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Olivia Frederick: This is Olivia Frederick with the University of Louisville Red Cross Hospital project. Today, August 30, I'm talking with Waverly Johnson at the West End Medical Center, in Louisville, Kentucky. Mr. Johnson was born on August 17, 1917, his father's name was James Johnson and his mother's name was Sally Johnson. Mr. Johnson, first why don't you tell us a little about yourself, where you were born, your education, that sort of thing.

Waverly Johnson: I was born in a town called Dendron, Virginia, which is located in Surry County in the southeastern part of the state of Virginia. At a very early age, we moved to Pittsburgh, Pennsylvania or in the vicinity of Pittsburgh, in a town called Wilmerding, Pennsylvania, and there I began my schooling, took my elementary school and secondary school training there. I was 1:00graduated from Turtle Creek High School in the year 1936. Then I pursued employment with the Westinghouse Air Brake Company where I worked as a clerk for a number of years. In 1945 I was inducted into the Armed Services of the United States where I served from there until 1947 or latter part of '47, in the Air Force as well as in the Infantry. I was discharged as a corporal. In 1948, I entered college to pursue the course of business administration at Hampton Institute in Hampton, Virginia. I graduated three years later in 1951. 1952 I 2:00entered Columbia University at New York City to pursue the course of hospital administration. There I finished that course in June of 1954. Upon the completion of that job, I was employed at the Red Cross Hospital, which was located at 1436 South Shelby Street in Louisville, Kentucky, and I came to Kentucky at that time. Since 1954 I have been living in Louisville.

OF: How was it that you learned about the Red Cross Hospital, or they contacted you?

WJ: I learned about the Red Cross Hospital through the placement office at Columbia University.

OF: What were your early impressions of Louisville and the hospital?

WJ: Well, I thought I was going to the hinter lands when I came here, but at the same time, I found Louisville to be a very pleasant place to live. And of course 3:00the hospital itself was struggling, and as all small private black institutions were at that time in the mid '50's. I found it to be very challenging and I gave it twenty years of my life.

OF: Now I believe there have been interim administrator between you, between Mr. Baker and yourself, when you took over, am I correct?

WJ: Yes. I understood that a Mrs. Hyatt, I believe, was the acting administrator during that period of time.

OF: What sort of, I guess, I'm wondering how large was the hospital at this time, how many patients?

WJ: At the time when I came to Louisville, the hospital could handle about a hundred and, well, say maybe a hundred beds. It was about a good 100-bed hospital, but all of the beds were not, you might say, at par level so that we 4:00tried to run about an eighty-five bed hospital.

OF: Is this considered a small, or?

WJ: Yes, small hospital.

OF: Small hospital. This was soon after the Heyburn Addition was built, is that correct?

WJ: I came after the Heyburn addition was built, yes. I think it was built in 1951 and I came there in 1954.

OF: What was the relationship of the administrator to the Board of Directors? And did it change over, during the period you were administrator?

WJ: I found that during the years that I worked at the hospital that there was a very good relationship between the administration or the administrator and the board of directors. However, as time go on you get new blood in and people don't 5:00always agree with the things that have been going on, they want to bring in new ideas and thoughts, and of course we had other pressures at that time, too. I came in here just as the integration thing had broken throughout this country, when there was declared not to have segregation anymore, and so that during the earlier periods, period of my time, primarily most of the we said, private paying patients, were using the Red Cross Hospital. And as the years passed and the other institutions and the advent of the Medicaid and Medicare program, where they began to push about non-desegregation and all of that, that the other 6:00institutions began to open up and therefore we had to, we had other, those kinds of problems to face, which meant that people coming in was trying to develop ideas and all on the basis of survival. And I felt, and I still feel, that a small institution to survive, must be very efficient, give high quality of care, and it can still survive, but you can't survive if you're going to continue to compete with the larger institutions because if they buy a piece of equipment and then you going to try to buy it and the next thing you're in the hole. So that many of the things that we did, or that was proposed to do, to try to save, so to speak, Red Cross Hospital as an institution, were not feasible. And so toward the latter part of my administration there, there seemed to be a feeling 7:00that, well, of division, so to speak, a slight division began to come in, and so I felt it was best that I go resign, let them have it, because doing the first twenty years of it and under the philosophy in which I was brought up under and how an institution was supposed to be run, I did not particularly buy modern buildings as giving good health care. I mean they're alright, but the buildings themselves are not, it's the people who give the care. And of course if you've got competition with the newer hospitals, and the newer techniques and whatnot, so that it made us look further back in terms of that, but still I don't believe that even until today, that any hospital including your most efficient new hospital, give the type of TLC that Red Cross gave.


