Louisiana hospital executives are shaking their heads about the age of the state's new healthcare boy wonder.
This month, newly elected Gov. Mike Foster appointed 24-year-old Bobby Jindal as secretary of the Department of Health and Hospitals, the state's largest agency with an annual budget of $5.6 billion.
Jokingly referred to in some circles as Louisiana's version of "Doogie Howser, M.D.," Jindal has a tough row to hoe. The state is facing probably the biggest Medicaid crisis in the nation as it tries to figure out how to make up for a $750 million drop in federal Medicaid funding.
Jindal wasn't available for comment. He was scheduled to start work on Jan. 18.
For his age, Jindal exhibits sterling credentials. He graduated with honors in biology and public policy from Brown University, posting a 4.0 average. He also was a Rhodes Scholar and has been a senior consultant in the Washington office of McKinsey & Co., an international management consulting firm.
Said Foster about his youthful appointee: "He knows more about healthcare than most people know in a lifetime."
Pennies on the dollar.Working Woman magazine brought discouraging news for women in healthcare administration last week.
The pay gap between male and female hospital managers has widened significantly, according to the magazine. Women managers at nongovernment hospitals earned a median base salary of $30,212 in 1994, compared with $44,200 for men, or just 68% as much. A year earlier, women in those jobs earned 79% as much as men.
Data was collected by the Bureau of Labor Statistics.
Pay inequity was greater in healthcare than in other fields, according to the magazine. In 28 fields for which data was available, women typically earned 85 cents to 95 cents per dollar earned by men.
The study also reported significant pay gaps between female and male doctors of various specialties, although female nurses fared better, making a median $35,360, or 95% of the $36,868 earned by men.
The author of the article, Working Woman Senior Editor Diane Harris, said she doesn't know why the numbers show an increased pay gap for hospital administrators. "Our plan is to track it," she said.
Cashing in.In 1994, Jeffrey Barbakow set forth to "monetize noncore assets" of National Medical Enterprises, the forerunner of Tenet Healthcare Corp., the nation's second-largest hospital chain.
In layman's terms, Tenet's chairman and chief executive officer wanted to sell off some businesses in order to raise money to pay down debt and buy more hospitals.
It's clear now that Barbakow did a commendable job in at least two cases. He spun off the businesses, which gave them a platform to grow, but kept a financial stake that turned out to be lucrative.
Earlier this month, Tenet issued $320 million in exchangeable subordinated notes. The notes allow the Santa Monica, Calif.-based hospital chain to get cash out of its stake in Vencor, which bought Tenet's former nursing home subsidiary, Hillhaven Corp.
When Louisville, Ky.-based Vencor acquired Hillhaven, it gave Tenet stock. Since then, the value of Tenet's stock in Vencor has risen 87%.
Another example is Tenet's former kidney dialysis business. It sold a 75% stake to investors and management for $75 million in 1994. Tenet kept a 25% holding, which has since been diluted to 14%. However, that 14% is now worth more than what Tenet sold the 75% for.
The company, called Total Renal Care Holdings, has flourished since its initial public offering less than three months ago. The company went public at $15.50, and last week was trading at $27.50. Tenet's stake is worth $82 million.
On the case.Emergency department staffers at Deering Hospital, Miami, soon will be using high-resolution cameras to document cases of domestic violence.
In the first program of its kind in South Florida, medical personnel are being trained this month to identify potential cases of spousal or child abuse and to take instant photographs, said Margarete Greene, a social worker at Deering who is coordinating the program.
Greene said the photographic evidence collected can be used to prosecute batterers.
Each day, three or four patients who are victims of abuse come to Deering's emergency department, Greene estimated. During the medical examination, nurses or physicians will ask permission to photograph the injury, she said.
"I think the majority will agree to the picture," said Greene, a former police officer. "We'll talk with the victim and suggest she go to (a domestic abuse support group) or recommend they stay at a shelter, or contact police to file a report."
If the patient files a report, Greene said because the medical record is confidential, prosecutors would be required to subpoena the photograph and medical record.
The costs of the Polaroid Spectra cameras and special high-resolution film will be paid by Deering, a 233-bed for-profit hospital owned by Columbia/HCA Healthcare Corp. No cost estimates were available.
Sweating to health.Intergroup of Arizona's SeniorCare health plan in Tucson is the first HMO to offer free health club memberships to its Medicare enrollees.
Intergroup is able to provide the free health club memberships through a contract with HealthCare Dimensions, a Tempe, Ariz.-based company that brings HMOs and health clubs together.
"Doctors are always telling patients to lose weight and get more exercise," said Lynn Lejcher, HealthCare Dimensions' director. "Now there's finally an access site for health plan members to achieve those goals. That's why we see (health club membership) as part of the healthcare continuum."
HealthCare Dimensions has assembled a network of about 125 health clubs serving HMOs in several states, including Arizona, California, Florida and Texas. It plans to have more than 100,000 enrollees in health clubs by year-end.
While the health club benefit is only a Medicare product at this point, Lejcher anticipates that HMOs will offer the benefit commercially "within the year."