Once again, for those new to this blog site, at present there are 28 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.
Well I thought it was significant enough to deserve a post. Included are Dr. Capilouto's announcement followed Dr. Karpf's eulogy.
Dear Colleagues and Students,
For the last two years, it's in a spirit of partnership and shared ambition for our University and a deep friendship that Dr. Karpf has talked with me about his leadership goals and his professional timeline. I knew his decision to retire was coming, but it does not make it any easier to accept. (Dr. Karpf's message to the UK HealthCare family is below.)
Many dream big. Few can turn a big dream into reality.
But when President Lee Todd recruited Dr. Mike Karpf nearly 15 years ago, they shared a goal for the Commonwealth. Their far-reaching and ambitious vision was the provision of quality care so that no Kentuckian would have to leave their own backyard for the best health care, no matter the seriousness of your illness, your walk of life, where you live, or your financial circumstance.
Today, the numbers – relentlessly driven by Mike Karpf’s compassion and vision – bear witness to our success.
During his tenure of 13 years:
But numbers only tell part of the story. They only paint a piece of the picture.
For Mike Karpf, these numbers can be gratifying, but he has never been satisfied. There has been – and still is – much work to do and so many to help and heal.
Dr. Mike Karpf understands, better than anyone, that behind each transfer to UKHC from hillside hamlet or small community, there were still so many patients who had to leave their communities and families and whose comfort and care would be lost in the distance between their home and Lexington.
Determined to keep loved ones and the sick as close together as possible, Dr. Mike Karpf grew partnerships with hospitals and physicians in 180 clinical locations across the state.
The Markey Cancer Center, the Gill Heart Institute, UK’s Comprehensive Stroke Center, and the Sanders-Brown Center on Aging today have a presence in communities across the Commonwealth through 88 affiliations with partner health care providers.
With tireless effort, Dr. Karpf partnered with the state’s providers to bring even better care to Kentucky’s neighborhoods.
I am convinced that UK HealthCare is the greatest success story in modern academic health center history.
This is not grandiosity. The numbers show it. The faces and stories behind those numbers paint an undeniable picture of progress, compassion, and care.
Through sheer determination and a brilliance to see far ahead into the future, and, more so, to prepare for it, Mike Karpf has authored a remarkable chapter in the history of UK HealthCare, the University of Kentucky, and the Commonwealth.
How did this happen?
So many of you have been with Mike along the way, providing support and assistance.
As always, it starts with talent and infrastructure.
To best care for Kentucky, Mike Karpf knew he needed even more of both.
Undaunted by the great recession, and with the support of President Todd and the Board of Trustees, UK HealthCare launched an ambitious capital plan, totally self-financed without any state funding, that today totals in excess of $1 billion.
To meet a rapidly escalating demand for care, the workforce of physicians, nurses, other professional caregivers, staff, and researchers grew from 5,539 to 11,640. The payroll from 2004 to 2016 tripled to nearly $1.05 billion. While never the purpose of this endeavor, one must not overlook the economic impact of the Mike-Karpf-era that produced thousands of construction jobs, new employment opportunities, and tens of millions of dollars in additional state and local taxes.
Mike Karpf grew UK HealthCare. He also helped grow Lexington and our region.
Up close, I had the pleasure and honor of watching Mike Karpf work his magic, and I grew to see the “how” that he sustained even when the road got bumpy. It is often said you can endure anything if the “why” – your purpose – is paramount.
This purpose is revealed to me in nearly every meeting with Mike Karpf as his cellphone never stops ringing with calls from every corner of the Commonwealth from someone in desperate need of care for themselves or a loved one.
At these frightening and vulnerable times, Mike Karpf heroically and invisibly, quietly and without fanfare, ensures that someone receives the care they need.
He’s done this thousands of times – because that’s who Mike Karpf is. Those are his values. That is how much he cares.
