Federation of State Medical Boards Releases Annual Summary of Board Actions

The Federation of State Medical Boards (FSMB) released its Annual Summary of Board Actions, a report that compiles data on licensure and disciplinary activities from 69 state medical boards.

      FSMB, responsible for promoting high standards for physician licensure and practice, documented 4,617 actions taken against physicians in 2000, a slight increase from 1999. Of the 4,617 actions taken, 3,951 were prejudicial, or punitive, in nature, and included license revocations, suspensions, probations or other types of restrictions or modifications to a physician's license. The 3,951 prejudicial actions taken were nearly a 3 percent increase over the 3,838 taken in 1999. Substance abuse, unprofessional conduct, prescribing violations and negligence ranked highest amongst the basis for prejudicial actions taken.

      "The nation's state medical boards continue to demonstrate their commitment to assuring the public access to qualified physicians by disciplining incompetent physicians and, when appropriate, removing them from practice," said Dale L. Austin, interim chief executive officer of the Federation of State Medical Boards.

      Non-prejudicial actions, which do not result in modification or termination of a physician's license or licensed privileges, decreased from 731 in 1999 to 666 in 2000. Non-prejudicial actions are usually administrative in nature, such as a reinstatement of license privileges after disciplinary action, or a license denial due to a lack of qualifications.

      The 4,617 actions taken in 2000 are included on a new FSMB Web site that offers consumers instant access to the nation's preeminent source of consolidated state medical board disciplinary data. The Federation Physician Data Center, located at www.docinfo.org, contains approximately 117,000 board actions taken against 35,000 physicians dating back to the early 1960s.

      The debut of the Federation Physician Data Center marks the first time this collection of consolidated state medical board disciplinary data has been opened to the public.

      "By providing the public with a national database of state medical board disciplinary actions, the Federation Physician Data Center is a significant and valuable new online resource for helping consumers make informed decisions about physicians," Austin said. "State medical boards, which are charged with protecting the public through rigorous physician licensure and disciplinary processes, have long been considered the best source for disciplinary information."

      The Disciplinary Search Report produced during each search of U.S. licensed physicians lists the type of disciplinary action, if any, taken against a physician. In addition, the report indicates the medical board or agency that initiated the action, the kind of action taken (e.g., license revocation, suspension or probation), the date the action was taken and the reason the action was taken (e.g., quality of care, substance abuse, sexual abuse or unprofessional conduct).

      "A clean report from the Federation Physician Data Center is a valuable asset for a physician, and thus for consumers as well," Austin said. "The integrity of the data and the thoroughness of the search made by the Data Center are of the highest quality."

      For additional information regarding the report you may go to http://www.fsmb.org. Back to TOC.

Dallas MD's File Bankruptcy

Less than six months after acquiring nine money-losing urgent-care clinics in the Dallas metropolitan area, a group of 16 doctors filed for bankruptcy protection last week, asking for more time to turn the struggling venture around.

      According to ModernHealthcare, Primary Care Management Corp., Dallas, which operates the nine PrimaCare Medical Centers serving some 200,000 patients annually, filed a Chapter 11petition in U.S. Bankruptcy Court in Dallas to avoid eviction after it failed to pay the past six months' rent to its landlord and former owner, Texas Health Resources.

      The doctors' group, which needs a quick infusion of about $2 million to pay its bills, hopes to continue to operate the clinics under bankruptcy protection. A hearing on Primary Care's petition has not been scheduled.

      The 16 doctors, all longtime former employees of the PrimaCare clinic system, purchased the urgent-care centers last September from THR, a 13-hospital not-for-profit system.

      Under the agreement, THR sold the clinic operations to Primary Care but retained ownership of the buildings through a leasing arrangement. Back to TOC.

Humana Q1 Earnings Rise, Revenues Slip

Humana Inc., one of the US's largest publicly traded managed-care companies, on Wednesday said revenue in the first quarter slipped due to a strategy to cut membership but netincomerose29%, from a reduced exposure to unprofitable markets.

      Hunab serves about 5.3 million members in 15 states and Puerto Rico, said income rose to $27 million, or 16 cents a share, from $21 million, or 13 cents a share, in the year earlier period.

      Total revenue for the quarter at Humana, which has been exiting unprofitable markets and eliminating non-core products under a massive turnaround effort, dipped to $2.45 billion from $2.64 billion. Revenue from premiums for the commercial segment fell to $1.31 billion in the quarter from $1.43 billion a year earlier.

      Commercial membership fell to about 2.9 million members. Membership in government-funded Medicare programs declined 10.8% to 2 million.

      Humana exited numerous non-core markets and products in the latter three-quarters of 2000, accounting for the decline in first-quarter revenues. Those markets and products were deemed non-core because they either lacked potential for profitability or did not fit into the company's strategic focus, or both, the company said.

