Let’s review, shall we, this high stakes war between Norton HealthCare and the University of Louisville.

On Feb. 19, Norton announced the formation of its new Neuroscience Institute, citing a need to recruit and attract more brain surgeons and vowing to spend $100 million. CEO Stephen Williams said it would also help the academic program at U of L, which has a complex relationship with doctors who work at both places.

It’s not like there’s a lot of brain surgeons on the market, so it makes sense that Norton wants to bring in every one it can for its new initiative, even if it ticks off U of L.

Days later, a C-J editorial acknowledged that U of L president James Ramsey was not pleased with the deal, and the paper backed Norton’s initiative.  It said Ramsey wanted to control its docs and make more money for the hospital. U of L responded Friday with an OpEd from medical school dean Edward Halperin, who wrote that the brain surgeons involved wouldn’t be controlled by U of L and that the result would be bad for the community.

Halperin took issue with the C-J’s editorial, saying it included untruths and speculation.  Then on Saturday, the C-J reported that the two sides had reached a temporary agreement, through March 31, that in no way was a permanent solution. Top brain man Dr. Christopher Shields was quoted saying the agreement doesn’t address the “bigger-picture problem.”

Sources tell the V.V. that there’s a lot more to the story, including a rift between Norton’s Williams and U of L’s Larry Cook, chancellor of the Health Sciences campus. Williams and Cook have been close in the past, but split over U of L’s efforts to dissolve a partnership with Norton. In the downtown medical community, it’s well-known that Williams barely speaks to Cook.

Read the Rest After the Jump…

There is also a fundamental conflict in mission between U of L and Norton, which is concerned with one thing; providing clinical care to patients and being paid for it. The Medical School and University Hospital have three missions, training new doctors, finding new therapies (research) and clinical care.  Jewish, Norton and Baptist may publicly say all the right things about a commitment to the University and its teaching agenda, but when push comes to shove, they will be driven by their mission to reduce spending in the area of teaching and research to make a profit on clinical care. Both Norton and Jewish have reduced their support of academic programs over the last five years.

Fundamentally, Jim Ramsey has his heart in the right place. He wants to raise the profile of both the University and the School of Medicine, which would improve the area’s medical reputation. Having world class doctors training the next generation of doctors and taking care of the medically indigent is worthwhile. He must also get along with Norton, Jewish and Baptist, but it appears the conflicts that exist in this deal are too tough to overcome.

Norton sees an opportunity to take the lead in a very profitable health care segment, and privately it doesn’t care so much how that affects U of L. If there were a solution making everyone happy, someone would have already come up with it. Now it appears that U of L isn’t getting its way.

This morning, Norton announced it is committing $10 million to U of L’s downtown basketball arena.  You’re right, it probably has nothing to do with the medical dispute.