Recently, in a national meeting in Atlanta, I met a hard-working young Kentuckian just beginning to make her way into the world. She shared that in recent months, her mother, battling a terminal disease, had traveled on what could be a final trip to Florida. Unfortunately, she cascaded into an acute medical crisis.
After frustrating and unsuccessful attempts to get her mother home to Lexington, someone got her Mike Karpf’s cell phone number. Taking the call from someone he barely knew, he arranged transport and hospital care where someone very sick was soon surrounded by loved ones.
This is the measure of this man – in quiet and profound moments, the moments that matter most to those in need, patients and their families come first.
That is the Mike Karpf I know about – far removed from the well-deserved headlines and notice regarding buildings, growth, numbers, and revenues.
He cares. He is a healer. And we, as a university family and community, are better because of Mike Karpf’s presence with us.
I will have more to say in the coming days about the next steps in the leadership of UK HealthCare.
Eli Capilouto
President
Announcing my plans to step down at the end of the academic year
Next month I will complete my 13th year as Executive Vice President for Health Affairs (EVPHA) at the University of Kentucky. My original mandate was to revitalize the clinical enterprise incorporating both the hospital system and the College of Medicine. We have made considerable progress, and I feel that the original goals that we established have been achieved. We have built a strong foundation for UK HealthCare.
Consequently, I think it is time for an organized transition to a new leader who has boundless energy to address the challenges of a rapidly evolving health care system. My successor can, with carefully structured and thoughtful growth, continue to assure that UK HealthCare remains essential to the health care delivery system of the Commonwealth and beyond and thereby make it secure for the foreseeable future.
Where we’ve been together
In order to develop a common vision for UK HealthCare, we undertook four simultaneous, coordinated, planning processes – strategic, facilities, financial, and academic. After considerable debate about our clinical strategy, we concluded that on campus we must develop advanced subspecialty care programs comparable to those available at the nation’s very best referral, research-intensive academic medical centers. We wanted Kentuckians to feel assured they could be taken care of in Kentucky regardless of how severe or unusual their medical problems were. They should not have to worry about whether their insurance would allow them to leave the state for care.
We recruited outstanding physicians and aggressively built nationally competitive tertiary and quaternary programs that have grown dramatically both in volume and quality. Today, in my opinion, we truly are a comprehensive referral academic medical center comparable to the best in the country.
While focusing on advanced subspecialty care on campus, we also understood we needed to develop strong “win-win” relationships with appropriate community providers. We felt if we made these providers more secure by expanding and improving the services they offered, they would then consider referring patients beyond their capabilities to UK HealthCare. The culmination of these efforts has been the launching of the Kentucky Health Collaborative, 10 major systems in Kentucky comprising more than 50 hospitals working together to deliver value-based care – producing the best outcomes at the highest level of efficiency.
Our clinical strategy has been successful. We have almost doubled patient discharges for the hospital system over the last 13 years. Our outpatient activity has grown dramatically, now exceeding 1.5 million outpatient encounters per year.
More important, in 2003, we accommodated 1,000 transfers from other facilities; in 2016, we received over 18,000 transfers from other providers and because of capacity limits we are working to address, we still had to turn away a substantial number of patients. We have become the critical linchpin of the health care system of Kentucky, taking care of patients other providers cannot effectively manage. Consequently, we have become essential to the integrity of the health care delivery system of the entire Commonwealth and this essentiality is what offers us security through turbulent times.
From a facilities planning perspective, we recognized that we would need new capabilities to accommodate the complex patients being targeted. This led to a commitment to develop a replacement hospital, now known as Chandler Hospital Pavilion A. When we finish the projects covered by the $150 million bond issuance our Board of Trustees approved in June, Pavilion A will be more than 96 percent complete.
