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Friday, June 30, 2006

Paging Dr. Kohler

The O had a little Q & A with the president of the OHSU Aerial Transit Co. yesterday. The reporter asked some good questions, albeit with tongue in cheek, and it was interesting to watch the interview subject revise history and explain what's in our future. Peter Kohler offered his comments as he wistfully prepares to leave his $600,000-a-year-plus-mansion position as the head of the state's public -- er, private -- er, why do you want to know -- medical school and soon-to-be major tourist attraction.

The good doctor's re-take on the SoWhat development was a doozy. Not too long ago, the stated reason that city taxpayers needed to borrow hundreds of millions to build a condo farm and OHSU facility down there (along with the aerial tram [rim shot], of course) was to bring thousands of biotech jobs to Portland. Now that all they're doing down there is building private doctors' offices and a health club, the story needs to change. And it has, apparently:

The pitch you made to the Legislature was that the investment would help OHSU spark a bioscience industry on the South Waterfront with 6,000 new jobs. Is that vision intact?

I think that was a 10-year plan that we are now a couple years into. I am a believer that this will occur. How much of the bioscience industry is on the waterfront versus somewhere else in the area is unpredictable. We're selling part of the OGI campus (the Oregon Graduate Institute site in Hillsboro), for instance, and that may be attractive to certain bioscience companies. There are a variety of ways this will play out. As much as possible, we'd like to have it on the river, but it may go elsewhere for other reasons.

Uh huh. You threatened to put a bunch of biotech jobs in Hillsboro if Portland didn't build you that stupid ski lift, and now that you've got it, you're putting the biotech jobs in Hillsboro anyway. Thanks, doc, what a guy.

Then there's the matter of OHSU's immunity from being sued for malpractice. Apparently they're thinking of raising their liability limits from $200,000 per botched surgery to something higher. But you've got to love the way he describes the process by which those rules will be changed:

Does OHSU's $200,000 damage liability cap limit your attractiveness for insured patients who have the option to go elsewhere?

I don't know. I don't think so. This is in the middle of change. We're in the process of disclosing it. We'll find out what's going to happen with the liability cap.

Er, ex-squeeze me? They're going to "find out what's going to happen" and they're "in the process of disclosing it"? Fascinating. I thought those decisions were made by our state legislature. But apparently not -- there's some other policymaking mechanism that the OHSU folks need to "find out about."

I remember back when the aerial tram [rim shot] was still being debated in the early days. The Trib dug out some communication or other about it from Sam Adams, then Vera Katz's right-hand man and now the city commissioner. Somebody was asking him whether Vera wanted the tram, and Sam said something to the effect that the mayor "felt that it was going to happen." Of course, in those days Neil Goldschmidt was representing Dr. Kohler, and the reason the Katz crew acted like these weren't their decisions was because they did whatever Neil told Vera had to be done.

Now we're debating OHSU's obscene liability limits, and the process of changing them is once again a force of nature that we'll "find out about" when OHSU is ready to "disclose" it. What arrogance. It makes Kohler's parting quote -- "humility -- that's what I've tried" -- that much more hysterically funny.

Comments (20)

Here's my translation of the Oregonian's softball question and the OHSU President's BS answer. It is only my opinion and could be wrong: "Does OHSU's $200,000 damage liability cap limit your attractiveness for insured patients who have the option to go elsewhere?" That should read, "Why would any person of means take a chance on being wiped out financially by having surgery at your instutution?" While the reporter did ask the right question, "limit your attractiveness" is putting it so softly that it almost reads like a laugh line. Here's an example in another context: "Does the fact that getting hit by a bus can kill you, limit the attractiveness of walking in front of one?" We're not talking about degrees of nice here. We're talking about the family of a boy who became brain-damaged by negligent care at OHSU and whose family is being wiped out financially covering the costs of taking care of him, and being worn down emotionally and physically because they can't afford future help. And the kid's getting bigger every year.
The OHSU president then chimes in with his lame answer, "I don't know. I don't think so. This is in the middle of change. We're in the process of disclosing it. We'll find out what's going to happen with the liability cap." In my opinion, "I don't know" translates into "Of course it does but I don't want to admit it." The guy made 600 grand a year to know the answer to that, but he doesn't want to say it. My guess at what "I don't think so" means is, "So far it hasn't hurt us too bad because the community hasn't been aware of it, and we're certainly not telling them in our ads or when they seek care." This last part - about informing the patients - was reported by local TV.
The change part may be referring to the outcome of the court case, but it may also refer to the true cost of the tram for OHSU: Because of the tram, Portland has taken a good long whiff of what they're selling up on Pill Hill. We've endured they're whining about being mistreated financially, and we found out what happens to the patients they mistreat medically. While they threatened to go to court over the tram, they were actually fighting the family of a brain-damaged boy in court for the privilege of not paying for their own mistakes.
OHSU had a good racket going up on the hill, but this last project was a Tram Too Far.

