Saturday, October 25, 2014.

October 22, 2012

The Trip Casscells Documentary

Last week, Houston lost one of its remarkable citizens -- S. Ward "Trip" Casscells -- to prostrate cancer at the age of 60. Dr. Casscells was a renowned cardiologist at the University of Texas Health Science Center in the Texas Medical Center who spent the final ten years of his life battling prostrate cancer while serving his country in a variety of important roles. The video below provides a glimpse of his incredible story. We in Houston are blessed to have known Trip. He will be missed.

S. Ward "Trip" Casscells Documentary from PCF on Vimeo.

Posted by Tom at 12:00 AM | Comments (0) |

September 7, 2012

Speeding Drugs to Market

Lynda Chin of M.D. Anderson's Department of Genomic Medicine.

Posted by Tom at 12:00 AM | Comments (0) |

August 9, 2012

Unaccountable

"Unaccountable" Book Trailer from Bloomsbury Press New Releases on Vimeo.

Posted by Tom at 12:00 AM | Comments (0) |

March 8, 2010

Making good on Baylor Med’s bad bet

27937 The Chronicle’s Todd Ackerman and Loren Steffy did a good job in this weekend article of chronicling the series of bad bets that Baylor College of Medicine’s Board of Trustee’s made in the wake of the school’s unfortunate 2004 divorce from The Methodist Hospital. Baylor Med’s travails have been a regular topic on this blog, most recently here.

The elephant in the parlor of Baylor' Med’s financial problems is the $600 million in bond debt that Baylor Med incurred in connection with its currently mothballed hospital project. Indeed, the difference between the total bond debt and the value of the underlying collateral would gobble up a large chunk of Baylor’s endowment, which is currently a tad under a billion dollars. That was enough to scare off Rice University, although I question whether that was the right long-term decision for Rice.

So, the future is bit cloudy for Baylor. But what I’m wondering is whether there is a local partnership that could bail Baylor out of most of current problems while providing an essential benefit for the Houston community?

The last time I look into the issue, estimates in the Houston metro area has one of the largest percentages of uninsured residents in the U.S. (over 30% versus a national average of about 16%). The Harris County Hospital District ultimately ends up with the issues involved with financing indigent care as well as ensuring that adequate medical facilities exist for local citizens.

Given the HCHD’s projected need for facilities to keep up with the growth of the Houston area, it makes sense for the HCHD to engage Baylor in discussions over a partnership in which HCHD would make an investment in the hospital in return for Baylor’s agreement to staff the institution as its primary teaching facility.

Baylor and the HCHD already work closely in connection with the staffing of the Ben Taub Hospital trauma unit in the Texas Medical Center. A pure teaching hospital for Baylor would provide a quasi-public, low-cost alternative to the Med Center’s impressive but expensive array of private hospitals.

Sure, the details would have to be worked out, such as management of the facility. But doesn’t such an investment by the county make sense, particularly when compared to ones such as this?

Posted by Tom at 12:01 AM | Comments (2) |

January 19, 2010

Did Rice blow it?

RiceU_BaylorCollegeMedicine So, Rice University last week finally decided to pass on the proposed merger with Baylor College of Medicine.

In theory, the deal makes sense. Both are top-notch academic institutions with campuses within a stone’s throw of each other. Each institution would have given the other something that it needs. Baylor would have gotten the financial support of Rice’s multi-billion dollar endowment, while Rice would have landed a strong scientific research and clinical care center in one of the nation’s leading medical institutions, the Texas Medical Center.

Although Rice President David Leebron supported the merger, large segments of the Rice faculty and alumni opposed the deal, primarily on financial and cultural grounds. Indeed, my sense is that Leebron quit pushing the Rice Board of Trustees to approve the deal when it became apparent that a consensus of Rice constituencies were opposed to the marriage.

And Baylor clearly finds itself in precarious financial condition, not completely of its own doing. After its 54-year teaching hospital relationship with Methodist Hospital soured in 2004, and a subsequent deal with St. Luke’s Episcopal Hospital did not work out, BCM decided on a plan to go it alone and build its own teaching hospital.

However, the ambitious deal has been pretty much a disaster from the start. After floating almost $900 million in bonds to finance construction of the hospital, Baylor announced last year that it was temporarily suspending construction of the hospital’s interior as it works through its financial problems.

Meanwhile, BCM has lost over $300 million since the split with Methodist. Inasmuch as Baylor’s endowment is less than a billion, those kinds of losses have placed BCM’s financial condition at risk. Already in in technical default on multiple bond covenants, BCM is now facing the prospect of hiring a bondholder-required “chief implementation officer” to oversee an overall financial reorganization. That would have been avoided if the Rice merger had succeeded.

Thus, Rice certainly had understandable reasons for passing on the deal.

Nevertheless, I wonder – did Rice make the right decision?

Despite its financial woes, BCM remains one of the elite medical and research institutions in the U.S. The merger would have undoubtedly brought a substantial increase in research funds in such fields as bioengineering, neurobiology, nano-biotechnology, stem cell biology and gene therapy. Although Rice would have been subsidizing BCM’s financial problems in the short term, my sense is that the increase in research resources flowing to Rice over the years would ultimately make that bailout well worth it.

But even more importantly, Rice passed on an opportunity to take a calculated risk that could well have elevated Rice, BCM, the Texas Medical Center and Houston to the forefront of medical and scientific research in the world.

Despite the risks, that kind of upside doesn’t come around very often. Failing to realize that is one of the key reasons why Texas has lagged badly behind states such as California and New York in the development of Tier 1 research institutions and all the benefits that such institutions provide to the state and its communities.

Thus, Rice is keeping its chips and betting that it can develop its scientific research just fine without BCM. But if I were to place a bet on which institution is closer to the cutting edge of such research after the next 25 years, I’m still putting my chips on Baylor.

Posted by Tom at 12:01 AM | Comments (4) |

June 8, 2009

A productive idea for the Dome

astrodome Over the weekend, the Chronicle ran this story about Harris County officials considering an idea to convert the Astrodome into a planetarium and a medical and science education facility. It's actually a good idea and one that was suggested here months ago. Given the Dome's proximity to the Texas Medical Center, a county/med center partnership to turn the Dome into the premiere medical/science educational facility in the world makes a lot of sense.

On the other hand, the financing of such a project is not going to be easy, particularly in this economic climate. Nevertheless, given the potential benefit to Houston of becoming a leader in medical/science education, hopefully county officials will give this proposal a fair shake. It certainly makes far more sense than the alternative proposal.

Common sense aside, everyone needs to realize that this new proposal could effectively be scuttled by the financial commitments that have already been made in connection with Houston's previous poor public financing choices. That risk reminds us that such poor utilization of resources ultimately has consequences. It could a harsh irony if Houston's most well-known landmark is a victim of those bad choices.

Posted by Tom at 12:01 AM | Comments (0) |

October 30, 2008

A good idea, but . . .

New Picture The Chron's top-notch Medical Center reporter Todd Ackerman reported yesterday that two venerable Houston academic -- Baylor College of Medicine and Rice University -- are in preliminary discussions regarding a possible merger (the Chron's excellent Science reporter Eric Berger also comments here).

This makes sense on many levels. Baylor and Rice are located near each other in the Medical Center area, so sharing faculty members between the two institutions would be a snap from a logistics standpoint. Indeed, the attraction of being able to teach and research at both institutions would be a valuable perk for both schools to attract talented teachers and students. Both schools have excellent academic reputations, so it's a good match from that standpoint, too.

But Ackerman zeroes in on the main problem with the merger. As usual, it involves money:

Rice is the more affluent of the two institutions. As of June 30, its endowment was $4.6 billion. As of Sept. 30, Baylor's was $954 million. [.  .  .]

One Rice professor said the key issue from the university's perspective will be making sure there's a firewall between Rice's endowment and Baylor's.

A "firewall" between the two institutions endowments? Come on, one of the main reasons why the merger makes sense is that Baylor would have access to Rice's superior capital. The benefit from Rice's standpoint is the association with a fine medical school that, with access to a better-capitalized endowment, may well propel itself into the best medical school in the country. That is precisely the type of academic excellence that Rice should be pursuing.

Which reminds me of a conversation that I had years ago with a member of the University of Houston Board of Regents. Given the need of Houston and Texas for more Tier 1 research institutions, I observed to this UH regent that I thought it was a good idea for the UH system to merge with the Texas A&M University System.

One one hand, the merger makes sense from UH's standpoint because it would provide the chronically-undercapitalized UH (endowment about $750 million or so) with access to capital (A&M's endowment is between $6-7 billion) that is the biggest obstacle in UH's path to Tier 1 status.

On the other hand, the merger makes sense from A&M's standpoint because UH would provide A&M with the urban presence that it has always lacked and UH's central campus in Houston that A&M could use as a carrot for attracting better teachers and students. Moreover, A&M for years has desired a law school and UH would deliver a very good one.

So, I asked the UH regent, such a merger makes sense, doesn't it?

The UH regent proceeded to give me a half-dozen reasons why the proposed merger would never work, most of which were tied to the fact that he would no longer be a member of an independent university system board if such a merger were consummated.

That is precisely the attitude that has placed Texas behind states such as California and New York in the development of Tier 1 research institutions and all the benefits that such universities provide to the state and its communities. Here's hoping that similar attitudes don't scuttle what appears to be a very good idea for Rice, Baylor and Houston.

Posted by Tom at 12:01 AM | Comments (0) |

August 16, 2008

Dr. Ralph Feigen, R.I.P.

Dr. Feigin In this recent post on the death of Michael DeBakey, I noted that a substantial part of Dr. DeBakey's legacy was his involvement in the massive importation of talented medical professionals to Houston over the past 60 years. That talent transformed the Texas Medical Center from a sleepy regional medical center into one of the largest and most dynamic medical centers in the world.

Dr. Ralph Feigen, who died at the age of 70 on Thursday,epitomizes the doctors who have been at the center of that transformation.

Drawn to Texas Children's Hospital and Baylor College of Medicine at the age of 40 in 1977, Dr. Feigen spent the rest of his life in Houston cultivating a culture of excellence in research and patient care that turned Texas Children's into one of the largest and best pediatric hospitals in the world. Dr. Feigen was an excellent teacher, superb clinician and a highly-regarded researcher, but his personal warmth for his patients is what thousands of parents and their children will remember most about this fine man. A large part of Dr. Feigen's legacy is that Texas Children's -- despite its enormous growth over the past 30 years -- still reflects the comfortable warmth of its long-time leader.

Todd Ackerman, the Chronicle's fine medical reporter, summarizes Dr. Feigen's enormous impact well (the NY Times obituary is here):

Feigin, considered by many the most important pediatrician of the past 25 years, died Thursday. [.  .  .]

Feigin transformed Baylor pediatrics from a small, poorly funded department into the nation's biggest, made Texas Children's Hospital one of the nation's elite children's hospitals and trained an amazing roster of doctors, including almost half of Harris County's current population of pediatricians and many academic leaders nationally.

He also was known for research that contributed to the better understanding and treatment of pediatric disease, as the author of textbooks that changed the care of children worldwide and as a tireless advocate who never missed a chance to take up the cause of children's health.

Colleagues described him as unfailingly cheerful and energetic, even after the lung cancer struck. Diagnosed with the disease in late 2007, he continued as Baylor's chairman of pediatrics and Texas Children's physician-in-chief while in treatment. In May, he announced he would step down but attributed the decision to a plan he had made at 65 to stop his administrative duties at 70. [.  .  .]

In all, Feigin trained more than 2,000 pediatricians and pediatric specialists. Of those, two went on to become medical school deans, 22 became associate medical school deans, 10 became pediatric department chairmen and 180 became section heads of pediatrics.

Feigin came to Houston in 1977, a time when neither Baylor pediatrics nor Texas Children's were players of any significance. In 30 years, Baylor's pediatric faculty grew from less than 40 to more than 500, and pediatric's federal research funding became the most in the country, nearly $100 million. Texas Children's created and developed several of the nation's most respected clinical centers, and its patient load skyrocketed.

In addition to his pediatric administrative and clinical duties, Feigin served as president of Baylor from 1996 to 2003 and as interim CEO of Texas Children's from 1987 to 1989.

Despite the administrative roles, Feigin remained focused on children's health. He pushed for the state to extend the Children's Health Insurance Program to the maximum number of children and Medicaid to the maximum number of indigent mothers. He and his colleagues were at the forefront whenever there was an infectious disease outbreak, giving shots to kids and urging people to exercise caution.

He was considered such a great diagnostician that twice a week residents would gather to seek his help on their most baffling cases at "stump Feigin" sessions.

Without books or computers, Feigin would reel off myriad possible causes, then describe what he'd do to arrive at a diagnosis as quickly as possible. The performance left the residents awed.

We often get sidetracked as to what bells and whistles will supposedly make Houston better, but it's people such as Ralph Feigen who truly make Houston such a special place to live.

Posted by Tom at 12:01 AM | Comments (0) |

July 13, 2008

Dr. Michael DeBakey, R.I.P.

Debakey071208 Dr. Michael DeBakey (previous posts here) died late Friday at the age of 99. One of the most influential men in Houston's history, Dr. DeBakey was the world-famous cardiovascular surgeon who researched, developed and initially implemented not only a variety of devices that help heart patients, but also such now-common surgical procedures as heart-bypass surgery. Two of the Chronicle's finest reporters -- Science reporter Eric Berger and Texas Medical Center reporter Todd Ackerman -- provide this outstanding article on Dr. DeBakey's remarkable life, and Eric provides an audio file of his 2005 interview of Dr. DeBakey here. The New York Times' article on Dr. DeBakey's death is here.

As with my late father, Dr. DeBakey was one of the leaders of a talented generation of post-World War II doctors who embraced the optimistic view of therapeutic intervention in the practice of medicine, which was a fundamental change from the sense of therapeutic powerlessness that was widely taught to doctors by their pre-WWII professors. As noted earlier here and here, that seismic shift in medicine has changed the course of human history.

