You have found an item located in the Kentuckiana Digital Library.
1986-05-07 Interview with Tony Goetz, May 7, 1986 1986OH136 UKMC 39 02:02:12 UKMC001 University of Kentucky Medical Center Oral History Project Louie B. Nunn Center for Oral History, University of Kentucky Libraries Goetz, Tony -- Interviews University of Kentucky. Medical Center -- History Hospitals -- Administration Physicians -- Kentucky Health systems agencies University of Kentucky. College of Agriculture Tony Goetz; interviewee Richard C. Smoot; interviewer 1986OH136_UKMC39_Goetz 1:|13(1)|29(9)|43(13)|56(15)|70(7)|85(1)|100(2)|112(10)|126(12)|142(7)|158(10)|175(7)|190(3)|204(2)|223(12)|239(1)|253(1)|269(5)|282(7)|297(11)|312(12)|328(2)|344(3)|363(1)|384(8)|398(6)|415(3)|428(10)|444(1)|458(5)|470(12)|485(12)|502(11)|518(4)|540(1)|555(2)|570(3)|586(10)|603(3)|621(9)|638(14)|658(7)|673(7)|691(12)|710(9)|736(1)|751(11)|766(7)|787(2)|808(2)|825(6)|839(4)|856(7)|871(10)|888(2)|920(4)|938(2)|962(7)|990(9)|1010(5)|1027(7)|1045(8)|1068(9)|1084(7)|1101(8)|1123(4)|1153(10)|1175(6)|1197(1)|1236(5)|1258(6)|1283(2)|1302(3)|1322(9)|1340(5)|1358(10)|1390(11)|1422(10)|1452(11)|1469(4)|1493(7)|1512(12)|1531(11)|1547(2)|1560(6)|1577(12)|1604(7)|1635(6)|1655(5)|1689(2)|1716(2)|1739(1)|1753(12)|1777(7)|1808(3)|1847(8)|1882(7)|1914(4)|1937(16)|1966(10)|1990(5)|2009(10)|2025(9)|2039(1)|2054(4)|2070(6)|2085(10)|2101(1)|2114(7)|2129(12)|2144(7)|2162(11)|2178(11)|2192(11)|2207(4)|2231(3)|2263(8)|2278(6)|2292(4)|2314(10)|2333(9)|2350(2) audiotrans UKMCoh interview SMOOT: Your background, uh, what it was like growing up in Owensboro, and your educational background. GOETZ: Okay I-- well I was born and raised uh, in Owensboro in Daviess County, Kentucky. Uh, and uh-- actually born in Owensboro but we lived outside of town about ten miles. Um, oldest of seven children, um, my father has got one brother and I guess six sisters so he comes from a fairly large family. My mother comes from a little bit larger family; uh, she had ten brothers and two sisters. (Smoot laughs) And all are rather prolific Catholics, so I've got something in excess of a hundred first cousins. Uh, the Blanfords and the Goetzs, uh, were the two families, uh, in Daviess County and have strong ties to a long history of living in that particular area, and um, as I say are a very close knit family, even though now I think many of us are gone to the four winds. Only one sister and one brother and I are still living in Kentucky. The rest of my brothers and sisters are scattered anywhere from Germany to Colorado to Texas to Virginia; and I think that's-- oh, and, and it seems like there's another one somewhere I can't think of right now. So kind of uh, spread out a little bit, but we still get home quite often. SMOOT: I noticed in reading a little bit about your background that you went to high school in Louisville? GOETZ: Yes I was in a seminary at Saint Thomas Seminary in Louisville, which is now closed. I studied for the Catholic priesthood, and in fact my youngest brother is a Catholic priest down in Grayson County. Uh, and I studied for six years at Saint Thomas and left there in 1961 I believe it was. Um, went back to Owensboro and enrolled in Brescia College, worked at a radio station for a while, did substitute teaching in the county school system, and um, spent four more years trying to complete my degree. I really had uh, two years of college by the time I got out of Saint Thomas; it took me four years to get the next two. Uh, taught-- well I guess, somewhere in there I ran a little short on money and became a salesman, still took a course or two, sold food for a couple years. Everybody has to eat so I did rather well actually, uh, selling food. Uh, then one of the parochial schools as I was dropping off some potato chips or something, one of the nuns who used to teach me when I was in grade school asked me if I'd come and help them out for a couple of years. They needed uh, some extra teachers and they were a little short on nuns, so they were going to try to hire uh, lay teachers and they offered me uh, the astronomical sum of eighteen hundred dollars, (Smoot laughs) uh, to come and teach, so-- and I did. Uh, I taught fifth grade for a couple of years. They gave me a little raise the second year, so I spent some time teaching school, uh, all the while I'm trying to get my degree. And I finally got the degree. I was supposed to graduate in '63 but graduated in '65 with a, uh, Bachelor of Arts degree in, uh, English with a minor in history and political science combined minor. Um, after graduation, soon after a fellow approached me about replacing him in a particular job that he had of executive director of the Owensboro Council for Retarded Children, a small nonprofit organization basically formed by parents of mentally retarded children who were trying to develop programs for these kids. You've got to remember in the fifties and sixties there really weren't many programs other than state institutions, and a lot of people felt like there had to be a little bit more for that, uh, for that kind of a problem. So I went down for the interview and like it is in a lot of places, it's probably not what you know but who knows you. And it turns out that three or four of the board members, uh, knew my family and knew me; I'd worked on their farms and what have you since I was in high school and college. Uh, the Banhowers and the Castlens and the Grants and some of the folks around Owensboro, so uh, I didn't know that much about mental retardation I must confess at that particular point in time, but I read a couple of books and checked into some articles and uh, found out that I probably knew more mentally retarded people than I'd ever thought. I'd just never really thought about it, uh, and um, uh, obviously I knew the Banhowers' child and I knew the Castlens' child, and uh-- but I never really thought of them as retarded. And um, we grew up together, so for one reason or another they gave me the job. Um, it was a big increase. I think by that time I was making thirty-six hundred dollars teaching school, and uh, uh-- I got all the way to five thousand or I think no I went to forty-four hundred dollars first and then six months after, uh, was able to pay my salary they raised me to five thousand dollars. It was an interesting raise, six hundred dollars, a good percentage. (Smoot laughs) Um, spent a lot of time then working back and forth between Owensboro and Frankfort trying to get some legislation for mental retardation. We were very fortunate to uh, over the next couple of years, to pick up a federal grant, uh, to build a sheltered workshop in Owensboro. The city school system in Owensboro helped us tremendously with uh, facilities and uh, picked up the salaries of some of our teachers. I had several teachers making more than I did since uh-- I served as principal of the school because nobody else wanted it, it was an old school building. So we, um, we had some-- a good couple of years there, uh, sort of put it on the map, and a lot of people started noticing the program. And a fellow from Lexington, John Swan, was executive director of the Bluegrass Association for Mental Retardation and John had just gotten a grant to develop a day activity program for mentally retarded adults. These are adults who at that particular time couldn't qualify even for a sheltered workshop, such at the opportunity workshop here in Lexington. Uh, they were people that were rather severely and some uh, we had a couple of profoundly retarded people who would a few years before this would have just been in a state institution. Uh, but as community programs were developing, we found that they could, there were certain things they could do and they could uh, lead uh, meaningful lives, understanding that the word meaningful is a relative term, (coughs) excuse me. Um, so John asked me to come up here, he and some of his board members, Charlie Coyle and Bill German, Jim Wilheit, uh, gosh there was, John- John McDonald, uh, several businessmen and-and um, leading people in the Lexington community. And uh, so I decided to, you know, why not. No one from uh, our family had ever left home and I thought well you know I can always move back, uh, to Owensboro if I have to. So I said yes and I came up here in, I guess April of '67 came to Lexington. A couple years after that John resigned as executive director to start Excepticon, which is a private, uh, for-profit organization, um, group homes and um, and-and uh, residential facilities for the mentally retarded, and he did rather well with it, he has since sold the company. But when he resigned I assumed the position of executive director of the Bluegrass Association of Mental Retardation and uh, kept that position until 1973, I believe when I was approached by several people, the same ones--Charlie Coyle, Jim Wilheit, and others who by this time were on the board of directors of an organization called the Bluegrass Regional Health Planning Council. I'd been to their meetings, and was not overly impressed with what they were doing, uh but, they talked me into it. I think Mac Vanderbeer here on our faculty was on that board. This-- I remember Vanderbeer and Dick McElvin, who was uh, either president of the Fayette County Medical Society or on the executive committee or president-elect or something at that time. Um, Jim Benedict from the Southeast Coal Company in Irvine; uh, Jim Wilheit, I can't remember a couple of others took me to dinner, talked to me about the job, and uh, since I'd been there for six years at the Association of Mental Retardation, I'd really never, wasn't able to keep a job more than two or three years, this is sort of a record. Uh, I said "Well I'll-I'll do it," so I had to give some notice at Bluegrass and they wanted me to start the very next day for the other organization, so for a while I carried two jobs for about two months. I worked one during the week, uh, my mental retardation job during the week, and I worked the health planning job on weekends. And we were able to get the board organized and uh, reorganized, develop some things and in the meantime there were a lot of things happening at the federal level with this particular project. That was 100 percent-- well it wasn't 100 percent, about 60 percent federally funded, and the remainder we had to raise locally. And we covered a seventeen county area, the Bluegrass Area Development District. Uh, we were not a part of the Area Development district, but we collaborated with them and did health planning for the AD district through a mutual agreement. But uh, basically we raised, oh some forty, forty-five thousand dollars a year for our budget; the budget's only about a hundred and five thousand, uh, to-- we raised it from cities and counties, so I would visit all the mayors and judges. Uh, I made it a point to visit them every three months, whether I had anything to talk to them about or not, uh, you could never go into any town and meet a mayor or a judge, uh, without something coming up. And eventually after they've talked for a while, there was always something you could do for them. You know you could go down and talk to their hospital administrator, or somebody in the nursing home business, or, or some little old lady that was trying to get a senior citizens program going or something of this nature. And they appreciated the, the contact and it made it a lot easier when budget time rolled around, uh, they would all just "Well, you all know Tony, that's-- you know he needs five hundred dollars for his budget." Somebody, you know up in Harrison County Judge Nunnalee used to tell the, tell the squire "You know squire you're going to move for this and you'll second it." It was all done very democratically and um, uh, worked out very well. So we had a lot of good support financially from the group and, and, more important probably than financial, uh, we had good moral support from the judges and mayors. Uh, we got to the point where, you know everybody wants everything for his or her county, whether they need it or not. If the next county's got one, we want one just a little bit bigger and a little bit better. And it got to the point where they would start talking with us about these things before they would make a public issue out of it, because once it gets public, uh, you can only go one way. You've got, you know, the judge has to be in favor of it. So we would talk about some things, uh, spend months sometimes developing and I guess really that's where real planning takes place is, you know instead of trying to do a hospital like they did in the other county, Judge, you know you've got to recognize the fact they're putting five thousand dollars a month into that place and it's still having trouble, and that's a little rough on county budgets especially the size of the county budgets we have around here. Instead of uh, putting that kind of money into the thing, let's talk about some type of a clinic operation. Maybe we can get some physicians interested, a couple of physicians to come in. It won't cost you anything but you know if you want to, uh, we could take that building downtown, dress it up a little bit, offer it to the physician for a year or so rent-free or at very low rent until he gets established. Uh, let's talk to the bank and see if the banker won't give the guy a loan and do it that way. We had some luck doing that. Uh, we had some other times that uh, it just didn't work out, the guys say Well I still want the bigger--a bigger hospital than Joe's got next door or something. So we did a lot of that and there was a lot of give and take, but I think the real planning took place uh, in that particular area, so I was, I was involved with that organization, uh, for a few years. Um, actually about a year or so after I was there the federal government started looking at changing from regional health planning or comprehensive health planning councils, CHP as they were called, to a more comprehensive kind of agency called uh, health systems agencies, and uh, our board got interested in that and asked me to investigate. Uh, and so we started working with the state and with the federal government to see what would occur in Kentucky, what people thought might occur. And we recommended that particular kind of thing happen, that uh, there'd be five HSAs in the state; we thought that would be very manageable. Of course we, you know being very objective, we were going to be one of them. (both laugh) Uh, the governor is the one who really has the final say, and the governor sort of disagreed with that, uh, took all of the information etc, and this was about '74 or '75 I guess-- '75, 1975. The governor uh, indicated we should have one or two HSAs in the state, no I'm sorry the governor indicated we should have one HSA. The feds wouldn't approve one but they did approve two, so that sort of revamped our thinking a little bit: Well if there's going to be two, somebody's got to take the lead in uh, developing eastern and western. And we worked with people all over the state, we were one of four federally funded agencies at the time so we did have a little bit of staff; the one in Louisville had a little more staff but they had a little less interest in outside the state, uh, at that particular time-- or outside the Jefferson County area, the small region area. So I got on my horse-- or my car, in my Volkswagen as a matter of fact, and started traveling around Eastern Kentucky (coughs) excuse me, sorry. Started traveling around Eastern Kentucky and I met all the county judges and all the mayors of the major cities, I didn't see all the mayors. (coughs) Talked to the-- [Pause in recording.] GOETZ: As I was saying, I talked to all of the judges of the, of the counties in Eastern Kentucky and we didn't really know where the