The February 2003 feature story in Brainstorm NW magazine is entitled "Banking on Biotech". It provides a good analysis of the potential for biotech development in sowhat. You can pull it up on their website.

What with yesterday's piece on Kohler and today's O piece on the convention center hotel, I am now certain that the powers-that-be have embarked on an ambitious plan to completely distract you from the World Cup proceedings .

Only yesterday I stumbled into this blog (I'm old enough to not completely understand blogs) while googling for uncensored, behind the scenes info on OHSU.

I thought I might have found something after reading the old OHSU items here, especially the ones garnished with rancourous inuendo, such as OHSU being "literally" in bed with The Oregonian. Alas, now I'm not so sure. If you are relying on a dyad that sleeps together to set the agenda for your attention and your editorial sniping, you may simply be functioning as dense air beneath a briefly visible arrow shot by an unseen bowman.

Don't get me wrong. I'm all for the sniping. But I'm more interested in seeing an all out assault by way of large-scale public opinion and grass-roots pressure.

Undoubtedly, you fellows have bothered to read E. Kimbark MacColl's trilogy on the infamous history of PDX. You know modern PDX is the incestuous child of generations of government-commerce consanguinity. That is the point of view from which to view the relatively insignificant tram, south waterfront, tort protection and the like.

Would you take the naïve position that it is the President who runs the country? That all power, direction and control flows from him alone, unfettered and unbeholden? Certainly not!

Who selects and maintains OHSU's figurehead? As important, where does the big money go? Who really are those people on OHSU's board of directors? How does a Govenor come to select them? Who are the invisible and unnamed puppeteers? That's what I want to read about. Where do I go to inform myself on those topics?

Maybe OHSU could let all the claimants that hit the $200k liability cap ride the Tram for free?

If that's where OHSU's excess capital is going, it only seems fair that those who helped subsidize it would get special consideration.

Could Disney sue them if they hand out Mouse Ears?

The sad fact is that the majority of medical negligence victims recover nothing via the legal system these days. Even if you can find a qualified malpractice attorney who is willing to represent you on a contingency fee contract you will be persoanlly liable for $100,000 or more in litigation expenses (most of which are non-recoverable even if you win) to have your day in court. The 200K tort cap is an evil thing because unless it is a truly open and shut case (maybe 5% fit this description) no lawyer in his or her right mind will consider taking it on. The best way to protect yourself from being wiped out by a medical mistake is to drive safely, lead a healthy life, maintain adequate insurance (auto, life, health and disability) and do your homework on your doctors and the hospitals you go to. It strikes my funny bone that Dr. Kohler shares his name with a high end toilet manufacturer.

Who are the invisible and unnamed puppeteers? That's what I want to read about. Where do I go to inform myself on those topics?

Go to the Portland Tribune archives. Find the story "Neil's Network." You'll find both Kulongoski and Saxton there.

Enjoy.

I've noted that the medical establishment routinely attempts to limit liability damage by occasionally throwing a binding arbitration agreement form in front of you at the last minute. I routinely try to reject these, and so far, except for Providence Health Systems, have been successful and (as far as I know) haven't been refused services for not signing one.

Nothing against trying this route anyway - I might choose to start out this way if I were in the situation - but I don't want to be forced to sit down with a medical establishment and their lawyers and insurers, and have them employ the process as a tactic to wear you down. I can state that I've seen OHSU's and Peter Kohler's performance first hand in this situation as a juror in a civil case involving OHSU hiring an employee, stealing his intellectual property, and then firing him. I felt the plaintiff had a very good case, and so did the jury. They pulled out all the stops, and when OHSU lost the case, simply appealed it to further wear him down.

How many people really read these forms and push back? Probably not many, I suspect. Sadly, this seems to be pervasive in other areas of society - Merrill Lynch tried it with me a year ago, and Broadway Toyota just tried it just last week.

Oregonian: Will Sam succesfully maintain his $57 million erection for 50 years?

Kohler: Our researchers are working hard on this.

I give it 20 years of sporadic and very expensive operation before it's removed -- at a cost of tens of millions, paid for by city taxpayers, of course.

Unless there's a big earthquake in the meantime, which will shut it down immediately and permanently.

I realize it's difficult to judge scale on a large construction project with the human eye. That said, the "wrist" (or narrowing) about two-thirds of the way up the Tram Tower looks very fragile.