OF: I've been processing the papers, I ran across letters from patients and that sort of thing testifying to that, to the quality of the personal attention they got at the hospital. You touched upon many things I want to try to get back to, during the course of this interview, but first I'd like to go back to the question of the board. Then there were divisions that developed, were you referring to over what course the hospital should take?

WJ: Towards the end, yeah.

OF: Towards the end, on the board. I know in about 1968 there were consultants who were brought in I think [inaudible] and Associates, who made a study and recommended that Red Cross become a convalescent care hospital rather than an acute care hospital, or perhaps go into nursing home sorts of care. And this would seem to me, it was debated back and forth and was discussed even before this, and I'm wondering if this was the type of split you were talking about on the board?


WJ: No, because at that time the board, I think the board was fully, had a strong feeling that, in the earlier days, and I say earlier days, I'm talking about in some of the days of its infancy and all, Red Cross perhaps was looked upon more or less as a nursing home type situation and not as a hospital per se. Now, once the hospital got its accreditations and all as being a full fledged small community hospital, they did not want to add to the hospital, and that time it was discussed, a wing for convalescent care, or a wing for nursing home care, because it felt it would take away from giving, we thought, acute care. Now in retrospect, I can tell you that many institutions that added those wings wished they hadn't now, because it did do something to the, we call primary focus, which was delivery of health care and getting people out, and not to be a 10:00place where they can, you know, stay around. So, no the split didn't come over that, I think the split came, when I say the split, if there was a split or disagreement, was that in terms of, we were getting short, there was a shortage of black physicians in this community and we were trying to get more and more physicians in, and at that time [it] was very difficult to bring them in because the hospital was short of funds itself. And that the only thing that we brought them in, then the hospital would be delivering healthcare without the private doctors. See Red Cross Hospital was one of the very few hospitals in this area, that the entire staff was private practicing physicians. There were no paid physicians on the staff. We had a house physician once or twice, but basically our hospital was supported by the community doctors, see. So they were trying to find a way to bring in more doctors and they felt that by changing the image, they called it, used the term "image" of the hospital, the first thing they did 11:00was change the name. They went from Red Cross to Community, they thought this would help it. My feeling was then, and still is, anything that is new people will go to. So when the other hospitals became open for integration, they, or the people who felt that they could get better service there, went. But I think if you would have a survey made and analyzed, that if they would be honestly about it they will tell you the service was no different. But they felt this way, it's the way of feeling, you know. If you're riding in a Ford and you've always wanted a Cadillac, you always feel that if I get that Cadillac it'll do things the Ford won't do. But once you get the Cadillac, you'll find that the only thing it will do is take you where you want to go and it will bring you just like the Ford will. Now you may do it in a little more comfort, but where 12:00the hospitals are concerned, I've always felt that as long as we offered quality care, tender loving care, to our patients even though our hospital was not totally air conditioned, you may say, well that's the reason I don't want to go. These are things that I believe that people went to other institutions at the beginning. And of course we know that in 1976 that under some reasons they closed and what reason it was then I don't know because I wasn't there, I wasn't a part of it at that period of time.

OF: Well, that explains the situation with the patients. Why were so many black physicians, or why didn't they use Red Cross Hospital, or go to other hospitals and not use Red Cross.

WJ: They did. I would say that all the black physicians in the community utilized Red Cross Hospital. However, when as I say when other hospitals opened 13:00up and certain doctors were given privileges, their reasoning to me was, that their patients requested to go there. Alright, one of the other things that the other hospitals offered that our hospital could not offer, and that was coverage of a physician. We didn't have a house staff, and we were short a house staff, so when other hospitals had house staffs, that if they needed to see a doctor three o'clock in the morning, instead of having to call the doctor, getting him out of his bed to came to the hospital, they had a doctor on site. That was, those were some of the things that I feel that caused our doctors to go to other hospitals.

