I think it's been pretty well established that PittGirl may be Pittsburgh's greatest self-promotional genius since Andy Warhol. Here's a woman who has reporters eating out of the palm of her hand -- to the extent that when her blog shuts down, it ends up on the front page of the Post-Gazette. 

Which means UPMC might want to hire her as an image consultant. 

As one of the state's largest employers, and a provider of life-saving services, UPMC is accustomed to getting good PR .. so much so that it can afford to run ads that don't actually say anything. But lately things have been turning sour.

A few days ago, the Post-Gazette's editorial page faulted the healthcare giant for closing a program to benefit poor mothers in Braddock. Now there's this story -- about the hospital's controverisal former transplant chief, Amadeo Marcos -- from today's Wall Street Journal. The story alleges that Marcos was symptomatic of a culture which put profit considerations above patients' health. 

You should read it at your earliest opportunity, but until then, a few highlights ...

• "To overcome a perennial shortage of organs, [Marcos]used more livers from older donors. He transplanted some of these into relatively healthy patients .... He used partial livers from living donors, and then understated complications from the controversial procedure."

• "'I couldn't square my own ethics with what was going on,' said Dr. [John] Fung, now chief of surgery at the Cleveland Clinic [and Marcos' predecessor at UPMC]. 'I didn't feel like the decisions that were being taken had the patient's best interest at heart.''"
  

• "'For the first time in years, we had people dying on the operating table or in the ICU,' says Dr. [Howard] Doyle, now director of surgical critical care at Montefiore Medical Center in New York. At times, according to him, patients healthy enough to walk into the hospital before being transplanted died 'because they had a high-risk liver put into them.'"

• Marcos and UPMC head Jeffrey Romoff "saw eye-to-eye on volume and profit."

Many of these concerns were outlined earlier this year by a Pittsburgh Tribune-Review investigation, "Transplanting Too Soon." Marcos suddenly left UPMC even as that series was heading to press. The Post-Gazette did a number of stories on Marcos' departure too. And while the P-G mentioned doubts about his approach to liver transplants, they played up concerns about Marcos' personal behavior even more.

Throughout the controversy, the hospital has defended its transplant program, and maintained that Marcos' departure did not reflect on the quality of care provided to patients, or with the issues discussed by the Trib.

UPMC attorneys, please take note: I make no representation as to whether the claims made by the Journal or anyone else are true. I'm merely flagging them as worthy of discussion. Please don't sue me, or put somebody else's brain in my head, or anything like that.

I will say this, though: I wouldn't be surprised if UPMC has to contend with increasing skepticsm in the weeks and months ahead. 

In the past year, we've already seen harsh questions about UPMC's role in the "Pittsburgh Promise" scholarship program. We've seen the Marcos kerfluffle blow up twice now. We've seen the non-profit slap its name across the tallest building in Pittsburgh ... only to announce layoffs a few months later. Meanwhile, wages everywhere are shrinking as healthcare costs soar. That's the sort of trend that tends to stoke a bit more curiousity about, say, the salary and perks that Romoff and other execs get. 

UPMC paid to have its name put on top of the US Steel Tower because it wanted more visibility. In the months ahead, it may come to regret that decision.