside the Commonwealth of Kentucky Model Procurement Laws.”

The KMSF Board of Directors had a fiduciary duty to inform the UK Clinical Faculty who were members of the Faculty Practice Plan, of these business activities of KMSF. To my information and belief, the Practice Plan Committee, set up under AR 3.14, was never convened or met as a separate independent committee during my tenure. Based on my understanding of AR 3.14, the failure of the Practice Plan Committee to meet or convene would be a violation of AR 3.14.

So now why are the lawyers for both the University of Kentucky and KMSF really suing this individual? For that matter, what was the real reason the University of Kentucky lawyers took away Dr. Paul Kearney’s patient privileges, teaching privileges and have continued to harass him in any way, shape and form that they can devise.

47 Comments

7/6/2016 08:45:05 am

I am a little confused here. This article suggests that UK is actively involved in this lawsuit against a physician in Kentucky who is requesting open records from KMSF. That by itself is stupid, but if you add the fact that UK is claiming KMSF is not a part of the university, then it is both more irrational and a big waste of taxpayers money (assuming as we have to that KMSF is not funding any of the legal aspects of this case that the university is involved in). I mean, what in the world is the university doing fighting legal battles for this private company. That would appear to be itself some form of money mismanagement. I was earlier believing that all of this KMSF stuff and money mismanagement was a bunch of hooie, but the actions of the university and hospital management over the past year leads me to agree, something really smells rotten in all of this.

Hatemis gonna hate

7/6/2016 12:46:15 pm

I agree that the argument that KMSF is independent from the university is asinine but the exemption of legitimate business information from open records requests is a real provision and, if you read the AGs opinions he doesn’t contest that this could be protected information, he just says that because he has not been shown the information he can’t make a determination about UK’s claim that it should be protected. Unfortunately, this is something that is likely going to have to be resolved in the courts. I am also not sure that it makes any sense for the various cases (Kearney, Hatemi vs UK/KMSF and UK/KMSF vs the AG) to be litigated separately. But I am not sure which of the cases takes precedence. Instead of all of the outraged ‘something to hide” conspiracy theorists and Kearney fans I would love to hear from someone who understands these open records laws and the likely standards and precedents that will eventually be used to adjudicate the case(s). Maybe it’s time for a guest post from Lachin Hatemi?

What do readers here think/want to happen? Presumably ideally you’d like everyone in the state to have real time online access to all accounts and records of UK, UKHC and KMSF. Is that really reasonable? Do you think UKHC/KMSF have to show all of their accounts, business plans, projections, contracts and so on to St Josephs and Central Baptist? Is there any information that any of you would concede could reasonably not be made public?

Bill

7/6/2016 06:46:39 pm

Mr. Hatemis gonna hate, I am a reader and I see nothing wrong with or damaging in the release of any of the records you listed. We are a public hospital serving the people of Kentucky. What is so important that we need to hide our information from the public. I tend to agree with Dr. Noonan in that $192,000,000.00 profit seems like plenty. I don't see where there are any advantages that we would reveal to Central Baptist or St. Josephs that would put us in the poor house. Therefore, in answer to your question, other than patient records which are exempt from disclosure, there is nothing I can think of that should not be made available to the public upon request. You seem to think there are, so I would be interested in hearing what it is and why you feel it would reduce this $192,000,000.00 profit to some unreasonable amount. Furthermore, it is clear you feel we need to compete with the other private hospitals in Lexington, so I would like to also hear why you feel this is a vital aspect of UK hospital survival? I surely hope you do not feel it has anything to do with our bonuses.

Watch 'em squirm

7/6/2016 07:01:38 pm

To answer your question about showing their records. The answer is a resounding yes. If they are utilizing one dollar of state tax money then all this information must be public. That's the difference between the university and the private hospitals. St. Joseph and Central Baptist are not advertising against each others with my tax dollars! I therefore could careless about their records.