OF: I you know ran across this in the records a lot, the efforts to try to find the board, the administrators and yourself and the ones that followed you, to try to get the physicians to use the hospital through various techniques, 14:00[inaudible], peer pressure, letters and all this sort of thing, and so I wondered what the reasons were?

WJ: I think those were the basic reasons, and then again when you have, let's put it this way, when Red Cross Hospital started, for a number of years, we classified it as a general practice hospital, okay? We had surgeons, and you must remember that prior to 1954, that there were, black doctors could not operate in the other hospitals in the city, and they didn't have, you know, they had the training and all, but they were not a part of what we call the total system. Then when the doors opened, and these doctors were given privileges there, that it was very difficult to say that, here you walk into a surgical suite and you have all the people and all the personnel and everything you need at your fingertips, and then you say bring them to another one where you had the 15:00personnel, true enough, but you didn't have as many, and you don't have as much equipment to work with, you know in a hospital equipment means a lot. A lot of times what we call life saving equipment is the type of equipment that you may need once this year and that's all. But somebody has to pay for it, you understand, and the hospital didn't have the money to buy this kind of equipment to protect. Now you said the doctor or the patient in the event of a catastrophic problem.

OF: Do you think that status was any part of it, that it was--?

WJ: Well, some say it was, you know, but I cannot, since I was not at that level, I can't say it was just a status symbol. It might have been a status symbol, how do I know, I don't know, I can't answer that.

OF: I've, in some of the records and then in talking with a board member and then a doctor, I've run across references to splits among an older and younger 16:00generation of doctors. That it was, that happens, you think, at most places? It was the older ones who were really dedicated to the Red Cross Hospital because for various reasons, one long time service--.

WJ: Right, right. You know, the older doctor had much more experience in reference to what happened down in this community for blacks in terms of their middle class structure, okay? Now, General Hospital is always open to the indigent, it was always open to the indigent. The middle class black that had a fairly decent insurance and all could not be taken anywhere, the other hospitals would not be taking them. Our doctors knew this, but when the younger doctors came up, when the younger doctors came in, they could get privileges at these hospitals, you understand?

OF: Uh, huh.

WJ: So that when you ask them to come over to here, to this institution, that 17:00this other doctor has worked hard and tried to [inaudible] and all that many of the people, I understand the doctors, I'm not going to blame the doctors for it, even though people say the doctors are the cause of it. Many of the people wanted to go to these institutions, too, as well as the doctors enjoy practicing there. Now, I have been told many, many times that the doctor controls where his patient goes, but this is something that I have to say that I believe, to a degree, because I feel that if I wanted to go to another place my doctor would carry me. Some people say the patient goes where the doctor say goes, well, it's up to the people, but I feel that people wanted to go to Jewish or to Baptist or to Norton's and if these places had available space and these doctors on the staff there, and this doctor would satisfy this patient, because after all this is relationship between the patient and the doctor. You see, the hospital really didn't have the relationship between the patient and the hospital because the 18:00hospital was not providing the service. The service was being provided by these private practicing physicians, who had this patient load or this patient panel. They wanted to keep this patient panel, so if the patient wanted to go to X hospital, they would take them to X hospital. And yet when the younger doctors came in, and like in every generation, we talked about the generation gap for years here, and that the older people had a basic way of doing things, and a way of thinking, and the younger ones wanted to come in change and go this other way and because of their lack of experience, they felt that this was the thing, this was needed now to attract them, and of course a lot of changes were made. Not only I don't think only in our institution was it a problem, but it was a problem in many of the institutions, because the seniors want to hold onto them and the young ones just want to get in.

OF: Uh, hum. I think that's human dimensions everywhere, human interactions. I 19:00guess this takes me into a more general question, of why are or why don't you think that the black community supported or are identified more closely with the Red Cross Hospital. I'm thinking of one board meeting, there was a very moving statement by Whitney Young, decrying the passing of black dominated institutions and his, and he's speaking of the Red Cross particularly, and bemoaning the fact that it wasn't supported enough among the black community in Louisville. Do you think this was true? And if so, why?