lines were going to be drawn as far as east and west, but we were fairly sure. Talked to the mayors of the major cities and, and more importantly talked to all the area development districts. There were nine area development districts involved in this uh, uh alignment, and got their agreement. Uh, we had to talk to the Ohio Valley Regional Medical Program, which was also a federally funded program which did a lot of things that were going to be involved in this new law. We had an Experimental Health Services Delivery System program located in Morehead as a matter of fact. It was one of twenty-two programs of that nature throughout the United States but it was right here in Morehead. Uh, talked to their people, and we decided to try to uh, form a consortium, if you would, made up of the chairmen of all the health planning councils, that's nine people, the chairmen of all the area development districts, was nine people, the chairman of the Ohio Valley Regional Medical Program, and the chairman of the, um, Experimental Health Services Delivery System. So we had a board of twenty people put together to develop a federal grant, uh, basically using staff of our Bluegrass Regional Health Planning Council. We developed a grant, submitted it, it was approved, and we were funded as the East Kentucky Health Systems Agency. Several things at that time, we had a lot of the black lung folks down in Eastern Kentucky concerned that we were going to have millions of dollars to hand out for people-- for healthcare; well that was not our job at all. (coughs) But they did have that misunderstanding. Uh, we also had um, uh, several other organizations, political organizations concerned about the size of the agency and the fact that merely because we had about one and a half million people and it was funded on a per capita basis plus the fact that we had an opportunity to get Appalachian Regional Commission funds, which would have increased our funding base, that we might get to be rather large. So we developed a program that used local initiative to the extent possible. We, instead of building a very large central office staff-- uh, first of all I should say that one of the major things we did and I still think, even though it's so insignificant, uh, it was very significant to people in Eastern Kentucky. We put the office in Winchester, Kentucky; we didn't put it in Lexington. And that was purely symbolic, uh, there's no real reason to have it in Winchester. However, it did work out very well; we could get anywhere within two and a half hours. I could get to Harlan, uh, I could get to anywhere in Eastern Kentucky in two and a half hours. And that's probably as fast as you could get anywhere; that, that point was about as central as you could get. Even if you were in-in Lexington it takes a half an hour just to get out of Lexington, so it really worked out rather well for us, even though it was kind of a symbolic move. The folks in Eastern Kentucky really appreciated it. Over a period of time they got to the point where they were not suspicious of Lexington anymore and they really didn't care where it was as long as it took care of them. But another way we, we tried to work it was to have sub-area councils, and we developed nine, one for each AD district. We had staff at each one of those sub-area councils funded by our budget. Uh we-we contracted with the Area Development districts and we gave them not only the salaries but the travel and some supplies and some other money. And they probably made a few bucks, you know maybe a thousand dollars a year; it wasn't much but it didn't cost them, and that's the key. Plus we provided a lot of central support for this, and we had a fairly homogeneous, uh, group. There were times, when uh, you know the sub-area staff, uh, who really were paid by us but worked for the AD districts, uh, got a little at odds with some of the folks in the HSA staff, and sometimes the sub-area council members, who were elected by their people down there. We had actual elections; we'd send out ballots and everything. (coughs) Uh, sometimes they would get a little forceful uh, with members from their area who were on our board, see the board had to be made up by a geographically distributed population base, also by economic, also by professional, uh, providers, consumers; it was a nightmare, a real puzzle to put together. But once we got it arranged and everybody agreed: Okay, this area will always have one provider and one consumer, this area will have one provider, this area will have one consumer and every other year they'll switch them or something of that nature. We worked all that out at the beginning, took a lot of, a lot of effort on a lot of people's part. Everybody gave something, you know, and everybody got something, uh, that's the only way it would work. So we developed that agency and I think we were rather successful. We had a couple of times when, as a staff person I would have to say this is not what I wished the board had voted, but when that board voted to build a hospital here or do something there and-and there was really no, uh, rhyme or reason to it uh, from a pure planning standpoint, uh, we went along with it as staff because we worked for that board. If we didn't like that decision our-our choice was to leave and go find another job somewhere and they'll find somebody else to do what the board wants, and that's basically the way it should be. And, and I'm emphasizing that thing: rhyme or reason from a pure planning standpoint because if you'll look at the way we really developed that agency, the (coughs) agency was developed on local input. And we kept fighting with the feds about this, you know if you want us to have local input then by golly we're going to have it; if you don't want it, tell us and we'll just impose something on the people and it won't work like nothing else has ever worked that's, that's been done that way. So while there wasn't a reason to have some things from a pure planning standpoint, there were many reasons from a socioeconomic standpoint. Uh, let's face it, some of the healthcare industry, some people wanted them because it would provide jobs not because it would do anything in healthcare. And all these factors came into play in considering some of these applications. They shouldn't have perhaps from a pure planning standpoint, pure health planning standpoint, but they certainly did from a, from a real standpoint-- a realistic standpoint. And uh, I think we made some major mistakes, I think we all-in-all though were 90, 95 percent very, very successful and developed some things that were out there that-- and-and we really (cough) had a-a group of people that got along. I was just telling someone the other day, we had a thirty member board of directors elected from a sixty-eight county area, probably one of the most difficult areas to traverse in the United States really. Uh, it certainly was different than downtown Fort Lauderdale, you know Fort Lauderdale their highest point was four feet above sea level. You know we've got, I used to tell people we had twenty-two thousand square miles, if you flattened it, it was something over fifty thousand, you know. Um, we averaged twenty-six board members at a meeting, six meetings a year, five to six hour meetings and not a penny for them in that thing, they were all volunteers. And over that four year period from '76 to '80 when I was there we-- and I was very proud of that fact that our board members were committed, we never had a board member elected who didn't want to serve. And we were very honest with people who were nominated, we'd go tell them, "You're going to have to spend this amount of time driving, this amount of time coming there, to the board meetings," not to mention committee meetings. Our board basically worked on a committee system, and uh, with-with the amount of work we had to do for, for sixty-eight counties in that amount time the committee system is the only way to work. And these people were fabulous. I remember the lady that was on the original nominating committee, it was December 10, 197-- 1975, um, ten below zero, it one of the coldest nights we ever had. Uh, she drove from Harlan, she was the executive director of the chamber of commerce in Harlan. She drove from Harlan, her car broke down in Richmond, she took a cab across Boonesboro Road to Winchester to come to this meeting. I felt just guilty as everything you know, stay with the cause or gosh, stay with your car, she wouldn't have missed it for the world; she was representing her area on that nominating committee and she felt obliged to be there. And those people took their job more seriously than a lot of paid people take their jobs. I was just, they-- that's what made the agency was the volunteers that we were able to come up with. And some of them, let me tell you it was not easy for them. Some of them had to make decisions sometimes that uh, got their mothers and fathers and brothers and sisters and neighbors angry at them. SMOOT: Uh-hm. GOETZ: Uh, but they tried to explain it to the people, you know "Here's where I'm coming from and you know if you don't like it, elect somebody else next time." Well they generally got re-elected because people do appreciate honesty, forthrightness. That's one of the things I found in Eastern Kentucky, most honest people anywhere. And I'm from western Kentucky and I thought we were tremendously honest, but uh, these people are more honest and forthright and-and uh, very um, forthright about, you know, Here's where I stand, that's where you stand, fine you know: As long as we don't hit each other we can talk about it and uh, walk off and you know everything was fine. We're, we're opposed to you on this one but we might be with you on the next one. And then a lot of times, uh, you know, there was a little bickering around Well you know I don't really like it but I'll give you that one if we've got something coming up next month you know (Smoot laughs) there was a little of that that went on too, it was real nice. SMOOT: Sure, sure. GOETZ: That's sort of the history prior to my coming to the University of Kentucky. SMOOT: Okay, now actually your relationship with the University of Kentucky started a little bit earlier, did it not, than your actual employment here. Did you not work on a master's here? GOETZ: Yes I, I-- when I moved here in '67 I had uh, I had started um, at Peabody working on a master's program in 1965 I guess, and uh, I was just going down during the summer. Uh, they'd give me time off from my job as long as I'd pick it up on weekends, so I'd drive down on Monday mornings to Vanderbilt-- or Peabody and uh, come back on Friday nights and then I'd work Saturdays and Sundays then go Monday back down there. When I moved to Lexington I transferred, Dr. Al Levy was the chairman I think of the Special Ed department here and that's what I was getting my degree in. Um, and uh, I-- we had uh, Lloyd Dunn and Sam-- or uh, what's his name? Polk, Sam I think, but I'm not sure of his first name now, uh two rather well known persons at Peabody. And I had a very good program, the only problem was when I moved it to uh-- from Peabody to here I think they transferred a total of six hours, uh, which was almost like starting over. Further I couldn't repeat any of the courses I'd had at Peabody and Peabody was, depending on whether you've talked to somebody from Peabody or Columbia, uh Peabody or Columbia was number one and two in the United States at that time in, in uh special education, especially administration, of special education programs. But uh, be that as it may, uh, Dr. Levy fixed me up so I would uh, be able to go here and still work, and so I took seven o'clock courses in the morning and I'd come over at lunch hour and take courses. And my board again sort of let me pick up a course here and there. I never could take more than one or two courses a semester. And I went here from I guess until 1970 and by that time I think Bill Tisdale had come in as chairman and uh, Ed Blackhurst was there and Ed was my advisor. I finally went to him after I picked up it seemed like three or four hundred hours, I don't think it was quite that many, but uh, I asked him how you'd graduate and I'd never really figured that out. Well it turned out I only had to take about two or three more courses believe it or not to get-- I forgot about that little thing about requirements. I was just taking what I liked (Smoot laughs) and things I thought would be very helpful, but you have to take some requirements, so we picked up a few requirements and I think I graduated around August of '70 or something, with a master's degree from UK. Uh, actually my ties to UK go even further than that because when I was at the Owensboro Council for Retarded Children we used to come to UK for seminars and workshops and what-have-you on mental retardation. Um, the folks down in Daviess County had been very strong UK supporters for many, many years. Uh, probably the Ag school has a lot to do with that quite honestly, the Agriculture Extension program is a key program in this state. It's very, very strong. When I was in grade school, uh, I don't know how old you have to be to be in 4H, but whatever it is the minimum age I was there. And that's run by the Ag extension uh, agency, the county agents of the, the Ag school people, uh, all while I was measuring tobacco. I did that part of my time in high school and what-have-you to get a few bucks to spend on candy bars and stuff during school. (Smoot laughs) That model has paid off for the university and it's kind of the model we may get into later, some of the things we're doing in the program I'm in now. It's kind of the model I followed in the cancer program and also in this very health education center programs. It's the model we followed in the health systems agency and the regional health planning. You can't do anything for people if they don't want you to do it for them-- or with them, and I should say with them. But uh, the University of Kentucky has been a very strong thing, and I remember in the fifties. I was just going into uh, high school and um, I knew very little about medicine, I mean we had a family physician and uh, uh, he was the guy that delivered me and what-have-you. And people from western Kentucky were having a hard time getting into medical school. Uh, Vanderbilt would take western Kentucky people and St. Louis would take western Kentucky people, but that was about it. It was very difficult unless you had a lot of money to go to many other schools, and a lot of people from there did have a lot of money and went away, but they were in a little different circle than I was at that point in time, and still am I guess. Uh, the development of the Medical Center, uh, by Governor Chandler and the legislature, of course Governor Chan-Chandler was well-liked in Daviess County. He had a county organization, I can remember still Joe Thomas coming around and getting my mother to work for him and that kind of stuff. Uh, I don't know whether anybody else ever got any votes down there or not, but I know he got votes. When he wanted a Medical Center here, everybody down there wanted a Medical Center here. When the Medical Center became a reality, it became a reality. Now the sort of an ethereal kind of thing, we couldn't relate to a Medical Center what it is or anything. Um, surprisingly, when I came here in '80 I didn't realize how big the Medical Center was, and I'd been working with Dr. Bosomworth, Dr. Bost and several other people from UK for many years on a very close base. Dr. Bosomworth was on my board in health planning for many years; uh, but I didn't realize the size of the faculties and the different uh, well the-the, the plethora of-of programs that-that are offered other than just the