Dan Noonan

7/6/2016 05:16:43 pm

Thanks DP and Hatemis for your comments. DP, I am with you all the way on this one. The administration likes to pretend that these open records requests being made by Dr. Hatemi are for something of great national importance, or something like patient records. That is not the case. Information about practice plan committee meetings, KMSF's involvement with Bucks for Brains, the Child Development Center and how KMSF is spending the money earned by this public hospital on outside projects and luxuries seems reasonable to me. Even information on salary bonuses is in line with the public information that everyone has access to with respect to salaries available for all the other faculty and staff of this university. I really tire of the line that we need to keep this information protected because for some reason it might impact our competitive edge with respect to the private hospitals in the area. Hogwash, if anything it would probably be expected to increase our competitive edge. That being the case it leaves me, like you, with the feeling that they have something to hide.

Well I am happy to see that you tend to agree that KMSF is part of UK hospital Hatemis. Unlike yourself, I personally don't view this as as a hate thing for Dr. Hatemi, but rather an attempt to expose a coverup of real mismanagement by the hospital and university administration. Whether he is right or wrong is yet to be determined, but the Dan Ross/Bucks for Brains evidence, the Hazard fiasco, this signed affidavit above by the former KMSF director and even the lawsuit itself suggest that he might be more right than wrong.

I do have a curiosity about your propensity to believe that this is a battle between UK hospital and the private hospitals in the area. I mean, how much more than 192 million dollars worth of profit in this non-profit institution do you think we need? Are we in the business of trying to destroy the so-called "competition"? Is there not room for all of us? This mentality just feeds into that RVU and quantity over quality syndrome other physicians have complained about. Do you not think that this might have contributed to those horrible scores on that Press-Ganey survey?

Being a reader of the blog, what I would like to see happen is a public audit of the university hospital and KMSF finances. I would also like to see release of the requested public records. I would like to see the administration restore Dr. Kearney's patient and teaching privileges. Finally, I would like to see the implementation of 3-year faculty/staff performance reviews of hospital and college administrators (implemented by an outside agency).

7/6/2016 05:40:20 pm

The point of my post was to promote a reasonable discussion about what if any records relating to the business operations of UKHC/KMSF would be exempt from the public records act because I think this is the basis on which the UK vs Kearney/Hatemi/AG cases will be adjudicated. The information is here:
http://www.lrc.ky.gov/lrcpubs/openmtgsrecords.pdf
Instead of ranting on and on about your rights to see everything and certainty that things are being hidden why don't we have a discussion about the law and its interpretation.

And regarding Hatemi he clearly had a beef with UK and the COM that pre dated any of the Kearney excitement so its a little difficult to see his obsession with these open records requests and his enthusiasm for Kearney as being anything other than opportunistic. Hopefully his real motives will be revealed by these lawsuits.

7/7/2016 03:24:51 am

I tend to agree with the others Mr./Ms Hatemi hater, what is so important that it needs to be kept a secret? Your desire to get into law interpretation would suggest you are a lawyer. I think the key word here is "interpretation", which means about anything you might want to twist it into meaning. Reading these various legal documents that Thro, Dadds and the AG have presented seems to fully support this. The big question is, why does this public university need to establish an agency outside its governance to handle the financial matters of this public hospital?

7/7/2016 04:41:36 am

I see it has been a busy night on the blog. Sorry I could not stay around to post your comments. Thanks Bill, Watch’em, Hatemis and LT for your comments. Hatemis, I think Bill asks a valid question, why do you think keeping the public ignorant of what is happening with their hospital generated revenue, as well as their future plans for use of this revenue, is vital to the success of the hospital?

I agree Watch ‘em, if Dr. Karpf wants to hide from the public how he is spending hospital revenue he might think about moving to a private hospital.

That does appear to be the “big question” LT, why do we even need a KMSF? The university has internal financial management capabilities for every other aspect of this institution, why not it’s hospital?

Mole Sauce

7/7/2016 06:03:11 am

Dan, the reason UKHC needs KMSF is that the compensation and other associated personnel costs for clinical faculty (e.g. malpractice insurance) are very different from those of all of the other faculty. Because UKHC/KMSF operate in a competitive business area all kinds of things that would upset you are routinely done for the clinical faculty, like productivity based bonuses, signing fees, forgivable loans, excessive moving/relocation expenses, waivers of the usual non compete contracts and so on.

The rest of you- as Hatemis points out- the open records law does have provisions for non disclosure of business information so clearly the lawmakers did acknowledge that there might be legitimate reasons not to put this in the public records. Presumably Hatemi, Kearney's attorney or the AG will have to eventually argue their case. But since UK won't even concede that KMSF should be subject to the open records law that issue will have to be settled first before we can even get to the issue of what information should be disclosed.