Although Pavilion A is as technologically advanced as any hospital in the country, it is also an exceptionally empathetic facility – comfortable and comforting for our patients, their families, visitors, and, just as important, for our faculty and staff. We will also have refurbished/repurposed four of the seven floors in Pavilion HA (Kentucky Children’s Hospital). Over the next 18 months we will finally have a state-of-the-art neonatal ICU (NICU) that appropriately supports a superb NICU staff and faculty. A new entryway into Kentucky Children’s Hospital will also allow us to develop critical support space for the families of pediatric patients.
I have very much enjoyed my involvement in the music and art programs, as well as the approaches to architecture and landscaping that make our facility a very special place. I am truly grateful for that experience.
Financially we have done very well. Over the last 13 years we have invested close to $2 billion for faculty recruitment, program development, technology acquisition, and bricks and mortar. Our bottom lines have been appropriately and necessarily strong. Our balance sheet continues in excellent shape. The next generation of leaders will have to continue to demand strong financial performances in order to generate the required resources necessary to invest in people, programs, technology, and facilities to sustain and continue our progress and success.
The College of Medicine has become substantially stronger and flourished as the clinical enterprise has expanded. Our training programs are in excellent shape and the research profile for the College of Medicine has improved and continues to improve. The fate and finances of the College of Medicine and the clinical enterprise are inextricably intertwined.
What lies ahead for UK HealthCare?
Much has been accomplished in the past 13 years, and we have built a strong foundation. However, much remains for the next generation of leaders to do. They must continue to enhance the quality of our subspecialty programs by ongoing recruitment of outstanding faculty and staff, supporting them with appropriate technology and facilities.
Future leaders will need to continue to strengthen relationships with our partners and mature the Kentucky Health Collaborative into an effective entity that can serve the Commonwealth and beyond to provide value-based care.
Most importantly, future leadership will need to anticipate and respond to a changing health care system. The push for value based reimbursement which demands the highest quality of care delivered at the most cost efficient will go unabated. Consequently, UK HealthCare must understand how it provides services today and how it needs to provide services in the future both on campus and in coordination with its partnering organizations and physicians.
UK HealthCare must be engaged in – and should lead – the change process to help develop a “rational system of care for Kentucky,” that addresses future reimbursement approaches. Therefore, developing systems for medical management that gather data and turn that data into meaningful information that can be used to change the clinical practices of providers, both on campus and in conjunction with our partners, will be the biggest challenge for future leaders.
Time for careful, thoughtful leadership transition
In my opinion, I have successfully completed my anticipated contributions to the University of Kentucky and UK HealthCare. Now it is time for a careful and thoughtful transition to new leadership. For the future, we need an EVPHA who relishes addressing the changes necessary to survive and thrive in the new world of health care on the horizon. I have informed President Capilouto that I would like to relinquish my responsibilities as EVPHA by the end of this academic year, or earlier, if a suitable replacement can be identified and in place.
These 13 years have been challenging but immensely rewarding to me personally. I respect the colleagues with whom I have worked, especially the faculty and staff in UK HealthCare and cherish the wonderful friends that Ellen and I have made here in Lexington. We have tried to be active in the community and we have been rewarded having been embraced by it. Consequently, we will be staying in Lexington, although spending more time in Wyoming and Los Angeles with family and friends.
I plan to transition to a part-time faculty position working on health service and health policy issues. I also hope to help strengthen health services research in all its aspects at the University, as it is important to the Commonwealth and country that we fully understand how the organization, finance, and delivery of care affects the health and well-being of our people.
I want to stay involved in the art, music and humanities program that makes UK HealthCare a very special place for all. I hope to be able to help develop the resources that can sustain these programs for the long haul. I also hope to be able to stay available to help make UK HealthCare accessible to the community, the Commonwealth and beyond.
I originally told Ellen that we would spend three to five years in Lexington to see if my ideas had any validity or practicality. Instead, we found a home for the duration and colleagues and friends for a lifetime.
With gratitude and great regard,
Michael Karpf, MD
Executive VP for Health Affairs
Well I thought it was significant enough to deserve a post. Included are Dr. Capilouto's announcement followed Dr. Karpf's eulogy.