But the tremendous impact that Dr. DeBakey had on medicine is exceeded by the massive effect that he had on Houston. When Dr. DeBakey accepted the president's position at Baylor College of Medicine a few years after the end of World War II, the Texas Medical Center was a sleepy regional medical center. Over the next two decades, Dr. DeBakey was one of the key leaders who transformed the Medical Center into one of the largest and best medical centers in the world. Dr. DeBakey was the catalyst who established the culture within the Texas Medical Center of cutting-edge research, productive competition but also widespread collaboration, quality care for patients and good, old-fashioned hard work that attracted the best and brightest physicians, teachers and students from around the world to the Medical Center.

This massive importation of intellectual capital over the last 60 years of Dr. DeBakey's life generated enormous wealth and benefits for Houston. Today, the medical facilities of the Texas Medical Center are the largest aggregate provider of jobs in the Houston area, even greater than the local jobs provided by the energy industry.

That's quite a legacy in my book.

Posted by Tom at 12:01 AM | Comments (0) |

December 19, 2007

The remarkable story of Kevin Everett

Kevin_everett.jpgThree months ago, Kevin Everett, a tight end for the Buffalo Bills who was born and raised in Port Arthur just east of Houston, suffered a serious spinal cord injury during an NFL game. At the time of the injury, there was grave doubt whether Everett would ever walk again.

As this Sports Illustrated article recounts, Everett's recovery from his serious injury has been nothing short of amazing. One of the interesting aspects of Everett's recovery is that it may have been fueled by the gutsy call of a 45 year-old orthopedic surgeon on the scene in Buffalo, but it was certainly facilitated by the remarkable rehabilitation services of the Texas Medical Center's Institute for Rehabilitation and Research (known as "TIRR") and the inspiring resolve of the 25 year old patient. TIRR is regularly ranked as one of the finest rehabilitation institutions in the U.S. and is one of the many reasons that Houston is among the world's finest medical centers.

Posted by Tom at 12:30 AM | Comments (0) |

November 28, 2007

The NY Times on the DeBakey-Cooley rapprochement

DeBakey%20and%20Cooley%20112807.jpgFollowing on this earlier post about Todd Ackerman's fine piece on the rapprochement between longtime Texas Medical Center rivals, Dr. Michael DeBakey and Dr. Denton Cooley, this New York Times article examines the history of the feud and the recent reconciliation.

The article passes along the following famous anecdote from the investigation into Dr. Cooley's use of an artificial heart back in the early 1960's without proper authorization:

Dr. Cooley recalled that a lawyer had once asked him during a trial if he considered himself the best heart surgeon in the world.

“Yes,” he replied.

“Don’t you think that’s being rather immodest?” the lawyer asked.

“Perhaps,” Dr. Cooley responded. “But remember I’m under oath.”

Read the entire article.

Posted by Tom at 12:05 AM | Comments (0) |

November 26, 2007

A Texas Medical Center giant

feigin.jpgThis Alexis Grant/Chronicle Q&A column interviews one of the truly outstanding physicians who has made the Texas Medical Center one of the most extraordinary medical centers in the world -- Dr. Ralph Feigin of Texas Children's Hospital. Take a moment to review Dr. Feigin's remarkable biography and the interview, and then take a moment to appreciate this man's tremendous contribution to pediatric medicine in Houston over the past 30 years. It's a legacy that will not soon be matched.


Posted by Tom at 12:00 AM | Comments (0) |

November 8, 2007

The DeBakey-Cooley rapprochement

DeBakey%20and%20Cooley.jpgThe longtime feud and resulting intense competition between Houston cardiovascular surgeons Michael DeBakey and Denton Cooley was a part of what catapulted Houston's Texas Medical Center into the upper tier of the world's great medical centers over the past 40 years.

Now, the Chronicle's fine Texas Medical Center reporter, Todd Ackerman, reports in this article that the DeBakey-Cooley rift is no more:

It's considered one of medicine's best-known feuds: two brilliant and egotistical doctors on the frontiers of cardiovascular surgery, whose falling-out divided a community and became the stuff of legend.

Immortalized in a Life magazine cover story, the rift persisted for decades. Although the competition spurred them to achievements that transformed the Texas Medical Center into the world's heart treatment center, the former collaborators avoided each other and barely spoke.

But recently, Michael DeBakey and Denton Cooley buried the hatchet.

"I'm glad the rivalry may have passed by," Cooley said on Oct. 27, presenting DeBakey with a lifetime achievement award at a meeting of Cooley's Cardiovascular Surgical Society. "I hope this is not just a temporary truce or cease-fire (but) ... a permanent treaty between us."

DeBakey, 99, responded that he was glad to be there for two reasons: "One is, I'm alive. And the other, of course, is to get this award. Denton, I am really touched by it."

Read the entire article.

Posted by Tom at 12:05 AM | Comments (1) |

August 18, 2007

A job well done

heart%20attack.jpgUniversity of Houston student-athlete and football player Jerrod Butler was stricken by sudden cardiac arrest on Monday during a weightlifting session at the University of Houston. Butler passed out and stopped breathing.

Members of the UH athletic training staff, led by Mike O'Shea and John Houston, immediately revived Butler, performing CPR and using an automatic external defibrillator. Butler was then rushed the short drive to the Methodist Hospital emergency room at the Texas Medical Center, where he was put on a ventilator and placed in the intensive care unit.

On Thursday, Butler was moved out of the ICU and into a regular room.

It's easy in our busy lives to take professionals such as O'Shea and Houston for granted, but they are the type of dedicated people who make Houston such a special place to live. A tip of the hat to these two fine professionals on a job well done.

Posted by Tom at 12:00 AM | Comments (0) |

June 5, 2007

Texas' medical licensing logjam

texas_doctors_comp.jpgThe number of insurance companies offering medical malpractice insurance policies has dramatically increased and malpractice insurance premiums have substantially decreased since the 2003 legislation enacting medical malpractice caps in Texas, but the med mal caps have contributed to at least one unanticipated problem:

. . . about 2,250 license applications await processing at the Texas Medical Board in Austin. The wait could be as long as a year for some of the more experienced doctors because it takes longer to review their records.

The fear is that some doctors will give up on Texas and go elsewhere instead of waiting. A $1.22 million emergency funding request was approved during the last days of Texas legislative session for the Texas Medical Board, which licenses physicians. That is on top of the $18.3 million regular biennial appropriation, said Jane McFarland, the board's chief of staff.

The board plans to add nine new employees to its 139-member staff, seven of which will help chop away at the backlog of license applications.

Posted by Tom at 4:05 AM | Comments (0) |

May 8, 2007

Dr. Don W. Chapman, R.I.P.

Don%20Chapman.jpgLongtime Houstonian Dr. Don W. Chapman died last Thursday at the age of 90 (a Chronicle article is here). With Don's passing, Houston has lost one of the extraordinary group of doctors who catapulted Houston's Texas Medical Center into one of the premier medical centers in the world. I had the privilege of getting to know Dr. Chapman and his loving wife of 60 years (!), Mary Lou, through my father and mother, who were lifelong friends of the Chapmans.

As with my father, Don was a member of the groundbreaking generation of post-World War II doctors who embraced the optimistic view of therapeutic intervention in the practice of medicine, which was a fundamental change from the sense of therapeutic powerlessness that was widely taught to doctors prior to the post-WWII medical professors such as Don Chapman and Walter Kirkendall. We all take therapeutic intervention in medicine so much for granted these days that it is easy to overlook just how revolutionary this change was in the way medicine had been dispensed for decades and even centuries before Don and Walter's special generation of teachers and researchers.

Don and my father completed their medical residencies together at the University of Iowa Medical School just in time for WWII. Don served in the war with great distinction as a Major in the Medical Corps of the U. S. Army and as the primary Cardiac Consultant for the European Theater while stationed at the 5th General Hospital and later the 98th General Hospital. Upon returning from the war, Don went on the faculty of Baylor College of Medicine and was one of the original ten Baylor faculty members who moved to Houston when Baylor moved to the Texas Medical Center location in 1944. Don and and the other Baylor faculty members at the time began operating in a fledging medical center that consisted of the new medical school and one 234-bed hospital.

Within two years of arriving in Houston, Don introduced cardiac catheterization to the Medical Center, which allowed Baylor faculty members and Methodist Hospital physicians to offer precise cardiovascular diagnosis and groundbreaking heart disease intervention for the first time. Under Don's leadership, the Medical Center quickly became a pioneer in cardiovascular diagnostics and surgery as Don pioneered the use of a mechanical pump to circulate blood during open heart surgery, participated in one of the first coronary bypass operations in a Houston hospital and was a member of the team that researched and developed the initial mechanical heart implants. For good measure, Don in 1955 was one of the founding partners in Houston Cardiovascular Associates, which grew into one of the best cadiology private practices in Houston.

As director of Baylor's Section of International Medicine, Don also became a leader in promoting cardiology education around the world by starting a program at Baylor that sends students to teaching centers around the world. Don served as a visiting professor and conducted seminars in numerous countries, including China, Columbia, Germany, South Africa, Guatemala, Switzerland, and Turkey. Not coincidentally, Texas Medical Center institutions now serve over 10,000 international patients annually.

Don was also a prolific researcher, authoring and contributing to more than 100 publications of medical literature. He received many professional honors, but the ones that he treasured the most were the ones he received for teaching, such as the Baylor Distinguished Faculty Award in 1978, 1981 and 1993 and the Outstanding Teacher Awards that he received from Baylor students in 1958 and 1962. In 1992, the Cain Foundation honored Don with the endowment of the Don W. Chapman, M.D. Chair of Cardiology at Baylor and, in 1993, the University of Iowa honored Don with that institution's Distinguished Alumni Award.

Don's contributions to Houston and the Medical Center were enormous. Today, 63 years after Don's arrival in Houston, the Texas Medical Center is comprised of over 45 institutions (including 11 educational institutions and 15 hospitals and specialized patient care centers) that contain 6,500 patient beds and employ 75,000 people. Not only is the Medical Center now the largest employment center in Houston, Baylor College of Medicine is now widely acknowledged to be one of the best medical schools in the country.

How's that for a professional legacy?

But Don's remarkable professional accomplishments don't provide the full measure of this man, who was a genuinely kind and warm human being. When my father at the age of 55 decided with my mother to move our large family (10 children!) to Houston from Iowa City at the beginning of 1972, Don and Mary Lou Chapman graciously welcomed us to Houston and took an active interest in the unwieldly Kirkendall clan. Don took a particular interest in me while I was a wayward undergraduate student in the early 1970's and kept up with me as I worked my way through law school and became a part of the Houston legal community. I will never forget the wonderful impression that this successful man made on me in taking the time to express his genuine interest in what I was doing in my career. I was particularly touched by his phone call to me after my father's sudden death in 1992 in which he told me how the eulogy that I delivered at the funeral had moved him to tears and how much he was going to miss his lifelong friend and colleague.

The memorial service for Don will be at 2:00 p.m. today in the sanctuary of the First Presbyterian Church, 5300 Main Street, in Houston's Museum District just north of the Texas Medical Center. Immediately following the service, the family will receive friends during a reception in the church's Fellowship Hall. In lieu of usual remembrances, contributions in memory of Don may be directed to the Memorial Garden, First Presbyterian Church, 5300 Main St., Houston, TX, 77004 or to Methodist Hospital Foundation Cardiology Department Research, 6565 Fannin St., Houston, TX, 77030.

Posted by Tom at 4:30 AM | Comments (0) |

May 3, 2007

Changing history

Debakey050307.jpgThe NY Times' medical reporter, Lawrence Altman, M.D., tells the story of how Houston's famed heart surgeon Michael E. DeBakey changed the course of history by persuading the late Boris Yeltsin that he could survive heart bypass surgery after the Russian president had suffered a heart attack in the fall of 1996. The surgery saved Yeltsin's life and allowed him to live for another decade.

Of course, there are some who would argue that Dr. DeBakey efforts did not change history for the better.

Posted by Tom at 4:10 AM | Comments (0) |

January 25, 2007

Thinking beyond the UH Medical School

TMC-arial.gifBlogHouston.net's Kevin Whited notes this Chronicle/Todd Ackerman article about the University of Houston floating a proposed new Texas Medical Center-based medical school in a collaborative project with The Methodist Hospital and Cornell University's Weill Medical School.

Unfortunately for UH, the proposal has zilch chance of floating for much more than a few minutes amidst the shark-infested waters of Texas educational politics. Heck, the political forces in Texas cannot even agree to provide adequate funding of UH's uncriticizable goal of becoming the state's third tier I research university. The University of Texas, Texas A&M University, and Baylor College of Medicine -- Methodist's former longtime partner -- are just a few of the powerful political forces that would almost certainly line up against the UH-Methodist proposal.

Yet, the UH-Methodist proposal has merit, so here's a proposed modification. Rather than start another medical school from scratch, let's merge the University of Houston system with the Texas A&M system and have A&M expand its fledgling medical school into the Texas Medical Center from its current central Texas outpost. From a broader standpoint, the merger makes sense because it gives the A&M system something that it desperately needs -- a major urban presence -- while also giving UH something that it has always lacked -- that is, access to adequate endowed capital. Such a merger would also provide A&M with the law school that it has always coveted and would greatly facilitate UH's elevation into a tier I research institution, which is something that would substantially benefit the Houston area.

While the University of Texas would almost certainly oppose such a merger, perhaps a deal could be struck at the same time to merge the Texas Tech University system into the UT system while organizing the remainder of Texas' non-affiliated public universities into a third university system for funding and administrative purposes. Such a structure would give Texas a similar structure to that of the reasonably successful California model, which has generated far more first rate, tier I research universities (10) than the current dysfunctional Texas system (2). Indeed, almost anything would be a huge improvement over the current Texas system, which allocates a disproportionate amount of endowed capital to the UT and A&M systems while starving the remainder of Texas' public universities.