academic programs. So (coughs) no one can really relate to it unless they see it, and it's mind-boggling. And I think we need to do a little better job of telling people about it, but we have to tell them in language they can understand. Uh, you don't want to go into too much detail because it just becomes gobbly-goop. So everybody, in Daviess County at least, uh, ties to UK i- are, are-- or everybody's ties are very strong. Uh, and by strong I mean we know more about it just because of UK, you hear it all your life. Uh, most people in Daviess County probably couldn't even find it if they came to Lexington. I can't remember, I think the first time I ever even came to Lexington was 19- oh geez, -63 probably. Um, I was twenty-some years old, twenty-two, twenty-three years old, twent-two I guess by then. Uh, other people that followed basketball and what-have-you and were fortunate enough to come to the state tournament-- well I don't think they were here though. They-they were in Louisville, so um; it-it was a long distance at that time. There weren't very good highways between here and there, it was about a six hour trip on Highway 60, which goes right through Owensboro and also goes through Lexington. So um, the ties were there. I got more involved when I got into health planning, more involved with the university than I'd ever been before. Uh, like I say Dr. Bost and Dr. Bosomworth-- Howard Bost at that time was sort of the father of the certificate of need legislation in the state, and was chairman of the certificate of need board and-and taught me a lot of lessons about uh, honesty, fairness, uh, consistency-- and I guess probably the big thing that Howard Bost preached was consistency of approach. And uh, by that I mean you use everything that you can and you develop the best plan you can but then follow that plan as consistently as possible. And people appreciate, even though you might get turned down and it's hard and you pout for a few days, uh, you have to admit "Well you know he didn't do anything to me, for me, against me, or, or what-have-you that he doesn't do for somebody else in these same circumstances." And I can remember the early days of the certificate of need board, it was a lot different than it is now. It was a much more formal, uh, yet relaxed but much more formal uh, and-and process oriented-- I'm sorry not process, people oriented, uh situations. They were very-- they were process oriented too, but they were just honest and fair and forthright, that's all I can say. We didn't have a lot of the legal entanglements that we have now, but we had a lot of discussion that we don't have now. SMOOT: Um-hm. GOETZ: So uh-- and like I said Dr. Bosomworth was on the board. The university was always planning some kind of project uh, looking five, ten, fifteen years ahead, uh, recognizing that whatever you build, uh, you're going to be uh, utilizing for at least twenty years and probably longer. Um, most people would like to say that whatever you build ought to fall down in twenty years, and health care ought to fall down in twenty years because it's going to be obsolete. Uh, we've done a pretty good job I think around here of revamping some these buildings that have been here twenty-five and thirty years, uh, and when you know that you're not going to have the luxury of tearing something down and rebuilding it, you have to do an even better job of planning something that can be uh, revamped and restructured, and uh, because (coughs) programs today are going to be so different twenty years from now. You know they may not even be existent. Uh, the whole insurance situation, HMO stuff, I can remember in '72 one of the hottest issues we dealt with was the-the new HMO in town, Hunter Foundation, you know it was socialistic, communistic, everything else you can think of but it didn't, sure wasn't, not one thing was ever said good about it. SMOOT: Yeah GOETZ: But everybody kind of tolerated it--uh, because uh, you couldn't be against motherhood and apple pie, but that's all that was ever done. Now everybody wants to be an HMO, if you're not an HMO you're, you're nothing. SMOOT: Something similar to the reaction that was uh, gendered by the development of Medicare and Medicaid. GOETZ: Oh yes, yes I know and I remember that very well, '65, '66 and-and frankly in '63. Uh, I don't know how much of this you'll want to but some names: Senator E. W. Richmond used to be a state senator and knew that uh, Medicare and Medicaid were coming along and so about '63 he developed a little organization which became one of the largest nursing home builders in the state of Kentucky. And he went around and built nursing homes whether they needed or not because he figured eventually we're going to use them. And he'd buy and sell or he'd build and sell, and he's still in the business. The-the fellow's an interesting guy; when he was state senator I measured his tobac-- no, yes I was measuring his tobacco. He-he was from about five miles from where I grew up and um, had a rather large farm. And he's still buzzing around the state messing around in nursing homes and what-have-you. Uh, he's probably built more nursing homes in the state than anybody, anybody else. And he built them in Powell County and Estill County. You know when I got into the HSA you know the last person in the world I'd ever expect to see was a guy from Glennville, Kentucky and here comes Senator Richmond. "Well Tony, what can we do here?" And all that, and um, so and he knew how to play the game really-- and he-- it was sort of a game, it was a purely a money thing. His wife did pick out colors and also equipment for the uh, physical therapy room. That's one thing-- or two things that his wife felt very strongly about were colors and what they did to people and the types of equipment that you ought to have for older folks. So-- and he gave her, you know he said she cost him a lot of money, but he gave her sort of freedom to do all that, but in-interesting fellow. SMOOT: Um-hm. GOETZ: So, getting back to your original thing, uh, point; yes my contact got a good bit stronger with UK from 1973 on because I dealt with it almost on a daily basis. Um, probably, and I don't know how much of this you're interested in but you can always throw the tape away if you don't like it, (Smoot laughs) um, I guess it was about '79, fall of '79, Dr. Bosomworth asked me to come over and speak to his students. And I think this may have been uh, one of the reasons I ended up at UK, I'm not sure. Uh, he asked me to give-- Dr. Bosomworth had come up with some interesting topics, and I'll never forget what he asked me to, to do was talk about my perceptions of other people's perceptions of the Medical Center. You can't really go wrong uh, on that because there's nothing factual in that at all, so I could make up anything and-and pretty much say "Well that's my perceptions of other people's perceptions." I mean there's enough slush in there. But I did, I-I talked to the deans uh, at that time at one of his meetings and-and it turned out what I thought was going to be a fifteen, twenty minute presentation turned out to be about three hours. And then I got a lot of questions. I got a lot of uh, denials on some people's part about some of the things I said, and all I could do was probably agree with them. My perceptions are probably different than their perceptions, but nonetheless they were my perceptions and uh, anyway over the next, oh month or so I got several phone calls. Dean Piper called wanting me to speak to the dental faculty and say the same thing. That's when I started getting a feel for the place, I guess because I went in this room and there must have been fifty people in that room. And I, you know I thought; dental faculty would be probably five or six people. I was really frankly amazed. I'd never really taken the time to look at the University Medical Center and see what it was. But I gave sort of the same talk and I got sort of the same reaction, but uh, some good very positive reactions. Uh-- and overall all of these reactions were very positive, and-and I think one of the positive things was that I saw an interest on a lot of people's part. If nothing else they were interested in the fact that at least Tony Goetz had that perception. You know If we could change his perception, you know maybe if somebody else has that perception, which we doubt, uh, we can change that too. Uh, then I think Dean McKenna had me come and speak to the College of Nursing. Uh, Dean Hamburg, I believe, had me come, and I can't remember all that-- I believe they all did, and one day I got a call from Dean Clawson, who was Dean of the medical school, and wanted to know if I could come by and see him. And I said "Well fine," I figured he wanted to have me come and speak to the medical school faculty. Because all these things, in fact I was coming by to speak to the dental faculty that day. And I said Well how about, I'll be finished about four-thirty how about that? And he said that'd be fine, so I went in his office and uh, chitchatted for a while and you know, what I used to call when I talked to county judges you know you always asked them about the corn crop first and then you'd get down to the rest of it. (Smoot laughs) And uh, Dean, uh, Clawson uh, sort of got to, he was pretty good at chitchat for about five minutes and then sort of started outlining this position that he had been trying to develop over several years and had a lot of good applicants and what have you, but he just thought maybe I might be interested. What he was kind of saying uh, a little stronger was that he had a lot of good applicants but he wasn't offering much and not too many people wanted it, and it was a position that was very, very nebulous. Uh, it was going to be whatever you made it. You call it one thing to get it through the university system if you will, but here's what we really needed to do. And it involved a lot of extramural uh, activities, public relations, some development, not really fundraising but development towards the fundraising, SMOOT: Um-hm. GOETZ: Developing an alumni association for the medical school, uh, which at that time had had something like uh, seventeen or eighteen graduating classes, or sixteen graduating classes I guess. Um, do a little work uh, making sure that legislators understand what the medical school is all about, and that's basically what he's interested- - well medical school and Medical Center, because you can't separate the two. And uh, the result was that uh, he sort of asked if I'd be interested and you know I'm-- I never turn anything down until I find- find out more about it. And I said "Well I'm not disinterested but I've got a pretty good job" I was very happy really with the job I had. And uh, he said "Well I'd like for you to come back and interview." So I thought you know this wasn't an interview? So when I really got to know a little bit about the Medical Center he scheduled an interview for about sometime in February or March, I can't-- February I guess-- or he told me to call Fran his secretary, so I called Fran a couple days later and I said "You know I've been looking at my calendar, and I can probably do this on Friday morning at eight o'clock, that way I can be at the office at ten." And she said "Well you don't understand, it'll be an all day interview." I said "All day?" You know I'd never interviewed more than five minutes and one dinner you know, for a grant job. And she said "Well yes you have to talk to these people," and then listed a whole bunch of people, none of whom-- or one of whom I knew. I knew uh, I knew uh, David Callan, and he was one of the people on the interview list. None of the others did I know. Uh, and um, so anyway I went ahead and took a vacation day, I needed a day off anyway and thought that'd be interesting. So I came to the university, spent an hour or two finding a parking place. (Smoot laughs) And uh went over and-- SMOOT: Some things never change, right? GOETZ: Eh-that's right. Went over for my eight o'clock interview and, uh, started talking with all of these people, and somebody took me to lunch. Uh, a couple people out of the business office took me to lunch, and I thought, Well, you know, what in the world would they do? Well, they were talking about fringe benefits and salary and how you get paid and all that stuff, and, uh, I didn't ask many questions because I didn't know anything to ask. Well, anyway, at the end of the day D-Dean Clawson asked me again would I be interested, and I said, "Well, you know, I really am not disinterested, but this is a little different than I thought and, uh, you know, maybe I better talk to my wife a little bit." He said, "That's fine. Go ahead." So I, uh, went home. We talked about it about five or ten minutes and decided I was pretty happy with what I was doing, and we had developed a pension plan by then and we had health insurance. Part of it was paid for and, you know it, I was doing okay and, uh, decided we'd stay there. So I called him--uh, went by to see him. I made an appointment and went by to see him and thanked him for his courtesies and indicated that I was very honored and pleased and, uh, uh, but I thought I'd stay. Well, he gets kind of a stiff lip and, you know, "Well, uh, I understand what you're saying, but I just don't take no for an answer." I said, "Well, you know, that's fine. No problems, I-- just as long as you're not holding it." "Oh, I'm not holding. I've got a lot of people who want this job." I said, "Well, maybe you ought to hire one of them." He said, "No. I'm-I'm going to call you back at the end of the month." I think this was around the first of the month. (Smoot laughs.) On April thirtieth, by golly, at ten-thirty in the morning he called me again, and I'd had probably one of the worst mornings I'd ever had. (Smoot laughs) And he said, "Ah, I noticed, you know, ha, ha. And told me "I noticed it's the end of April," and everything--and, uh, this was only about the third or fourth time I'd probably ever seen him in my life. I saw him, as a matter of fact, uh, in '75 when he was in here for an interview. I just happened to be in the medical center talking with Jarecky and Doane Fisher, who were co-acting deans at the time, and Clawson was walking through with his lovely wife, Janet. But anyway, uh, he said, you know, "I know it's the end of the month. I said I'd call, and he said, uh, I wondered if you'd be interested. Have you given it any more thought?" I said, "Well, I have. I guess you haven't found anybody that'll take it yet?" And he said, "Well, to be honest with you, no." He said, uh, "The one good guy I thought I could get from KMA"--turned out it was a good friend of mine, Joe Witherington, and, uh, Joe, for some personal reasons, didn't want to move and leave family for reasons mainly with his son, and didn't want to leave Louisville, and, uh, he was in school. So, uh, Dr. Clawson says, uh, "You know, would you be interested?" And I said, "Well, as a matter of fact, yes. I think I'll take it." And, um, he said, "Well, when can we talk about it?" (Clears throat.) I said, "Well, you know, I'm going to a KMA meeting tomorrow morning, one of the quarterly meetings or something." And he said, "Well, I'm going, too." Says "Why don't we ride up together?" I said, "Fine. I'll pick you up at seven-thirty at your office," or something or "out back of the medical school." He said, "That'll be great." But anyway, that afternoon I went by to see my board chairman who happened to be Al Graham who was a surgeon here in town, told Al I was resigning and give him a couple months' notice--May and June. I would quit July one. That was all fine. So the next morning, Dr. Clawson got in the car with me. I told him I'd resigned and everything. He said, "Wait a minute. We