The perks of practicing medicine in Louisville, KY
The perks of practicing medicine in Louisville, KY

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Community profile: Louisville, KY

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Ask George Scott, MD, born and bred in Detroit and medically educated in Chicago, how he ended up in Louisville. After finishing a residency in Morgantown, West Virginia, Louisville became his “test case,” as he tells it. “I was headed to Chicago,” he says. “I had set up an interview there and happened on this opportunity in Louisville. It was like an audition. I wanted to see how well I interviewed, and I wanted to see what Louisville was like.”

Down the stretch come contenders for the blanket of roses awarded to the winner of the Kentucky Derby each year.
Down the stretch come contenders for the blanket of roses awarded to the winner of the Kentucky Derby each year.

Fireworks soon began, not the spectacular pyrotechnics that light up the sky for the grand opening of the Kentucky Derby Festival, but the kind that go off in your head when something exciting happens. Scott says, “It completely blew me away.

I met the people at Jewish Hospital & St. Mary’s Healthcare, and they showed me around town. My wife, Andrea, and I were just floored by how diverse the area is. There are immigrants from all over theorld. It’s an urban environment. The job seemed right up my alley, what I was looking forward to doing and the type of practice that I wanted to be associated with.

One of the many beautiful neighborhoods in the area, Saint Matthews is a prominent suburb of Louisville.
One of the many beautiful neighborhoods in the area, Saint Matthews is a prominent suburb of Louisville.
Louisville scenery 2
Homes in the Cherokee Triangle, a vibrant historic neighborhood just two miles from downtown, is near Olmstead-designed Cherokee Park.

“We left with a very good taste in our mouths about Louisville. I thought, ‘Maybe we should stay.’” Scott has now been with Louisville Neurology Associates for a year. The cultural atmosphere seems almost made to order for him. “I’m an artist—a painter—and Louisville is very steeped in art. It has the largest art fair in the world (the juried St. James Art Fair with 700 exhibitors).

Just on our street—in the downtown art district—there are 10 or 15 galleries. Probably once a month, they bring in new artists. (He has already exhibited some of his own works.) Across the street there’s a glassworks gallery, too.” Another big plus for Scott is the city’s Art Hop. At the end of every month all the galleries stay open late, and so do the restaurants, including his neighborhood favorite, the Mayan Café, a fusion of Latin and contemporary American cuisine. Admitting that he’s a “Hispanophile,” he puts a Cuban bistro, Havana Rumba, on top of his list.

The list of gourmet favorites is long and includes Vincenzo’s, Equus, Maker’s Mark Bourbon House & Lounge, Artemisia, Café Bristol and—not to be left out, gourmet or not—Claudia Sanders Dinner House, named for the colonel’s wife and ensconced in the Sanders’ former home and headquarters building. Yum Brands, Inc., the current owner of KFC and several other national fast food operations is the city’s second most lucrative publicly traded company. Texas Roadhouse makes its home in the city and so does “locally grown” Papa John’s International, the world’s largest pizza purveyor.

Aside from gustatory explorers, Scott is not the only new arrival to be surprised by Louisville’s cultural, cosmopolitan ambience. Still, in Kentucky’s largest city, residents are seldom shocked when uninformed newcomers expect to meet a smiling Col. Sanders with fried chicken in one hand and a shot of bourbon in the other. The idea didn’t develop by accident.

Louisville’s hospitality history

According to historian George H. Yater, in his book Two Hundred Years at the Falls of the Ohio, (Filson Club, 1987), said, “When manufacturing was dominant, Louisville became basically Midwestern in temperament, although it assiduously cultivated a romantic image of southern gentility. It managed to convince the nation that this was so. It has been found difficult to erase that image.” But “southern gentility” was also interpreted as “drowsy languor under the magnolias.” Still, “hope” was on the horizon in 1987 when Yater’s book appeared and he said at the time, “The erasing process is, however, under way.”

The Mohammed Ali Center opened on Main Street's Museum Row in 2005 alongside other traditional and functional art galleries and museums.
The Mohammed Ali Center opened on Main Street’s Museum Row in 2005 alongside other traditional and functional art galleries and museums.

He was partly right. The friendliness and Southernstyle hospitality seems as prevalent as ever, but this city has embellished its image with a cultural arts district; a thriving downtown night scene; 126 parks of all sizes, including one former waterfront trash dumping ground transformed into green space and now cited as the Number One Waterfront Park in the country; AAA baseball (Louisville Bats), college football and basketball, and almost countless museums, several clustered in a downtown Museum Row, along with a thriving art community.