Make sense? You bet. Chances of happening? Probably not much. But just as UCLA and Cal-Berkeley co-exist productively in the same university system in California, UH and A&M could do the same in Texas. And just as two major university systems work side-by-side together to educate Californians, a similar structure would be a substantial improvement in the educational system of Texas.

Posted by Tom at 4:54 AM | Comments (1) |

December 30, 2006

Reacting to the DeBakey surgery story

heart surgery.jpgThe reactions to last weekend's fascinating story about the surgery to repair a dissecting aortic aneurysm in 97-year old Medical Center icon, Dr. Michael DeBakey, are as interesting as the story itself. The following are a few comments selected from letters to the NY Times regarding the story:

"Dr. Michael E. DeBakey’s surgery may have been a technical advance of heroic and dramatic proportions, but it was a setback for patients’ rights. Dr. DeBakey is the epitome of the informed patient, and a document evidently existed that said he did not want surgery for his disease.

Progressing into a coma as one dies is a normal part of the terminal stages of many illnesses. Directives exist to prevent such an incapacitated patient from becoming a victim of the grieving spouse or the frightened caregiver.

Because of Dr. DeBakey’s stature and publicity about his case, this surgery may decrease patients’ right to die in a manner they desire, an unfortunate result of a remarkable feat."

"Your article about Dr. Michael E. DeBakey’s aortic aneurysm operation was described as emblematic of the difficulties of end-of-life care, but it is as much or more emblematic of the difficulty patients encounter in having their wishes to forgo treatment respected. No one in the world had better capacity to refuse this operation than Dr. DeBakey, and he did.

. . .After the world’s best medical care, months in the hospital and a million dollars, Dr. DeBakey and his family had a happy outcome.

But for those thousands of ordinary patients who must struggle against family, church and state to refuse invasive, risky, experimental or simply unwanted care, it is not necessarily a happy ending."

"I wonder if Katrin DeBakey would have been so eager for her husband’s surgery if she had had to provide all the postoperative care herself as the rest of us have to do.

Almost any elderly patient with good insurance and an educated and younger spouse making decisions can get good high-tech surgery, but the system fails when the hospital dumps the patient back home on the spouse after only two days of postoperative hospital care.

In Mrs. DeBakey’s case, her husband received months of in-hospital intensive care, emergency care, more surgery, physical therapy and psychological support.

The rest of us caregivers would have long since passed the breaking point from dealing on our own with medical emergencies, unavailable doctors, no home nurses, no respite time and the psychiatric problems of many elderly male patients — rage and depression."

"The article about Dr. Michael E. DeBakey illustrates many central issues that arise in determining types of care for gravely ill patients and whether to perform a risky but potentially lifesaving procedure.

The case exposes the standards of patient autonomy and informed consent — foundational principles of ethical medicine — to be impossible ideals. Even Dr. DeBakey, likely the person most thoroughly informed about the procedure, regretted his prior decision to forgo the surgery.

Another problem exposed by this case is the persistent misuse of the do-not-resuscitate order, interpreting it to signify more general wishes about less aggressive care instead of its actual, more restricted meaning: not resuscitating in the event of cardiac arrest."

As one of the other letter-writers pointed out, the story also reflects that Dr. DeBakey is the consummate educator, using his experience to prompt consideration and discussion of important medical and ethical issues in caring for patients who are close to death. He is truly one of Houston's treasures.

Posted by Tom at 7:09 AM | Comments (0) |

December 26, 2006

A patient of the surgery he created

heart surgery.jpgThis NY Sunday Times story by Lawrence K. Altman, MD reports that one of Houston's greatest surgeons continues to be on the cutting edge of surgical and related medical issues even as he approaches 100 years of age:

In late afternoon last Dec. 31, Dr. Michael E. DeBakey, then 97, was alone at home in Houston in his study preparing a lecture when a sharp pain ripped through his upper chest and between his shoulder blades, then moved into his neck.

Dr. DeBakey, one of the most influential heart surgeons in history, assumed his heart would stop in a few seconds. [. . .]

But when his heart kept beating, Dr. DeBakey suspected that he was not having a heart attack. As he sat alone, he decided that a ballooning had probably weakened the aorta, the main artery leading from the heart, and that the inner lining of the artery had torn, known as a dissecting aortic aneurysm.

No one in the world was more qualified to make that diagnosis than Dr. DeBakey because, as a younger man, he devised the operation to repair such torn aortas, a condition virtually always fatal. The operation has been performed at least 10,000 times around the world and is among the most demanding for surgeons and patients.

Over the past 60 years, Dr. DeBakey has changed the way heart surgery is performed. He was one of the first to perform coronary bypass operations. He trained generations of surgeons at the Baylor College of Medicine; operated on more than 60,000 patients; and in 1996 was summoned to Moscow by Boris Yeltsin, then the president of Russia, to aid in his quintuple heart bypass operation.

Now Dr. DeBakey is making history in a different way — as a patient. He was released from Methodist Hospital in Houston in September and is back at work. At 98, he is the oldest survivor of his own operation, proving that a healthy man of his age could endure it. [. . .]

But beyond the medical advances, Dr. DeBakey’s story is emblematic of the difficulties that often accompany care at the end of life. It is a story of debates over how far to go in treating someone so old, late-night disputes among specialists about what the patient would want, and risky decisions that, while still being argued over, clearly saved Dr. DeBakey’s life.

It is also a story of Dr. DeBakey himself, a strong-willed pioneer who at one point was willing to die, concedes he was at times in denial about how sick he was and is now plowing into life with as much zest and verve as ever.

But Dr. DeBakey’s rescue almost never happened.

Read the entire fascinating story, which includes Dr. DeBakey's frank admissions that death seemed like a reasonable alternative to the pain he was enduring, that he initially declined the surgery because he would rather die than risk becoming an invalid and that he went into denial as his condition deteriorated. It is a fascinating story about facing death by a man whose legacy is saving lives.

Posted by Tom at 4:20 AM | Comments (1) |

October 20, 2006

Texas Children's huge expansion

Texas Children's Hospital logo.jpgTexas Children's Hospital -- already the largest pediatric hospital in the country -- announced a massive $1.5 billion expansion earlier this week that calls for 2 million square foot expansion, including construction of a maternity center, a neurological research institute and a satellite hospital in west Houston. Texas Children's is one of the largest employers in the Medical Center and expects to create an additional 2,500-3,000 jobs in connection with the expansion. The Chronicle's Todd Ackerman has story here.

Juxaposed between earlier posts here and here on the struggles of Baylor College of Medicine and the University of Texas Medical Branch to define their future in the troubled waters of America's health care system, Texas Children's bold expansion is a reminder of the strong influence that Houston's Texas Medical Center and vibrant medical community will have on this key domestic policy and economic issues facing American society.

Posted by Tom at 4:05 AM | Comments (0) |

October 7, 2006

M.D. Andersen patients get a nice Friday surprise

MD Andersen.jpgThe University of Texas M.D. Andersen Cancer Center in Houston's Texas Medical Center is one of the nation's leading cancer hospitals and research centers. It is a place where difficult issues relating to life and death are confronted on a daily basis, yet the M.D. Andersen professionals work hard to encourage a culture of hope and optimism. It is truly one of Houston's most remarkable places.

Sheryl Crow.jpgConsistent with that remarkable nature, look at who M.D. Andersen patients and workers were able to stumble across yesterday over the lunch hour:

On her way to Friday night's concert in The Woodlands, Sheryl Crow made a detour for a smaller, kindred audience: women with breast cancer.

Six months after her own breast cancer made headlines, the Grammy-winning rocker stopped by the University of Texas M.D. Anderson Cancer Center to mingle with and play for patients and survivors of the disease.

"After I was diagnosed Feb. 22, everything screeched to a halt," Crow told about 200 women who gathered at the hospital's Nellie B. Connally Breast Center for the intimate mini-concert. "I'm on a new path now: I don't want to spend any time doing anything I don't want to do."

Crow, 44, who had surgery and then reconstruction, joked that "breasts are everything" in her business. She said she's been given a clean bill of health, and called her bout with cancer as "life-changing" for her mostly male crew as for her.

Introduced as a "self-described schoolteacher from Missouri who's built a second career as a singer-songwriter," Crow didn't grant media interviews.

An M.D. Anderson spokesperson said her staff had contacted the center to say that Crow wanted to visit and play a few songs for patients.

Wearing jeans, a white vest and heels, Crow sang Soak Up the Sun and Every Day Is A Winding Road to an appreciative audience that packed the center's lobby even though M.D. Anderson gave no official notice of the event. Cell phone cameras clicked away as she played. [. . .]

Crow made the M.D. Anderson appearance as she winds down a national tour with John Mayer.

The tour had been postponed after surgery she's described as "minimally invasive" and follow-up radiation treatment. . .

She made no in-depth references to the ordeal Friday, sticking to music and intimate conversations with patients.

"This brightened everyone's spirits," said Cory Hanson, a Richmond woman with Stage 3 breast cancer. "I'd been a little upset because I'd wanted to get tickets to The Woodlands show, but decided not to because I wouldn't have the energy after today's treatment. But this was a pretty good substitute. At The Woodlands, I wouldn't have sat up front or gotten a hug."

By the way, my teenage daughter reports that the Crow-Mayer concert at The Woodlands Cynthia Mitchell Pavilion was a "10."

Posted by Tom at 7:58 AM | Comments (0) |

September 30, 2006

Baylor Med decides to go it alone

photo_tmc_aerial2002.jpgThe Houston professional community and the Medical Center was abuzz yesterday with Baylor College of Medicine's announcement late this week that the school will construct a new teaching hospital in the Texas Medical Center and end its recent affiliation with St. Luke's Episcopal Hospital as its primary teaching hospital. This move comes only a couple of years after Baylor (which has no affiliation with Baylor University in Waco) terminated its longstanding with the Methodist Hospital as its primary teaching facility (previous posts here), a relationship that was as storied as the Medical Center itself. As usual, the Chronicle's Todd Ackerman -- who has done a superlative job in covering the Baylor-Methodist split and the changing nature of Baylor within the Medical Center -- has this excellent report on the development.

Baylor's new hospital will resolve Baylor's increasing concern over being the nation's only top-20 medical school that does not own a hospital or whose department chairs do not head the key medical departments at an affiliated teaching hospital. The announcement is really not a surprise as there have been rumors for the past six months or so that Baylor-St. Luke's partnership was on the rocks. Although the two institutions entered into merger negotiations shortly after they entered into the teaching hospital affiliation, those negotiations didn't go anywhere as St. Luke's staked a vision of providing medical services in new hospitals throughout the far-flung Houston metropolitan area. The straw that broke the camel's back was St. Luke's dragging its feet in making Baylor department chairs the head of the hospital's parallel medical departments.

The demise of Baylor's relationships with both Methodist and St. Luke's is a reflection of the difficulties involved in sustaining long-term business and professional relationships in the face of the fast-changing world of American health care finance. When those pressures overwhelm a productive relationship such as the one that Baylor and Methodist long-enjoyed, the risk increases that a decline in the quality of medical care will be the ultimate result, which is a risk that should concern all of us. On the other hand, Baylor is presenting an ambitious plan for maintaining its position as one of the top medical schools in the country, and more competition between outstanding hospital facilities in one of the nation's top medical centers could well generate even better medical care and research. How it turns out will reflect much in regard to the direction of the American health-care finance system and the challenges of training physicians within that changing system.

Posted by Tom at 8:00 AM | Comments (0) |

June 26, 2006

Houston's gift to Botswana

bradshaw_lrg.jpgMajor W. Bradshaw has long been one of the talented physician-teachers that makes Houston Texas Medical Center such a fascinating place. Dr. Bradshaw came to Houston and the Baylor College of Medicine as an Assistant Professor of Medicine in 1972 to ramrod Baylor's development of expertise in microbiology and immunology. An outstanding teacher, Dr. Bradshaw was promoted to Dean of Education in 1996 and to Senior Vice-President and Dean of Medical Education in 2004. Now, while most contemporaries are planning their retirement, the Chronicle's Leigh Hopper reports that Dr. Bradshaw has other things in mind:

[After 30 years at Baylor], Bradshaw is making an unusual career move. He's heading to Botswana, a country in sub-Saharan Africa that is roughly the size of Texas.

Baylor is expected to announce this week that Bradshaw has accepted a job as interim founding dean at University of Botswana's medical school, the first such school in a country with one of the world's worst HIV rates. Next month, he and his wife move to Gaborone, Botswana's capital, leaving their home, their children and grandchildren for at least a year.

"It's pretty remarkable for (the University of Botswana) to have the sitting dean of education for the No. 10 medical school in the United States to all the sudden be their new founding dean," said Baylor College of Medicine President Peter Traber. "That's quite a recruitment."

Dr. Bradshaw's appointment is part of Baylor's affiliation agreement with the University of Botswana, which is starting the country's first medical school to address Botswana's critical health needs, including a high percentage of the population that is infected with the HIV virus. Under the leadership of Baylor pediatric professor Mark Kline, Baylor has already opened a treatment center for HIV-infected children in Botswana in 2003 as a part of Baylor's International Pediatric AIDS Initiative. What better legacy for a teacher such as Bradshaw -- who has had a major influence on one of America's finest medical schools -- than to contribute his talents to the creation of a medical teaching institution in a part of the world that needs it the most. Just another example of the magnificent influence that the professionals of Houston's remarkable Texas Medical Center are having throughout the world.

Posted by Tom at 5:37 AM | Comments (0) |

April 10, 2006

The Medical Center philanthropist

dan duncan3.jpgTodd Ackerman does a fine job covering the Texas Medical Center for the Chronicle and, in this Sunday Chronicle article, profiles Dan Duncan (previous posts here), chairman of Houston-based Enterprise Products Partners, LP and the leading philanthropist to Houston's famed Texas Medical Center.