don't have the position established. We've got to go through the board of trustees." I said, "Well, that's a fine time to tell me. You offered me the job, I took it. (Smoot laughs) I didn't understand the university. Uh, you know, whenever I--see, my board always gave me the authority. They established positions, and every board I've ever worked for, I've always insisted on certain things. They establish positions and salary schedule and, and they-- SMOOT: Let's stop there. GOETZ: Okay. [Pause in recording.] GOETZ: Uh, I've always, you know, insisted to do a job for a board or for an employer you've got to have some flexibility. Now you've got to have some very rigorous guidelines, but-but I had enough, uh, courses in administration to try-- you know, I don't know that much about it. I've always been in it, but I always try to do something and then I always give it my own personal touch, which screws it up royally. (Smoot laughs) But, uh, my board always--(clears throat)--approved my budget. They approved the salary schedule. SMOOT: Um-hm. GOETZ: Not the salary for an individual particularly, but a salary schedule. In fact, my board never insisted, never wanted to know the names of people. We went by positions. That way you had less opportunity for somebody's granddaughter to get favoritism over somebody else or something, you know, and, and uh-- so they never interviewed people. I always-- they, they hired the executive director and then I hired all the staff, and, and it was basically up to me. Now if there was somebody working in my project review division then the project review director would review people and come to me and, I, you know, give me two or three applicants or one applicant or however he or she felt and we'd decide then, Okay, we're going to make the offer. But I'd make the offer, and that person knew he was working for me through Doug Schneider who happened to be Director of Project Review or something. But anyway, uh, I thought everybody worked that way. Not the university. Uh, he had to get a salary established. He had to get a, uh, a position established. They had to do a job description which, uh, at that time was about a half a page and so general that anything I did fit in it. On the other hand, anything I did might not fit in it, too. It was one of those, uh, you know, heads you lose and tails you lose kind of things. (Smoot laughs.) Uh, but it was fine with me because I've always, I've always kind of worked under that kind of thing, and-and, you know, you make your own job anywhere. And, uh, so we--you know, he said, uh, I said, "Well, you know, I'd kind of be embarrassed to go back to Al and tell him I don't have the job." And he said, "Well, I probably, I think things will probably be okay." And I said, "Well, I don't know." So I never did tell my wife about that until later, uh, afterwards. But anyway, uh, he said, uh, "Go ahead. You know, we'll-we'll run it through." So he kept giving me a report every week or two about, you know, of course the stage, what process it's going through, et cetera. But, uh, anyway, uh, it developed, and- and I'm very pleased to be here. The job is, uh, basically the same as it was then. I just do whatever somebody tells you to do and try to do it as well as you can, and that-that's about it. SMOOT: What do you mean "It-it's the same as it was then"? Is, is it from the beginning to-to now or, or is this job really something that developed, uh, from a position that had existed before but had kind of branched off into other areas or-- GOETZ: To my knowledge, there was no position before for this, this job. It was the new associate dean's position--at that time, I think we called it Associate Dean for Planning. Then it became Associate Dean for Program Development. Then it became Associate Dean for Development. Then Associate Dean for Planning and Program Development, and I may have all the chronology wrong but that's kind of what it's done. But basically it comes down to working with the Alumni Affairs for the medical school, uh, working as a liaison between the medical school, the Medical Center and the university with legislative matters-- SMOOT: Um-hm. GOETZ: --uh, with business industry, politicians at the state, federal and local levels. SMOOT: Um-hm. GOETZ: Uh, to the extent that, you know, not be a burden or not bugging people to death but just be available, uh, working with our--(clears throat)--external constituencies which, uh, include not only the students and their families but, uh, uh, the politicians out there, the physicians and, uh, uh, any interested-- any person, you know, who's really got some kind of problem. I generally get a call somehow or another, and we chase it down as best we can. It's a stamping out brushfires kind of approach in a way; however, it's also a very personal approach. And what you do for one ends up having a lot of, uh, does a lot of good for everybody because if you can get somebody to change the way we're handling, uh, referrals to the neonatal unit-- SMOOT: Um-hm. GOETZ: --and families who are, have the children and our feedback to a local physician who, who uh, uh, is really the physician for that family, uh, if you can get something changed and maybe a little bit more personal, uh, then it pays dividends for people who haven't referred yet or haven't been referred yet. And it, you know, it just works out. It becomes a--you use a specific instance, I guess, to get the point across and get something done. Uh, a little bit of development and fundraising, uh, lot of flathanding. Uh, the AHEC Program, uh, was requiring about 50 percent of my time. I spent a couple or three years with our McDowell Cancer Network during that period of time. We had an executive director resign, uh, in 1980 about a month before I got here, and five minutes after I got here I was working with McDowell even though there was nothing mentioned about McDowell in my job description or anything. Dean Clawson always wrote a little thing. "Performs other duties as assigned," or something. SMOOT: A catchall? GOETZ: Always-- yeah. You got it. (Smoot laughs) And that was assigned five minutes after I got here in 1980, July, and I worked with that up until about 1982, 3--about '83, I guess. I, uh, then took over the, what is now, Area Health Education Center program. We, we changed it from an Area Education System program, and the basic thing on that program is we're trying to, uh, consolidate all of our colleges, all five colleges' efforts in extramural education; uh, not from a standpoint of academics or anything. Each college has that responsibility from purely an administrative standpoint and a reporting standpoint and hopefully from a, a, uh, I think, quality and, uh, quality assurance standpoint in a way because we're developing--again now, this is something we didn't have before--but we have local agencies. We've got an Area Health Education Center at Morehead which covers several counties in northeastern Kentucky. We've got one in Hazard where I was last night, uh, uh, which covers Southeastern Kentucky. We'll be developing one down in southern Kentucky which uh, Corbin, Somerset, London, that area. It will cover all the way up to Danville, as a matter of fact, uh, but it will have its own board of directors with their advisory board. But we actually contract them with a private non-profit agency out there. I generally go to a hospital. It has to be a, an agency that can kind of float us. They have to, they have to believe us that if they spend this money we're going to repay them, and we repay them if they did what we agreed to begin with that we would do. We do personal service contracts with them, and we outline a scope of work. You will do this. You will do that. You will do that. In return for that, we'll give you this much money. And then unofficially, I say, "Here's how you're going to spend the money." And they-they have to hire this person, this person, this person, this person, and as long as they do all then they get the, they get paid on a quarterly basis. But, it's-- I wish we could give it to them up front. We can't. We have to wait until they do the job, and, uh, it's difficult for them. But they're willing to do it because it ties them close to the university, it gives them medical students and residents that they might--and other students. Uh, I need to get out of my College of Medicine hat here and get into my medical center hat--uh, that they might be able to recruit, uh, and that's the name of the game is what we can do for the state. And that's what we're supposed to do. We're supposed to be training people for the state and uh, we don't want to lose sight of it, and we won't lose sight of it as long as we've got watchdogs out there--and I call those watchdogs out there, those boards out there. We've got the same thing with the McDowell Cancer. We've got five, I think, district cancer councils. Let's see; Northern Kentucky, Morehead, uh, uh, Hyden actually, Somerset and one in Lexington. Uh, these are groups of people that kind of keep our nose to the grindstone. We-we don't get to feeling too smug about things because, you know, and I worry about when I come in and everything seems wonderful and I'm all caught up because I know something's going haywire somewhere, and, uh, you know, somewhere we've, we've let somebody down or we haven't maintained contact; we haven't stroked them a little bit. And a lot of times it's just a phone call. Once they know you, a phone call will work, but until they know you, you should be down there face to face. I never conduct any business with strangers on the phone. I always go face to face, and that way then they're not strangers. And sometimes I don't do anything the first time. I just get to know them, and somewhere in there, "By the way, you know, next time we meet let's talk about this or that." But I don't want to-- they've got to have time to check you out, and there will be somebody in that town that will know you and they'll want to know how it work. And if they check you out and everything checks out then it's carte blanche. But, uh, the people out there are, uh- -we, we respond very well to outside pressures here. We don't respond so well to inside pressures I don't think. We respond very well to outside pressures, and, and I don't think that's bad. I think that's what we're supposed to do. You know, I think if we just did what the inside pressures tell us to do, hell, we might be going off in the wrong direction. Uh, you know, it's kind of like, uh, this interview. I may be talking about things you don't even want. You know, so you've got to keep me on the, on the track, and, and the people out there, if they keep us on the track we do very, very well. SMOOT: No, I, I think that you're very much on track. I do want to back up and ask you a couple of questions about some of things that you've said. GOETZ: Okay. SMOOT: First of all, of course the position that was created for you was new, but uh, you were undoubtedly aware of the work that was being done by Bob Johnson at some point in-- as a director of state and local services? GOETZ: Oh, way back in the-- yes, back in the sixties. Sure. SMOOT: All right. And so this seems-- GOETZ: Sixties and early seventies. SMOOT: This-this office seems to be a-a combination of things; at least the position that was created for you in the beginning seems to be a combination of things. Uh, most of the, uh, relationships that were developed with the state legislature and to the governor's office, that was taken care of by Dr. Willard, uh, up until the administration of Jack Oswald from what I understand. GOETZ: You are absolutely correct. SMOOT: Okay. And then the other state and local services--similar to what you've been doing but not-- I think perhaps not as extensive as what you've been doing. I may be wrong on that--were care-- taken care of by Bob Johnson's office. GOETZ: I think, I don't think there's any way you can--Willard and Johnson are in a different plateau. Uh, there's no way you'll ever compare. (Laughs.) My, my work is probably with, uh--how do I say this without being--uh, my work is, uh, with more the general public. I think they, they were at a higher plane. Uh, those two guys were public relations. They could walk into a governor's office. I've got to go through somebody to get to a governor's office. Uh, you know, I can get there, but I've got to go through sometimes three or four people. They can go direct. SMOOT: Um-hm. GOETZ: Uh, Bob Johnson is-is probably, uh--off the record--one of my--if I could do a tenth of what he does there's no way in the world I could ever fail at anything. I mean he is a really fabulous individual. SMOOT: Um-hm. I think so, too. GOETZ: And his job must have been, uh, terrible back then, I mean, trying to sell something that, that people didn't even know anything about really, and we didn't have a whole lot to sell. I mean, honestly we just had a lot of promise. SMOOT: Um-hm. GOETZ: And he did it, and he's got a lot of, uh, a lot of pull, a lot of ability to do that, and here again, there's an honest, straightforward- -you know, I-I've never talked to that man without him saying, "Here's what I feel like." You know? And sometimes I know I'd have to go around that a little bit to get somewhere because he has a very strong opinion. Now we are, as a matter of fact, our Hazard operation is, uh, with the ARH. We contract with them as one of our AHECs. Uh, because basically their philosophy at ARH is very similar to that of the University of Kentucky, uh, in many ways. Obviously they're--uh, and- and while they're competitors, in many ways that we're not competitors either. Uh, we need to feed them personnel, manpower and that's part of our job. SMOOT: You see them more as partners really? GOETZ: Yeah. They really are partners and that's the whole thing. And I've used that term many times about the cancer network and the AHEC. Without that partnership, it won't work. SMOOT: Um-hm. GOETZ: We can't just go out there and, you know, keep all the money here from the state and send medical students out there, and everybody says, you know, They're just using us. I want them to use us, you know, the local people to have to use us. But-- (clears throat.) yeah, there have been many people who've done, and, and I just, I didn't-- I don't even equate what I'm doing with what they're doing at all, uh, because, uh-- SMOOT: Well-- times have changed. GOETZ: --they, they've developed a lot of things where nothing existed-- SMOOT: Right. GOETZ: --and I'm just trying to build on it. I'm just working with things that already exist. I'm not, I'm not even sure I'm building on some of them. We might be tearing down. You know, you try to get enough things going that, uh, you know, if something works that one balloon might go up and that'd be great or stay up, you know. SMOOT: Well, that was part of the question, though. You see, I wanted to ask you afterwards what kind of a foundation had they laid for you and-and the work that you've done? GOETZ: Oh, the university--see, you can walk--you can do better outside of Lexington and Fayette County selling the university than you can inside because inside it's, it's either taken for granted, it's too large, it's too impersonal; what-have-you, I don't know. But outside, uh, people are very positive, very favorably disposed about this place. All we've got to do every once in a while is thank them out there for their help because we wouldn't be here if it weren't for them. There'd be no reason for us to be here. Uh, you really don't need, uh, a hospital in Lexington like this hospital. There are other hospitals that do a lot of what we do. Now there are some things that only we do and it's appropriate that only we do, but you do need this place for Central and Eastern Kentucky, uh, and