WJ: Red Cross Hospital at that time when Whitney Young made that plea, I don't know what year it was now, but I can remember it. Throughout the country, there seemed to have been a movement that anything that was run and operated by blacks was not up to standards. They had to be inferior to some degree. It happened to 20:00the school systems, many of our schools were closed they merged into the system and all that. In other words, when the system, they had to [divide] the school system and they were going to move in, who lost their jobs were the black teachers and whatnot. So this movement was going on, it happened to the fraternal world, it happened to the health field and all of it. Now many of these communities have had their hospitals throughout the country. I could name you a few, a few are still existing, that hospitals had to close. They closed because of the fact that, they said we can't stand, we don't want this now, in other words so we want to go here. I feel at the time he was trying to help to develop enthusiasm - I think the same fever hit Louisville. The same fever hit 21:00Louisville, that well, why have a Red Cross Hospital that's not up to par. And the thinking of people, what they call up to par. I say we were up to par. Why? Because we were able to pass the joint commission surveys and all just like everybody else. So we have our certificates and everything, so I say we are up to par. But that doesn't mean anything to the individual out in the street, you understand? Because if another patient goes out and says well they treated me bad there and they say that's why I don't want to go there anymore, you know. You get both pro and con and I think in your best institutions you still get these problems, 'cause that's why they have public relations people and all try to keep these things at a minimum for the people who go. Now, being involved in the hospital field, and being involved in the health field, I have talked to people, service station attendants and all that about going to X hospital and they say don't take me to X hospital now, and these were NOT Red Cross, understand? But the point is that this is I think is a common thing but being a 22:00minority group and a minority hospital like it was, and I felt that, well we felt that within the people, within the new educational setting and whatnot, that people were saying well, we were not, they want business for themselves, yes, but they're saying that now, but then they was thinking that most things we had were not at the same level. Our colleges were not at the same level, we couldn't produce educators and yet men like Whitney Young came out of black schools, you understand?

OF: Yes.

WJ: So that, I don't know why, I can't explain to you why that the country would get a feeling - and however, maybe it was because of the Supreme Court decision in 1954, by proving the inferiority of these people in separate schools. And maybe that's a carryover from that, they say well it had to be inferior. That in itself was not the real, to me was not the real answer.

OF: How big a factor do you think the location of the Red Cross Hospital was in 23:00its failure to survive. For instance, if it had been in the West End, do you think it would have survived as a hospital?

WJ: Uh----from what you have been able to obtain, have you been able to find what caused the demise of it?

OF: No, I think what I see, there were many factors involved.

WJ: Well, I will say this, alright. Okay.

OF: I think that may have been part of it.

WJ: Let's put it this way. I've heard many times that Red Cross was in the wrong location. Basically, from the map and all Red Cross was centrally located for the blacks in Louisville and Jefferson County, okay? Let's go back to the early '60's. There was no Baptist East, there was no Humana, there was no Southwest 24:00General or whatever is the name of it now hospital, so that from the black community, which was a concentration at that time which was the West End, you might have said that the people did not have transportation or didn't have this, that and the other. But, the way I saw it, and the way I see it now, is that we still got automobiles, gasoline was cheaper, people go where they want to go, and that Red Cross, that was not the primary factor. I would think the primary factor was, that the, well, let's try to put it this way: for any institution to survive, there has to be a group of people who are solidly, 100% behind. For a hospital to survive, you have to have doctors, doctors, not just one or two, but 25:00you have doctors who will bring in patients to the institution. Now, and I do feel that toward, well even until today, we don't have that many black doctors in the community. Our whole population of black doctors has diminished and yet not been replaced. And I feel that when you have a small group, and if some of them split off, you take the dominant group which is [inaudible] white physicians, you got say nine thousand doctors in the community. So if one or two pull away to go somewhere else, you really don't miss them. But if you've got twenty, and three or four decide to use this institution and three or four who's getting too old and retire, they don't, not doing for the work, you don't have the people to bring you the patient load. And I think this is one of the reasons, one of the major reasons was, that there wasn't enough providers, health providers, to maintain it. Now, had the hospital gone and say under today's standards where you have all these governmental programs and all these other things being done and so the hospital board had said that well alright, we 26:00want to start delivering healthcare to an underprivileged group and that we'll get a 100% government financing or 75% government financing. And then the hospital could have gone out and hired the younger doctors coming out of medical school to say you're on our payroll, we're paying you to see these people, that's one thing. But when you're depending upon the doctors to voluntarily bring you patient load, and that they for any reason or for whatever the reason may be, not a personal reason, but whatever the reason may be, that this patient load he has doesn't want to utilize this institution, then you're going to begin to hurt, begin hurting. And so I feel that, too, was a large part to play into that. And the doctors began to get older, like Dr. Bell and all the others who begin not active anymore, real active, who want to be active and then you didn't have that many new young ones coming in to take their place. Years ago I understood that there was about fifty doctors in this town at one time, black doctors.