Duncan's life is a quintessential Houston success story, a hard-working, self-made man who started his first company with $10,000 and a trailer-truck and, after working for a small independent oil and gas company, started Enterprise in 1968 and built it into a $15 billion company that is one of the two largest companies in the nation that transports natural gas between exploration and end-use. As Ackerman's profile points out, that task has not always been easy -- such as during the mid-1980's when the bottom fell out of the natural gas market -- but Duncan perservered and was ultimately rewarded for his vision and hard work. Couldn't happen to a nicer fellow.

Posted by Tom at 4:44 AM | Comments (0) |

January 31, 2006

Baylor's cancer research and care initiative

dan duncan.jpgThe Chronicle's Todd Ackerman -- who does a fine job of reporting on matters relating to Houston's Texas Medical Center -- reports today that Dan Duncan, chairman of Houston-based Enterprise Products Partners, LP, has donated $100 million to Baylor College of Medicine to trigger funding of Baylor's effort to become the second comprehensive cancer center in Houston's Texas Medical Center (the other is the University of Texas M.D. Anderson Cancer Center). The gift follows Duncan's earlier $35 million gift to Baylor last year.

This is a major development for the Medical Center, which -- through M.D. Anderson -- is already one of the primary cancer care and research venues in the United States. The collaborative effort of M.D. Anderson and Baylor's new facility may propel the Texas Medical Center to the forefront of cancer research and care in the entire world.

Posted by Tom at 6:47 AM | Comments (0) |

December 6, 2005

M.D. Anderson research center continues to grow

MD Anderson3.jpgThe Chronicle's Todd Ackerman reports that the University of Texas M.D. Anderson Cancer Center has received a $20 million donation from Lowry and Peggy Mays as the cancer center continues raising funds for its 116 acre research park under development about a mile and a half south from the main M.D. Anderson hospital complex in Houston's Texas Medical Center. The Mays gift to M.D. Anderson comes on the heels of an earlier $30 million gift from the Red McCombs family. Mr. Mays built San Antonio-based Clear Channel Communications into the largest radio station company in the U.S.

Posted by Tom at 5:33 AM | Comments (0) |

November 29, 2005

A great Houstonian

Sam Casscells.jpgSamuel Ward Casscells, III is a 53 year old M.D. and professor of biotechnology at the University of Texas Health Science Center at Houston in Houston's amazing Texas Medical Center. He is also an Army medical corps reservist, and recently was awarded both the General Maxwell Thurman Award and the Army Meritorious Service Medal for his service during Operation Iraqi Freedom. In this Houston Chronicle op-ed, Dr. Casscells writes about the reason that he joined the military and the surprising experience that followed:

I had joined the Army Reserve for what seemed good reasons at the time: to help a hard-working medical corps, to live up to the examples of some of my heroes (Drs. Denton Cooley, James "Red" Duke, Michael DeBakey, and my father, surgical giants who wore Army green), and to set an example for my children.

It proved to be more than that: gripping, inspiring and filled with surprises. As only one in 200 Americans is in uniform today, most do not know any soldiers; hence this report.

One month after being commissioned, I received a phone call from Army Surgeon General Kevin Kiley: "Col. Casscells, welcome aboard. I want to be ready in case of a flu pandemic. You have some experience. We may even have some fun. Stand by for orders."

In a few months, I felt like a member of a big family. I would not say a team because there was so little rah-rah, and — to my surprise — no bragging, no macho, no arguing and very little politics. Even in the sand, with all the surgeons from Operation Iraqi Freedom, the focus was the mission: how to prevent and treat injuries and illness.

All suggestions were welcome. All are addressed by rank, but the general speaks as respectfully to the sergeant as to a colonel. And there is lots of laughing and gentle teasing (a perennial: the Air Force, always ready, will go anywhere — as long as there is a dry golf course, and cocktails).

[snip]

Equally wondrous to me: There was not a shred of racial awareness, much less tension. I finally had to ask. The answer is that, since President Truman integrated the Army Officer Corps in 1948, there have been several generations of advancement based on merit (which means hard work, smart work, but especially teamwork). Thus there are thousands of black officers who command with quiet confidence.

Read the entire piece. Hat tip to Clear Thinkers reader Byron Hood for the link to Dr. Casscells' inspiring op-ed.

Posted by Tom at 7:40 AM | Comments (0) |

October 1, 2005

Texas Medical Center players make nice

TMC7.jpgThe Chronicle's Todd Ackerman, who has done a fine job over the past couple of years of covering the divisive split between former Texas Medical Center partners, Baylor College of Medicine and the Methodist Hospital -- reports today that Baylor and Methodist have entered into a settlement brokered by Texas Attorney General Greg Abbott and that Baylor and its new teaching hospital -- St. Luke's Episcopal Hospital -- have decided to shelve their ongoing merger negotiations for the time being.

Whew! Never a dull moment in the Medical Center, eh?

Mr. Ackerman reports that the Baylor-Methodist truce is centered around a new collaborative $16 million program between the institutions to improve immunization and emergency room programs for Houston's underprivileged:

"I have great respect for these institutions and am grateful we were all able to sit at the table to transform some serious differences into a cooperative environment of good will," said Abbott. "The ultimate goal is to ensure the highest level of care to the community, as well as to the neediest among us, especially the children of Houston."

The agreement also calls for Baylor and Methodist to renew a spirit of collaboration by agreeing to share teaching, research and clinical programs and to limit the recruitment of staff from one institution to another.

During the negotiations, chaired by former Harris County Commissioner and current Texas Medical Center board member Elizabeth Ghrist and attended by three members from both insitutions' boards, Abbott barred negative communication and recruiting of staff by either institution. He extended the negotiations, originally scheduled to finish at the end of August, through September, when he promised to make a pronouncement.

Friday, Abbott made that pronouncement. Joined by top officials of Baylor, Methodist and the Texas Medical Center, he said the new agreement ends the protracted dispute and marks "a new era."

The agreement between the institutions calls for 90 to 130 Baylor residents to rotate through Methodist for at least the next five years; for the two to share urology; ear, nose and throat; cardiovascular disease prevention; and cell and gene therapy programs; and for scientists at Baylor and at Methodist's new research institute to collaborate.

It calls for both institutions to attract new doctors and scientists to the Texas Medical Center rather than recruit from each other.

Given the raid on Baylor's faculty that Methodist engineered over the past year, it remains to be seen whether that last provision of the settlement holds up. However, Mr. Abbott's involvement in brokering the settlement certainly adds an element of governmental action that did not exist before in the various dust-ups that have taken place between the two institutions in their messy divorce.

Meanwhile, Mr. Ackerman reports that the Baylor-St. Luke's merger negotiations have been shelved on a friendly basis as the new partners assess their new medical school-teaching hospital relationship. That such negotiations have been put on hold is not particularly surprising given that such a merger would be highly unusual in the world of academic medicine between even longtime partners, much less ones that have been together for a less than a year. My sense is that the negotiations may revive as the parties get more comfortable with their relationship and evaluate how a merger could facilitate both parties' goals in the ever-shifting sands of financing and providing health care in the U.S.

Posted by Tom at 8:47 AM | Comments (0) |

August 31, 2005

AG intervenes in Baylor-Methodist squabble

TMC5.jpgThe Chronicle's Todd Ackerman continues his fine reporting on the saga of the Medical Center divorce between The Methodist Hospital and Baylor College of Medicine with this report that Texas Attorney General Greg Abbott has engaged the feuding ex-partners in a series of meetings over the past two weeks for the purpose of ending the bickering between the institutions, which has been going on for the better part of two years now.

In the meantime, Mr. Ackerman reports that, even as the talks took place, eleven Baylor cardiologists left for Methodist, bringing to 80 the total number of physician and faculty defections that Baylor has suffered since the split in April, 2004. Previously, Baylor departments of pathology, neurology/neurosurgery, plastic surgery, anesthesiology and orthopedics suffered physician or faculty losses to Methodist.

A former Houstonian, Mr. Abbott clearly is taking a special interest in resolving the Baylor-Methodist feud that has shaken Houston's Texas Medical Center. Mr. Abbott was a young attorney in private practice in Houston during the early 1980's when he was paralyzed from the waist down after being seriously injured by a falling tree branch while jogging at Houston's Memorial Park. Mr. Abbott was treated at Medical Center hospitals, and he has often publicly expressed his appreciation for the extraordinary treatment that he received there, particularly his rehabilitation stint at The Institute for Rehabilitation and Research (known as "TIRR"). As such, he is a powerful voice for the public interest in mediating the Baylor-Methodist dispute.

Posted by Tom at 6:25 AM | Comments (0) |

August 9, 2005

The politics of charity in the world of health care

O'Quinn.gifWealthy Houston plaintiff's lawyer John O'Quinn (earlier posts here and here) recently proposed to donate $25 million to St. Luke's Episcopal Hospital -- the largest gift in the hospital's 50 year history -- in return for renaming the hospital's highly-recognizable medical tower the "O'Quinn Medical Tower at St. Luke's."

Well, the Chronicle's Todd Ackerman, who does a fine job of staying on top of Medical Center stories, reports in this article that the St. Luke's board's decision to accept the donation from Mr. O'Quinn is not going over well with a number of St. Luke's doctors:
St. Luke's tower.jpg

The plan to rename the edifice after John O'Quinn in recognition of a $25 million donation by his foundation has infuriated many St. Luke's doctors, who last week began circulating a petition against it and Monday night convened an emergency meeting of the medical executive committee.

"Perhaps you are unaware of the intensity of feelings held by many physicians about Mr. John O'Quinn," says the petition, which is addressed to the Rev. Don Wimberly, bishop of the Episcopal Diocese of Texas and chairman of the St. Luke's Episcopal Health System board of directors. "The primary source of his financial success has been representing plaintiffs in medical liability and products liability cases, many of them groundless."
Dr. Priscilla Ray, a psychiatrist who wrote the petition, said that even though doctors were let out of the breast-implant litigation, it was onerous because they had to hire lawyers, prepare for trial and be deposed.

"The bottom line is, Mr. O'Quinn has contributed toward the litigious environment in which doctors work, toward the changed relationship between doctors and patients," said Ray. "Now, doctors have to fight not to see each patient as potential plaintiff, and patients might have impaired confidence in their doctor."

"It offends us to have money we earned ? and which he took by suing us ? going to name after him a medical building in which we work each day," says the petition. "The naming of buildings at the law school or perhaps at a medical liability carrier seems much more appropriate."

Well, the University of Houston is way ahead of the docs on that idea, as the law school has already named its library after Mr. O'Quinn. But now that idea on the medical liability carrier building . . .

Despite the current hub-bub, my sense is that this will die down soon and the board's decision to accept the donation will not be changed. Raising funds is too important in the dog-eat-dog worlds of academic medicine and health care finance to let little things such as principle stand in the way of a big donation.

Posted by Tom at 6:21 AM | Comments (2) |

July 17, 2005

The Robertsons of Houston

crobertson.jpgThe late Corbin Robertson, Sr. was a bright business mind when he came to Texas as a young man from Minnesota in the 1940's. After marrying Wilhelmina Cullen -- the daughter of famous Houston wildcatter Hugh Roy Cullen -- Mr. Robertson ultimately became the brains behind the investment of the Cullen Family oil and gas fortune, a role that Richard Rainwater successfully emulated decades later for Ft. Worth's Bass Family. Houston benefitted greatly from Mr. Robertson's business acumen as both the Cullen and Robertson families became among Houston's greatest philanthropists, contributing huge amounts to institutions such as the University of Houston and the Texas Medical Center.

Mr. Robertson's son -- longtime Houston businessman Corby Robertson, Jr. -- has continued his legacy of astute business acumen and philanthropy. After starring as an outside linebacker for the University of Texas football teams of the late 1960's, Mr. Robertson returned to Houston and worked his way into assuming leadership from his father of the Robertson Family's closely-owned oil and gas business, Quintana Petroleum Corporation. However, over the years, Mr. Robertson has branched his family's fortune into the ownership of a non-sexy but more plentiful (and potentially more lucrative) alternative energy resource -- coal.

As this Chronicle article reports (here is an earlier Forbes article), Mr. Robertson's Natural Resource Partners, a Houston-based master limited partnership -- has a market capitalization of $1.6 billion and, since going public on the New York Stock Exchange in 2002, the value of the partnership's units have more than tripled to a recent price of $63. Quarterly distributions have also increased 62 percent since the partnership went public.

By the way, one item the Chronicle article missed is that, among his many civic duties, Mr. Robertson is currently the chairman of the board of Baylor College of Medicine, where he has led Baylor's board during its historic split last year with its longtime primary teaching hospital in the Texas Medical Center, Methodist Hospital. Nevertheless, the Chronicle article is a good overview of the business background of Houston's First Family of energy and highlights the business talent that has helped make Houston the energy capitol of the United States.

Posted by Tom at 5:00 AM | Comments (0) |

July 9, 2005

Medical Center institutions rank highly again

TMC.jpgU.S. News & World Report's annual "America's Best Hospitals" survey is out again and, as usual, Houston's Texas Medical Center is well-represented in the lists of the top hospitals in a number of different categories. Here is a previous post on the 2004 survey.

The U.S. News and World Report survey ranks the country's top 50 hospitals in 17 specialties. Less than a third of the 6,000 U.S. hospitals meet the eligibility criteria and only 176 of those institutions qualified for a ranking. The rankings are based on a survey of board-certified physicians around the country, patient survival data and various other indicators, such as the ratio of nurses to patients, technologies and services available to patients, the number of discharges over a three-year period, and whether the institution has Magnet status as determined by the American Nurses Credentialing Center.

M.D. Anderson was again ranked as one of the top two hospitals in cancer care, a position that it has held since U.S. News and World Report began its annual survey in 1990. M.D. Anderson held the No. 1 position in 1992, 2000, and 2002 through 2004. M.D. Anderson also ranked fifth in gynecology, and 11th in both otolaryngology (i.e., ear, nose and throat diseases) and in urology.