it's, it's frankly as far as I would expect anybody to have to drive to get to it, tertiary. So-- SMOOT: Um-hm. GOETZ: And when you're coming from South Williamson, Kentucky, or you're coming from Lynch, Kentucky, uh, I wouldn't want people to drive any further than they have to drive to get here, and I hope that, you know, with our new air transport system which we're trying to develop that, uh, it'll make it even more convenient for them. I hope we can afford to keep that thing going. I don't know-- we did some studies on this kind of thing back in the early seventies and it's very expensive, but, uh, if you or I are laying out somewhere with a very serious life- threatening injury, uh, there's no expense too great, you know, for you or me. SMOOT: Certainly not. GOETZ: Uh, so, uh, it's, uh--the foundation was there. Uh, I mean, Chandler laid the foundation for one thing, Willard and uh, Johnson. Dr. Bosomworth is a superb, uh, uh, public relations man when it comes to this kind of thing. He has worked with, uh, well, he's been, you know, on the board because of his position probably, but the fact is he's been a good, steady member of many organizations; Kentucky Municipal League, Chambers of Commerce, things that you wouldn't normally think about in healthcare. SMOOT: Um-hm. GOETZ: Uh, these are very important, uh, because this place, uh, again--for reasons you don't think of. I mean, sure we do things for neonatal care and burn unit and bone marrow transplants and kidney, uh, transplant, uh, open heart surgery and soon to be, uh, heart and lung transplants, et cetera. Uh, those are wonderful--but we also are a very large employer. Economically, it's a heck of a boost for this area. Uh, the city of Lexington and the University of Kentucky have long been very, very friendly. Uh, the medical center just increased the size of the university tremendously. Uh, the university is the largest employer in Eastern Kentucky. Uh, there are a lot of people from Harlan, Lynch, uh, wherever, working at the medical center. Uh, I run into people down there. "You know so and so? That's my son," or, "My daughter works there in the medical center." Uh, so it's, it's a rather positive. It's a matter of just trying to keep it all in hand, you know, and you're going to win some, you're going to lose some. But we, we're winning most of them. SMOOT: Let me ask you another question following up on some things that you said earlier. You know, I've heard people say that, uh, although the University of Kentucky was developed for the very purpose of providing more physicians for the state of Kentucky, they really haven't done a good job of putting those physician-physicians back where they're needed most; that is to say in rural areas. How do you respond to that? GOETZ: Well, first of all, over in my alumni office we have a map with all the pins in it. Gold pins are those who have graduated from this place and where they're practicing in Kentucky. Black pins are those who didn't graduate from here but graduated from our residency program. In other words, they're people who came from other medical centers throughout the United States to do a residency program here-- SMOOT: Um-hm. GOETZ: --and ended up settling in Kentucky. So we don't think about those sometimes, but there are a lot of those. I have a pin of the-- or a map of the United States with pins in it telling you how many of our graduates, now these are just our medical school graduates, are practicing. We have somebody practicing in every state in the union. We have eight or ten overseas. Uh, they're usually in the Armed Services and what-have-you, and I think we have a responsibility to provide those people for the Armed Services. Uh, I would think right now--this is just an estimate off the top of my head--roughly 50 percent of our graduates are practicing in Kentucky, and that's a very, very good figure. 60-some percent of our graduates are practicing in, in primary care specialties, and that's what we had hoped. That's what Willard and all of them foresaw, and, you know, how these people could see that far, I mean-- you know, I saw your, your film. Uh, uh, the place, it was desolate. (Smoot laughs) Uh, I wasn't in Lexington in '55. I don't know what--but it must have been nothing, and how you can sit in a farmhouse and plan for thirty, forty years down the pike, I don't know. I can't do that. I can plan for tomorrow and the next day, uh, and that's generally if you give me half of the answer to begin with. But, uh, uh, basically, uh, it's doing what people said it was supposed to do. Now that's, that's in medicine. In dentistry--I believe, I'm not-- now I'm not sure of this, but you can check--I believe we've done even better percentage-wise. I think a much higher percentage of our dental graduates are in Kentucky. I can tell you for a fact the Allied Health Graduates, something like uh, in the high seventies or eighties of physical therapy graduates, for example, are in the state, and you talk about an area of need. That is one of the biggest areas of need in the state right now-- SMOOT: Um-hm. GOETZ: --physical therapy, uh, and we're trying our best to fill that need. So, I can respond very positively and very favorably, and, uh, uh, there is no way that a hundred percent, uh, of your graduates are going to stay here. There's just no way. Uh, I wish they would. Uh, ninety percent of our graduates are from Kentucky; at least ninety. It's really about ninety-two or ninety-three percent. They are Kentucky natives. You know, it's like I just mentioned; families today are different. You know, out of seven of us in my family, four of us are out of the state, outside of the state. Um, so, you know, uh-- SMOOT: Well, the economic situation has changed considerably. Mobility is part of our society now. GOETZ: Yeah, it's just-- interestingly enough, uh, as you get further away from graduation and medicine, for example, you really can't look at people in the first ten years even though we've got a good number here and we've got a good number other places. SMOOT: Um-hm. GOETZ: And what-what'll throw your statistics off is some people will go out of state for a residency program then they may practice there for a little while, but then they'll come back. Okay? At the end-- after ten years you can really look a little better, and your percentage is much higher because after ten years a physician has generally, generally found his or her place. SMOOT: Um-hm. GOETZ: Uh, we see more and more now going to Eastern Kentucky. We've still got to develop Southeastern Kentucky. That is the area-- the main, if you asked me right now what my number one priority is--it may be the university's, but I'm sure it's not--my number one priority is to develop more training sites and get more students to go down there for training in Southeastern Kentucky; more residents in Southeastern Kentucky. And eventually, we know from our experience in Morehead and those places, uh, that's where they will practice. SMOOT: So you're looking at Middlesboro, Somerset, uh, territory down through there? GOETZ: Hazard. SMOOT: Hazard. Corbin, right? GOETZ: We only have three graduates practicing in Perry County. That's a shame. Corbin, Whitesburg, SMOOT: Right. GOETZ: Pikeville, Prestonsburg, SMOOT: Um-hm. GOETZ: Martin--or, or Inez--Martin, uh, Jackson, uh, Hyden, Harlan--did I say that--Lynch, Cumberland, Benham and Lynch. Uh, Jack Coop, one of our graduates from about ten or twelve years ago practiced in Lynch for ten or twelve years and then he went with an HMO in Arizona, uh, and, and he didn't go to get out of Kentucky. He went to get to Arizona. I mean, you know, they've got something called low humidity and uh, sunshine. SMOOT: Yes, I've heard that. GOETZ: And, uh, that's one thing. As long as I don't go there and visit and know about it, I may not want it. Okay? SMOOT: Right. GOETZ: So anyway, uh, no, I can respond very favorably, and I also respond this way. If we hadn't been here, I can tell you it would be a lot different than it is today if it hadn't been here, and it would not be positively different. It would be very negatively different. Uh, there are other things. There's-there's a clinic down at, uh, Shepherdsville. It's there because the University of Kentucky started that clinic back in the sixties. Johnson had something to do with that. Uh, Kurt Deuschle, who was the Chairman of Community Medicine, had something to do with that. Uh, there are thing out there that wouldn't be there. Uh-- SMOOT: Can you give me specific names of places? Just kinda remind-- GOETZ: That's the only one I can say right now, but now Dr. Bosomworth and, uh-- SMOOT: Okay. GOETZ: --could probably do something in that order. Possibly, uh, Vanderbeer-- oh. One of the things that we've got out there that is fabulous, I mean, people don't--and I, and I even tend to overlook it, uh, and I shouldn't--our physicians and medical staff have dozens, dozens of clinics on a regular basis throughout Eastern Kentucky. The neurosurgeons go to Morehead and see fifteen hundred patients a year in Morehead. These are people that would have to come here. Now they're following up some patients that have been here. They're seeing some patients that they can take care of there and help the local physicians with them and what have you. They go to Somerset, they go to Pikeville. Uh, neurology people in Pikeville. Our pediatric cardiology that Jackie Noonan, Dr. Noonan runs, uh, are absolutely fabulous. That's something that, I mean, Dr. Noonan happens to be one of the United States, and probably world, experts in pediatric card- cardiology, uh, but we overlook those. Um, I don't know whether you've seen this book or not. Uh, we did this for-- SMOOT: Your District and the UK A.B. Chandler Medical Center. GOETZ: We did this for the state representatives and senators this past year. Dr. Bosomworth's office put it together. SMOOT: Could I have a copy of it? GOETZ: Uh, yeah. Let me give you this other one. SMOOT: Okay. I can return it to you. GOETZ: No. No. I had an extra one, and I knew I'd find a good thing for it. SMOOT: Thank you. GOETZ: But just uh, let's look at something. Uh-- SMOOT: Okay. GOETZ: Oh here's an area that you wouldn't think we impact very heavily. Uh, Mark Brown, House of Representatives 27th District. Uh, what is that? SMOOT: That's 34th. GOETZ: Of the Senate. Is that the 37th? Look at, uh, 27. SMOOT: Okay. GOETZ: 31st. SMOOT: 28th. GOETZ: Okay, now this is Bullet, Hardin and Meade County. SMOOT: Okay. GOETZ: All right. Inpatient admissions, not very many during this particular year. I think it was the last, I can't remember whether it was fiscal year or calendar year. Only at twenty-one, but you would figure most of those would go to Elizabethtown and Louisville. Okay? Patient care registrations, this means that our inventory, outpatient, 171. Uh, dentistry, eighty-nine. I mean, but that's something. But now, come on down and look at some of the things. Uh, Direct Care Service, we have adult and pediatric chest disease clinics in Bullet and in Shepherdsville; adult and pediatric uh at, uh, the district health department in Brandenburg; adult and pediatric chest disease clinics in, uh, Elizabethtown. Uh, look here. Teaching-based care. Location and number of students: Fort Knox Independent-- or Dependent Schools--Dependent? Surely, it should be independent. Maybe it isn't. Two, two, um, two students there. SMOOT: Um-hm. GOETZ: Hardin Memorial Hospital in E-town, one; Ireland Army Hospital in Fort Knox, nine; Woodland Clinic in Elizabethtown. Those are where students are going from here for their training. Uh, down at the bottom, "Enrollment. College of Allied Health Professions." Twelve students from those three counties in our College of Allied Health; uh, five in our College of Dentistry; four in our College of Medicine; thirteen in our College of Nursing; seven in our College of Pharmacy students. Um, look at the next page. Here's Jefferson County. Now all of the Jefferson County people that figured-- we couldn't split the districts because, you know, we don't have it that fine, so all of those are going to read the same. In other words, that's the county even though Bill Lile only represents a part of that county. SMOOT: Okay, sure. GOETZ: Uh, let's look at, uh, Senator Benny Ray Bailey. He's 29th. Here he is. I just happened to open to it, 29th Senate District. SMOOT: Senate, okay, okay. Senate comes before House-- GOETZ: Let's see, that's Sam Mac-- oh, this, this happens to be the district I grew up in. All right. What is he? Uh-- SMOOT: Okay, Okay 7th District. GOETZ: Seventh District in the House? That is, that is my district. That's Rome, Kentucky, and Sorgho and Stanley and-- (Smoot laughs) it goes all the way down to, uh--here's Sam. Sam McElroy. Twenty-two people admitted to our hospital that year from, from, I mean, this is Daviess County, McClean County--or no--Daviess County, Henderson County, Webster County, Hopkins County. I mean, Union County, he's even got some of that. That's, that's uh, four hours; three and a half to four hours. GOETZ: Yeah. Right, that's a good distance from here. SMOOT: Twenty-two people, two hundred thirty-three, uh, uh, in our outpatient clinics; dentistry, seventy-two. But look at, look at where we put our students, you know? Thirteen in pharmacy in Owensboro go down there, and I can vouch for that because we write the checks for them. Um, but you can see all the things. Trover Clinic in Morganfield. Trover-- oh, they have a, they have a clinic in Morganfield, but look at the students; Allied Health, eighteen. This, this is important. Uh, dentistry, four; medicine, thirteen; seven from nursing. Remember a while ago I said back in the fifties when I was growing up, you didn't come--there was no place in this state to go for medical school, and this is just out of, this group of, out of, uh, less than four hundred students. Thirteen of them are from these little rural counties, okay? Pharmacy, ten. But these are important. Go on back here to Benny Ray, and you'll see the difference now in Eastern Kentucky obviously because of distance. Benny Ray is 29th District in the Senate. Thirtieth, next one. Wait a minute. Yeah. That's right. That's Ed Forgy. SMOOT: Okay. GOETZ: Okay, here's uh, here's Benny Ray. You can see already it's different, pages. 828 pat-patients that year from-- admitted to our hospital. 