Russ, in any and all facets of medicine, it only takes one bad apple to cause lots of problems. This has been true since I first worked in the field in 1962. A classic example of this was experienced by a good friend of mine in Florida this past week. He was having some chest pains, went to the ER, the ER doc brought in an in house cardiologist, who did a stress test, then said there were abnormalities and recommended a cardiac cath be one right away, to which he consented. The idiot doing the procedure encountered a blockage and jammed the catheter through the wall of the coronary artery. Now he is undergoing bypass surgery to repair the damage done by an inept cardiologist who failed to check the patient's medical records, which revealed that he had a previous stent emplacement, which is where the blockage occurred. He is fortunate in that he didn't bleed to death and die during the procedure.

In my lifetime, I have encountered more bad doctors than I have encountered poor caregivers in assisted living centers and nursing homes. I know there are bad ones here as well, particularly in the areas bordering Washington, DC. One of my wife's nephews and his wife are state inspectors for extended care facilities. They tell me all about the horror stories they see on a daily basis. The local lawyers love these cases because they usually win and the law suits amount to huge sums, often in the millions. Believe me, those big corporations do everything they can to avoid the law suits, at least in this part of the world. I also know that many of the small, interdependent nursing homes are sub standard here. The larger, corporate assisted living centers and nursing homes here provide very high quality care.

I know we disagree on this subject, and I have always applauded your efforts to change things in Kentucky. I sincerely hope you are successful in that endeavor.

Talk to you soon,

Gary