THE UNIVERSITY DAILY
Relays Edition Med Center
KANSAN
Results of use of acupuncture unsure, doctors say
Vol.86 No.125
The University of Kansas—Lawrence, Kansas
Friday, April 16, 1976
See page 6
Staff photo by GEORGE MILLENER
Clinical welding
A welder puts some final touches on the steel superstructure of the new KU Medical Center clinical facilities building. The 700,000 square-foot building is scheduled to open in late spring.
Blue Cross, Med Center debate need of 'unnecessary' operations
Bv BILL SNIFFEN
Staff Writer
experiments by Blue Cross-Bleu Shield to some concerned some KU Medical, Gerp. physician
At issue are what are called "unnecessary operations"—operations that are costing patients $4 billion, according to a report by Representatives subcommittee report.
But definitions of "unnecessary" differ-
blered means one thing to Blue Cross
mother; another to
IN AN EFFORT to screen out unnecessary operations, Blue Cross-Blue Shield is expanding an experiment that was first tried in Albany, New York. The experiment successfully lowered hospital costs there.
Basically, the program recommends that a patient get a second opinion by another doctor.
patient. Second-opinion surgery plans have now been expanded by Blue Cross to New York City, Michigan and the New Hampshire-Vermont region.
Kansas City area Blue Cross officials are watching this experiment closely.
GARY HIDE, vice president or the institutional providers division of Blue Cross-Blue Shield in the Kansas City area said "I'm certain that we will study the feasibility of I and probably, within the context of the law, make a decision whether to implement a prescription."
In another experiment, Kansas City Blue Cross-Blue Shield has stopped paying its policy-holders for what it calls "unnecessary diademic admissions."
As a matter of convenience to the physician, or the patient, or both, a patient often admitted to a hospital for prehospitalizing. That, Blue Cross says, is unnecessary.
THE FIRST day in any hospital, including the Med Center, is usually the most expensive. Dan Duffin, director for accruals at Med Center, states that the patient is usually given all lab tests, x-rays and a complete physical. Duffin said. The average daily cost at the Med Center is $150; a figure that includes all costs, he but isn't representative of each day's cost.
The first day in the hospital is more expensive than the last day, when a patient is an out-patient, he said. The average stay at the Med Center is 7-4 days, he said.
Lou Savastane, public information
coordinator, said we "are denying the hospital-
room charges and a number of other things to
promote these kinds of things which
will be denied."
"IN MOST cases, we'll say 'Okay, you're"
Distinguished Med Center faculty made great medical contributions
in the hospital. We'll pay you for the tests
we've done, but we're not paying for the room and board.
Duffin said this experiment would have little effect on the Med Center. Most diagnostic procedures are handled on an on-camera monitor at the Med Center has a bad shortage, he said.
Loren J. Humphrey, chairman of the Med
Department, department, echod
Duffin S. nappilpheu
THAT SHORTAGE is often caused by special services offered by the Med Center, he said. Consequently, patients who are admitted to the Med Center usually need treatment—often surgery—and not just diagnosis, he said.
By JOHN FULLER
"in our type of environment," he said,
we don't see that because we always have
The history of the University of Kansas Medical Center can be divided into three time periods: the Dark Ages, the Renaissance and the Modern Era.
In his memoirs of his life at the Med Center, Dr. Ralph H. Mayer, former chairman of the department of medicine, used those categories to show how the center grew from a 50 bed hospital with primitive facilities and a $30,000 yearly budget 62 years ago to the modern facility it is today.
It was irreverently named "Gost Hill" because of the steep paths leading to the hospital. The rough terrain and the railroad tracks were too dangerous. "Gost Hill" wasn't the place for a growing medical center and legislators steadfastly opposed expansion until another site was chosen.
IT WILL soon have more than 800 beds and its budget year is almost 867 million dollars.
IT'S EASY to see why Major termed the early years of the center on "Goat Hill" the dark ages. When he arrived, the dean told him that he was glad that Major had ac
for the same reason, Humphrey said,
needless operations aren't performed at the Maternal Health Unit.