10,289. Are you on the-- SMOOT: Now I am. There I am. GOETZ: 10, 289 outpatient visits-- or registrations, I'm sorry, not visits. These are registered, active patients. They may not have been here for anything. Um, 589 College of Dentistry patients. Look at where we do things. Occupational health program, pediatric cardiology clinics, um, adult cardiology, adult cardiology, neurology, neurosurgery, pediatric cardiology, pediatric genetic counseling-- this is the, uh, Brian Hall. Brian's an--okay--Brian's a native of Prestonsburg. Um, didn't graduate from UK. I think he graduated from U of L, if I'm not mistaken. Went out west, did a fellowship and what-have-you, now he's back here on our faculty. You know, he wouldn't have that opportunity if we weren't here. He's doing, he is a dysmorphologist which means he-- uh, if there's a genetic possibility that you may have a defective or deformed or retarded or whatever child, he can counsel the families and they can make their decisions from that. Um, but, and there-there's a lot of that where you have uh, inbreeding, where you have, uh, poor nutrition-- SMOOT: Um-hm, yes. GOETZ: --and stuff over a period of years, and it comes there-- so anyway. Pediatric genetic counseling at, uh, Hazard, at McDowell, Hazard; uh, cardiothoracic surgery clinics. I mean, you know, these are amazing things that, that go on. They're not just, uh, they're-they're regular. Well look at the, the students now. Oh-oh, teaching-based care, where we put students. We need to up this. We are, this is, this is pitiful. It's really poor that we, that we don't have any more students going out there for training, but we're working on it. But let's look at the Allied Health Professions. Uh, well, first of all, we've got McDowell Cancer Network down there. College of Allied Health Professionals, eleven students here; dentistry, twelve; medicine, eleven; nursing, six; pharmacy, seven. And you'll see the, you'll see the, uh, the counties. He has part of Floyd, all of Knott, I think he has all of Martin and part of Perry County at any rate. So those are, I think they're significant-- SMOOT: Um-hm. This is-- yeah. GOETZ: I think they're significant figures. Um, we gave this to all the legislators. Each one of them got, they got a little bitty three- or four-page thing; they were just this, this cover--or actually this cover--a little letter--"dear so and so"-- SMOOT: Right. GOETZ: --uh, this thing here, "The Medical Center is an expression of faith in Kentucky's future." Governor Bert Combs' dedication ceremony 1960, and then they got the pages out of here, you know, like Greg Higgins. Oh, my gosh. You talk about far away. Look here at Fancy Farm. Now he's from Fancy Farm, Calloway, Carlisle, Fulton, Graves, Hickman and Trigg, you know. SMOOT: They're all far west. GOETZ: Yeah. We had eight people admitted to the hospital from there and 112 patients registered, but look down here at the students; seven-- SMOOT: That's-- GOETZ: --in Allied Health, four in dentistry, seven in medicine, two in pharm-- two in nursing, eight in pharmacy. I mean, I think that's very significant that our students come almost equally, it seems, from all areas of the state. SMOOT: Um-hm. GOETZ: And, uh, you know, in-state tuition beats paying out-of-state tuition at Harvard or somewhere. SMOOT: Certainly. GOETZ: And, uh, so, uh, it-it really makes it available to more people in the state than we've ever had. So I can't get--I get pretty excited about that part of it. SMOOT: I can see why. GOETZ: Every, every once in a while I get excited. SMOOT: (laughs) Well, that is a significant document there that, um-- GOETZ: I think you ought to have that, Rick. SMOOT: I appreciate it. GOETZ: That's an extra one, actually. Jean Keating, uh, put this together up in the chancellor's office, and, uh, I hope that we continue to do this now on a regular basis. We need it every two years because it, it just keeps that kind of thing in front of, uh, the legislators, and, uh, let me tell you they appreciate it. They-they- they like to know that. Uh, they don't memorize it or anything else, but they don't throw that away either because I saw them on the desks when I go up there, so-- anyway. SMOOT: Are there any particular people that you look to in the legislature to support UK programs or is this, is this the kind of thing where we just, we really want to, uh--of course we want to have everybody aware of what's going on here, but-- GOETZ: There are some that are stronger than others, uh, as far as supporting us. SMOOT: Naturally. GOETZ: Uh, obviously the Fayette County Delegation, but they can't-- that's only a few votes. SMOOT: Right. GOETZ: They can't pass anything. Eastern Kentucky but, you know, I get some of my strongest support from Western Kentucky. SMOOT: Okay. GOETZ: Um, we've got our little book, uh, which the legislature puts, LRC, puts out which tells you a little bit about every legislator, and you can see in there who graduated from here and who didn't. You know from talking with them who's favorable and who's not. I haven't found anybody who's unfavorable. I've found some who've been a little frustrated at times. I've found some who don't know much about us and so we have to talk to them a little bit, and, you know, you take them out to lunch or dinner and talk to them. SMOOT: Um-hm. GOETZ: You've got to get them out of the--you can't talk to them while there's four hundred other people talking to them about how to vote on their bills, you know. SMOOT: Right. GOETZ: So you've got to just chew the fat with people. It takes a long time and you probably never get it done because, uh, you know, the guy gets beat next time, and you've got to start all over with the new guy, um, but depending on the issues, uh, there-there are. Yes. Uh, you- you just kind of feel around. And you know, I, I might start out with Jack Trevey and say, "Jack, you know, we need to do this and that," and he'll say, "Well, you know, I probably shouldn't sponsor that, Tony, because I've been doing this or that. Why don't you talk to so and so?" I'll talk to, uh, the leadership, uh, generally. That's where you start. If you've got, if you've got some-- something and you have to go from nothing, uh, talk to the leadership and say, "You know, we've got this thing. We're really interested in it," and, uh, leadership will generally tell you that uh, "Well you know, I make it a, uh, personal thing. You know, I'm not going to sponsor an individual piece of legislation unless it's something really down my line. Uh, I'll probably be, you know, sponsoring administration bills and that kind of thing and uh-- but, uh, so and so will probably do that." You know? And, uh, they'll generally do better than that. They'll-- when-- by the time you get to so and so, he's already--he or she's already had a call from somebody saying, "Tony's coming over to see you and wanted to know if you, maybe you could help him out on that. You know if you have any problems, get back with me and we'll find somebody else or give him someone else or some other suggestions." They're very-- legislators are a lot more helpful than people think. Uh, I've never had one hurt me. I've had a lot of them vote against me and you just go "ouch", but uh, most of them, you know I know how most of them are going to vote on most of these issues. Uh, you know, I've never--my cousin--this is off the record. My cousin-- SMOOT: Off the record literally? GOETZ: Yeah. [Pause in recording.] GOETZ: Uh, most of the legislators, uh, they're going-- they're going to help you. They, they want to pass good bills, and you've got to convince them they're good and you've got to be straight out honest. When you've got something that you know has got some alligators in swam-- in the swamp, you've got to tell them where those alligators are and who they are, and, uh, we had some strong help from some good people this year. I remember Senator Bailey helped me so much on a, on a particular bill by just getting the, uh, a couple of guys in the House--he's in the Senate--but he got a couple of guys in the House to get the lobbyists together for a particular issue, and, and Benny Ray said, "You know, I want, uh, this thing to go through clean." In five minutes, they had five or six different groups off of this bill. They were putting amendments all over this thing, and they got them off of it. I'll tell you what it was. It was the PA Certification Bill, which was important to our College of Allied Health and our physicians' assistants that are, that are going here, and it's the first time they had a bill in that we could really support from the medical center. Uh, in the past, it's been a-a splinter type operation, another review board and all that stuff. This time they came out with a very nice piece of legislation that we could support, and, uh, we never worked against the PAs before but we didn't work for them. This time we did, and-and, uh, people who I'm not even sure they liked PAs voted for this because certain people over there thought it was about time. SMOOT: Hmm. GOETZ: And, uh, and it was, was something that everybody could support. So it went sailing right through; didn't have a single, I don't think, I don't think--well, it had a few votes against it probably. I don't think anything goes through without a few votes against it--but it didn't have any discussion against it. So to answer your question, I guess it's yes and no. (both laugh) Uh, if you look at the votes on university-type things, uh, they're, they're pretty favorable. The budget was the number one thing this time, and-and people had decided- -not just the University of Kentucky, but all the universities. They had help because the private institutions got with us on it--um, and everybody was in favor of doing something for higher education because the message got out last summer. And when Dr. Singletary and his people decided to have those alumni meetings, in my estimation--I had more legislators tell me about the contacts they got--in my estimation that is the single thing that turned everything around. SMOOT: Um-hm. GOETZ: When we had those thirty-five alumni-- we had thirty-one-- one, one night in Hazard. Uh, we-we did the one in Hazard the first night. Excellent meeting. Had forty people just from Perry County there, and, uh, that was just a very small group and it was, it was a very, very good group, um, and thirty-four the next night. That turned it around, and really, I don't think it turned it around. I think it got it started. It-- and I think we were just sitting dead in the water. And, uh, it was the most fabulous, uh, show of support from throughout the state that I've ever seen, and, uh, we need to keep people, we need to keep people informed now about what we're going to do with this money, what we are doing with it and, uh, keep them recognizing that as long as you give it to us we can do a good job. And that's kind of where we are. SMOOT: Let me ask you, uh, about local state--Eastern Kentucky, Western Kentucky--the people in the state who would be best to talk to concerning the impact of the University Medical Center on the lives of their community. GOETZ: Number one--and I don't know what he would say. He's a strong UK supporter-- uh, Jim Collins is administrator of the Owensboro Daviess County Hospital. SMOOT: Okay. GOETZ: Uh, strong UK supporter but I'm not sure how much we've impacted. The-- he's got several of our positions and, and, uh, I know he definitely wants to see more impact. David Bolt at St. Clair Medical Center in Morehead, Kentucky; uh, Dr. Warren Proudfoot, a surgeon at the Cave Run Clinic in Morehead; Lois Baker, L-o-i-s Baker, she's got a son in our medical school now, matter of fact. Uh, I would, uh, talk to Lois. Uh, she's in Whitesburg, Kentucky, with the--she's the executive director of the Mountain Conference of Health corporation. You're going to hear some negatives from some of these people now, okay? SMOOT: That's to be expected. GOETZ: Yeah. But we-- we're doing a little bit, but we can always do more. SMOOT: Sure. Sure. GOETZ: I'd talk to--let's see. Let me think. Uh, this, this gentleman is-is a fine gentleman. He's, he's run a residency program for us down at Harlan for many years, uh, Ken Herlocker, Dr. Ken Herlocker. He's an OB/GYN person. He's at the Daniel Boone Clinic in Harlan. He's been very much associated with the, with the Medical Center. He's, he's very negative right now, uh, and, and treat this part, uh-uh, yeah. [Pause in recording.] GOETZ: Oh, shoot. Gosh, I, you know, this is-- who else have we talked to? Uh-- SMOOT: What about some people in Western Kentucky? People around Madisonville or-- GOETZ: Uh, I'd talk to, uh, talk to Loman Trover, Trover Clinic. SMOOT: Okay. GOETZ: All right. Now he's going to, he's going to give you a sermon about everything from, (Smoot laughs) from here to there, but, you know, he's got a daughter and maybe a son who graduated from this place. SMOOT: Um-hm. GOETZ: Uh, but talk to Loman Trover. Uh, uh, definitely talk to him and talk to Robert Slaton also there. Robert Slaton, S-l-a-t-o-n. Robert's in a good position. He, he's with Trover Clinic but used to be Chairman of Health here, uh, for the state, and he was a chief assistant to three, uh, secretaries for human resources; Laurel True, uh, uh, Les Dawson and Peter Conn. Uh, but he's a good one to talk to. Uh, I'm trying to think of somebody in Paducah itself. SMOOT: Um-hm. GOETZ: Uh, we've got some graduates down there. Uh, uh, golly. Uh, I don't know. Luke Ross. This is an interesting-- Luke graduated in '77, and his son graduated in '81-- (Smoot laughs) --uh, which is an interesting thing, uh-- SMOOT: Luke Ross. GOETZ: Luke Ross. He's a family practitioner. I don't know how much Luke is going to give you and I haven't talked to him in a while, but you can call him. He's an alumnus of the College of Medicine. SMOOT: Okay. GOETZ: Talk to Luke and ask him. SMOOT: Okay. GOETZ: Uh, uh, we-- I, I--to my knowledge we only had one graduate in those four river counties. Uh, I'm not positive about that, but, see, Ballard, Carlisle, Hickman and Fulton-- SMOOT: Right. GOETZ: See, people talk about Appalachia. They don't realize down there are probably four of the poorest counties that we've got as far as healthcare. Now they've got a lot of soybean fields and stuff and there are great big farms and what-have-you, but they're poor in healthcare. Those four river counties, uh, you've got to drive a good distance to get to the doctor. Now it's flat land, I'll grant you, but you still got to drive there. Uh, Graves, Calloway, Marshall-- nothing's ringing a bell right now. SMOOT: Okay. Let me go back east again. Do you have anybody in Ashland? GOETZ: Yeah. Talk to, uh, talk to Dr. Jerry Ford, obstetrician, graduate of this place. Right now we're having some, uh, problems in Ashland. We've got an OB residency program up there that the physicians want to keep but the hospital administrator wants to terminate our contract like (makes whistle sound) now. Uh-- [Pause in recording.] SMOOT: We were talking about some other people maybe sta-- around the state that, uh, could be helpful in giving us some ideas on what was going on. You mentioned, uh, uh, Jerry Ford, Dr. Jerry Ford in Ashland. Others, uh, perhaps that you would-- GOETZ: Leon Hisle, who is the administrator of Our Lady of Bellefonte Hospital. SMOOT: Okay. GOETZ: Do you know Leon? SMOOT: No. I know some people that work there. I was born at Bellefonte Hospital. GOETZ: Oh, were you really? SMOOT: Yeah. GOETZ: Who do you know who works there? SMOOT: Well, I know, uh, Cathy Hill very well who is the physical therapist there. Uh, most of the, most of the people are out in the hospital; physicians that work in the hospital, uh, not really the administration there. I do know of Leon Hisle, but I don't know him yet. GOETZ: Yeah. Well, you will. Leon's a very fine gentleman. He used to be down at Pineville then he went to, uh, Saudi Arabia and then went to, uh, Norton's in Louisville and, uh, he's now at Bellefonte. Um, hmm. SMOOT: All right. Let me, let me point you to Northern Kentucky. I haven't heard anything on, uh, Covington, Newport area. GOETZ: I'd go see Dick Allnutt, Richard Allnutt, Dr. Richard Allnutt. SMOOT: Okay. GOETZ: He runs a freestanding family practice residency program up there. It's not really associated with us--in fact, it's in competition with us in some ways--but it's, their, their state money flows through us for the residents, et cetera. But Dr. Allnutt has had a lot of, uh, relationships with our Department of Family Practice, and he may know some things. SMOOT: Okay. GOETZ: Uh, we've got a graduate up there in family practice, uh, Steven Jennings, Dr. Steve Jennings. Uh, talk to him. Uh, let me think. Uh, the county judges in--I can't even think right now. Uh, we haven't had a lot of impact up there. We've got some medical students from up there. SMOOT: Um-hm. GOETZ: Well, I say we haven't had a--we've had a lot of impact. It, it's less significant in a larger metropolitan area than it is in a smaller area where there's absolutely nothing to start with. SMOOT: Sure. Right. GOETZ: Um, Benny Ray Bailey would fill your ears. SMOOT: Okay. GOETZ: Uh, Benny Ray and, of