OF: Oh really?

WJ: This from what I'm made to understand, at one time and I know that when I left from up there I think we had about twenty. Now I don't know how many were active, but we had about twenty in the community.

OF: I wonder why doctors, black doctors aren't attracted to Louisville?

WJ: That I cannot answer, I cannot answer that.

OF: Maybe unanswerable.

WJ: Well as far as I'm concerned it is. I think that the community has a lot of offer culturally, educationally, and all. They can continue their education here with University Medical School and all that. But why they have not, I would say, migrated to Louisville area, I don't know. I don't know if whether because of an industry, not enough industries hiring blacks, that they feel they can make a decent living and whatnot, I don't know, I mean, I can't say.

OF: What effect did the federal health programs of the '60's have on Red Cross 28:00Hospital, was it harmful or helpful?

WJ: I would say it was helpful, since I was there until '74. It was helpful because many people that we were not being able to get monies from we were able to get money from because they became part of these programs. Under the Kentucky Medical Assistance Program, and under the Medicare Program for elderly people, you know many of them didn't have the funds to pay and yes, that helped the hospital tremendously to have the cash flow that carried on.

OF: Did it also increase the paperwork?

WJ: Oh yes it increased the paperwork, yes it increased the paperwork tremendously, and we had to bring on more employees and we had to have more reporting. aActually all governmental work brings on that. More inspections, because you have to have more auditing and whatnot. And those were the things 29:00that I felt it did make a heavier load that away with medical records and keeping things up for Blue Cross audits and for Medicare audits and Medicaid audits and then your joint commission accreditation surveys and then your state surveys and you know all these things are all a part of the daily job you know.

OF: I guess it increased your work more than anyone's.

WJ: It increased the workload of the people, it increased the workload of the staff, increased the staff, and so that as you increase the staff and of course the increase in wages played a part, too. Minimum wage went up, kept going up, that played a part when especially people hollered about healthcare and the healthcare cost was rising, you want to keep your healthcare cost down. And the wages was going up, I mean, you're just like caught between a rock and a hard place you know.



OF: I guess the biggest problems of Red Cross, or one of the biggest was it's constant financial struggle. Do all hospitals have this sort of problem?


WJ: Yes and no. I will say both yes and no. It depends upon the philosophy of the institution, and the board and all that. For years, the financial setup of a hospital - many, many years ago - was that with the three classes of patient load, I would call the private, semi-private and ward patient, would be that you had a few ward beds to take care of people who were paying less than cost for services. You had the semi-private that you felt would be paying the cost of the services, and of course you had a few privates who were supposed to be paying the cream of the crop. Now in Red Cross Hospital, we didn't have enough private beds to have that group, most of our beds were, went under the New Haven Wing were set up as semi-private beds, which means that you just [about most you get out of that was] your cost, your cost there was no really big profit. And when 31:00you are in competition with other institutions, you really can't go that far from them in terms of cost and in terms of services because we try to keep them within a certain parameter. We had problems, we had problems there in terms of, I would say that overall financial problems, yes, but at the same time, in the twenty years I was there we were not in such a strife that we couldn't meet payroll, or we couldn't pay our vendors. You know, we may have to delay payment [inaudible] sometimes because of cash flow. But basically, there was no funds available for expansion. You know, there wasn't that kind of a program. Patient load kept about the same level, there was no growth in patient load, in terms of patient days. We kept about the same level of patient days, and the funds that we needed and we asked for, we had a mail order campaign, I call them mail order 32:00solicitation program, for a while that did very well, helped us along with your cash flow. Then we went into the community chest, they took us in as an agency in the community chest, and of course that's when the studies came up about well, you're not making money here, you're not making money there, you ought to cut out this service, you ought to cut out that service, like, well, like Community Hospital for a time began to cut out OB services, because OB is a costly service. We never did run the emergency room so we didn't have that cost on our hands, but OB was a losing proposition. --But people, what the doctors wanted for the convenience of their patients was to have babies [inaudible]. Now, it was recommended that this area be closed, don't have it you know.