When KU welcomed its first class in 1866, there were no classes in medicine. It wasn't until 1880 that the University offered a two-year course in medicine. In 1892 who completed the course were admitted to the second year of a three year course in medicine at colleges in Chicago and Cin-
Inde said he thought the Med Center was conservative in its operation policies; that it performed operations with care. No intensive study has been made of the Med Center, he said.
See HISTORY page 5
City, Kan.) physician, Dr. Simeon Bishop Bell. Bell appointed $80,000 and five acres of land on a bluff overlooking Southwest Boulevard at Seventh St. to build and equip a hospital and medical school in memory of his wife.
OPERATIONS THAT HAVE been called unnecessary include tonillegemites, infant hernia operations, hysterectomies, knee infections, and reconstructive and plastic surgery.
A local paper called the site one of the most beautiful in the country but after the Eleanor Taylor Bell Memorial Hospital and a laboratory were built on it in 1906, the tube was it was inaccessible and hampered by smoke and noise from the nearby railroads.
In 1899, KU established its own two-year medical school and seven years later it merged with three privately owned medical colleges. City to offer a full four-year curriculum.
THE MERGER was made possible by a gift from a Rosedale (now part of Kansas
“不necessary” depends on one’s definition of the word. Humphrey said.
'In our country, where everybody's got a
tin and everybody has a car—that you've got an
wagon,' she said.
HUMPHEPRE CONTRASTED patient requests for surgery with the requests in England. Palliative or cosmetic surgery is said, and because the people can't afford it.
See OPERATION page 3
By MARION ABARE
KU studies need for physicians
Staff Writer
By BILL SNIFFEN
Abortion controversy continues but discussion of issue sensitive
It's tough to find a doctor in some parts of Kansas because the state lacks doctors if they are originally from the state, are sometimes reluctant to return because of the social and financial benefits of working abroad.
Three women will have abortions at the KU Medical Center today.
To meet the health care needs in the state,
The abortion will probably be their first. Two of the three probably won't be married.
See related story page 8
a University of Kansas Task Force for Health Related Programs is studying what
CHANCLELLOR ARCHIE R. Dykes appointed David Waxman, vice chancellor for students and coordinator of Medical Center and coordinated last month as chairman of the task force.
Waxman said recently that the immediate concern was to increase the number of family practice residency schools.
we teal an increase in these residency positions will help train more family practitioners for Kanaes," he said. "The program would give students a one-year residency at
The women will most likely be between 17-24 years old.
Total statistics on abortions performed in Kansas are public information, and are collected by the Board of Vital Statistics. The number of abortions performed in Kansas, Mental health was given by women as the reason for wanting an abortion in 4,683 of them.
See MED CENTER page 9
The two abortion methods most commonly used last year were the vacuum method, where a suction tube is inserted into the cervix and dilatation and curettage are performed. The womb scraped. A total of 4.946 abortions were done using these two methods.
THE AGE-GROUP which had the largest number of abortions was 20-24. A total of 3,534 women between the ages of 17 and 30 had abortions last year. A total of 4,885 women who had abortions last year had never had an abortion before.
The number of abortions performed at an individual hospital is virtually impossible to obtain. Officials at the State Board of Vital Statistics say the release of that in-
counties are Douglas, Sedgwick, Shawnee and Wyandotte. The source, who asked to remain anonymous, said the Med Center reported that 25 percent of abortions in 1975—slightly more than 1,000.
formation is against the law. Atty. Gen.
Curt Schnelder has agreed. Med Center
officials are reluctant to discuss the issue at
all
But a source who has access to information on abortions performed by information on the year's abortions in Kansas were performed in four counties. Alphabetically listed, the
RELUCTANCE on the part of state and Med Center offices to discuss the issue is understandable; abortion is a sensitive issue. Reasons cited for the reluctance to discuss abortion always include the protection of the women's right to privacy. That's a valid reason for a small hospital in a small Kansas county. But the Med Center about 320,000 patients a year, in a metropolitan area containing over a million people.