Other Medical Center institutions also ranked highly in various categories. Texas Children's Hospital ranked fourth in pediatrics, while The Menninger Clinic ranked tenth in psychiatry and The Institute for Rehabilitation and Research (known as "TIRR") ranked fifth in rehabilitation. The Texas Heart Institute at St. Luke's Hospital ranked eighth in heart and heart surgery, while St. Luke's also ranked 40th in urology and 42nd in kidney disease. Memorial Hermann Hospital -- the teaching hospital for the University of Texas Health Science Center -- was ranked 41st in kidney disease and 49th in urology.

Finally, the The Methodist Hospital ranked in more specialties than any other Texas hospital -- tenth in neurology and neurosurgery, 13th in urology, 14th in opthamology, 16th in heart and heart surgery, 17th otolaryngology, 19th in psychiatry and 42nd in gynecology.

As I have noted many times, not only is the Texas Medical Center one of Houston's largest centers of employment, it is an amazing collection of medical services talent.

Posted by Tom at 7:12 AM | Comments (1) |

McCombs makes huge gift for M.D. Anderson research

mccombs.jpgSan Antonio-based businessman Red McCombs has given the University of Texas M.D. Anderson Cancer Center $30 million for its huge $500 million research park that will eventually consist of six centers focusing on cutting edge areas of cancer research.

The gift -- which is one of the two largest that M.D. Anderson has ever received -- will go to help fund the developing Red and Charline McCombs Institute for the Early Detection and Treatment of Cancer on M.D. Anderson's 116-acre south campus. That campus is about a mile and a half from the main M.D. Anderson hospital complex in the Texas Medical Center.

Posted by Tom at 6:16 AM | Comments (1) |

June 19, 2005

Remembering a special father

Walter Kirkendall.jpgInasmuch as I am one of ten children of the marriage of Walter M. and Margaret Kirkendall, I have a large number of family members (over 30 nieces and nephews at last count), many of whom are regular readers of this blog. This particular blog post is primarily for those family members and our family friends, but even if you are not a member of those groups, feel free to read on and learn about a special father and a remarkable Houstonian.

The memory of where I was when my father died remains indelibly etched on my mind.

Shortly after 8:00 a.m. on Saturday morning, July 13, 1991, I was preparing to play golf in Iowa City, Iowa during my 20th high school reunion. Unexpectedly, the pro shop summoned me from the first tee that I had a telephone call. When I reached the phone, my brother Matt was on the line with terrible news.

Our father, Dr. Walter M. Kirkendall, had suffered a serious heart attack moments earlier in a Chicago-area hotel room while preparing to attend his niece Sarah's wedding with our mother. At the time of the call, Matt did not know whether our father had survived the attack. Minutes later, after I had quickly returned to my hotel room to gather my things for a hurried trip to Chicago, Matt called again. Our father had died that morning in Chicago at the age of 74, probably before I had left the golf course in Iowa City.

Consequently, my memories of Walter Kirkendall's death are inextricably intertwined with golf. To a large degree, that is utterly appropriate because, over the final 15 years of his life, Walter and I spent countless hours together golfing.

These regular golf games began in 1976 when I entered law school at the University of Houston. Back then, we would rise early most weekend and holiday mornings to play the venerable back nine at Memorial Park Golf Course in Houston.

In 1982, we transferred those weekly games at Memorial to several Houston-area clubs, concluding at Lochinvar Golf Club. The final time I saw Walter alive was the Sunday morning before his death when we played golf together at Lochinvar. Inasmuch as he played quite well that day, one of my enduring memories of Walter is his chortling in the clubhouse as he collected his golf bets from me.

Thus, my golfing memories of Walter are surrounded by an aura of good fortune and warm appreciation. Good fortune because golf allowed me to enjoy many hours of Walter's wisdom, insight, and humor. Warm appreciation because golf allowed me to give something back to this man who premised his life on giving to others.

You see, despite his love of golf, Walter never became an active member of a private golf club. Walter gladly sacrificed something that would have been primarily for his enjoyment -- that is, golf on a private course -- for what he considered the more important needs of his large (ten children!) family. Accordingly, as I joined several golf clubs over the final decade of Walter's life, I made a point to give Walter an opportunity to play golf at those clubs as much as he wanted. His pure enjoyment of our golf outings is one of my life's greatest satisfactions.

In addition to being a special father, Walter Kirkendall was a remarkable doctor and teacher. Born in 1917 and raised in Louisville, Kentucky, Walter graduated from the University of Louisville Medical School in 1941 and then went to the University of Iowa in Iowa City for an internship the following year. As with many men of his generation, Walter finished his internship and residency at Iowa just in time to serve three years as an Army medical officer in North Africa and Italy during World War II, after which he returned to Iowa City to complete his training in medicine.

In 1949, Walter joined the University of Iowa Medical School Faculty and -- along with esteemed colleagues such as Jack Eckstein, William Bean, Lew January, Frank Abboud and many others -- proceeded to play a major role in the development of the University of Iowa's fine medical school over the next 23 years.

Walter and his colleagues were at the forefront of the post-WWII doctors who embraced the optimistic view of therapeutic intervention in the practice of medicine, which was a fundamental change from the sense of therapeutic powerlessness that was widely taught to these men by their pre-WWII professors. Several of Walter's colleagues have told me that Walter's attitude of therapeutic optimism was his greatest contribution to the education of his students.

Over his 40+ year academic career, Walter developed a program of teaching and research in hypertension and renal disease for which he received national and international recognition. His first professional publications were on renal disease, but by the mid-1950's, he was publishing papers on hypertension and the effects of drugs in patients. After 1960, almost all of his 85 abstracts and 72 papers involved research on the clinical pharmacology of hypertension. In addition to his teaching, research, and service on multiple professional committees, Walter also directed the Cardiovascular Research Laboratories at the University of Iowa from 1958-70 and the Renal-Hypertension Division from 1970-72. Iowa honored Walter for his contributions to the University by awarding him the Distinguished Achievement Award in 1986.

Perhaps most remarkably, however, is that Walter in 1972 -- at the age of 55 when most other academics are settling in to comfortable surroundings -- decided to uproot his large family and move to Houston where he became the first Chairman of the Department of Medicine at the then-new University of Texas Medical School in Houston's famed Texas Medical Center.

In Houston, Walter continued his professional passions -- teaching, research and clinical medicine -- for the remainder of his life at UT-Houston. In addition to being the first Chairman of the Department of Medicine, Walter was director of UT-Houston's Hypertension Unit from 1976 and director of the General Medicine Division from 1982 until his death. During his 20 years at UT-Houston, Walter became the patriarch of UT-Houston's faculty and student body, reflected by the UT-Houston alumni awarding him the first Benjy F. Brooks Medal in 1991 as the outstanding clinical faculty member, the school's naming of it's internal medicine library and suite in Walter's honor, and the Walter M. Kirkendall Endowed Lecture Series that UT-Houston sponsors each year.

Consequently, the foregoing outlines Walter's remarkable professional legacy -- two institutions served for over 20 years each while teaching and pursuing cutting edge research in a key area of medicine throughout his career. James T. Willerson, M.D., the current president and medical director of the Texas Heart Institute, observed the following in his eulogy at UT-Houston's memorial service for Walter:

Dr. Frank Abboud called me two days ago, wanted to come join me yesterday, early in the morning to visit and talk about Dr. Kirkendall, and then go to his funeral with me. . . Dr. Abboud told me that people in Iowa at the Medical School had never felt that Dr. Kirkendall had left. He was still there. What he had given, what he represented, what he continued to give was part of Iowa.

Can you imagine having that impact on an institution, and people years after you've left? Dr. Kirkendall did. How many of us could claim the same thing, ever?

But the foregoing summary cannot adequately convey Walter's truly endearing qualities. He was a devoted teacher to his medical students and residents, and was constantly interested in the development of their careers. Patients appreciated his thoroughness, fairness and profound concern for them and their families. Many conversations with Walter invariably turned to stories about his aversion to wastefulness, the clutter in his office, his sense of humor, his competitiveness, and his suspicion that the sodium ion is bad for one's health.

The following eulogies that were given at Walter's funeral and memorial service elaborate on these qualities: the eulogy of my brother Bud, who is a district judge in Seguin, TX; my eulogy; the eulogy of my brother Matt, who is an internist in Dubuque, Iowa; the memorial service closing of my sister Mary, who is a pediatric emergency room physician in San Antonio; the eulogy of Dr. Willerson; the eulogy of Dr. Chevis M. Smythe, and the eulogy of Dr. Philip Johnson.

I close with two of my favorite stories about Walter. One is recounted by Tom S. McHorse, M.D., former president of the Travis County, Texas (Austin) Medical Association. Dr. McHorse recalls vividly his experience with Walter in examining a patient while in medical school:

The setting is the University of Iowa Hospital staff service ward one February morning. For physicians who graduated after 1980, ward is defined as a large room with eight to ten patient beds separated by curtains, as many emergency rooms currently have. As medicine was practiced in 1968, acute MIs, bacterial endocarditis, and other illnesses were treated in hospital for six weeks or more. The patient in bed four was such an extended stay patient.

Dr. Kirkendall was rounding with his entourage of residents and nurses. As we approached this frequently examined patient, a distinct change was obvious from the day before. The patient truly had the worst "soup bowl" haircut you can imagine. At bedside, Dr. Kirkendall addressed his first question to the patient:

"Who cut your hair?"

"The hospital barber," replied the patient, somewhat taken aback.

Dr. Kirkendall was clearly not pleased as he turned to his residents and declared:
"Incompetence at any level should not be tolerated."

I have no memory of the patient's diagnosis or anything else Dr. Kirkendall taught us that week, but I have long remembered that statement of Dr. Kirkendall.

The second story was passed along by Dr. Smythe in his eulogy during UT-Houston's memorial service for Walter, in which he recounted a particularly personal experience with Walter:

Now, at this time, I want to skip ahead to something very personal. 1975-76 was also not a bed of roses at this institution. And, when I was bounced out of the Dean's Office, I was profoundly hurt, very profoundly hurt, and, I was also puzzled. Since those who were relatively active in my demise had been the people to whom I was closest, I was also alone and considerably puzzled as to whom to turn.

Now, Dr. Kirkendall himself was under no mean pressure at that same time. And indeed, the forces that were playing on us were pretty much identical. But, Walter is the person who said "Cheves, come to my office every Thursday at 11:00 o'clock." And, he was a person who said "I will help you retrain yourself as a physician." And, he did.

And, that episode illustrated this man's extraordinary generosity of spirit more than anything that I've ever seen.

I will be grateful to him for the rest of my life.

Walter's understanding of the importance of service to others is the thread that binds the fabric of families, friendships, schools, professions, communities, and, ultimately, societies. In his quiet and confident manner, Walter understood the importance of his life's work, and this understanding formed the cornerstone of his unbendable sense of fulfillment and contentment in his personal and professional life. In my book, that's quite a fine legacy, and I am taking this Father's Day to appreciate my blessing to have been touched by it.

Posted by Tom at 4:00 PM | Comments (8) |

June 16, 2005

TMC rejects Baylor complaint on Methodist

medical center2.jpgAs predicted here and here, this Todd Ackerman/Chronicle article reports that the Texas Medical Center managers' board of directors rejected Baylor College of Medicine complaint's Wednesday that the Medical Center's historic charter and deed restrictions prohibit Methodist Hospital's creation and operation of its own education and research programs and its partnership with the New York-based Cornell University Weill Medical School.

As an aside, Mr. Ackerman notes that the TMC board and the Texas Attorney General are tiring of the Baylor-Methodist spat:

In a letter to the presidents of Baylor and Methodist, the board also delivered a rebuke of sorts, reminding the battling institutions of their historic obligation to cooperate "to better serve the interests of the people of Texas" and calling for them to resolve their dispute. It marked the first time since the longtime partners split in April 2004 that the TMC made such a formal appeal.

A similar appeal was made after the meeting by Texas Attorney General Greg Abbott's office, which previously had stayed out of the dispute. Saying it has concerns about the future of the Medical Center, it released a statement expressing hope the two institutions "exhaust every avenue in trying to work out their differences."

My sense is that a lawsuit between the two former Medical Center partners is still a distinct possibility. Stay tuned.

Posted by Tom at 6:14 AM | Comments (0) |

June 13, 2005

Baylor Medical School lays the wood to Methodist

medical center.jpgFollowing up on a story noted in this earlier post, the Chronicle's Todd Ackerman continues his outstanding reporting over the past year on the historic split between Baylor Medical School and Methodist Hospital with this article in which he reports that Baylor has formally accused Methodist of attempting to put the medical school out of busienss in connection with an administrative proceeding before the entity that manages the Texas Medical Center.

The context of the current phase of the dispute between the two longtime Medical Center partners is a proceeding before the Texas Medical Center's covenant compliance committee in which the committee will determine whether Methodist is violating the Medical Center's deed restrictions by starting competitive education and research programs with New York's Cornell University Weill Medical School. Baylor contends that the programs and affiliation between Methodist and Cornell is an attempt by Methodist to harm Baylor.

Although a legal longshot (Texas law does not favor covenants that restrict competition), Baylor's latest salvo is another public relations nightmare for Methodist, which is attempting to carve out a post-Baylor plan to remain a primary research institution. Methodist has a big advantage in that its $2.3 billion endowment is over twice the size of Baylor's endowment, but Baylor is aggressively pursuing new affiliations with other Medical Center institutions. Consequently, there is no assurance that Methodist's current financial advantage will result in a dominant position in the Medical Center five to ten years down the road, particularly if Methodist's research affiliations do not compete effectively with those of Baylor and other Medical Center institutions.

Posted by Tom at 5:57 AM | Comments (1) |

May 18, 2005

Merger rumblings in the Medical Center

St. Luke's logo.jpgThe Texas Medical Center has already been rocked over the past year by the split between longtime partners Baylor Medical School and The Methodist Hospital, but today's Chronicle article by Todd Ackerman adds a new level of uncertainty for the heart of Houston's medical community:

St. Luke's Episcopal Hospital is weighing offers that would align it with either Memorial Hermann Hospital or a consortium of Texas Children's and The Methodist hospitals. . . St. Luke's would merge with Memorial Hermann under the first scenario.