If you don't think this is "morally" acceptable then you should lobby to change the law to remove any protections for business information. Otherwise I'm afraid that interpretation of the law is what the courts will now have to do.

7/7/2016 10:18:10 am

Audit: Lexington parks employee falsified concession stand reports

http://www.kentucky.com/news/local/counties/fayette-county/article88185492.html

Good to see that the real criminals in Fayette County are being held accountable for their financial shenanigans :-)

7/7/2016 11:56:18 am

Thanks Mole Sauce for these additions. This second one is shocking news. See, this is what an audit can reveal. :-)

I am still having trouble seeing where issues like "productivity based bonuses, signing fees, forgivable loans, excessive moving/relocation expenses, waivers of the usual non compete contracts and so on" should be surprising to most or withheld from the public. We (the public) know this business is competitive and that physicians are paid (in salary, bonuses and benefits) wayyyyyy more then minimum wage, so why try to hide the fact. Again, this is not a private hospital and with that comes the fact that we can't play under the same set of rules that the privates do. Creating a bogus corporation like KMSF that basically takes university money (hospital revenue) and launders it to hide these salaries and benefits, is, at least to me, unethical if not illegal. But I may be in the minority in this.

7/8/2016 06:31:44 am

Someone should check to see if the airplane leased by KMFS ever flew the Karpfs to their newly constructed $3 million dollar property in Jackson Hole, Wyoming.

This is a man that has increased the cost of healthcare for every Kentuckian. Imagine for one moment a single mother in Hazard struggling to pay a thousand dollar UK Healthcare bill that would have been a fraction of that amount before Karpf came to town. Now imagine Karpf sitting in his luxury place in Wyoming laughing at what a bunch of fools we all are.

Keep in mind, Mike Karpf is a man that has been quoted to say, "a patient with a tracheostomy in the ICU is like a slot machine paying out every day." This relates to the fact that the acuity of those patients automatically bills a daily level 5 intensive care charge.

7/8/2016 05:03:43 pm

I was skiing in JH between Christmas and New Year (spending all of my ill gotten UKHC/KMSF cash) and I can tell you that while the Karpf's are <1%ters in Lexington they will will not be anywhere near the top of the food chain out there. Most of the big dogs in JH own their own G4 and wouldn't be seen dead in a leased plane. We had a guide take us around the mountain one day and along with pointing out Dick Cheney's ranch the told me that he had been teaching kids to ski who were heading to their other vacation home in the Bahamas for New Year.

Anyway, to get back to reality, surely "AB" can't possibly really think that Karpf is personally responsible for all of the problems with healthcare in the KY which just mirror the larger problems in the USA. What about the large debts that doctors graduate with? Or the fact that a much larger proportion of physician visits in the U.S. are to specialists who get higher fees and usually order more high-tech diagnostic and therapeutic procedures than primary care physicians.

Noonan seems to want UKHC to become some sort of a group health cooperative providing affordable care in a transparent way and not making a profit while academic physicians work there for low salaries and the honor of serving the people of the state and educating doctors (while of course not doing any research because that should only be supported by grants). Maybe Kearney could be dean and EVPHA?

7/9/2016 03:10:31 am

Thanks Mole Sauce for this comment. Hold on a sec while I wipe the tears from my eyes. Such a sad story. This must be simply humiliating for Dr. Karpf. If he had only built that 3 million dollar vacation home in Hazard he would have been King. Furthermore, the private plane would have been a write off. Oh, while on the subject, did you stay with the Karpfs while vacationing in JH?

But as you say, back to reality. It is beyond me why you feel that exposure of the bonuses and benefits of being a physician at UK hospital would jeopardize them? I can tell you it hasn’t impacted any of the other UK administrators, athletic coaches, faculty etc. What is it about these benefits that makes you believe that exposure would lead “UKHC to become some sort of a group health cooperative providing affordable care in a transparent way and not making a profit”? I guess the real question is, what is wrong with “affordable care in a transparent way”? Are you once again worried about impacting this 192 million dollar profit we are making in this nonprofit institution?