I wonder what sort of vertical/horizontal load it was designed to carry? If we ever suffered a large earthquake, I would be willing to bet $57 million of OHSU's money that it breaks at that "wrist" location.

I also think it's amazing that their "design competition" results (sparse though they are), look nothing like what is actually being built.

When did all those design changes occur? Did PATI sign off on them?

The design competition (Mrs. Goldschmidt and Mr. Francesconi in charge), the gushy Randy Gragg articles, Mike Lindberg selling his good name, the PSU planning weasels, pretty much everything that greased this through was a lie -- a lie gladly winked at by Messrs. Sten, Saltzman and Adams. Even Fireman Randy drank the Kool-Aid for a while.

Let's start a pool on what the next one will be.

And if you don't think this monstrosity is going to cause major accidents on I-5 beneath it, you haven't driven through there lately. We'll pay many hundreds of thousands for warning signs.

And have you tried getting into downtown from LO and other points south on Macadam Avenue lately? SoWhat is like a roadblock. All the more reason to site your corporate offices in Clackamas County.

Really nice call here, Vera/Erik/Sam. Great "planning."

Jack bog: Let's start a pool on what the next one will be.

My take: A Government Camp-to-Timberline Tram. After all, they've already said as much.

Hey, Earl walked around the mountain with, who was it, Walden? So now we can expect nothing but the best.

I was driving Southbound on Macadam at 2:00 yesterday, with sparse traffic.

Northbound was complete gridlock, and I didn't see any accidents. Must have been related to SoWhat construction.

With a long line of imported luxury cars starting out for tee times on a Saturday morning, and think I'll start using Barbur Blvd as my principal arterial. Thank god they didn't build the second tram.

northbound Macadam is q mess. they have it down to one lane where the tram tower is, which is totally gratuitous. it guarantees gridlock during rush hour..

Worse, while you sit there in traffic, you look over you left shoulder across the curbed median and see the two -TWO! - totally unused lanes to handle the non-existent traffic exiting off I-5.

Hardly anyone ever uses that exit, but the PDOTGeniuses dedicate two lanes to it while forcing the thousands of cars on northbound Macadam to squeeze thru a one lane bottleneck.

If they aren't actually TRYING to make driving miserable, then they are incompetent indeed.

And if the reason for doing this IS to create congestion, they should be publicly floggee

If we had a city auditor or D.A. that wasn't in go-along-to-get-along mode, we could build a tram from City Hall to Wapato.

Cost saving design proposal: it only needs to move in one direction!

SoWa planners included a new I-5 fly-over exit to SoWa to handle that portion of traffic entering the area.

Unfortunately like so many road improvements there is no money for the $40 plus million project.

Bluntly put, The SoWa plan continues to suck more every day.

The new median curb, new signal, and left turn off the freeway ramp is a panic driven "temporary" fix but it is a perfect demonstration of asinine and dysfunctional planning.
Along with the many other ridiculous components
and mounting project's cost overruns the PDC, PDOT and other city planners have planned themselves into a corner.

With elected officials seemingly in some trance and incapable of recognizing the mounting problems or even getting basic information to ponder the situation is the perfect recipe for municipal fiscal calamity.
One which will demand countless millions in new revenue and taxes just to stop the bleeding.

Especially with every public official so enamored with and deluded by the status quo.

When the OHSU "Oregon Opportunity" $200 million dries up, construction grinds to a halt, OGI campus sale proceeds are spent, and Tram debt payments chew into OHSU operating budgets the taxpayers will be on the hook for stabilizing the city's biggest employer.

I can just hear the city hall groupies making the pitch to bail them out.

The bailout will be another linchpin.

Kohler will be enjoying golf in the tropics.

Rob: the "PDOT geniuses" was mainly Matt Brown (the tram man) who many times came to URAC, neighoborhood meetings and explained how Macadam modifications could be made to handle NoMac traffic. When he was questioned on his suppositions (5 designs) he would smile and say that we would have to accept "congestion", "but it may work". PDOT and Matt should be held accountable for the havoc NoMac is creating, even after only 5% NM build out. Accountability should be more than talking about it.

PDOT keeps using the same old traffic engineer,in the same bed, consultants (NoMac-Hovee Traffic Engineers) that follow the PDOT, City Council line.

Posted by: Jerry at July 5, 2006 10:24 PM

Impossible commute from Lake O. and West Linn -- just one more reason not to work or site your business in downtown Portland.

And the beat goes on...

Posted by: Jack Bog at July 5, 2006 11:02 PM

(Posted as indicated, restored later.)




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