R. Clayton McWhorter's surprise announcement that he was going to resign as chairman of Columbia/HCA Healthcare Corp. isn't the only management change under way there.
Two other well-known names at the nation's largest for-profit healthcare provider are making changes. Joey Jacobs, who's headed efforts on the Nashville, Tenn.-based company's home turf, is leaving at the end of this month.
Jacobs, who started with precursor firm Hospital Corporation of America nearly 20 years ago, is president of Columbia's Tennessee division. He didn't respond to telephone inquiries, but spokeswoman Eve Hutcherson said Jacobs will look at other opportunities and spend more time with his family.
Meanwhile, in Atlanta, Frank Houser, M.D., is leaving his post as president of the Georgia division to become president of physician management services, a new title within Columbia.
Although Houser is staying with Columbia, his shift from the Atlanta market may be a strategic one. It's no secret that Atlanta has been one of the most difficult cities for the company. Joint-venture deals with two large not-for-profits fell apart last year, and Columbia is still looking to partner with a tertiary-care hospital in that important market.
What's more, Houser's departure from Atlanta follows by less than a month the resignation of Sam Holtzman, who headed Columbia's Chicago operations. Chicago has been tough as well for Columbia, and Holtzman left without any announced plans.
Speaking of R. Clayton, in an interview, the outgoing Columbia chairman said he has no immediate plans to go into the home-care or HMO businesses, despite rumors to the contrary. He is going to get involved in several civic activities in Nashville, which will be announced later, he said.
McWhorter, who has been Columbia's chairman for less than a year, said he originally planned to stay on for two years. He acknowledged that it was a challenge being a team player when he was used to running the show at Healthtrust, which merged with Columbia in April 1995.
"It hasn't always been easy, but I've learned to keep my mouth shut and listen," McWhorter said about being in large meetings with Columbia executives. Later, McWhorter said he'd express his feelings one-on-one to Columbia Chief Executive Officer Richard Scott or Chief Operating Officer David Vandewater. "I'm a pretty outspoken person," he added.
The Florida Medical Association is hopping mad at an effort by a Tampa-based company that wants to provide the public with a physician referral service.
The 17,000-member FMA believes the Medical Access and Referral Coalition is attempting to blackmail doctors into paying a $20 monthly fee for a listing on its referral service.
The FMA cites the following threat as exhibit A: The MARC informed physicians that a decision "not to participate...would be unfortunate, and an enormous disservice will have been done to your patients. We are commissioned to list and expose those providers unwilling to cooperate."
Alvin E. Smith, M.D., FMA president, said: "This is a blatant example of an attempt to profit by intimidating medical professionals."
An FMA spokesman said only one physician in the Tampa Bay area ponied up the $20 fee.
An alliance of large teaching hospitals is stepping up its profile as managed care threatens their ability to provide graduate medical education and research.
The Alliance of Independent Academic Medical Centers includes 43 teaching hospitals that aren't university-based. It has grown from the dozen members who started in the alliance in 1989.
"We are concerned about the general issue of how one supports and nurtures medical education," said Stephen Larned, M.D., president of the alliance and vice president of medical affairs at Maine Medical Center in Portland.
Membership in the alliance is open to independent academic medical centers that provide residency education for 100 or more residents; are affiliated with one or more medical schools; and support an institutional research program.
Last year, the group hired its first staffer, Nancie Noie, who works as managing director of the alliance from an office in Chicago.
The alliance held its first annual meeting last month in Scottsdale, Ariz. The organization had been meeting in recent years, but on a sporadic basis. Now, it's studying the potential uses of graduate medical education in healthcare system building while staying competitive with community hospitals.
Teaching hospitals' costs can be 30% to 40% higher than those of their community hospital counterparts, according to the federal Prospective Payment Assessment Commission. "We need to focus on how do you take out costs across the board on the operation side and education side as well," Larned said.
For a time in 1992, Sister Irene Kraus, who will be inducted into the Health Care Hall of Fame in March, didn't know if she'd be around for one year much less four years.
During a routine physical examination, Kraus, who at the time was president and chief executive officer of Daughters of Charity National Health System, St. Louis, learned she had a tumor. She was admitted for surgery that afternoon at St. Agnes Hospital in Baltimore, and was told the tumor was malignant.
Kraus, now 71, was given a 50-50 chance of living another year.
"From my work in the operating room (earlier in her career) I always thought I'd go crazy if anybody told me I had cancer. But I was surprised because I was as peaceful as anybody could be," she said.
For the next year, Kraus was treated with chemotherapy as she continued her work.
"God gave me a special grace to accept things," she said. "The cancer put my life in a better perspective. I was put into a condition that could have snuffed my life out in six months to one year."
Each time Kraus sees her doctor and is told she is cancer-free, she said she feels a "most marvelous sense of peace."
Kraus now is administrator of the provincial house of the Daughters of Charity in Emmitsburg, Md., and serves on the boards of two healthcare systems.