course, Grady's a graduate of here, but, uh, do you know Benny Ray, the Senator? SMOOT: No. GOETZ: He's, he's a Ph.D. Uh, he's at the East Kentucky Health Services Center in Hindman. In fact that would be an interesting interview for you anyway, and if you could get one with Grady that'd be even more interesting. You know who I'm talking about? SMOOT: Oh, yes. GOETZ: Grady graduated in '71. SMOOT: Okay. GOETZ: Oh, and John Poundstone who's a health officer here in, uh, Fayette County. I don't know if he'd be able to fill your ears with anything new or not. John's a graduate of this place in '66, uh, but he's over at the Fayette County Health Department. He's the commissioner. Um, oh, by golly. Talk to Charlie Becknell down in Manchester. He's a graduate, a '75 graduate of the College of Medicine. SMOOT: Becknell? GOETZ: B-e-c-k-n-e-l-l. We just started, uh, some cardiology clinics down there. SMOOT: Okay. GOETZ: Charlie's an entertaining sort, an-and that's the Becknell dynasty down there. His uncles and fathers and everybody's doctor down there. You don't do anything in Manchester without going through the Becknells. Um, we do tours of boards and things around. Uh, gosh. Uh, Bill Hacker, Dr. Bill Hacker down in Corbin and, uh, while you're on that one, Bill Pratt over in London. Both are graduates. Now these, some of these are going to be kind of superficial. Okay? I mean, I-- you know, they may be better than I think. I don't have as many--Hacker I'm seeing because he's going to help me set up that AHEC down there, you know, so he's pretty involved, and he has residents. I think Pratt has had students and residents through his program, through his office, but I don't know what they've had recently. SMOOT: Okay. GOETZ: Um, what about Bowling Green. Let me think about Bowling Green a minute. Call Debbie Sowell. She's a recent graduate. Uh, she's a pediatrician down there. Debbie, Dr. Debbie Sowell, S-o-w-e-l-l, and her husband Ron used to work, uh, right down the hall from me in the College of Medicine. He's now working at one of the hospitals, but call Debbie. SMOOT: Okay. GOETZ: Uh, she's fairly new in practice, so she's not going to--but she's from Bowling Green. Went back home to Bowling Green to practice, see? SMOOT: Okay. GOETZ: There's a-- there's a good story. Uh, from there, came here to school, did her residency here and went back to practice. I guess it's a hundred percent success -----?? SMOOT: Okay. GOETZ: Uh, there's a guy named, uh, Robert Johnson--believe it or not- -Bob Johnson who's a family practitioner in Harpy. He takes students, uh, occasionally. I don't know what--he's trying to find somebody to take over his practice. He wants to quit. Uh, he's trying to find a nice, honest young fellow that will come down there and, uh, sort of work with him for a year or two and then just probably take it over or buy him out or something. I, scratch-- I, I don't know that he'd have a whole lot to add-- SMOOT: Okay. GOETZ: --to what some of these people are going to say. SMOOT: Okay. GOETZ: Uh, while you're in the Owensboro thing, you can talk to, uh, Angela Jarvis. She's a, uh, physician there, and I can't remember what her specialty is. She's a graduate here-- of here. SMOOT: Okay. GOETZ: Uh-- SMOOT: Anybody over in Henderson? GOETZ: Uh, yeah. But I can't think of who. SMOOT: Okay. Let's see. E-town? GOETZ: Uh, yes. But I can't think who right now. Uh, uh, Litchfield, we've just had several medical students go to Litchfield this year, uh, to train, and one of them lives there I guess. SMOOT: Okay. GOETZ: Uh, but I can't remember who, uh, who the contact is. SMOOT: Okay. Well, that's, that's a pretty good list. That will keep me busy. GOETZ: That should keep you busy most of the afternoon I would think. If you, if you need more, call me back and I can go to a map. Where I see the pins, I can probably pick out people. SMOOT: Okay. GOETZ: Uh--oh, shoot. Talk to Jim Pigg in Pikeville. SMOOT: Jim-- GOETZ: Pigg, P-i-g-g. Jim's an obstetrician. He graduated from here. SMOOT: Okay. GOETZ: He-- he's president of our Medical Alumni Association. He'd shoot me if I didn't have you talk to him. SMOOT: (laughs) Okay. GOETZ: Now he's, he's so blue. You've got to understand, he-he's lost all objectivity about-- SMOOT: That's fine. Oh well that's okay. GOETZ: --uh, UK. He's, uh--well, he'll tell you some of the problems we have, too, how they treat the deferring physicians and things; sometimes it's a little impersonal. We're working on it. We're working on it. Rome wasn't built in a day. I was from Rome, Kentucky. Did you know there is a Rome? SMOOT: Yes. GOETZ: Do you? How did you know that? That's where I was born and raised. SMOOT: Well, I didn't know you were born and raised there, but-- GOETZ: Well, I wasn't born there, but I was raised there. SMOOT: Okay. But I, it's just like all the other names of--that kind of stick out. There's a Paris, Kentucky, too, and there's a Moscow, Kentucky, too. GOETZ: Yes, yes. Yeah, you got it. SMOOT: So, I know-- GOETZ: Rome is in Daviess County, right outside of Owensboro. SMOOT: Yeah. I, I try to keep up with what's, you know, the geography of the state. Among other things, I like to study about Kentucky. I need to know about Kentucky for all my different projects as much as possible and all the various ins and outs of the state. SMOOT: Yeah. GOETZ: People want to talk about those little towns and who they know here and there, so it's-it's good to have that in your, in your head somewhere. Uh-- GOETZ: Yeah. It is, and in Kentucky, you know, the second question is about the second person will ask you, Where are you from? SMOOT: That's right. GOETZ: I don't know why. It's almost a habit. SMOOT: I do it, too. GOETZ: Where are you from? Somehow or other I can relate to people from there because I probably know somebody from there. SMOOT: Yeah. GOETZ: You know. Uh, Lepanto, the radiologist or the, uh, the radiotherapist at St. Mary's in, uh, Huntington. SMOOT: Um-hm. GOETZ: Um, nice guy. Phil Lepanto, works over in Ashland. That's the last one. Now he's picked up two or three radiotherapists who are on-- they've got a real battle going on. You're probably very familiar with the battles. That's the reason I was a little-- in Ashland it's hard to say. There are some people who thought that we should have taken a more straightforward stance in favor of this hospital or that hospital for radiotherapy, and I tried to explain to them, "Look, I'll support one radiotherapy unit in Boyd County, but I won't support two." SMOOT: Um-hm. GOETZ: Both you guys are active. Now you guys get together and decide where it is and I'll support it, but I would not support two. And-- and I even helped them write their applications. That's, you know, how dumb I am. Uh, Bellefonte, I worked hours and hours and hours on their application, and then they got upset when I went before the board and I didn't say it had to be there because it doesn't have to be there. They did need them. They do need one. SMOOT: Um-hm. GOETZ: But I can't say whether it should be at Bellefonte or Kings Daughters. SMOOT: Right. GOETZ: All I know is they need one. Now both of them have one. And I can't--that's one of those heads you lose, tails you lose deals. Uh, no way. And, and, uh, doctor, uh--shoot. I'm just blocking on his name. Very dear friend of mine-- Reams, won't even talk to me anymore. Got very upset that I wouldn't take care of him. Strong stance in favor of Kings Daughters. Meanwhile Oscar Breadley is saying it should be for Bellefonte. "Tony, will you help us write the thing?" I said, "Sure. Wonderful." But I can't, you know, it's not for or against you. I'm for the people. I'm for getting this program up there. SMOOT: Well, is it, is it just a matter of--of being able to say that we provide that service, too, or is it, you know-- GOETZ: Underlying everything, it's a matter of money. SMOOT: Yeah. GOETZ: Okay? SMOOT: Well sure. GOETZ: Then it's pride and bragging rights, but money is number one. SMOOT: So instead of just having the, uh, money spent at their inst-- particular healthcare facility, now you have to have to spend it at both healthcare facilities which is a waste of money? GOETZ: That's right because you both have multi-million dollar facilities-- SMOOT: Right. GOETZ: --which have to be paid for, and there are only so many patients which we basically have almost proved beyond a shadow of a doubt. We know about how many patients you're going to have and how many treatments you're going to do per day, and radiation therapy is not something you just go shooting around, uh, you know, whether you need it or not. You only do it when you need it, and, uh, it has to be prescribed by somebody and then the radiotherapist does his thing. Uh, you know, it's not, uh, the radiotherapist isn't the generator of that business, and a guy who's taking care of cancer patients is very picky about what happens to his patients. And, uh, so, uh, it's just one of those things. It's-it's not the first waste that we've had, but it's, it's one that could have been prevented and should have been but it won't be. SMOOT: Do you-- do you work much with the, uh, the university administration or do you work primarily just with, say, the administration of the medical center, in what you do? GOETZ: No. During the legislative session I spend every day in Frankfort, and I'm on the phone constantly with Jim King. Every day-- SMOOT: Right. GOETZ: --I call in. Every morning we discuss what we think might happen and generally doesn't, but we, (laughs) uh, so I'm, so I'm very closely tied with the administration there. I own basketball tickets and things like that-- SMOOT: Sure. GOETZ: --so, you know, there'll be other things that we try and do, uh, basically during the, uh, session, though, uh, um, most of the time I try to go through Dr. Powell, through Dr. Bosomworth, that kind of thing. I relate ninety-nine percent to Dr. Powell and Dr. Bosomworth. The-the lines are pretty clear. I work for the Dean of the College of Medicine who works for the Chancellor who works for the President. SMOOT: Right. GOETZ: And there are always people that really do the work in there somewhere. SMOOT: (laughs) So there's a good relationship there as far as the Medical Center and the regular university administration? GOETZ: Oh yes, sure. E-everybody--I guess, everybody fairly well understands my job. Of course they've still been trying to explain it to me. (both laugh) Um, you know, there's no--if I need to call Jim King right now, I'll call Jim King. I don't go through Dr. Bosomworth to do that. If it's something very significant, uh, that affects something, you know, I'll probably check with Dr. Powell and Dr. Bosomworth and say, "Should I call Jim King about this or would you all like to bring that up with him." But if it's something, uh, like, uh, "Jim, do you remember who we had a problem with on such and such a bill," Something, I'm not going to go through them for that, you know, because they're not even going to understand what the thing was to begin with. Uh, so I don't have very many-- you know there-- there are different levels, you know, and I don't deal with those levels. Uh, the stuff I do, I just do. It's just kind of hard to explain as a matter of fact. SMOOT: Let me ask you, if you could, we've really been talking about this all along but could you kind of summarize the impact of this institution not only on the community, also on the state, and if you can and would be willing to do so regionally and even on a national basis. GOETZ: That's sort of difficult. You know, I wouldn't, uh, the impact, the major impact that I feel that we have is on the state. Uh, I think that some of the data we were looking at, where our students come from, is fairly even--evenly distributed throughout the state; not necessarily by, by, uh--well, yes. It-it's, if you look at it by legislative and senatorial districts, which are even--in other words, that's the greatest equalizer there is--you can be a representative from downtown Louisville and you don't represent any more people than the guy from Hindman represents. In other words, uh, if you're in the Senate you represent a hundred thousand people. That's basically because we've got three-point eight million people and we've got thirty- eight districts. Uh, if you're in the House, you're representing about thirty-eight thousand people no matter where you're from. It looks to me like, uh, with-with uh, hardly any exceptions at all that we have students, uh, equally distributed throughout that population base when you look at it that way, and that's probably as it should be. It's not done that way on purpose. This was just, I think, a blooming, uh, miracle and-and probably fortunate for us, but it does show that we get very strong student applicants, uh, for our professional schools and colleges here in the, in the medical center from throughout the state. And I know for a fact one of the things they don't look at is what district are you from and this kind of thing, uh, because I've tried to, you know, check and see if we couldn't help get somebody in for some representative or senator, and, uh, the Admissions Committee is not too impressed by that. They're impressed by credentials, and how that person does on interviews and what have you, and I think it speaks well for what, what those admissions committees are doing in, in all of these. And I can say the same thing. I've dealt with the law school and some other professional schools on campus. So I think our impact is, is major statewide, uh, and I think that same impact is true for Lexington/Fayette County, if you will. I think the major difference in Lexington/Fayette County is we have an economic, uh, influence; uh, a major economic influence on Lexington/Fayette County. I think we have almost the same degree as we do anywhere else in the state, uh, the academic influence on, on this area--maybe for the arts and stuff like that that everybody comes in here, you know, wanting to support the arts, uh, or they, as I-- my experience with that is everybody comes in here and wants everybody else to support the arts. SMOOT: Hmm. GOETZ: So they can go-- uh, but I think we're finally getting a group of faculty now that's starting to put their money where their mouth is. Uh, then, uh, regionally, I would say in the Southeastern United States, uh, we're very, very strong. Of course, we're a land grant university. We're, we're a well-known university. Uh, when I was in health planning I ran into some people in the lowlands of Charleston, a physician there, a black physician there who went to undergraduate school at the University of Kentucky, um, and he was taking care of the healthcare problems, uh, down there. But I have to believe that, that, uh, if he hadn't gotten his undergraduate education at UK, he couldn't have gotten his medical degee-- medical degree somewhere, and, uh, you know, maybe it's just pure fortune that he did it. So I, I run into people throughout-- I've run into, uh, physicians who graduated from our medical school who are located throughout the Southeastern United States and they are high--highly regarded. They're very active. Uh, some of them are, are quite good. There's one that you'd probably be interested in as a matter of fact. I can't recall his name, but I can get it. He happens to be a medical historian, and he's gone all over the county and the world, in fact, giving, uh, speeches on, uh, medical history, uh, the history of medicine. And he's very interesting. He's coming back to this university on faculty if we can ever figure out a way and hope to get him. He's a neurologist by trade, but he's gotten interested in medical history. So I think-- uh, Doug Scutchfield is one of our graduates. Used to be up in Morehead. Uh, he's now at San Diego, Dean of