Texas Children's and Methodist would purchase the hospital under the second.

Those options ? and a third that St. Luke's continue to go it alone ? are before the St. Luke's board of directors now, . . .

A decision should come within a few months.

Never a dull moment in the Medical Center, eh? Mr. Ackerman reports that the negotiations are the product of a developing consensus within the Medical Center that more collaboration is needed between the various institutions.

Nevertheless, the proposed collaborations are ambitious and complicated, to say the least. Inasmuch as St. Luke's is the new teaching hospital of Baylor Medical School and Memorial Hermann is the longtime teaching hospital for the University of Texas Health Science Center, any St. Luke's-Hermann merger would have the added complication of providing resources for two medical schools.

Similarly, an acquisition of St. Luke's by Methodist would be akin to annulling the acrimonious divorce between Methodist and Baylor.

So, stay tuned. The pressures of providing quality health care services in this era of strained health care finance makes for some very interesting bedfellows.

Posted by Tom at 5:54 AM | Comments (1) |

May 11, 2005

Baylor lobs another grenade at Methodist

methodist2.gifSeems like it's been awhile since we checked in on the ongoing divorce between those former Texas Medical Center partners, Methodist Hospital and Baylor College of Medicine. Here are the earlier posts on the historic divorce between the medical school and its former teaching hospital.

In this article, the Chronicle's Todd Ackerman, who has done a fine job covering this story, reports that Baylor's counsel has sent a letter to the Texas to the corporation that manages the Medical Center questioning whether three Methodist activities violate the Medical Center's guiding principle of "institutional cooperation and coordination" -- operating its own residency program; operating a research facility without the affiliation of a Medical Center institution; and using its teaching beds in conjunction with New York's Cornell University Weill Medical School, which is not located in the Medical Center. Mr. Ackerman reports that the Texas Medical Center has hired outside counsel and commenced an investigation into the matter.

Baylor logo_lg.gifBaylor's latest salvo in the ongoing battle between the former Medical Center partners is unlikely to succeed because it, in effect, attempts to enforce a covenant not to compete, which are not favored under Texas law. Nevertheless, Baylor continues to let its bigger and better-endowed rival know that it will not slip meekly away. It will be fascinating to watch this institutional competition unfold and to assess where each institution stands in 5-10 years.

Posted by Tom at 5:56 AM | Comments (1) |

March 30, 2005

Baylor Med and M.D. Anderson announce huge new research project

baylor logo.gifTwo research giants of Houston's Texas Medical Center are teaming up on a massive new research project focusing on the genetic abnormalities that cause cancer.

This Todd Ackerman Houston Chronicle article reports on the planned collaboration of Baylor College of Medicine and the University of Texas M.D. Anderson Cancer Center on the proposed Human Cancer Genome Project, which is an extension study to the Human Genome Project, a recently completed 10-year Baylor-led study. The goal of the cancer project is to determine the DNA sequence of tumor samples in hopes of identifying the mutations that are key to the development of cancers.

md anderson.jpgInasmuch as Baylor has already developed the genome-sequencing research infrastructure and M.D. Anderson can contribute the tumor samples, the collaboration on the research project is a natural for both institutions. The estimated cost of the complete project is roughly $1.35 billion, which is yet another example of the huge impact that such Medical Center research projects have on the local Houston economy.

Posted by Tom at 5:34 AM | Comments (0) |

March 20, 2005

More on the impact of the Baylor-Methodist split

baylormed.gifOn the heels of this fine earlier series on the breakdown of the primary teaching hospital relationship between Baylor College of Medicine and The Methodist Hospital in Houston's famed Texas Medical Center, the Chronicle's Todd Ackerman teams with fellow Chronicle reporter Eric Berger to provide this story on the initial impact that the split is having on research planning at both institutions and the threat that the richer Methodist will pluck the prime Baylor researchers for its own research facility.

methodist.gifMr. Ackerman's reporting on the Baylor-Methodist split has been outstanding over the past year, and well-known Texas Monthly journalist Mimi Schwartz chimed in with this article ($) in the March edition of the magazine on the background and personalities involved in the negotiations leading up to the split. The Chronicle series and Ms. Schwartz's article are both providing much grist for the gossip mill in the Medical Center community regarding this historic readjustment of professional relationships in the Medical Center.

Posted by Tom at 7:11 AM | Comments (0) |

February 20, 2005

The historic Medical Center divorce

Todd Ackerman is the Houston Chronicle reporter who has been doing an outstanding job covering the termination of the Methodist Hospital's 50 year primary teaching hospital relationship with Baylor College of Medicine that occurred last year. Here are the earlier posts on this historic split.

In this Sunday Chronicle article, Mr. Ackerman begins a series of articles that will explore the demise of the Baylor-Methodist relationship. Inasmuch as the Baylor-Methodist relationship was one of the many reasons that the Texas Medical Center grew over the past 30 years into one of the world's premier medical and primary research centers, the termination of the Baylor-Methodist relationship is an important part of Houston's history.

However, the divorce is also a reflection of the difficulties involved in sustaining even long-term business and professional relationships during this tumultuous period in the American health care industry. When those pressures overwhelm a productive relationship such as the one that Baylor and Methodist developed, the risk increases that a decline in the quality of medical care will be the ultimate result. That is an issue for which all of us should be concerned.

Update: Here is second article in the series.

And the third, which closes with this anecdote:

[A]s the squabbling between Baylor and Methodist shows no signs of abating, the best view might be the last line in a thank you note received by Dr. Richard Stasney, a Methodist ear, nose and throat specialist. It said,
"Let's pray for peace in the Middle East ? and the Texas Medical Center."

Posted by Tom at 6:25 AM | Comments (0) |

January 15, 2005

Baylor-Methodist split -- heading to court?

Todd Ackerman reports in this Chronicle article on the latest flare-up in the divisive Texas Medical Center divorce of Baylor College of Medicine and the Methodist Hospital after a highly-productive 50 year marriage. Here are the earlier posts on this increasingly acrimonious split.

The latest salvo in the divorce was the accusation by Baylor President Peter Traber that Methodist's new medical school affiliate -- Cornell Medical School -- is meeting with Baylor professors to induce them to leave Baylor for Methodist and Cornell. The Chronicle reports that Dr. Traber's letter made the following accusation:

"Cornell has been actively involved in trying to convince Baylor faculty members to leave the college. The dean of Cornell has personally visited with and/or contacted Baylor faculty members in an attempt to recruit them to the Methodist Physician Organization and Cornell faculty positions."

Legal translation: "Knock off the bribes or else we're going to lay a tortious interference lawsuit on your lap."

Other than the accusations of unethical conduct, things are just fine between Baylor and Methodist, as the Chronicle article notes:

Oddly, both Traber and [Methodist President Ron] Girotto reported that recent negotiations ? they resumed last week after mediators threw up their arms in December ? were the most productive they've had.

Posted by Tom at 8:03 AM | Comments (0) |

December 23, 2004

Medical Center notes 50 year anniversary of first transplant operation

On the anniversary of the first kidney transplant in Boston 50 years ago, Eric Berger of the Chronicle does a fine job in this article of reviewing the accomplishments of Houston's Texas Medical Center doctors in contributing to the advancement of transplant procedures. Inasmuch as the Chronicle does not maintain online links to many of its articles for very long, check it out soon.

Posted by Tom at 6:07 AM | Comments (0) |

December 9, 2004

Another major change in the Medical Center

As these earlier posts reflect, a huge Texas Medical Center rift arose earlier this year between Baylor College of Medicine and the Methodist Hospital over Baylor's decision to terminate its 50 year relationship with Methodist and make St. Luke's Episcopal Hospital its primary teaching hospital.

The Baylor-Methodist split has now officially replaced the longstanding acrimony between the world reknowned heart surgeons -- Dr. Michael DeBakey of Baylor's DeBakey Heart Center and Dr. Denton Cooley of St. Luke's Texas Heart Institute -- as the most severe professional turf war in the always tumultuous world of academic medicine in the Medical Center.

The signal for the change in the relative positions of these two heartfelt disputes was the announcement yesterday that Dr. Cooley had appointed a Baylor heart surgeon -- Dr. Joseph Coselli -- as the chief of adult cardiac surgery at the Texas Heart Institute.

Longtime observers of Medical Center politics expected dogs and cats to live together as best friends before such a development would ever occur.

This development will revitalize the Texas Heart Institute, which used to be one of the nation's premier heart centers before lagging behind the top national centers over the past decade or so. The appointment also means that the Texas Heart Institute will be led by an unusual management team comprised of doctors from both of the Medical Center's medical schools, Dr. Coselli from Baylor and Dr. James Willerson from the UT Health Science Center at Houston, who is the institute's president-elect, medical director, chief of cardiology and director of cardiology research.

Here is the Chronicle story on this development.

Posted by Tom at 5:01 AM | Comments (0) |

November 20, 2004

Texas Childrens Hospital Heart Unit celebrates 50th year

One of many benefits of living in Houston is the extraordinary Texas Children's Hospital located in Houston's famed Texas Medical Center. Texas Children's -- as Houstonians call it -- is truly one of the most remarkable medical facilities for children in the world.

This Chronicle article reports on a reception that Texas Childrens held on Friday to celebrate the 50th year of service by the hospital's pediatric heart unit, which reflects Texas Childrens' overall excellence:

Texas Children's Hospital . . . opened in February 1954. Pediatric cardiology was the hospital's first subspecialty. Today, as many as 12,000 patients are treated and 700 surgeries performed annually at the heart center.

More than 35,000 children a year are born with congenital heart defects, a primary cause of first-year death of infants. Since the 1960s, . . . survival rates in such cases have increased to nearly 95 percent from 70 percent.

Dr. Ralph Feigin, the hospital's physician-in-chief, said the hospital's heart center has been a "cradle of innovations since its inception."

"The center has pioneered numerous pediatric cardiology procedures and maintains one of the nation's highest success rates in treating patients with congenital heart abnormalities," he said.

Increasingly, the hospital has moved into high-tech medicine. About 550 fetal echocardiograms are performed each year to identify heart problems before birth. Such early detection can ensure that babies receive immediate care, including surgery, for their problems.

In another high-tech development, heart center surgeons have performed 158 pediatric heart transplants ? 17 of them this year ? since the program began 20 years ago.

Texas Children's Hospital is a treasure of the Houston community.

Meanwhile, in other Medical Center news, Methodist Hospital announced on Friday the Methodist Board's approval of an initial $30 million endowment to launch the creation of the Southwest's first neurological institute to advance the discovery of the origins of neurological disease and to provide comprehensive care for patients with disorders and injuries of the brain and spinal cord.

The creation of the institute is the latest step in Methodist's plan to become an academic institution in the aftermath of this year's acrimonious split with Baylor College of Medicine, its partner and supplier of physician-scientists and residents for the past 50 years.

Posted by Tom at 7:58 AM | Comments (0) |

September 25, 2004

Fake Doc assaults female patients at Methodist

This Chronicle article reports that a man wearing hospital scrubs and a white lab coat sexually assaulted three female patients at Methodist Hospital in Houston's Texas Medical Center over the past two weeks.

Disguised as a medical professional wearing blue scrubs and a stethoscope, the man entered the rooms of female patients on Sept. 15, 19 and 20 and asked them several questions before saying he wanted to perform pelvic examinations on them. The women were sexually assaulted under the guise of the false exams, and each episode lasted about ten minutes.

Posted by Tom at 7:22 AM | Comments (0) |

September 23, 2004

Dan Duncan gives $35 million to Baylor College of Medicine

Kicking off a capital campaign, Baylor College of Medicine announced Wednesday it has received a $35 million gift from Baylor trustee and longtime Houstonian Dan Duncan to kick off the building of a new Baylor-operated clinic in the Texas Medical Center.

Mr. Duncan's donation will be paid over 10 years and represents about a third of the clinic's estimated cost. The clinic will be between 250,000 to 350,000 square feet and finished by late 2007 at a cost of about $90 million. The clinic will offer a full range of medical services from cardiology to ophthalmology, checkups, lab tests, and day surgery. The clinic will also allow patients to receive diagnosis and treatment in one place for conditions that cross specialties.

The University of Texas Health Science Center at Houston earlier this month announced the purchase the Hermann Professional Building to use as its outpatient clinic and Methodist Hospital has plans to build such a clinic, a plan that was part of the reason that Baylor and Methodist ended their 50 year relationship earlier this year.

Posted by Tom at 6:48 AM | Comments (2) |

September 2, 2004

Latest chapter in Baylor-Methodist divorce

This Chronicle article reports on the the latest dustup between longtime partners Baylor College of Medicine and the Methodist Hospital -- Baylor has started moving residents to St. Luke's Episcopal Hospital, which is generating even more acrimoney in the already chippy split with between Baylor and Methodist. Here are earlier posts on the Baylor-Methodist divorce.

Executives at Methodist claim to be "dumbfounded" at th e move and claim that the transfer reneges on a previous agreement between the two institutions regarding involving the allotment of residents.

This latest dispute is only the latest in a series of disputes that have arise after Baylor and Methodist's decision to part ways in April ended an historic 50-year Texas Medical Center relationship during which the hospital was Baylor's primary teaching hospital for its medical students and residents. St. Luke's is Baylor's new teaching hospital and Methodist's new primary partner is Cornell University's medical school, which is located in New York.

In other Medical Center news, this Chronicle article reports that Memorial Hermann Hospital System and The University of Texas Health Science Center at Houston renewed their agreement in which Memorial Hermann serves as the school's primary teaching hospital. UT-Houston and Hermann -- which have been partners since 1968 -- agreed to continue their partnership for 15 more years.