Nevertheless, the old heritage has not been ignored in

The Kentucky Museum of Art and Craft, on Main Street's Museum Row, houses four exhibition galleries and an award-winning gallery shop. The non-profit organization was founded in 1981.
The Kentucky Museum of Art and Craft houses four exhibition galleries and an award-winning gallery shop. The non-profit organization was founded in 1981.

a rush of revitalization. The city’s Victorian neighborhood shelters America’s largest number of late 19thcentury homes, according to the Louisville Visitor’s Bureau. Architectural aficionados point out that the term “largest-in-America” also applies to the city’s downtown group of buildings with iron façades.

There’s good news on the economic horizon, too. “We never had the bubble, so we never had the bust,” says Carmen Hickerson at Greater Louisville Inc., the city’s version of a chamber of commerce. City spokesman Chris Poynter points out that the population increased gradually over the years, so “we never had the peaks and valleys” of a sudden influx or decline. Still, in the current recession there have been thousands of layoffs. “Just now, though, layoffs have stopped, and we’re starting to see signs that the economy is bouncing back,” Poynter says.

With multiple thousands of employees, General Electric was a dominant presence complete with a “company town,” also know as Rangeland (for stoves). Its Appliance Park covered a huge swath of city land. Hard times came when the company sold the division and production went to China. But things have changed again. GE will soon add 840 more workers to join 5,000 current employees in manufacturing its first new products in 30 years—energy-efficient washers, dryers and water heaters, all programmed to operate automatically at low-use times.

Louisville sits at both the widest and deepest part of the Ohio River.
Louisville sits at both the widest and deepest part of the Ohio River.

The golden days of manufacturing have been overshadowed by service and wholesale/retail industries, but the sector still counts some 84,000 employees or about 16 percent of the workforce. GE “companions” include two Ford Motor plants, Tyson Foods, trade publication printing (since 1866), automotive supplies defense systems, river barges, and not to be forgotten, bourbon. Ford production, an economic cornerstone since 1913 operates two plants. Although it moved production of its Explorer SUV to Chicago, it is investing $500 million to retool one of the Louisville plants to
build crossover models.

The Louisville Cardinals Fall 2010 season opened with new head coach Charlie Strong.
The Louisville Cardinals Fall 2010 season opened with new head coach Charlie Strong.

Today, as proof of the business axiom, “location, location, location,” the current largest employer, UPS, established its hub here, transforming a “sleepy” passenger airport into the world’s third largest cargo airport, a benefit to everyday travelers who now enjoy some 90 departures daily on several national and regional airlines. Poynter says, “Everything you order online, from live lobster to jewelry, comes here first. Indirectly, a hundred companies we know of have moved their offices here because of UPS.” With 25,000 employees, the company is now Louisville’s top private-sector company.

(A $21.4 billion enterprise, Humana, Inc., the health insurance company, is the top publicly traded company.)

New trends in Louisville

With a larger and larger mix of more innovative ventures, including research and education, city leaders have dubbed their town Possibility City, complete with a web site:

The hospitable atmosphere was not lost on the medical community, especially at the University of Louisville with its immense research arm. In 1999, medical oncologist Donald Miller, MD, left cancer research at the University of Alabama to become the director of the James Graham Brown Cancer Center at the U of L. The center is one of four components of the U of L Health Sciences Center, which also includes the School of Medicine and the University of Louisville Hospital. Hospital patients benefit from leading-edge clinical trials at the Brown Center, where a team concept of treatment has been set up with treatment plans customized to patients.

Miller says, “One major focus that we’re very good at is developing new drugs for cancer. Three are in clinical trials now out of our labs and another 25 are coming along. We have one of the most robust pipelines of anti-cancer drugs of any cancer center in the nation.” One of them has been called the first 100 percent effective cancer vaccine. Another, now in Phase II trials, is AS1411, a tumor cell growth inhibitor that has inspired the formation of a biotech firm by Miller and two colleagues.

Center researchers have also capitalized on tobacco, a long-gone mainstay of Louisville manufacturing, with the goal of using the plant to develop a less expensive version of the vaccine Gardasil.

Louisville statistics
Louisville statistics

As for the city itself, Miller admits, “We didn’t have any expectations whatsoever, but we have found Louisville a pleasant, accepting, welcoming place.” “There is a wide variety of housing at all levels of expense, so that you can find a place to live that you like.” Even though the city “is in the middle of the country where people don’t commonly go unless they have business, we’ve recruited more than 90 people here, and, without exception, they have been very happy.”

