Perusing a transcript of a 167-page deposition given by Richard Scott in a Florida lawsuit, Outliers thought at first that the Columbia/HCA Healthcare Corp. chief either has a bad memory or has been widely and thoroughly misquoted.
Scott's curious remarks were in response to Orlando Regional Healthcare System's lawsuit against Columbia over ownership of South Seminole Hospital in Longwood, Fla.
Sounding more like a forgetful Ronald Reagan than the head of a multibillion-dollar healthcare conglomerate, Scott couldn't remember more than a dozen statements attributed to him in articles, his own speeches and company documents.
For instance, Scott couldn't state unequivocally that Columbia was the biggest U.S. hospital chain.
Scott also couldn't say for sure that in 1993 he had said that about 30% of the nation's hospitals would close in five years and that the healthcare industry has a capacity problem. "I'm not sure I understand what `serious' is.... I'm not sure what you mean by `overcapacity,'*" Scott said in response to an Orlando Regional attorney's questions.
Although Scott frequently talks about developing integrated delivery networks to serve geographic areas, he refused to acknowledge that he knew what the word "market" meant.
But one of the more interesting exchanges came when Scott couldn't remember details of the former Galen Health Care, the huge hospital chain that Columbia acquired in 1993. When asked if Galen had been known formerly as Humana or had been spun off from Humana, Scott replied: "I don't know the corporate history of Galen."
As to whether not-for-profit hospitals are fulfilling their tax-exempt mission, Scott again waffled. Many Columbia executives, including Scott, have often stated that they don't believe not-for-profit hospitals deliver enough charity care to justify their tax exemptions.
Asked if he had ever said "the mission of the not-for-profit hospital was to take care of charity patients, and that mission (has ended)," he replied: "Not that I recall."
Outliers was indeed baffled by all this. But then we recalled that Scott used to be a practicing attorney.
We got it.When it comes to a theme for an annual recognition banquet, Saint Mary of Nazareth Hospital Center in Chicago nearly beat Outliers over the head until we understood this year's motif: "Loaves & Fishes."
To honor one of the hospital's board members, Robert A. Gonnella, president of Chicago-based Gonnella Baking Co., the hospital sent its press release, a loaf of bread in the shape of a catfish and a plastic mug adorned with psychedelic underwater doodads.
The bakery and the hospital have been located near each other for more than 100 years, so Gonnella, being a good neighbor, was a natural to be this year's "Man of the Year." Past honorees include Chicago Mayor Richard M. Daley, former Chicago Bears coach Mike Ditka and Cardinal Joseph Bernardin.
Gonnella will be honored May 12 at-where else?-the John G. Shedd Aquarium on the shores of Lake Michigan. As for the bread, it was a bit hard by the time it arrived at our office. But that's OK. The story pitch was feast enough.
Learning to communicate.Thirty-one specialist physicians and two dentists on staff at Long Beach (Calif.) Memorial Medical Center went back to school this spring to learn a new language: business.
"The practice of medicine has changed," said Stanley Carson, M.D., an ophthalmologist and former chief of staff at Long Beach Memorial, who organized the class. The program was offered through the University of Southern California.
"We need to learn the language of business so we can trust each other and communicate with each other" in the managed-care environment, Carson said. USC designed the 12-week mini-MBA course for physicians and offered it at the hospital. The course covered marketing, financial and cost accounting, communication, and consumer satisfaction.
Under capitation, physicians have to know how to keep careful track of costs, he said. Before the advent of managed care, "it's not that we didn't care about costs, but we were flying by the seat of our pants," Carson said.
And with the hospital and physicians working as a team to win managed-care contracts, doctors have to be able to understand a hospital's financial statements and evaluate balance sheets, he said. The increasing number of physicians moving into executive positions at hospitals also need a basic knowledge of business.
Still NME.Old monikers are hard to shake, and that's true with Tenet Healthcare Corp., the nation's second-largest investor-owned hospital chain.
Outliers recently noticed that Tenet's stock was still listed under its former name, National Medical Enterprises.
That seemed odd because two months have passed since NME changed its name as part of a $3.3 billion merger with American Medical International (March 6, p. 68).
Now it seems that the Santa Monica, Calif.-based hospital chain can't "officially" change its name without shareholder approval.
Spokeswoman Diana Takvam explained that shareholder proxies on the name change will be mailed in the next couple of weeks.
"It's just part of the transition period," Takvam said about the old name in the stock listings. However, the company's trading symbol has already been changed to THC (a fact some find amusing because that's also the chemical symbol for the hallucinogenic component of marijuana).
Tenet's operations center in Dallas may soon bear the new name as well. Currently, the north Dallas building that houses most of Tenet's corporate staff still bears the AMI logo. Takvam said a new sign is in the works. "It's a rather cumbersome job to take down that large a sign," she said.
Quotable.Last week the American Medical Association put on a conference in Chicago on how physician payment methods are changing.
William Pollock, an actuary with Milliman & Robertson, titled his lecture "Understanding Capitation/Avoiding Decapitation."
"By the way," he observed dryly to the roomful of doctors and practice managers, "the guillotine was named for a French physician."