OF: By Community Chest you mean?

WJ: By Community, well, by the consultants that check this wing of the building 33:00here, and open up this and do that and try to do these things to keep, we call a cash flow, or keep the thing moving, you know, to make it attractive. I would say that we never had any surplus of funds that we could just go out here and do anything with, you know. I say anything, I'm talking about, if we decided that we want a new piece of equipment, we would appeal to the doctors for it, or we'd appeal to somebody to try to help give it us, like the Crusade for Children helped us with the nursery and others, the Lions, I think it was the Lions, or the eye bank, or the Lions, one or the other, gave the vehicle for the [inaudible] to the place, you know. We didn't have that kind of money to spend. But we just probably just had enough to keep moving, there was no big reserve there. Of course, as an institution like ours, if you wanted to put in new services and whatnot you needed funds. If you need funds for renovation, or we had, we built a new lobby, we tore down one of our old buildings because it didn't meet standards. And we tore it down and we tried to-- would you cut that off for a minute?

[Tape resumes]

WJ: You know, try to find other ways because, okay, what was happening was that, 34:00your going to have your cost centers. Look at your cost centers in a hospital, you find that one area is making money, another area is making money, another area is losing money, other area is losing money. Alright. We were losing money in surgery and we were losing money in OB. Because they cut them out because [we couldn't do no surgery if there were no surgeons you know] so that we couldn't do it. Now, then they came up with a feeling that people should be paying for the costs of services, okay? That's when the prices, wages and film rates began to shoot up high in the city, because you'd have to try to recover costs, the government wants you to recover costs. In other words, they didn't want you to be, costing you fifty dollars for something and you be charging ten. They want you to be charging at least fifty dollars, and if you didn't collect it, well, of course they'd be there to help, but at least you were charging that. So they 35:00want your charges to be in the realm of costs, not to be that you're underwriting it, see. And that was one of the problems, when we began to increase rates and all that, and then we began to give competitive rates to other institutions and of course we began to measure then, what you have to offer for these. And yet, the basic component of that is the same in all hospitals and that's labor. Your labor is your biggest component, you see, of your dollar, and so to have the kind of service would cost that.

OF: The hospital received state and city money I think for some years, why did that end, do you know?

WJ: Integration.

OF: Integration?

WJ: You see when all these institutions were segregated, the state felt it was an obligation to help provide for their constituents. See, the black constituents they provided hospital services, the state paid it, the city paid it and at that time you couldn't go down to General Hospital to be a nurse, you 36:00couldn't go to General Hospital to be a lab tech, you couldn't go to General Hospital to be an X-ray tech. All you could do was be a patient there and because this was free. And so that many people were denied, until the state felt that here's an institution here that can provide these services, because in the earlier days I'm told that crippled children, all the crippled children in Kentucky used to come there. Many years ago, before crippled children commission began to take over all that. That was the only place for the black kids to come because all the other agencies were segregated. But after that stopped, then you'd be saying what is the need for it, unless it can carry on its own self. I mean, why should we support it. So that's when the state, because in other words they began to show had they supported us and not supported another institution, then they would say it's segregation. You see, because if they were supporting us and giving us money to help operations, and they wouldn't give it to a white institution to help operations, then of course it would be segregation, so they cut it out.

OF: That's about all the questions I had. Can you think of anything that we should talk about concerning the hospital that hasn't occurred to me? Are there 37:00administrative problems that you encountered perhaps? That you felt were --..

WJ: Well, as I look back, and maybe things are much more pleasant when you look back than what they were when you're going through them, but when I look back at the years I spent at that institution, trying to build it and trying to help build it and trying to maintain it, that I felt that the people in the community, the type of board that we had, and all, was very, very cooperative, you know, it was very cooperative. That was prior to the time, now when I was here, when the shift came to the West End, I don't know how long you've been in Louisville?

OF: Oh, I was born here.