Dear Colleagues and Students,
For the last two years, it's in a spirit of partnership and shared ambition for our University and a deep friendship that Dr. Karpf has talked with me about his leadership goals and his professional timeline. I knew his decision to retire was coming, but it does not make it any easier to accept. (Dr. Karpf's message to the UK HealthCare family is below.)
Many dream big. Few can turn a big dream into reality.
But when President Lee Todd recruited Dr. Mike Karpf nearly 15 years ago, they shared a goal for the Commonwealth. Their far-reaching and ambitious vision was the provision of quality care so that no Kentuckian would have to leave their own backyard for the best health care, no matter the seriousness of your illness, your walk of life, where you live, or your financial circumstance.
Today, the numbers – relentlessly driven by Mike Karpf’s compassion and vision – bear witness to our success.
During his tenure of 13 years:
- Discharges from the hospital doubled to 37,789, annually,
- Patient visits to our clinics grew to 1.5 million, annually,
- And transfer of patients from other hospitals for subspecialty care astoundingly grew from 1,000 to more than 18,000, annually.
But numbers only tell part of the story. They only paint a piece of the picture.
For Mike Karpf, these numbers can be gratifying, but he has never been satisfied. There has been – and still is – much work to do and so many to help and heal.
Dr. Mike Karpf understands, better than anyone, that behind each transfer to UKHC from hillside hamlet or small community, there were still so many patients who had to leave their communities and families and whose comfort and care would be lost in the distance between their home and Lexington.
Determined to keep loved ones and the sick as close together as possible, Dr. Mike Karpf grew partnerships with hospitals and physicians in 180 clinical locations across the state.
The Markey Cancer Center, the Gill Heart Institute, UK’s Comprehensive Stroke Center, and the Sanders-Brown Center on Aging today have a presence in communities across the Commonwealth through 88 affiliations with partner health care providers.
With tireless effort, Dr. Karpf partnered with the state’s providers to bring even better care to Kentucky’s neighborhoods.
I am convinced that UK HealthCare is the greatest success story in modern academic health center history.
This is not grandiosity. The numbers show it. The faces and stories behind those numbers paint an undeniable picture of progress, compassion, and care.
Through sheer determination and a brilliance to see far ahead into the future, and, more so, to prepare for it, Mike Karpf has authored a remarkable chapter in the history of UK HealthCare, the University of Kentucky, and the Commonwealth.
How did this happen?
So many of you have been with Mike along the way, providing support and assistance.
As always, it starts with talent and infrastructure.
To best care for Kentucky, Mike Karpf knew he needed even more of both.
Undaunted by the great recession, and with the support of President Todd and the Board of Trustees, UK HealthCare launched an ambitious capital plan, totally self-financed without any state funding, that today totals in excess of $1 billion.
To meet a rapidly escalating demand for care, the workforce of physicians, nurses, other professional caregivers, staff, and researchers grew from 5,539 to 11,640. The payroll from 2004 to 2016 tripled to nearly $1.05 billion. While never the purpose of this endeavor, one must not overlook the economic impact of the Mike-Karpf-era that produced thousands of construction jobs, new employment opportunities, and tens of millions of dollars in additional state and local taxes.
Mike Karpf grew UK HealthCare. He also helped grow Lexington and our region.
Up close, I had the pleasure and honor of watching Mike Karpf work his magic, and I grew to see the “how” that he sustained even when the road got bumpy. It is often said you can endure anything if the “why” – your purpose – is paramount.
This purpose is revealed to me in nearly every meeting with Mike Karpf as his cellphone never stops ringing with calls from every corner of the Commonwealth from someone in desperate need of care for themselves or a loved one.
At these frightening and vulnerable times, Mike Karpf heroically and invisibly, quietly and without fanfare, ensures that someone receives the care they need.
He’s done this thousands of times – because that’s who Mike Karpf is. Those are his values. That is how much he cares.