the School of Public Health. Our--our dental school has been dramatic. Uh, something like ten of our ex-faculty or what-have-you or graduates or something have been--or have been deans. So I think we're making an impact. Um, we are not bashful. We let our representatives and senators, uh, know what we think about certain things and we have an impact that way, and I think they respect our faculty. Uh--(clears throat)--I can't judge the national and regional as well as some of the academicians probably can. I can judge the state, I think, pretty well, and I don't look at it from the academics. Now I'm-I'm taking all that as a given, that academically we're there. We're with anybody, and I think our grades and stuff tend to prove that; uh, and how-how our people do on tests, et cetera. (coughs) Um, my major thing is that, uh, from, from the standpoint of the three major things that we're about--education, research and service--uh, this university has tremendous impact statewide and doesn't tend to favor any particular area. Everybody says Eastern Kentucky. Well, it's, that's a, that's an accident of birth. You know, we happen to be born in Lexington and we're here. Uh, somebody with a real mind-boggling, uh, life-threatening injury in Paducah would kind of be stupid to drive all the way to Lexington when you could go to Vanderbilt or St. Louis or Louisville. It's a little bit faster; maybe even Evansville now. Uh, Evansville's developed some, uh, situation. (coughs) Memphis, they can get to Memphis from Paducah pretty fast. Uh, you don't expect us to be the merti--the major tertiary referral center for those kinds of places, but for the area that you would expect it, it looks to me like we're covering 99 percent of the need, um, in spite of what people say about, you know, they don't take these people. They don't take those. Nobody who needs this place that's every turned down, nobody, and all the complaints I've ever gotten without exception--there's not one single exception to what I'm about to say-- I get complaints about the medical center there's not one complaint about the quality of care. It's always the personal, interpersonal relationships they're concerned about. I got a call from a lady in Morehead the other day--(clears throat)--out of--don't even know the lady. David Bolt said, "Well you ought to call Tony Goetz and tell him." She was sent down here by her physician to see Dr. Tibbs. She didn't want to come here. She had heard about the Medical Center, how terrible--the buildings are falling down, the nurses are bitchy, they don't even dress nice--(Smoot laughs) terrible. She came down here, and she couldn't believe it. The opulence almost. You know, she ended up on the eighth floor, I think--or no. She ended up on uh, 3 North, which is not our nicest area anymore. 6 North to me is fantastic. She ended up there. The physicians were wonderful, the nurses were great. She goes back to St. Clair. Why can't you all be as good as the University of Kentucky, and they talking, not quality and depth, they're talking about the amenities, and this is absolutely true. Uh, you're finding more and more people are coming here only because they have to, and they go home saying, Gee, that was great. Herbie Deskins who is a state representative--his father was in here a year ago. Nothing but great things to say about this place. Whatever UK wants, if we can do it we're going to do it in the Legislature. So (clears throat) uh, never, uh never have heard a concern about quality, never. It's always been the amenities, relationships and that's something that we really do need to work on, especially in this day of competition because the only thing that makes this doctor better than that doctor oftentimes is bedside manner. Frankly, that's one of the things that makes doctors less susceptible to lawsuits. You know, you just don't sue your friends as much as you sue your enemies. SMOOT: That's right. GOETZ: You sue the people who don't care; the people who are cold. And, uh, so I, I feel very strong about that, so I guess I feel more qualified to give an opinion--and that's all it is--about our impact statewide. And there's nothing else in this state that I can think of that has the impact that the University of Kentucky does, and I started my whole thing, if you remember, by my, probably I never heard of the University of Kentucky until I was in second or third grade and got in 4-H. If you go down to Western Kentucky, David Boswell who's now Commissioner of Agriculture, who used to be a representative representing good old Rome and Sorgho and all that, before McElroy, David started out the same way I did. I mean, his aunt and uncle I used to work for, -----?? brothers. But he went to, he's a strong UK supporter, and he wouldn't run--he's running for Lieutenant Governor- -he won't run for anything without checking with Charlie Barnhart. Uh, but David, uh, went to 4-H just like I did. I mean, they came--we were in a little old parochial school, three rooms; you know, first and second grade in one room and, uh, third, fourth and fifth in another and sixth, seventh and eighth in another. And by golly, they had time to come out there and once every two weeks or whatever, and, you know, we all raised our, our pig or our cow or something that we showed. But then they did some other things for us. They got us interested in things like, uh--in addition to having a, a calf which I, you know, would show at the fair and all that stuff--uh, they told us--they didn't tell us we had to, but they sort of made you feel funny if you didn't--I had to take electricity. I learned how to make extension cords and lamps and stuff like that. Now this is Rome, Kentucky. Hell we, I -- I guess we did have a telephone by that time. It was, like, a six-party line. Um, there were no TVs in our area at that time, and, you know, this is just a few years ago; uh, I think a few years ago. It's not that long ago. Uh, but, uh, they did some things for us that we didn't realize what they were doing. They were broadening our horizons, and I'm not even sure they realized it but I think they did. Uh, what in the hell would a guy--why do I need to know how to do that stuff, you know? Of course, I did really. I mean, you always were working with electricity on the farm, uh, but I guess they figured, Let's teach him right. Uh, underwriter's knot. My gosh, I never would have studied that anywhere in my college or anything else, but you know, when you do that extension cord you've got to tie that underwriter's knot inside the plug. And, uh, uh, I guess they figured, Teach him right and we'll have less barns burning down, or what have you. I mean there is no way to know. My cousin is speaker of the House, and he graduated from that same grade school. (Smoot laughs) No way to know that we're going to anything other than farm in Daviess County, and that was back in the late forties, early fifties. I guess, probably '47--'48 is when I joined 4-H. Never won anything, (Smoot laughs) but other than that I think they were partial to dirty people myself. (clears throat) But anyway, that--that's the impact of this place, and the more we can do to develop that, that outreach type of networking activity, the better off we'll be. We can't just stay. The community colleges, a prime example of the same thing. My God. See, that's where we got a lot of our support this last time. There's thirteen of them, soon to be fourteen. Guess where that fourteen one's going. Owensboro. (Clears throat.) That--those, those are important. Those are very important. It's-it's-it's the lifeblood of this whole place, but are people sitting here every day working with students and monkeying around with broken equipment and seeing the crummy offices and what have you that they're living in, and some people here--I mean, it's not the nicest place in the world to work. I'll- I'll give you that. I remember the first day I pulled up out here. Got here about six- thirty or seven in the morning because I knew it was going to be hard to park. Still got a parking place about--somewhere, I--you know, I didn't have a sticker then or anything, and I'm walking up and I'm thinking, My God. What have I gotten myself into? Because every office I've ever been in before I pulled right up to the front door, jumped out of my car, go upstairs, don't have to pay a parking fee. You know, I'd never had to pay to park in a place of work in my life. I figured if they want me to work they shouldn't charge me to park. SMOOT: (laughs) Right. GOETZ: And, and, you know, all this is just foreign to me, you know. When I went to school here, I was going part-time and usually it was at night or early morning, and I never had to buy one of those parking stickers. So I had just never had to pay to park. Peabody, you just- -hell, they had more lot than they had anything else; you just pull in there and park. Uh, Brescia College in Owensboro you didn't, you know you certainly didn't do that, and at St. Thomas you didn't have a car. So, you know, I just wasn't familiar with all that stuff. Being from downtown Rome, we didn't do things like that, so--(Smoot laughs)-- (Clears throat.) uh, but I've gotten used to it, and it's been really an educational experience in itself, yeah. SMOOT: Let me ask you one more question. GOETZ: Okay. SMOOT: Can Kentucky afford two major medical skin-- centers like we have? GOETZ: Yeah. Yeah. I'm not sure we have to have 'em, but we can afford them. We can afford them. SMOOT: Okay. So the economics are all in line? They are there? We can, we can support them both, but you said you're not sure that we need them both. GOETZ: I'm not sure you need two, no, but I think we can afford two. I'm happy that we've got the two. SMOOT: Um-hm. GOETZ: Uh, you know, you've got to put all this in perspective. SMOOT: Right. GOETZ: Kentucky only had one medical school until 1970. Then in 1970, U of L became a Kentucky medical school. SMOOT: Right. GOETZ: And, and I'm not being vicious on that, but I'm, I'm being truly honest. When you look at enrollment at the University of Louisville Medical School, where they came from, socioec-economic backgrounds before they became a state school--(clears throat)--then you understand why they became a state school. They were in terrible financial trouble; the whole University of Louisville was in terrible financial trouble. It was a, an urban, downtown university that tried to be a private school to attract people from out of state which it did and, and it's a good school, good school but their mark--their competition was a lot different. And, uh, you know, if they had been more of a Kentucky school, we probably wouldn't have had the University of Kentucky Medical School. Probably wouldn't have had it, wouldn't have needed it, but the point is we did. And-and uh, you don't dump something like this. When they dumped the Rush Presbyterian school up there, it wasn't a few years until they came back and started it up again. Uh, your whole market forces change if you lose the--there is a little bit of friendly competition between the two schools, I think. We've spoke on it some. And, yes, we can definitely, uh, afford it, uh, because, uh, the ideal size of the schools, uh, probably could be a little bit smaller and--and be ideal. Uh, you don't want a medical school with two hundred in a class, not that--there are some in this country, and they're very good schools. They're mainly good because they've been there a long time and everybody knows them, okay? I think you need to reevaluate the situation every once in a while and compare them to uh the, the, uh, younger schools that maybe are doing a super top-notch job--and, of course, we're not even one of the youngest schools anymore, at twenty-five. You know, there were a lot of schools started up after we did. But yeah--(clears throat)--the other thing is you can afford anything you want, you know, or maybe anything that there's a demand for, and there's a heck of a demand for the University of Kentucky Medical Center. We lose contact with that, and, you know, again, I'll bring it back to some of the, uh, some of the negative reasons that we unfortunately--it breeds when you're inside four walls. You need to get out in the fresh air every once in a while and listen to other people and, and, uh, it kills germs. SMOOT: Right. Is there anything else that you think we should discuss concerning the development of the Medical Center or its current impact? Uh, anything else that you think that I should be touching on but I have not touched upon? GOETZ: Gosh, I can't think of anything. Uh, there's probably a bunch of things out there, but I just can't think of them now. SMOOT: You'll let me know if-if you do? GOETZ: Yeah. Yeah. I figured you're getting--the internal stuff you're going to get from the people who have been here and know the place, and, uh, you know, I'm more interested in what we do outside anyway. SMOOT: Right. GOETZ: You know, I mean, we have to have everything, all the ducks lined up here, but I want to see more courses outside. I want to see more spreading the wealth around a little bit, if you will. I want to see more impact from outside on what happens inside. Uh, I just think it makes for a lot healthier atmosphere. SMOOT: Right. GOETZ: It-it-it really gets away from a lot of--you know, if-if you're on the faculty over there and all you see is the same people every day, it just helps if somebody from outside is walking down the hall. You know, and the important thing to me is when we put graduates out there, let's get them back in here for a week every once in a while or a day or two. Let them come back and talk to a medical school class. Let them come back for a seminar, Grand Rounds. Uh, let's get out there with CE programs--which we're doing very, very well. But you-you can't ever, it's not one of those things you--it's like, uh, uh, my favorite analogy to all of this is, uh, you know, I used to do a little consulting work, and hell, I had some of it already typed. You know, you could always go into any organization and say your communication needs to be improved, and you could write up several pages. You could get the same things and just put different names after there. Communication needs to be improved everywhere, even when it's almost perfect. It can be improved. I don't know where perfect communication is, so I think that, um, uh, that's one of the areas that, uh, or some of the, some of the things that, uh--there-there are certain things, just like communication, that we can always improve on, and maybe they're even--it is communication, but that--that's improved, everything else comes along; you know, nothing but positive things. There are a lot of negative things out here, gee. You know, if you want to come back in to, I can tell you a lot of things that are wrong, but they're only wrong from my perspective. They're probably very right from everybody else's. (Smoot laughs) The day they get too wrong for me, I'll leave and go do something else. SMOOT: Let me thank you. I've enjoyed it. I've learned a lot, and I hope if-if the time and the need shows itself that we can get together and talk again. GOETZ: I'd love to. Appreciate it. Okay. SMOOT: Thank you. [End of interview.] Goetz outlines his history before coming to the University of Kentucky, as a director and coordinator of different health agencies and development councils. He discusses his position as an Associate Dean for Planning at the Medical center and his different approaches to dealing with program challenges. Goetz also describes the impact the University Medical Center has had on the state of Kentucky, particularly in creating opportunities for future health professionals. In addition, he discusses specific University of Kentucky graduates working in Kentucky. insert here