7/9/2016 04:58:03 am

Dan- the reason UKHC makes these profits is that medicaid/medicare and private insurance will pay for expensive diagnostic and therapeutic procedures performed by highly paid specialists. If you want to make health care costs more affordable then you have to limit or eliminate these expensive services and have more preventive care. Someone asked you if you got your healthcare from the VA. If you want to see what this more affordable model looks like give that a try sometime.

KMSF exists to manage the UKHC physicians practice plan. Every other public university healthcare enterprise has something similar. As I explained, this is because of the recongised need to manage the employment of physicians separately from regular faculty. I don't think the primary purpose of KMSF is secrecy. However KMSF has clearly not been operating completely in line with the relevant regulations and I expect we are going to eventually see some consequences for that.

UKHC will continue to make a profit unless there is radical healthcare reform, one or more of the competing hospitals takes over the market or Karpf leaves and whoever takes over screws things up.

Once Karpf is gone, one very likely outcome will be that Capilouto will now control (through his appointee) these profits and instead of them being used to support the enterprise, build stuff or fit out already built stuff they will flow downhill into the main campus coffers to pay for all of the unfunded initiatives over there.

Rainbow Mole Sauce

7/9/2016 05:29:58 am

Apologies if this has been posted but this is a must read about the leadership now at UK hospital....

"That’s right – UCLA’s Medical Center sold liver transplants to Japanese mob bosses in exchange for donations of dirty money.

Just who was at the helm of UCLA until 2003? None other than Michael Karpf."

https://pageonekentucky.com/2012/08/01/uk-medical-centers-problems-bubbling-to-the-top/

7/9/2016 09:05:53 am

I am not sure why you all want to make this a personal vendetta against Karpf. If you want to get outraged about people making money from the broken healthcare system there are plenty of more egregious examples in Lexington alone. At the national level there are executives running other healthcare systems that make >10 X what Karpf does.

The liver transplant thing is old news- something that happened in 2001 and has been picked over by the press in LA and beyond. Even the "story" you linked to is from 2012. Lets at least try to come up with some more up to date Karpf burns.

7/9/2016 09:53:35 am

Thanks for the comment Mole Sauce. I missed this when responding to your earlier comment. I personally do not see any vendetta against Dr. Karpf. A vendetta is what Dr. Karpf and the university administration has underway against Dr. Kearney. Furthermore, why should we need to go outside the university to search out other worst case scenarios. I would suspect the folks here choose to look in-house because it directly impacts their lives and their work environment. You may feel that Dr. Karpf is totally innocent in all this, but when the vast majority of physicians in your hospital are not happy working there as the Press-Ganey survey suggests, then you have to start the blame game at the top not the bottom.

7/9/2016 12:26:18 pm

I just learned about it. So it's new to me.

I think it's very pertinent in that he's not a stranger to controversy and questionable practices. It's possible that's relevant, no?

7/9/2016 02:48:13 pm

Thanks again for the post Rainbow and thanks for reminding, or in other cases informing, us that Dr. Karpf does have a track record.

7/9/2016 09:29:46 am

Thanks Mole Sauce and Rainbow Mole Sauce for these contributions. Rainbow, others have mentioned Dr. Karpf's record at UCLA as well as his embarrassing CNN interview concerning UK Hospital's pediatric heart surgery record. I have to believe Dr. Todd knew about the Japanese mafia thing when he hired him.

Again Mole Sauce, the question is why does KMSF have to be isolated from the university governance. What is the big problem with having a hospital financial management group that is part of the university? Just because private hospitals are able to do this does not mean that we should be able to do it. The observation you made that "KMSF has clearly not been operating completely in line with the relevant regulations" fully supports the contention that an entity like KMSF should not be handling UKHC finances. 2-4 billion dollars a year is too big a temptation, as is suggested by some of the mismanagement already identified, as well as the refusal of open records and outside auditing.

Finally, I am still not totally buying into this idea that Dr. Capilouto will ruin everything if he is allowed to get his hands on all of this UKHC money. I mean, last that I heard UKHC is a part of the university, the funds/profits generated by UKHC are university property and Dr. Capilouto is the President of the university. Beyond that, Dr. Capilouto has the BoT and its University Health Care Committee that he has to respond to. Finally, as noted earlier, Dr. Capilouto has a doctorate from Harvard in Health Policy and Management, so he definitely knows the value of the hospital and would be expected to be able to balance that against the bigger picture of the needs of the university. Don't get me wrong, I am not a big fan of Dr. Capilouto. I think he delegates too much of his responsibilities to his General Council, whom I have little respect for, but I recognize him as the president of the university and respect that office.