Recently, in a national meeting in Atlanta, I met a hard-working young Kentuckian just beginning to make her way into the world. She shared that in recent months, her mother, battling a terminal disease, had traveled on what could be a final trip to Florida. Unfortunately, she cascaded into an acute medical crisis.
After frustrating and unsuccessful attempts to get her mother home to Lexington, someone got her Mike Karpf’s cell phone number. Taking the call from someone he barely knew, he arranged transport and hospital care where someone very sick was soon surrounded by loved ones.
This is the measure of this man – in quiet and profound moments, the moments that matter most to those in need, patients and their families come first.
That is the Mike Karpf I know about – far removed from the well-deserved headlines and notice regarding buildings, growth, numbers, and revenues.
He cares. He is a healer. And we, as a university family and community, are better because of Mike Karpf’s presence with us.
I will have more to say in the coming days about the next steps in the leadership of UK HealthCare.
Eli Capilouto
President
Announcing my plans to step down at the end of the academic year
Next month I will complete my 13th year as Executive Vice President for Health Affairs (EVPHA) at the University of Kentucky. My original mandate was to revitalize the clinical enterprise incorporating both the hospital system and the College of Medicine. We have made considerable progress, and I feel that the original goals that we established have been achieved. We have built a strong foundation for UK HealthCare.
Consequently, I think it is time for an organized transition to a new leader who has boundless energy to address the challenges of a rapidly evolving health care system. My successor can, with carefully structured and thoughtful growth, continue to assure that UK HealthCare remains essential to the health care delivery system of the Commonwealth and beyond and thereby make it secure for the foreseeable future.
Where we’ve been together
In order to develop a common vision for UK HealthCare, we undertook four simultaneous, coordinated, planning processes – strategic, facilities, financial, and academic. After considerable debate about our clinical strategy, we concluded that on campus we must develop advanced subspecialty care programs comparable to those available at the nation’s very best referral, research-intensive academic medical centers. We wanted Kentuckians to feel assured they could be taken care of in Kentucky regardless of how severe or unusual their medical problems were. They should not have to worry about whether their insurance would allow them to leave the state for care.
We recruited outstanding physicians and aggressively built nationally competitive tertiary and quaternary programs that have grown dramatically both in volume and quality. Today, in my opinion, we truly are a comprehensive referral academic medical center comparable to the best in the country.
While focusing on advanced subspecialty care on campus, we also understood we needed to develop strong “win-win” relationships with appropriate community providers. We felt if we made these providers more secure by expanding and improving the services they offered, they would then consider referring patients beyond their capabilities to UK HealthCare. The culmination of these efforts has been the launching of the Kentucky Health Collaborative, 10 major systems in Kentucky comprising more than 50 hospitals working together to deliver value-based care – producing the best outcomes at the highest level of efficiency.
Our clinical strategy has been successful. We have almost doubled patient discharges for the hospital system over the last 13 years. Our outpatient activity has grown dramatically, now exceeding 1.5 million outpatient encounters per year.
More important, in 2003, we accommodated 1,000 transfers from other facilities; in 2016, we received over 18,000 transfers from other providers and because of capacity limits we are working to address, we still had to turn away a substantial number of patients. We have become the critical linchpin of the health care system of Kentucky, taking care of patients other providers cannot effectively manage. Consequently, we have become essential to the integrity of the health care delivery system of the entire Commonwealth and this essentiality is what offers us security through turbulent times.
From a facilities planning perspective, we recognized that we would need new capabilities to accommodate the complex patients being targeted. This led to a commitment to develop a replacement hospital, now known as Chandler Hospital Pavilion A. When we finish the projects covered by the $150 million bond issuance our Board of Trustees approved in June, Pavilion A will be more than 96 percent complete.