He also gives kudos to city revitalization over the last decade, including a now vibrant waterfront. “It has added much more of a big-city flavor.” Much credit for the “new look” goes to the city’s equally vibrant Mayor Jerry Abramson, who became the “metro” mayor after engineering a Louisville/Jefferson County consolidation in 2003, which, among other benefits, slashed administrative costs.

Today four large hospital groups seem to have the population needs well covered. Three have major presences in the downtown area—University Hospital Jewish Hospital, and Norton Healthcare. The latter two have several other locations, while the Baptist Healthcare System has two locations in the metro area and three in other Kentucky cities. Their collective history offers an unusual lesson in ecumenism.

Its name alone is enough to prove the case for Jewish Hospital & St. Mary’s Healthcare (JHSMH), a regional network of some 70 healthcare facilities, including Our Lady of Peace, a psychiatric hospital for children and teens. The group’s history dates to 1874 with the founding of St. Mary & Elizabeth Hospital. One of several charming stories from the archives is about Sister Augustine Donovan, who cared for 24 patients in one ward.

Jewish Hospital opened in 1905, a time when Jewish physicians found it difficult to affiliate with Christian facilities. The hospital, however, declared itself a nonsectarian institution to treat patients of all religious sects.

By the time a series of mergers brought them together in 2005, each had a history of healthcare innovation that continues today. One of its current campaigns, “Less Time in the Hospital,” is a concerted effort to increase minimally invasive surgeries. The transplant center at Jewish Hospital is one of 12 federally-designated facilities. Its surgeons performed the country’s first hand transplant as well as the first AbioCor surgery to implant an artificial heart with a battery pack. Scott, the neurologist, is among the physicians involved in its Neuroscience Center of Excellence.

As the third-leading cause of death in Kentucky, stroke is not a surprising focus for several Louisville hospitals, especially Norton Healthcare. For a while, and for several reasons, it was difficult to attract neurosurgeons, according to hospital spokesman Steve Menaugh, but last year, the Norton Neuroscience Institute opened, and chief medical officer Steven Hester, MD, recruited 15 surgeons with specialties in endovascular surgery, spine care, tumor oncology, movement disorders, pediatric surgery, and deep brain stimulation. Hester says the success was probably due to the recruiting philosophy, “We were able to create a shared vision: Here are the things we want tobuild. How, as surgeons, do we do that?’”

The “brain” focus is not limited to Norton, though. Kerri Remmel, MD, the director of the University Hospital Stroke Center, promotes rapid access and response in stroke cases. University Hospital has partnered with 12 regional hospitals and three veterans centers, each of which is equipped with a rolling robot. It may look like a TV screen on top of a vacuum cleaner, but its mission is to save lives. The space-age machines also work well for neonatologists and intensive care specialists.

Wheeled into a room at one of the regional hospitals, a robot connected to University Hospital allows a live specialist to diagnose a problem and recommend quick action and/or a transfer. Physicians wary of “machine medicine,” are quickly converted. “This robot walks into the room, and in 30 seconds [the robot has become] Dr. Remmel,” she says. “I had no idea that I would develop a relationship
with a patient and his family.”

There is one hitch, though. “A robot doesn’t interfere with the physician/patient relationship, but if you have a bad bedside manner (the robot) won’t help you,” Remmel says.

Another important aspect is the medical community’s openness to cutting-edge surgery. Lori Warren, MD, a gynecological surgeon affiliated with Baptist Hospital East, has become a nationally recognized evangelist for minimally invasive hysterectomies and other female surgery. Her quest has involved appearances, magazine articles, and training sessions for both students and established physicians. “Once I had developed (the use of) minimally invasive surgery myself and with my group, I started realizing it wasn’t the standard of care for all women, that across the country not all women were being offered minimally invasive surgery for hysterectomies and other gynecological problems,” she says. “Now I try to educate doctors and other women to let them know that they have options.”

She’s spurred on by the fact that one in three women will have the surgery by age 50, “but more than 60 percent are still done open.” In her practice, the percentage is dramatically lower. “I very rarely have to open anyone up for a gynecological procedure,” she says.

Paige Walker, MD, an OB/GYN with Norton Healthcare, is among the believers in Warren’s gospel. “We do total laparoscopic surgery,” she says.

Louisville: Possibility City

As a place to live, Louisville, says Walker, is like Atlanta of the 1970s, where she lived with her parents. At that time, “you knew everybody, there were a lot of little neighborhoods with their own personalities, and you could get around really well. Today, in Possibility City, she says, “I’ve never felt like I don’t fit into the scene because I moved in from out of town.”

According to Warren, Louisville has something to offer everyone, “This is an accessible, easy-to-live-in city. Anything you would possibly want to do is right here in Louisville.”


Eileen Lockwood

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