When contestants lose on a game show, they get parting gifts. When CEOs lose their touch running physician practice management companies, they also get parting gifts, but they're worth quite a bit more than a year's supply of Turtle Wax.
Severance packages -- which are payments given to executives upon their usually forced departure -- are part of the deal when a CEO signs on to lead a PPM, or any corporation for that matter. Unions and other critics have taken aim at severance packages as part of their attack on CEO salaries. The question they ask is, why should a company pay a lousy CEO to leave?
The following chart, based on Securities and Exchange Commission filings, details some of the biggest severance packages for departed CEOs, listed in order of size. Analysts and physicians haven't made a fuss about pay given to executives to leave -- primarily because most of these companies have bigger problems.
That's Dr. Bottomline to you. If physicians think they get a better break under M.D.-run managed care than they do without doctors in charge, they should think again. A University of California San Francisco study of nearly 100 California independent practice associations found that when money's on the line, an M.D. will act just like an MBA, especially in IPAs, which rely heavily on capitated income.
Among the study's findings: IPA boards are physician-dominated but tend to be centralized, autocratic organizations. Among IPAs that had terminated one or more physician contracts, 27% said one reason for doing so was excessively costly practice patterns. Like large, vertically integrated HMOs, IPAs "appear to have reached the saturation point in their complement of specialist physicians"; half said they didn't want any more.
The study was published in the May/June issue of the journal Health Affairs.
Beam me up, doc. On the television series "Star Trek," Dr. McCoy worked futuristic medical miracles in the sick bay of the Starship Enterprise. McCoy's fictional sick bay is not too far from 1998 reality, as Wilmington, Del., family physician John Hocutt, M.D., can attest. The Office of the Future Consortium, which comprises seven medical equipment manufacturers, redesigned and re-engineered two of Hocutt's eight examining rooms as the pilot project of the Office of the Future. The futuristic exam room features video-based equipment, modular furnishings and a power examination table. The project is intended to give consortium members feedback they can use in the development of new products that both are more patient-friendly and cost-efficient.
While magnifying patients' moles onto a video screen did not make the "Star Trek" director's cut, Hocutt says such futuristic touches already are improving his relationship with his patients. "It brings them in and makes them know more and more about what's going on, and then they become better patients," he says.
Yada, yada, yada. In one episode of "Seinfeld," Jerry's cohort George attempted to break up with his girlfriend, but she refused the breakup and simply told him, "No, I don't think so." They continued to date, although Jerry tried to convince George that breakups don't have to be a mutual and collaborative decision; one person simply dumps the other. Aetna U.S. Healthcare appears to be pulling a Seinfeld in Louisville, Ky.
The Physicians Inc., an IPA representing 1,850 doctors in Louisville and Southern Indiana, terminated its contract with Aetna last month because of Aetna's new "all-or-nothing" contract, which requires providers to participate in all of Aetna's products. Aetna has been slow to accept the breakup, however, and an American Medical Association publication reported that Aetna "had not accepted the termination" because it was working on an alternate risk-sharing arrangement with the group.
Paul Jennings, TPI's executive vice president, says when the IPA sent Aetna a "Dear John" letter, the company replied, "Let's talk." Presumably, it wasn't over pie at the corner diner.
In other words. Those victory cigars smoked by Michael Jordan, Scottie Pippen and other Chicago Bulls players following their National Basketball Association championship victory over the Utah Jazz drew the ire of delegates to the American Medical Association meeting in Chicago last month. In discussion prior to passage of an emergency resolution denouncing cigar-smoking athletes, one doctor said winning the NBA championship now means, "Where are you going? Disneyland, with a bunch of cigars."