7/9/2016 09:49:32 am

I don't think we are getting anywhere with this debate. Do you want UKHC to make a profit or not? If it does make a profit you seem to be saying that you would prefer that is used for "university needs" than for investment in the hospital or what you clearly regard as excessive compensation for some people in the hospital. Eli or his appointee would then have to convince people to buy into this new arrangement. I doubt that most of the profit generators at UKHC would be too thrilled with the idea that they are being squeezed to work hard and take a ht on their large salaries so that Eli can pay off the loan on the new student activities center. And lets be clear, Capilouto, Tim Tracy and the BOT have no experience running a large healthcare business. None. Lets just wait and see what happens next. I guarantee that Karpf will be replaced (at least initially) by someone already working at UK and I am not confident that any of the candidates are up to the job.

7/9/2016 11:25:08 am

I agree Mole Sauce, we are getting nowhere in this debate. Unfortunately Mole Sauce you have this propensity to totally distort what people say in their comments to fit some agenda or point you wish to make. Of course we all want UKHC to be a thriving healthcare business. Our point is that we believe it can be a thriving profitable healthcare business in the absence of some outside agency masking how it is succeeding. You appear to believe it can’t be profitable without this ability to hide from the public how it is spending the UKHC generated university money.

Furthermore, I never stated nor suggested that compensation for UKHC employees is excessive. I simply questioned why, unlike the rest of the employees at the university, compensation for this subset of UKHC employees needs to be kept a secret.

Finally, neither you nor I can predict how good or bad Dr. Capilouto and whomever he should recruit or appoint would be at administering this situation, nor what he would do with access to this UKHC revenue. Unlike you, I tend to believe that he is smart enough to recognize the profitability of UKHC and will do everything he can to maintain this profitability.

7/9/2016 11:27:03 am

Ooops, where are my manners. Thanks for the comment Mole Sauce.

Titanic

7/9/2016 05:11:18 pm

It's funny to hear profitability being discussed in this debate. I happen to believe the enterprise is going to sink like an enormous ship built of iron. Those profit numbers are hiding tremendous debt being piled on by Dr. Karpf...and yes I am pointing my finger directly at him. He's the one that built that monstrosity with god only knows how many state bonds. That's not monopoly money. Once people realize they are being cared for by a bunch of unhappy overworked doctors and trainees the business will slow.

7/10/2016 09:06:51 am

Here's a fun read:

http://www.jpands.org/vol20no1/huntoon.pdf

7/10/2016 10:45:37 am

Thanks DD for this. An interesting read.

7/10/2016 09:38:22 am

As it happens I was hanging with the UKHC/KMSF elite last night (sort of like being at a Trump fundraiser- I needed a long shower afterwards) and here is what I found out.
1. After a lot of posturing, Capilouto and Karpf now agree that nobody presently at UK has the knowledge and experience to run UKHC.
2. On or just before the September BOT meeting there will be an announcement that Karpf will step down in 1 years’ time.
3. At that point he will take a “sabbatical” and then possibly return in some part time role.
4. UK will (or has begun to) engage with a search firm to find someone with high level experience running a large public university healthcare system to replace Karpf.
5. The expectation is that this position will be attractive to highly qualified candidates and the appointment will be made well before Karpf steps down on or around September 2017.
6. It will be interesting to see how this plays out. Presumably anyone credible would want to see (and be able to evaluate) all of the UKHC financial and business information so if this really is a huge debt ridden house of cards then this will impact on the type of individual they can appoint.
7. Let me remind you that just about everything I have posted here has been correct. That is all. Mole out.

7/10/2016 10:44:38 am

Thanks Mole Sauce for this update. This actually sounds like promising news. It will be interesting to see or hear who the candidates are and who the interviewers will be.

7/10/2016 11:20:07 am

I would be shocked if this is done in an open way.

If I was going to bet on this the first thing I would do is see if there is anyone Eli knows from UAB that could do it...

But of course if any of you want to take a look at other public university healthcare operations and identify a few that you think are run well and in line with your expectations I'm sure Dr Capilouto would like to hear from you.