      Humana said its medical expense ratio in the first quarter was 83.2%, versus a ratio of 85.0% for the same period in 2000. A decline in the ratio shows efficiency on the part of a managed care company and is generally viewed favorably by Wall Street. Back to TOC.

LifePoint Hospitals Doubles First Quarter Profits of Previous Year

LifePoint Hospitals Inc., (formerly a part of COL/HCA) an operator of 21 hospitals in seven states, announced its first-quarter profits more than doubled from a year earlier, driven by higher admissions to its facilities.

      The Brentwood, Tenn.-based company reported profits of $8.6 million, or 24 cents per diluted share, compared with $4.0 million, or 13 cents per share a year ago. That exceeded forecasts by analysts who expected the firm to post earnings in a range of 18 to 23 cents per share, with a consensus of 20 cents per share, according to 16 brokers polled by Thomson Financial/First Call.

      The results for the 2001 first quarter excluded a one-time gain that amounted to 1 cent per share. LifePoint said revenue rose 13.5 percent in the quarter to $154.3 million from $136.0 million, driven by a 9.9 percent increase in admissions. Back to TOC.

Triad Hospitals Finalizes Purchase of Quorum Health

Triad Hospitals Inc. announced that it has completed its $1.37 billion acquisition of Quorum Health Group Inc., forming the third largest U.S. hospital company in terms of revenue.

      Triad will issue $3.50 in cash and 0.4107 shares of Triad stock for each share of Brentwood, Tenn.-based Quorum, which owned 21 hospitals and manages over 200 hospitals. During the fourth quarter of 2000, Quorum had about 86.5 million diluted shares outstanding.

      Based on Triad's $30 closing price on April 26, Triad holders will get about $12.32 in Triad stock, plus $3.50 in cash per share. Triad will also assume about $1.2 billion of Quorum debt.

      The transaction will be tax-free to Quorum shareholders with respect to the stock portion of the consideration.

      Triad financed the deal and refinanced its bank debt simultaneously through the issuance in a private placement of $600 million of 8.75 percent senior notes due 2009, plus new term loan bank debt of $950 million and a revolving credit facility of $250 million. Triad completed the financing transactions Friday.

      Before the deal, Dallas-based Triad owned nearly 30 hospitals and 10 outpatient surgery centers in the Southwest, mostly in smaller cities. The company generated $1.24 billion in 2000 revenues. The combined Triad now has 49 hospitals, excluding one Quorum hospital which is under contract to be sold, and 14 ambulatory surgery centers in 17 states with about 9,000 licensed beds. Back to TOC.

Trigon First Quarter Profit 14 % Above Estimates

U.S. managed care firm Trigon Healthcare Inc. said it expected to post first-quarter earnings 14 percent above estimates, excluding items, stemming primarily from its self-funded business.

      Trigon said it expected first-quarter earnings to be about 95 cents per share, excluding realized gains and losses on investments and a one-time $3.5 million gain from the March sale of Trigon Administrators Inc.

      Analysts had been expecting it to earn between 81 cents and 84 cents per share, with a consensus expectation of 83 cents per share, according to research firm Thomson Financial/First Call.

      For the full year in 2001 the company anticipates 20 to 25 percent growth in earnings per share, excluding gains and losses and the gain from the Trigon Administrators sale. Back to TOC.

WellPoint Reports Net Income Increased by 21 Percent From Prior Year's Results

WellPoint Health Networks Inc. announced that net income for the first quarter ended March 31, 2001, was $96.5 million, or $1.48 per diluted share. Comparable net income for the first quarter of 2000 was $79.6 million, or $1.23 per diluted share. Membership in WellPoint's medical plans totaled approximately 9.8 million at the end of the first quarter of 2001, compared with 7.5 million at the end of the first quarter last year. The increase in membership was the result of continued strong growth in California and the acquisition on March 15, 2001 of Cerulean Companies, Inc., the parent of Blue Cross Blue Shield of Georgia, which offset membership declines primarily in nonstrategic states.

      In California, medical membership increased by 376,000, or 7.1 percent, for the 12 months ended March 31, 2001, to nearly 5.7 million members. The Cerulean transaction added over 1.9 million medical members, mainly in Georgia. WellPoint's same store membership in nonstrategic states declined by 67,000 members over the last year as a result of attrition in previously acquired businesses.

      WellPoint Health Networks Inc. covers approximately 9.8 million medical and over 40 million specialty levies through Blue Cross of California, Blue Cross Blue Shield of Georgia and UNICARE. Back to TOC.