Under the renewal, UT-Houston purchased the Hermann Professional Building and adjacent garage for $31 million and renamed the building the University of Texas Health Science Center Professional Building. It will be UT-Houston's first outpatient clinic, and its location (across the street from UT-Houston) will be convenient for UT-Houston faculty and students.

Posted by Tom at 4:55 PM | Comments (0) |

August 18, 2004

H'mm . . .

As if there wasn't enough gossip being generated in the Texas Medical Center these days, this Chronicle article reports as follows:

Texas Children's Hospital's longtime chief financial officer, Sally Nelson, has resigned from her job as executive vice president and CFO after 18 years with the hospital.

Nelson left the positions she's held since 1987 a week ago, the hospital said. On Tuesday it released a brief statement thanking Nelson for her years of service without offering an explanation for her sudden exit.

Reached at her Houston home, Nelson directed all inquiries about the reason for her abrupt resignation to Texas Children's, the nation's largest pediatric hospital.

"You'll have to call the marketing department at the hospital about that," she said. "They'll tell you all about it."

The hospital, however, would not comment beyond saying that Randall Wright, senior vice president and chief information officer at Texas Children's, will serve as the acting executive vice president and CFO.

"It's our policy and our practice to respect the privacy of our current and former employes, so the statement includes only the information that we can release," Texas Children's spokeswoman Jennifer Hart said.

Posted by Tom at 6:58 AM | Comments (0) |

July 28, 2004

More Medical Center political strife

Daniel Arnold, a member of the Baylor College of Medicine board of trustees and the former chairman of that board, has sent the full board a July 14 letter calling for Baylor President Dr. Peter Traber to be fired for failed leadership. Mr. Arnold's letter states that Traber's management of Baylor is "deleterious" and "divisive," and that "his lack of realistic vision and fundamental errors in judgment" are not what Baylor needs in a leader. Here is the Houston Chronicle article on this latest Medical Center dustup. The letter is expected to be discussed today at a meeting of the 48-member board.

Corby Robertson, the current chairman of the Baylor board, told the Chronicle that he believes that Dr. Traber has the board's support

Mr. Arnold sent his letter amid the recent political fallout over the split of the long teaching relationship between Baylor and The Methodist Hospital (earlier posts here). The institutions have been in open conflict since deciding to sever their 50-year relationship in which Methodist served as the teaching hospital for Baylor students and residents. Last week, Baylor threatened legal action against Methodist if the hospital does not cease actions that Baylor alleges are interfering with Baylor's operations, including Methodist's "aggressive recruiting" of Baylor faculty members.

Mr. Arnold was the Baylor board chairman who butted heads with popular Baylor faculty member and president, Dr. Ralph Feigin. In that conflict, Mr. Arnold attempted to force Dr. Feigin to choose between the presidency and his other job as physician-in-chief at Texas Children's Hospital. Dr. Feigin subsequently announced he was stepping down, only to have the decision overturned a month later after key faculty and trustees objected. Dr. Traber replaced Dr. Feigin in March, 2003 when Dr. Feigin resigned at the age of 65.

Update: The Baylor board voted unanimously (with one abstention) to support Dr. Traber.

Posted by Tom at 8:24 PM | Comments (0) |

July 23, 2004

George Mitchell funds grant for UT Alzheimer's research

Longtime Houston oilman and real estate developer George Mitchell and his wife Cynthia have donated $2.5 million to the University of Texas Medical Branch at Galveston to fund the creation of the George P. and Cynthia Woods Mitchell Center for Alzheimer's Disease Research, which will coordinate UTMB's expanded research into Alzheimer's disease. Mrs. Mitchell has suffered from Alzheimer's over the past several years.

The new UTMB center will focus on Alzheimer's but also will conduct research on similar degenerative neurological disorders such as Parkinson's disease. The Mitchell donation will be combined with other donations and grants to intensify UTMB's overall neurological research.

Although Mr. Mitchell has long been a major player in Houston independent oil and gas circles, he is best known as the developer and visionary of The Woodlands, the planned suburban community 30 miles north of downtown Houston that Mr. Mitchell started 30 years ago and which now is home to almost 100,000 residents.

Posted by Tom at 6:09 AM | Comments (0) |

Baylor threatens litigation against Methodist

The stakes in the ugly divorce between Baylor College of Medicine and The Methodist Hospital (earlier posts here) that has had medical officials in Houston's famed Texas Medical Center chattering for months just zoomed through the roof.

As predicted here earlier, Baylor Board of Trustees Chairman Corbin Robertson Jr. sent Methodist's board a letter on July 20 threatening legal action against the hospital if it doesn't stop alleged illegal interference with Baylor's medical business, putting its accreditation at risk by recruiting faculty under contract, evicting it from space, and refusing to negotiate a contract that would allot some faculty and residents to the hospital.

"Baylor and its longstanding programs at all affiliated hospitals will be damaged as a result of Methodist's actions," Robertson wrote in the July 20 letter. "It is our fervent desire to maintain or repair our relationship rather than engage in legal debates or worse, but you will, of course, understand the fiduciary obligation of the Baylor board to assure Baylor's compliance with law and to safeguard our assets."

Methodist officials reacted to the letter by calling its claims "highly offensive" and "not in the spirit of the Texas Medical Center," and by saying they have no intention of altering their actions. The now open free-for-all between the two former institutional partners is a remarkable development within the Medical Center community, which has always prided itself on harmonious relations between its various member institutions.

The conflict between Methodist and Baylor has been escalating since the two institutions decided earlier this year to end their 50-year relationship in which Methodist served as Baylor's primary teaching hospital for medical students and residents. St. Luke's Episcopal Hospital is Baylor's new primary teaching hospital, and Baylor is now building its own outpatient clinic. Methodist in turn recently entered into a relationship with Cornell University's Weill Medical School, which is in New York.

In the wake of their split, conflicts have developed between Baylor and Methodist over a new affiliation agreement, Baylor's use of space at Methodist, and over retention of staff and faculty physicians. After a Methodist official earlier this year stated publicly that Methodist hospital division chiefs ? most of whom also are Baylor department chairmen ? needed to choose between the two institutions, Methodist's chief of surgery resigned from the hospital and Baylor's chairman of pathology resigned from the college. More doctor fallout from the two institutions is expected.

Mr. Robertson's letter focuses on rank-and-file Baylor faculty, most of whom are under contract. The letter contends that Methodist's "aggressive recruiting" of those faculty members amounts to tortious interference with Baylor's contractual relations.

Stay tuned on this front folks. As we say in the legal community: "Let's get ready to rumble!"

Posted by Tom at 5:48 AM | Comments (2) |

July 13, 2004

Another Baylor doctor defects to Methodist

Deep divisions in the Texas Medical Center resulted from the decision of Baylor College of Medicine to terminate its 50 year relationship with the Methodist Hospital earlier this year. One by-product of the split is that Baylor and Methodist began to compete with each other for medical talent (earlier posts here) that previously served both institutions.

This Chronicle story reports on Dr. Michael Lieberman's resignation yesterday as chairman of Baylor's pathology department to become director of Methodist's new research instititue. This move follows the earlier resignation of Methodist's chief of surgery to remain with Baylor.

Dr. Lieberman is the first key defection from Baylor to Methodist in the battle between Methodist and Baylor to retain staff members. Before the Baylor-Methodist breakup, 19 of Methodist's division chiefs were Baylor department chairs; now that number is down to 17 and almost certain to reduce further.

Dr. Lieberman was one of the doctors who co-signed a letter to Baylor trustees in April opposing the breakup because it could cause "a crisis of major proportions" and predicting that many faculty would "undoubtedly" stay at Methodist.

Expect more defections between these two fine institutions as the dust settles after this unfortunate divorce in a long-standing Medical Center relationship.

Posted by Tom at 5:44 AM | Comments (0) |

July 6, 2004

UT School of Public Health announces new dean

Guy S. Parcel, Ph.D has been appointed to a three-year term as dean of The University of Texas School of Public Health at Houston in the Texas Medical Center.

Dr. Parcel, who is currently executive dean, will take over the deanship when Dr. R. Palmer Beasley retires in December. Beasley has served as UT School of Public Health dean for more than 17 years and is now completing a two-year term as chairman of the Association of Schools of Public Health. The appointment makes Parcel only the third dean in the 35-year history of what is the oldest school of public health in Texas. Dr. Parcel, a John P. McGovern Professor in Health Promotion at UT School of Public Health, was appointed executive dean in February 2003 and had previously served as acting dean of the school on several occasions.

The UT School of Public Health is ranked as the fifth-largest in student enrollment and seventh in research funding. About 50 percent of the school's more than 3,000 graduates work in Texas.

Posted by Tom at 3:39 PM | Comments (0) |

July 2, 2004

U.S. News annual survey rates Medical Center hospitals highly

U.S. News & World Report's annual survey of hospitals ranks several hospitals in Houston's famed Texas Medical Center as among the best in their respective fields in the United States.

The annual survey ranks The University of Texas M.D. Anderson Cancer Center for the third year in a row as the nation's top cancer hospital. Besides being named the best cancer hospital for the fourth time in the last five years, M.D. Anderson was also named the fifth best in gynecology, and the 10th best in both the specialties of ear, nose and throat, and urology.

The Institute for Rehabilitation and Research was recognized as the third best rehabilitation hospital in the country. Texas Children's Hospital ranked fourth in pediatrics in the magazine's survey. The Menninger Clinic was named the sixth best psychiatric hospital in the country.

The Texas Heart Institute at St. Luke's Episcopal Hospital was named the ninth best heart center. Moreover, The Methodist Hospital ranked in nine of the survey's categories, including 10th best in the area of neurology and neurosurgery.

The magazine's rankings are based on a nationwide survey of doctors, on hospital reputations in 17 medical specialties, and an analysis of indicators such as death rates, technology and nurse staffing. Of the more than 6,000 U.S. hospitals, only 177 ranked in even a single specialty in this year's survey.

The Texas Medical Center is one amazing collection of medical talent.

Posted by Tom at 5:14 PM | Comments (2) |

June 24, 2004

Methodist Hospital continues on the offensive

After the controversial split earlier this year (previous posts here) with longtime partner Baylor College of Medicine, The Methodist Hospital has been announcing a series of bold moves as it attempts to define its post-Baylor research and teaching role in Houston's famed Texas Medical Center. Yesterday, Methodist announced its boldest move yet -- a 30 year primary affiliation agreement with Cornell University's Weill Medical School in New York City.

No one can of another teaching hospital-medical school partnership in which such a vast distance separated the from its medical school. According to the Chronicle article on the deal, Methodist President Dr. Ron Girotto downplayed the mileage separating the hospital from Cornell, saying "distance is not an obstacle. Technology today makes anything possible -- the sharing of information, quality data and collaboration on research and patient care."

Cornell's Weill Medical College's primary teaching hospital has long been New York-Presbyterian Hospital which is one of the largest hospitals in the country. That affiliation will not change, as Methodist's deal with the medical school includes a Methodist affiliation with New York-Presbyterian, also.

Still unclear from Wednesday's announcement is how the affiliation deal will work in practice. Given the distance between Houston and New York, the relationship would appear to limit the typical type of faculty-student relationships that a teaching hospital typically enjoys with a medical school. Under the agreement, Methodist physicians can choose to have faculty appointments at Cornell, which Methodist believes will be a lure in recruiting. Methodist also contends that the affiliation will accelerate the development of the hospital's new research institute, which it recently announced.

Notably, the affiliation with Cornell and New York-Presbyterian is not an exclusive arrangement, and Methodist will continue to search for other medical school partners. Methodist forsees having multiple affiliations and are open to other ones in Texas. In that connection, talks are still ongoing between Methodist and the University of Texas Health Science Center at Houston, the other medical school in the Medical Center.

Posted by Tom at 6:20 AM | Comments (0) |

June 16, 2004

More Baylor-Methodist split fallout

Following on this post of earlier this week regarding the brewing divisions in the Texas Medical Center resulting from the decision of Baylor College of Medicine to terminate its 50 year relationship with the Methodist Hospital, this Chronicle story reports on Dr. Charles Brunicardi's resignation as the Methodist Hospital's chief of surgery, which is the first key defection from Methodist in the battle between Methodist and Baylor to retain staff members.
Dr. Brunicardi did not resign from Methodist's medical staff and will continue treating patients and performing surgical procedures at Methodist.

Dr. Brunicardi is a heavyweight in the Medical Center, and his defection is a blow to Methodist. Stay tuned as the battle for doctors between Baylor and Methodist heats up.

Posted by Tom at 4:32 AM | Comments (0) |

June 14, 2004

Methodist: "Docs, time to choose"

This earlier post reported on the controversial decision of Baylor College of Medicine earlier this year to sever its long ties with The Methodist Hospital and switch its teaching hospital relationship to St. Luke's Episcopal Hospital. That news rocked the medical community in and around Houston's famed Texas Medical Center.

Well, it looks like Methodist is upping the ante on Baylor. This Chronicle story reports on Methodist's move to create a special corporation that will employ doctors effective July 1. The corporation may force Medical Center doctors to decide between Baylor and Methodist, which -- as noted earlier here -- has been a major issue since Baylor ended their historic relationship.

Apparently, that difficult choice has already been put to Baylor doctors who are Methodist division chiefs. The physicians have been asked to stay and told they cannot maintain practices at St. Luke's or a new clinic that Baylor plans to build.

In creating the new physicians' organization along with a previously announced research institute, Methodist will allow be able to hire physicians and scientists on the condition that they do not work for Baylor. Texas hospitals typically create such physician organizations because of the state law that forbids hospitals from employing doctors in order to lessen the pressure that a hospital's financial conditoin would impair doctors' medical decisions.

Methodist's new organizations turn up the heat on the festering issue that has loomed since the breakup of the historic partnership -- that is, whether Baylor faculty members will elect to remain at Methodist rather than relocate to St. Luke's. As noted here, a group of Baylor faculty publicly opposed Baylor's decision to split from Methodist on those grounds. More than 1,000 doctors currently practice at Methodist and approximately 300 of them are currently Baylor faculty members.