WTY

7/13/2016 06:27:21 am

How did everyone enjoy the "meeting" and the announcement that our salary raises will be delayed? So much for that 192 million dollar profit.

7/13/2016 06:35:09 am

Thanks for the comment WTY.

Inside man

7/13/2016 07:07:07 pm

Have not been on blog in awhile but appears that things are really heating up now. Lots of press, lots of rumors circulating. Boulanger gone. Moliterno out as executive VP but retains IM chair job. Zwischenberger on the hot seat (where he belongs). BTW Zwischenberger had a sham six year review in 2013 with no input from faculty just a thumbs up from bully de Beer. Mole Sauce seems to think that Moliterno got six more years without a review. I am wondering on what basis does Mole Sauce reach that conclusion? As I read his resignation letter, I thought he would have just one year remaining prior to review. I don't see DiPaola making a de Beer move?

7/14/2016 02:55:34 am

Thanks for the comment Inside Man. Yes things are happening, hopefully for the better. The College and hospital sure could use some good things happening.

7/14/2016 10:27:38 am

My conclusion was based on Moliterno's letter/email which said

"Dr. Karpf and Dr. DiPaola, our new Dean, are fully supportive, and have asked me to commit to the Department for another 6-year term, and I am honored and revitalized to do just that."

I am not aware of any review process. I assume this means that at the September BOT meeting he will be renewed as IM chair unless something else happens in the interim.

Its quite possible that both Moliterno and more importantly Zwishenberger have been told that they have to leave and all of these arrangements are being made to make it easier for them to find another job. Of course, the problem for both of them is that nobody in their right mind will ever pay them the salaries they are making at UK (unless I suppose they want to go back to doing interventional cardiology and surgery).

Interesting times.

Curious George

7/16/2016 09:04:28 am

Just wondering, does anyone know if this 2 month reduction in any annual pay raise we were scheduled to receive is a campus-wide thing or restricted to physicians or COM faculty? Anyway, it sure seems to be pretty bad timing on the Capster's behalf considering his 47% salary raise. I am betting he did not include himself in this 2 month thingy.

7/16/2016 09:11:55 am

Thanks for the comment Curious George. Good question, but I am retired so I only know what I read in the papers and see on the blog. Maybe some other blog reader might be able to answer that.

7/16/2016 09:18:14 am

Dipaola has done a makeover for the COM web site. Its interesting that both Moliterno and DeBeer are now gone from the "leadership" page. I can’t imagine DiPaoloa is too pleased that both of them have been getting paid considerably more than him. Hopefully their salaries are getting wacked as well.
Also, in the interest of promoting some more discussion, another thing that I have heard from multiple sources is that neither Karpf or Capilouto were behind the Kearney harassment/vendetta and are both quite upset that it all got so far out of hand but don’t see any way back now. This was largely instigated and followed through on by DeBeer, Zwischenberger and Boulanger out of some combination of a desire to “defend” Karpf, anger at being “challenged” by Kearney and (I suspect) because there really are things going on at KMSF that are less than 100% kosher. I appreciate that this happened on Karpf and Capilouto’s watch so they are ultimately responsible. But my personal view is that Karpf was the instigator of any of this (yes I know that the Kearney Cannon is that he was threatened by Karpf). Indeed, most of the things that you are all upset about (lack of faculty engagement, emphasis on funding over other academic pursuits) can all be laid squarely at DeBeer’s feet. DeBeer was supposed to be Karpf’s academic conscience. Instead he used his positions as chair of medicine and then dean to dismantle departments, pursue personal vendettas and to promote the careers of all of his cronies which include people like Lisa Tannock (a member of the panel that upheld the sanctioning of Kearney), Alan Daugherty (with his ridiculous number of “leadership” roles, Sibu Saha who bought his position as Chief of CT surgery by donating a small amount of money to the CV research center) and his prize “mentee” Lisa Cassis. With Boulanger gone, DeBeer as good as gone the only one of the gang of three remaining is Zwishenberger. Hopefully that particular shoe is getting ready to drop.

7/16/2016 11:16:04 am

Thanks Mole Sauce for another informative comment. In looking at this revised COM leadership page I see the COM is down to a mere 20 Deans and Deanlets. I believe that is down by 3 from the previous listings.