Magellan Behavioral Health Renews and Expands Contract With State of Illinois

Magellan Behavioral Health announced that it has renewed and expanded its contract with the State of Illinois Group Insurance Program. The new three-year contract has an option to renew for another seven years and takes effect on July 1, 2001. Under this contract, Magellan will manage mental health and substance abuse benefits for approximately 200,000 state employees, local government employees, retired downstate public school teachers and community college retirees. In addition, Magellan will offer EAP services for state employees. The contract is administered through Magellan's Chicago regional service center and its Springfield, Ill., office.

      Magellan has managed mental health and substance abuse services for Illinois state and local government employees since 1996.

      Magellan Behavioral Health is the country's leader in managed behavioral health and employee assistance programs, serving individuals across the United States and Puerto Rico. The company specializes in managed mental health and substance abuse services as well as employee assistance/work-life programs, and serves over 3,000 client organizations representing health plans, government agencies, unions, and corporations. Its parent organization is Magellan Health Services, Inc Back to TOC.

In This Issue--Also See Archive

FSMB Summary of Board Actions

The Federation of State Medical Boards (FSMB) released its Annual Summary of Board Actions...

Dallas MD Partners File Bankruptcy

Less than six months after acquiring nine money-losing urgent-care clinics in the Dallas metropolitan area...

Humana Earnings Up, But Revenue Slips

Humana Inc., one of the US's largest publicly traded managed-care companies, on Wednesday said...

LifePoint Doubles Last Years Q1 Results

LifePoint Hospitals Inc., (formerly a part of COL/HCA) an operator of 21 hospitals in seven states, announced...

Triad Takes Over Quorum Health

Triad Hospitals Inc. announced that it has completed its $1.37 billion acquisition of Quorum Health...

Trigon Tops Estimates by 14%

US managed care firm Trigon Healthcare Inc. said it expected to post first-quarter earnings 14 percent above estimates...

WellPoint Net Up 21% from Last Year

WellPoint Health Networks Inc. announced that net income for the first quarter ended March 31, 2001...

Magellan Expands Contract with Illinois

Magellan Behavioral Health announced that it has renewed and expanded its contract with the State of Illinois

drkoop.com Buys Home Infusion Provider

drkoop.com Inc. (Nasdaq:KOOP - news) has agreed to acquire home infusion service provider IVonyx for approx...

US Oncology Tries Net Earnings Model

US Oncology is progressing with a plan to convert all its practices to a "net earnings" business model...

How to Work with a Recruiter

When a recruiter calls, or when you call a recruiter, a process is set in motion that can sometimes be...

drkoop.com To Acquire Home Infusion Provider

drkoop.com Inc. (Nasdaq:KOOP - news) has agreed to acquire home infusion service provider IVonyx for approximately $7 million in cash and stock, expanding its health and wellness offerings into the fast-growing home therapy segment.

      Upon completion of the transaction, Ed Cespedes, president, will become vice chairman of the company's board of directors, and IVonyx Chief Executive Officer Peter Molloy, a veteran health-care industry executive, will become president of drkoop.com, continuing the commitment to establishing a world-class management team.

      The $4 billion to $5 billion U.S. home infusion market is expanding as a result of an aging population and a growing trend to offer cost-effective clinical care in outpatient settings.

      This is the most recent in a series of acquisitions that leverage the drkoop.com brand to provide high-quality products, services and information to consumers who are increasingly taking more responsibility for managing their own health and choosing wellness lifestyles.

      Last month, the company acquired StayfitUSA to provide large employers with supplemental wellness benefits for their employees, such as discounted fitness center memberships, smoking cessation programs and other programs that keep employees healthy.

      The IVonyx acquisition represents another step in the drkoop.com strategic plan to transform the company from an online advertising and e-commerce business model to a company intending to take a leadership role in the currently fragmented health and wellness marketplace, establishing multiple revenue models as a provider of products and services under the drkoop.com brand. It is anticipated that all of the acquisitions that are being integrated into the company will be rebranded with the drkoop.com name. Back to TOC.

US Oncology Tries Net Earnings Compensation Plan

US Oncology is progressing with a plan to convert all its practices to a "net earnings" business model rather than using the traditional percentage-of-revenue compensation plan. After signing renegotiated contracts with two major affiliates, the Houston-based firm now derives more than half its revenues from affiliated medical groups compensated based on profits.

      Instead of figuring payments to doctors as a percentage of net revenue, US Oncology will share net income with its affiliated physicians. The Houston-based firm says the arrangement encourages the practices to operate as efficiently as possible and allows the company to reinvest profits into infrastructure improvements like expensive but lucrative positron emission tomography (PET) centers.

      RMCC, which has 54 affiliated oncologists in Colorado and another six at a clinic in Santa Fe, N.M., is one of two US Oncology holdings that converted to the net income model in February. Physicians with the Kansas City (Mo.) Oncology and Hematology Group also renegotiated their affiliation agreement. After several under the new plan, DiBello says physicians on staff bring home about the same paycheck as before.