H'mm. Any bets as to when the first "tortious interference with contractual relations-type" lawsuit will emerge from this brewing controversy?

Posted by Tom at 5:53 AM | Comments (0) |

May 2, 2004

Billy Cohn, M.D.

This Chronicle story does a nice job reporting on Dr. Billy Cohn, one of newer wave of cardiovascular surgeons who are fulfilling the legacy of great heart surgeons at Houston's famed Texas Medical Center that Drs. Michael DeBakey and Denton Cooley began.

Dr. Cohn, 43, has already improved the relatively new method of operating on a heart that is still beating by inventing a cardiac stabilizer that secures the part of the organ that needs surgical attention while the rest of the heart continues to pump blood. Moreover, Dr. Cohn is one of the leaders in a movement within cardiovascular surgery that is attempting to make heart surgery less costly and burdensome to the patient. Eventually, this movement among heart surgeons believes that open-heart surgery will be done without cutting into a patient's chest.

Dr. Cohn grew up in Houston, attended Memorial High School, and has recently returned to Houston from Boston to practice at St. Luke's Episcopal Hospital and the Texas Heart Institute. The entire article is well worth reading and provides a good summary of developments in heart surgery in the Medical Center.

As an aside, whenever I see an article about a doctor such as this one, I cannot help but recall noted medical academician Dr. Walter M. Kirkendall's (my late father) standard observation about such articles:

"Good advertising."

Posted by Tom at 2:49 PM | Comments (0) |

April 29, 2004

Baylor faculty members go public with criticism of move from Methodist to St. Luke's

This Chronicle story reports on a recent letter from seven Baylor College of Medicine faculty members to the Baylor Board of Trustees that predicted "a crisis of major proportions" if the Baylor Board followed through with its decision to sever Baylor's 50 year relationship with Methodist Hospital. The Baylor Board announced the decision to sever its ties with Methodist and commence a relationship with St. Luke's Episcopal Hospital on April 21, as reported earlier here.

Apparently, a group of prominent Baylor physicians tried to prevent last week's breakup between the medical school and Methodist by warning of "a crisis of major proportions" that could cause the school to "implode financially." On April 18, seven Baylor faculty members -- who are apparently either department chairs or division chiefs -- wrote the letter to the Baylor Board and the Methodist Board pleading that their affiliation not be terminated. The Chronicle reports that the letter says the following in part:

"If the St. Luke's affiliation proposal is adopted, a crisis of major proportions for Baylor will develop, and we will struggle to avoid devastating consequences. With (St. Luke's), the college will be burdened by more debt and, in fact, may implode financially."

The letter went on to say that Baylor had never "faced such an alarming crisis over its future." The letter also predicted that many Baylor's faculty members would "undoubtedly" keep their clinical practices at Methodist because Baylor and Methodist over the years have established so-called "centers of excellence" in various medical fields, including cardiovascular surgery, neurosurgery, psychiatry, ophthalmology and gene therapy. The letter contends that St. Luke's does not have the financial ability or facilities to build such programs in the near future, and also does not have sufficient operating rooms or bed space to meet Baylor's needs.

Finally, the letter predicts that some Baylor faculty members would become "voluntary faculty" to avoid moving to St. Luke's and that others would "leave Baylor and Methodist altogether." Replacing these faculty members, states the letter, would be costly and a blow to Baylor's academic prestige.

Dr. Richard Stasney, a long-time ear, nose and throat specialist at Methodist and a Baylor faculty member, was quoted in the Chronicle as saying: "It's very upsetting that a 50-year marriage ended. It's going to hurt Baylor a lot more than Methodist." Dr. Stasney was not one of the seven faculty members who signed the April 18 letter.

Read the entire article. More than a few ears are going to be burning in the Medical Center over this public disclosure.

Posted by Tom at 8:40 PM | Comments (0) |

April 23, 2004

The DeBakey-Cooley rift

One of the most well-known stories of Houston lore -- yet not discussed publicly much -- is the long-time rift that has existed between two giants of cardiovascular surgery and of Houston's amazing Texas Medical Center, Dr. Michael DeBakey of the DeBakey Heart Institute and the Baylor College of Medicine, and Dr. Denton Cooley of the Texas Heart Institute at St. Luke's Episcopal Hospital. That rift has resulted in Dr. DeBakey and Dr. Cooley rarely speaking to each other over the past 40 years.

As a result of the major announcement of this past Wednesday that Baylor College of Medicine is changing its primary teaching facility from Methodist Hospital to St. Luke's, Dr. DeBakey (of Baylor) and Dr. Cooley (or St. Luke's) are being forced to speak to each other again, at least to a limited extent. As this Chronicle artice reports, the first meeting occurred yesterday when both Dr. DeBakey and Dr. Cooley attended a meeting in which the historic agreement linking Baylor and St. Luke's was consummated. Cooley, 83, and DeBakey, 95, shook hands and greeted each other, then sat down at a table where institutional leaders signed contracts making St. Luke's the primary teaching hospital for Baylor. As the Chronicle report notes:

The pair's relationship dates back to 1951, when DeBakey offered Cooley a job at Baylor, allowing the Houston native to return home after completing his training at Johns Hopkins University School of Medicine in Baltimore. For the next decade the two would collaborate closely.

Cooley left in 1962 to found the Texas Heart Institute, acknowledging that directly competing with DeBakey in the same hospital became problematic. The two remained friends and were both still on the Baylor faculty, but no longer operated together.

In 1965, DeBakey participated in a federally funded program to design an artificial heart. Within a few years he had a device that some physicians felt was ready for human trials, but DeBakey believed it needed more work.

Then, to international acclaim in 1969, Cooley performed the first artificial heart implant in the chest of 47-year-old Haskell Karp, a dying heart surgery patient. Karp lived with the heart in his chest 65 hours before dying shortly after a heart transplant.

But Cooley's notoriety was quickly tarnished after DeBakey said the heart was identical to one under development in the Baylor labs, and that Cooley had used it without permission.

Cooley said he and Dr. Domingo Liotta, who also designed artificial hearts in DeBakey's lab, had built the heart privately, and that he had no choice but to use the heart because the patient's life was in jeopardy.

In a 2004 interview, Methodist heart surgeon Mike Reardon said the episode "stole DeBakey's shot at a Nobel Prize. What Mike needed was one crowning event to make him a candidate. And that was going to be the artificial heart."

After the incident the American College of Surgeons voted to censure Cooley and, amid a dispute with the trustees of Baylor, Cooley resigned from the institution. DeBakey changed his focus and decided funds would be better spent developing pumps to assist failing hearts. Such devices became the mainstream treatment for patients with failing hearts.

Posted by Tom at 7:44 AM | Comments (0) |

April 22, 2004

Big Medical Center news: Baylor picks St. Luke's over Methodist

In a move that has been expected for over a year but nevertheless shakes the foundation of Houston's huge Texas Medical Center community, Baylor College of Medicine announced yesterday that it is ending its 50 year primary affiliation with Methodist Hospital as its main teaching hospital and entering into an agreement to make St. Luke's Episcopal Hospital its primary teaching hospital.

Baylor (which has no affiliation with Baylor University in Waco) is one of two medical schools in the Medical Center (the University of Texas Health Science Center is the other) and the older of the two. In addition to the financial considerations that induced Baylor to make the move, the affiliation with St. Luke's now gives Baylor a direct relationship with two of the Medical Center's best hospitals, St. Luke's and its world-renowned affiliate, Texas Children's Hospital.

Although the severing of the Baylor-Methodist relationship is unfortunate in several respects, it may turn out to be a good thing for the Medical Center as a whole if Methodist and UT agree that Methodist would become UT's main teaching facility in the Medical Center. Such a relationship would give Methodist a direct relationship with another of the Medical Center's world recognized hospitals -- UT's M.D. Anderson Cancer Center and would either supplement or replace UT's existing relationship with the Memorial Hermann Hospital System. UT's relationship with Memorial Hermann has always been hindered by Memorial Hermann's relatively limited presence in the Medical Center, where its only hospital is Hermann Hospital, which is much smaller than either Methodist or St. Luke's.

Posted by Tom at 4:48 AM | Comments (1) |

March 26, 2004

Dr. Bill Fields dies

One of Houston's elite group of doctors who were integral to the development of the Texas Medical Center as one of the world's finest medical institutions has died.

Dr. William Fields, a long-time professor of neurology at both Baylor Medical School and the University of Texas Medical School in the Medical Center, died Sunday at his Houston home at the age of 90. Dr. Fields was a pioneer in medical research and testing of the role of aspirin in the treatment and prevention of strokes. In the late 1970's, Dr. Fields directed a major research project at 10 medical centers that established that aspirin may reduce minor stroke symptoms and also the likelihood of catastrophic strokes. Dr. Fields also was the first to assess the clinical value of carotid endarterectomy, which is the surgical removal of the lining of diseased or blocked arteries.

Dr. Fields was a colleague and dear friend of my late father, Dr. Walter Kirkendall, with whom he collaborated on many research projects. Through this friendship with my father, I had the privilege of knowing Dr. Fields, who was a wonderful and engaging man. Dr. Fields and my father were members of a generation of American doctors who revolutionized the purpose of medicine and health care in our society, and we all should pause and contemplate the magnificent contributions that this generation of doctors has given to each of us.

Posted by Tom at 6:34 AM | Comments (2) |

March 4, 2004

Heart developments in the The Medical Center

The Texas Heart Institute and the DeBakey Heart Center in Houston's Texas Medical Center are two of the best cardiovascular surgical care facilities in the world. Yesterday, the Texas Heart Institute announced that the 12th and only living recipient of an experimental, self-contained mechanical heart called the AbioCor replacement heart underwent surgery to implant the device on Feb. 20 at its facility in Houston. The recipient of the AbioCor replacement heart is in critical but stable condition. This is the fifth patient to receive the device at Texas Heart Institute under the care of Dr. O.H. Frazier, chief of cardiopulmonary transplantation and director of surgical research at the Texas Heart Institute and chief of transplant services at St. Luke's Episcopal Hospital. The AbioCor clinical trial began in July 2001.

In this related Chronicle article, several of Houston's leading cardiologists discuss the merits of the increasingly popular "off-bump" heart bypass procedure in which the operation is done "off-pump" -- i.e., without circulating the blood of the patient through a heart-lung machine. While some Houston doctors believe that the benefits of minimizing a patient's recovery time are so great that they use the procedure almost exclusively, other surgeons are skeptical about the procedure's ability to reduce the risk of stroke and other side effects.

Posted by Tom at 6:51 AM | Comments (0) |

February 27, 2004

UT honors Dr. Denton Cooley

Dr. Denton Cooley is one of Houston's many legendary doctors who have helped build the Texas Medical Center into one of the world's great medical centers. Dr. Cooley founded The Texas Heart Institute at St. Luke's Episcopal Hospital, and he performed the first successful heart transplant in the United States in 1968 and the first involving an artificial heart in 1969.

As Houston sportswriter Mickey Herskowitz writes in this column today, Dr. Cooley was a starting basketball player at the University of Texas at Austin in the late 1930's, and UT is honoring Dr. Cooley by naming its new basketball practice facility after him. The entire column is worth reading, but this part is essential for all fans of legendary former UT football coach Darrell Royal:

Among the speakers in Austin the other night were Mack Brown and Rick Barnes, who coach the marquee men's sports at UT. But the one who stole the show was Jody Conradt, the Hall of Famer who gave the Longhorns a national championship in women's basketball.

"They built the Erwin Center 21 years ago," she said, "and obviously it never occurred to anyone that the women would need a separate locker room. So every room in this place had urinals in it.

"Now we have one of our own. Before one of our games, coach Darrell Royal was kind enough to speak to my team. Before he left, someone asked what the biggest difference was between our locker room and all the ones he knew from all his years of coaching. Coach Royal said, `Offhand, I can't remember anyone ironing anything before a game in one of our locker rooms.' "

Posted by Tom at 6:43 AM | Comments (0) |

February 26, 2004

St. Luke's expanding

On the heels of this announcement regarding Methodist Hospital's expansion, St. Luke's Episcopal Hospital in Houston's Texas Medical Center announced a $200 million expansion project that will involve razing the original St. Luke's Hospital building and the construction of a 10 story patient care center. St. Luke's is the home of the famous Texas Heart Institute.

Posted by Tom at 6:44 AM | Comments (0) |

February 11, 2004

Methodist Hospital Announces Major Expansion Project

The Houston Chronicle reports today that Methodist Hospital in Houston's Texas Medical Center has announced a huge expansion that will likely cost just under a billion dollars when completed. Methodist Hospital and St. Luke's Episcopal Hospital are two of the major hospitals in the Texas Medical Center. Baylor College of Medicine, one of two medical schools in the Medical Center, has traditionally used Methodist as its primary teaching hospital, but has recently expanded its relationship with St. Luke's amidst widespread speculation that Baylor is considering termination of its relationship with Methodist. It will be interesting to see how or if Methodist's expansion impacts Baylor's decision on whether to maintain its long relationship with Methodist.

Posted by Tom at 6:39 AM | Comments (0) |

February 3, 2004

Wrong Type of Research, Docs

The Houston Chronicle reports today that the FBI has commenced an investigation into teen porn websites that certain individuals at the University of Texas Health Science Center at Houston apparently visited on a regular basis. The UT Health Science Center is home to the University of Texas Medical School, one of two medical schools (Baylor Medical School is the other) in Houston's famed Texas Medical Center.

The Kirkendall family has long and deep ties with the UT Health Science Center. My late father--Dr. Walter M. Kirkendall--was a longtime and loved Professor of Medicine at the UT Medical School at Houston from 1972 until his death in 1991, and the school still holds an annual lectureship in his name. I also have a brother (Matt of Dubuque, Iowa) and sister (Mary of Boerne, TX) who graduated from the UT Medical School at Houston.

Posted by Tom at 8:11 AM | Comments (0) |

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