They must have not yet updated the UKHC leadership page (http://ukhealthcare.uky.edu/about/leadership/) because they still list Dr. Moliterno as VP for Clinical Affairs.

I don't envy Dr. DiPaoloa's job of trying to clean up the messes Dr. de Beer and Dr. Zwishenberger have created. I truly wish him luck because the COM could use it. Both the Price-Ganey survey and the emails I am receiving suggests that the exodus is not finished. Some have suggested that physicians, especially surgeons, are a dime a dozen. I would disagree, but in any case, identifying and recruiting quality replacements is both expensive and time consuming.

Finally, if what you say is true about Dr. Karpf, one would have to say that he is minimally inept at identifying quality leadership to implement his strategic plan. Although many leaders do this, I personally do not believe in blaming subordinates I hire for their ineptitudes. The next thing you know, they will try to blame the physicians participants for the horrendous scores on the Price-Ganey survey.

7/16/2016 01:59:46 pm

Finally something we can both agree on! Karpf is really quite good at healthcare “strategy” but in the process of operationalizing the strategy he surrounds himself with bozos, yes men and people who are playing him for their own advantage. Since Lofgren left the whole inner circle has got worse and worse. The current Cofield/Chang situation is a disaster. Moliterno isn’t a bad guy, he just got played by DeBeer into taking over medicine and putting even more of a squeeze on the faculty and now he has been hung out to dry. Debeer really went off the deep end when his henchman/consigliere Bob Means left for the prestigious position of Dean of East Tennessee State University College of Medicine. In fact, I can remember sitting in DeBeer’s office with him sputtering and red in the face and I then noticed Means sitting quietly in the corner, presumably so that they could deny anything that was said to me. Boluanger clearly had previous evidence of angry vindictive behavior. “Zwischen” means “between” in German from “zwei” which perfectly captures his two faced manipulative troublemaking persona. DiPaola probably took the job thinking he could run the whole thing (clearly he can’t) and is now in the position of having to wait and see who his new boss is (and if the boss wants to keep him as dean). Things will be quiet for the next few weeks but once the Karpf exit process enters the end game it will be interesting to see who is left standing. And to revisit an earlier post, there is absolutely no way that the EVPHA position hiring process will involve any sort of faculty consultation or involvement. This will be done by Eli, Karpf and the BOT. Few people will know who the pick is until the decision is made. But of course I will do my best to find out what I can and share it with you.

7/19/2016 12:03:37 pm

Been away from the computer for awhile, but thanks again for the update Mole Sauce. Things appear to be running pretty silent at present but keep monitoring the blog because you never know when a new crisis will arise.

Spoon Snake

7/20/2016 08:28:43 am

http://uknow.uky.edu/content/video-brent-seales-motivated-possibilities-seemingly-impossible-problems

"Seales has dedicated most of his career to uncovering treasures buried in old manuscripts and damaged materials."

If he wants a real challenge he could try using this technology to uncover the KMSF accounting records...

7/20/2016 10:00:29 am

Thanks for the comment Spoon. Hmmm, he might be good with buried records but I wonder how good he is with burned records?

7/22/2016 02:23:41 pm

I managed to get a look at the detailed faculty engagement survey results. No surprise that the (by far) lowest scoring department was...drum roll please....Surgery (with a mind boggling 3.11). Clearly there is an inverse correlation between department chair salary and faculty engagement. Zwischenberger needs to go.

7/22/2016 04:39:32 pm

Thanks Mole Sauce for this update.

Outsider

7/23/2016 12:01:15 pm

Just reading this latest blog post. I noticed not mentioned in the affidavit by Darrell Griffith is the item that KMSF also lent Joe Wyse, the director of Coldstream Labs, money to keep this operation going. Again, it is not a question of whether this was a good or bad decision, but rather the observation that this was done executively and was beyond the scope of what KMSF was established for. Just one more example of why establishing a company outside the jurisdiction of the university to secretly manage this isolated pot of university money is so wrong.

7/23/2016 12:08:41 pm

Thanks Outsider for this information and comment. I agree, KMSF and this billion dollar pot of university money being outside the jurisdiction of the university (or anyone but a few hospital executives for that matter) just begs for possible mismanagement and abuse.

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