Perhaps not surprisingly, those most willing to discuss abortion are its opponents.
"The complete openness of abortion, as it is permitted today, tends to devalue and cheapean human life," says State Rep. Victor W. Kearns, Jr., R-Merriam.
"IT SHOULD not be another form of birth See ABORTION page 2.
Lives saved amid chaos
Bv BILL SNIFFEN
KANSAS CITY, Kan.--Emergency facilities at the KU Medical Center are a panorama of controlled chaos done in pictures and sound.
A teenage girl waits to vomit the 100 Excedrin she took to kill herself. Her face is blue; her father is a portrait of despair and resignation.
A 77-year-old woman, eyes fixed blankly on the ceiling, is wheeled in. She is the witch who had been taken.
"She can't breathe very long on her own.
No blood pressure. It doesn't sound like she's in too good a shape. Snatch her (blood) pressure in the hall . . ."
A young man screams with pain and demands that a doctor check his sprained ankle.
And the sounds:
Last year, the emergency facilities at the Med Center treated 32,461 patients—an average of 80 a day. Of that total, 17,508 were classified as 'true' emergencies—mostly in cases of severe measures. Non-emergencies tolled 12,582; and 2,001 patients were return visits.
"AND SHE'S how old? Have you been
before? Last name. First. Middle
name."
"Did your baby have a fever yesterday?
Did old is he? How much did you give him?"
THE LOG of patients treated from 7 a.m. Friday to 7 a.m. Saturday reads like a dictionary of medical problems. In included in that 24-hour period were four cases requiring psychiatric attention, three ear infections, one case of diarrhea, four infections, one patient who was dead on arrival, one case of acute asthma and one raps.
The only typical about an "average day" at the emergency facilities is that it's full of surprises, says Collette Foster, head nurse from 3 p.m. to 11 p.m. on weekends.
And there are less common problems as well. Foster said. One of the most unusual problems is that some children have
"There were some people who came up to the desk," she said. "With them was an elderly gentleman who was so well-dressed. He had on a vest; he even had on spats.
The man was referred to a psychiatrist, who also played along. Foster said. The patient was suffering from a lack of blood to sustain, a common problem of old age, she said.
"You think, 'This is really weird,' and you'll have a good laugh about it. But then you stop and think, and you can't laugh." Elizabeth Jobe, head nurse of the Med Center's emergency facilities, remembers two more serious cases.
"THEY HANDED me this note which read 'Please play along. He thinks he' be here."
Several years ago, she said, a chlorine tank at a swimming pool ruptured, she said. Six children were taken to the emergency facilities; all required oxygen.
Cases such as his are only half-funny, she said.
THE TOTAL number of children
requiring oxygen climbed to 47, she said, as more were rushed in.
More recently, a train deraliment sent 27 persons to KU's emergency facilities, she said. A lot of those victims were "cru-cunes" the nickname for persons suffering from three or more physiological manifestations; she said. A crunch could require aortoplasty (surgery) a neurosurgeon and a general surgeon, Jobe said.
"It all went like clockwork as far as getting everything organized," Jobe said. "That's the main thing in any disaster situation—organization."
In crisis situations, an emergency room nurse can't go to pieces, Jobe said, because she's not a doctor.
FOSTER SAID her reactions to crisis situations were automatic.
Because emergency room (E. E.) nurses have to be calm during crisis situations, many people think they are cold-hearted, Jobe said.
"It's just bing-bing-bing-bing. You don't even stop and think about it."
"that isn't the way it is all," she said. "They (E. R. nurses) like to take care of these patients—patients who need immediate and lots of care to live."
After a crisis, whether it involved one person or several, the doctors and nurses often fail to respond.
"THAT'S WHEN a nurse lets her hair down," she said. "Usually you'll get together with the doctors and nurses and bush over the case. Get your mind off it."
See EMERGENCY page 9
Emergency
An elderly woman with a fractured hip is given top priority at the
Staff photo by BILL SNIFFEN
KU Med Center Emergency Facilities. Medical problems brought here range from colds to heart attacks.