Although Pavilion A is as technologically advanced as any hospital in the country, it is also an exceptionally empathetic facility – comfortable and comforting for our patients, their families, visitors, and, just as important, for our faculty and staff. We will also have refurbished/repurposed four of the seven floors in Pavilion HA (Kentucky Children’s Hospital). Over the next 18 months we will finally have a state-of-the-art neonatal ICU (NICU) that appropriately supports a superb NICU staff and faculty. A new entryway into Kentucky Children’s Hospital will also allow us to develop critical support space for the families of pediatric patients.
I have very much enjoyed my involvement in the music and art programs, as well as the approaches to architecture and landscaping that make our facility a very special place. I am truly grateful for that experience.
Financially we have done very well. Over the last 13 years we have invested close to $2 billion for faculty recruitment, program development, technology acquisition, and bricks and mortar. Our bottom lines have been appropriately and necessarily strong. Our balance sheet continues in excellent shape. The next generation of leaders will have to continue to demand strong financial performances in order to generate the required resources necessary to invest in people, programs, technology, and facilities to sustain and continue our progress and success.
The College of Medicine has become substantially stronger and flourished as the clinical enterprise has expanded. Our training programs are in excellent shape and the research profile for the College of Medicine has improved and continues to improve. The fate and finances of the College of Medicine and the clinical enterprise are inextricably intertwined.
What lies ahead for UK HealthCare?
Much has been accomplished in the past 13 years, and we have built a strong foundation. However, much remains for the next generation of leaders to do. They must continue to enhance the quality of our subspecialty programs by ongoing recruitment of outstanding faculty and staff, supporting them with appropriate technology and facilities.
Future leaders will need to continue to strengthen relationships with our partners and mature the Kentucky Health Collaborative into an effective entity that can serve the Commonwealth and beyond to provide value-based care.
Most importantly, future leadership will need to anticipate and respond to a changing health care system. The push for value based reimbursement which demands the highest quality of care delivered at the most cost efficient will go unabated. Consequently, UK HealthCare must understand how it provides services today and how it needs to provide services in the future both on campus and in coordination with its partnering organizations and physicians.
UK HealthCare must be engaged in – and should lead – the change process to help develop a “rational system of care for Kentucky,” that addresses future reimbursement approaches. Therefore, developing systems for medical management that gather data and turn that data into meaningful information that can be used to change the clinical practices of providers, both on campus and in conjunction with our partners, will be the biggest challenge for future leaders.
Time for careful, thoughtful leadership transition
In my opinion, I have successfully completed my anticipated contributions to the University of Kentucky and UK HealthCare. Now it is time for a careful and thoughtful transition to new leadership. For the future, we need an EVPHA who relishes addressing the changes necessary to survive and thrive in the new world of health care on the horizon. I have informed President Capilouto that I would like to relinquish my responsibilities as EVPHA by the end of this academic year, or earlier, if a suitable replacement can be identified and in place.
These 13 years have been challenging but immensely rewarding to me personally. I respect the colleagues with whom I have worked, especially the faculty and staff in UK HealthCare and cherish the wonderful friends that Ellen and I have made here in Lexington. We have tried to be active in the community and we have been rewarded having been embraced by it. Consequently, we will be staying in Lexington, although spending more time in Wyoming and Los Angeles with family and friends.
I plan to transition to a part-time faculty position working on health service and health policy issues. I also hope to help strengthen health services research in all its aspects at the University, as it is important to the Commonwealth and country that we fully understand how the organization, finance, and delivery of care affects the health and well-being of our people.
I want to stay involved in the art, music and humanities program that makes UK HealthCare a very special place for all. I hope to be able to help develop the resources that can sustain these programs for the long haul. I also hope to be able to stay available to help make UK HealthCare accessible to the community, the Commonwealth and beyond.
I originally told Ellen that we would spend three to five years in Lexington to see if my ideas had any validity or practicality. Instead, we found a home for the duration and colleagues and friends for a lifetime.
With gratitude and great regard,
Michael Karpf, MD
Executive VP for Health Affairs