      US Oncology so far has been successful during its transition to the net earnings model. At a time when other PPMs are failing miserably, US Oncology reported a net income of $35.7 million during the first nine months of 2000. The firm now is affiliated with more than 850 physicians at 72 practices in 26 states.

      Changing physician incentives is a way in which healthcare facilities companies are learning from the mistakes of PPMs. Others are the sale of practices back to the doctors and straight management arrangements without practice ownership.

      It is believed investors might shy away from companies that operate only from contract to contract and have essentially no hard assets, while a firm that owns real estate and medical equipment has the assets to keep its value up. Back to TOC.

How to Work with a Recruiter

When a recruiter calls, or when you call a recruiter, a process is set in motion that can sometimes be overwhelming. You want to find the best situation for your family and yourself. The recruiter wants to find the best possible physician candidate for the client (which is usually a hosptial, HMO or clinic.)

      An outside recruiter or "search consultant" is paid a fee by the facility to (1) locate, screen and select appropriate candidates, (2) to present the facility to candidates and (3) to work with the candidate and facility through the recruitment process, smoothing the way and facilitating. If the search consultant has no appropriate facility for you at first, they may work on your behalf to locate the specific kind of opportunity that fits you needs. Our firm, like most, would never charge the physician a fee for services in the recruitment process.

      As a physician making a major change you may want to see several facilities before making a decision. On the other hand, if the first facility you see is terrific and you have about 85% of your needs met there, don't be afraid to listen to your intuition. Your consultant can help you screen facilities with answers to such questions as:

      Is this a group or solo practice? What is the call coverage? What does call mean? How many patients are seen each day? What types of procedures are performed in the office? What is the compensation? Salary? Guarantee? Fee for Service? Is there a production bonus? A signing bonus? What is the community like? Geography? What are the schools like? Is there a job for my spouse? Is there recreation in the area that we will enjoy?

      The recruiter's credibility and income rests on the ability to satisfy the client's needs as well as pleasing physician candidates. This means that you likely will not be the only candidate presented on a specific opportunity. If you are interested in moving to a desirable location or even if you are interested in exploring possibilities, here are some tips to help you become a more attractive candidate to both the facility and to the recruiter..

      Work with a firm that has both expertise in your specialty and the professional staff that enables them to cover the market. Many firms do not have the resources needed to effectively cover the marketplace. The industry is saturated with "mom and pop" shops that are not capable to handle even one specialty, much less other fields.

      Return calls promptly. The consultant needs to have appropriate access to you when facilities express an interest in you or if the recruiter wants to present a facility to you. In finding a job, timing is everything.

      Be polite. You need to sell yourself not only to the staff at the facility but also to the recruiter. Recruiters are gatekeepers and if you don't make a favorable impression with your recruiter they can't represent you appropriately to the facility. If you really blow it, you won't get presented at all by the best consultants.

      If your situation changes, notify the recruiter. Perhaps you have decided not to move, or have obtained a new certification or you family situation has changed. Perhaps after looking for a while, you've decided to broaden you geographic preferences. Perhaps you've married and your new spouse needs a job. It is important to let your recruiter know so that effort is not wasted and that you are not presented to facilities that are inappropriate for you.

      Don't call five or six recruiters and make you CV available. This can open a huge Pandora's box of phone calls and confusion. It is better to work with one or at most two recruiters with whom you have developed some trust. If you decided to work with more than one recruiter let them know about each other. Seldom does a recruiting firm have an exclusive arrangement with a client. Most contingency firms will have some of the same positions that the other firms are representing.

      Give us the good with the bad. If the job is not right, let us know as soon as possible. Life goes on and so does the search.

      Involve your spouse.

      Manage the process. To do this, you need to keep track of where you CV is, whom you have talked to and what facilities have been presented to you. Don't give permission to publish you CV or send it out without your approval. This will reduce the likelihood of several people presenting you to the same location, creating embarrassment and making you look disorganized. The best way many physicians have found to control the process is to keep a notebook with dates and results of calls, emails and contacts.

      For a free copy of our interviewing guide, "Effective Presentations", call of email our firm.

Diffenbaugh & Associates, Inc. is a physician consulting firm specializing in the recruitment and placement of psychiatrists throughout the United States. Diffenbaugh & Associates, Inc. recruits psychiatrists, period. All day, every day of the year we recruit physicians for our clients' organizations throughout the United States. We serve the needs of group practices, single and multi-system hospitals, specialty hospitals and community-based programs in 49 states. Over the years we have recruited and placed hundreds of physicians for our clients. We attribute our success to: Our experience, our values and our methods. Visit with one of our 6 full time associates to learn more about these opportunities.