WJ: You were born here, okay. Many years ago, you know, the black population was concentrated between twenty-sixth street and down here and all that, then the 38:00shift came to the West End. And as you look out today, the shift is to the County. The West End now is beginning to fall and the shift is to the County, so that the shift of population and the new people coming in, and the old people passing, that it was a continuing problem of trying to keep people informed of the institution, and especially the right information about it, and trying to solicit their support. See because when you begin to get in the competitive world, there are fields that you have no knowledge of, or what's happening in those fields, because you're concentrated over here in your area. So you're a librarian, so you're not really interested in what doctors are doing, how it's progressing, whether it's progressed or not. So that I looked at it in that way, here we are here running an institution and there are people coming into the 39:00community with new jobs and all, and they say I want a doctor, I want to go to a hospital, you know. And unless somebody was there with a good favorable attitude and say, "Well, here's a good hospital, here's a good doctor here that you can go to," they will choose the first thing that comes, because they feel, "I have the money to pay for it." You see, that created, the KMAP program and the Medicare program and all, created that independence in people that was not exactly there before, because they felt before, that "I don't have the money, where can I get the services," if I say I'm going to give it to you they'll come to me. But once they get dollars in their hands, they say, "Well I have my own choice." So it became a problem then of trying to keep up. I said a problem, it was a task, it was a challenge to keep the hospital in the eyes of the public, in a bright light, you see? Which means you couldn't let anything mar its image. And the people that we've had on our board, and I don't know which board member you talked to, which ones you talked to, but there were some that were on there for many numbers years. Now, I know that Mr. Heyburn was on there for the whole 40:00time I was there and Mr. Tachau was on there--.

OF: I talked to him.

WJ: You talked to Eric Tachau? And we had Mr. Strickler from University of Louisville on our board and Ms. [Nevillecamp?] and Dr. Whitney Young and Mr. Hackett who is retired now with the [inaudible] school here, [Demoyne?] Beard from down the Housing Authority. We had a very good board, LaVal Duncan who is passed now, was with the Housing Authority for years on the board. And I felt we had a very good relationship. But toward the end, in the middle '70's-- toward the end of it, I think many of these people had passed from the scene, the older 41:00people had passed from the scene, young ones coming in with their ideas and all, you know, they just didn't mesh. And of course at the same time, predictions could be made after seeing what was happening throughout the country. Well even I predicted that the hospital wouldn't continue unless they begin to look at a certain approach to it, because you couldn't be always competing, you see, you can't be always competing, you know.

OF: Do you think they should have specialized then to a degree rather than, is that what, am I misinterpreting--.

WJ: When I say competing, I meant to try to be doing everything because somebody else is doing it, you understand? To pick up an area and say look this is the area we are going to work with. We're going to deal with this area. Whether it's going to be general practice medicine, or whether it's going to be obstetrical medicine, to try to become a lying-in hospital or whatever you want to call it, but to be something that's it, and let that be it, and not to try to have some of everything. Should we be having surgery, when open heart surgery was becoming popular and all that. Could we afford that? No. So would it be really necessary to run a surgical suite in this hospital. This was the kind of questions I would 42:00bring up, see. Even though I know we had surgeons who would want it. But now when surgeons, when this doctor passed and left the scene, alright there's nobody else to perform the surgery. What good is having the surgical suite? You see, these rooms could be used for something else. You know, these are the kinds of things that happen as time goes on, so that you have to make a pick or choice. Now, I understand from my reading that throughout the country that Jewish Hospital is noted now for hand surgery. People from everywhere come for hand surgery. So they are specializing in a particular form, or open heart surgery or whatever they're doing, you see. With our tertiary hospitals coming up with a whole new system of hospitals that's called secondary hospitals, and tertiary hospitals and your primary cares. That you move up the ladder, that these, what used to be you wanted a big scene in a small area, and our hospital is no different that Shelbyville. We are right there in the same class as 43:00Shelbyville, Carrollton and these little small community hospitals. They couldn't afford everything, you understand? But we were in the midst of a city where they had all this, see? So that in Shelbyville, they don't need open heart surgery out in Shelbyville, but they do need obstetrics [inaudible] for people being born. They do need some kind of surgical suite where they can do some kind of minor operations and all that, but if you have to have a major operation, you have your center here. So that's how they push it up. So therefore it is relieving, and so that I could see that when I was there, the way health picture was going, that the hospital would have to go into a given, confined area of healthcare, whether it be preventive, or whether or not it would be worth it to carry on.

OF: It has become so specialized that in a large urban setting, you have to concentrate in one or two areas, you can't spread yourself so thin, especially when you have limited resources to begin with.


WJ: Resources and personnel, yeah.

OF: Well, I thank you very much for participating in this.