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A Kansas specialty hospital is accusing HCA of pressuring managed-care companies to exclude rivals from networks and is suing the chain. "This is another mechanism by which (specialty hospitals) can get relief from the conduct of larger hospitals that are doing everything they can to put them out of business," says Norman Siegel, left, attorney for Heartland SpineSpecialty Hospital.

Once among the nation's most-respected professionals, doctors have fallen to No. 5--a step below grade-school teachers and tying with druggists. A survey by the American College of Physician Executives reveals that some docs are critically examining their own medical values and moral principles. Kenneth Goodman, left, director of the University of Miami's bioethics program, says the survey will prove that business as usual is not necessarily good business.

More physicians are stepping forward to buy their own hospitals, often aging or faltering facilities that need some special attention. Kamlesh Gosai, left, led a group that helped keep open Brownsville (Pa.) General Hospital, saving 250 jobs. Often such doc investors are confident they'll suceed in managing their fellow physicians. But others warn they'll face some tough decisions.

When MedCath Corp. pulled the plug on the Heart Hospital of Milwaukee last week, it marked the first failure of a specialty hospital. Some saw the move as the result of oversupply. With 13 heart programs in the area, "It was inevitable that one of them wouldn't succeed," said Leo Brideau, left.

In the biggest deal of its kind, not-for-profit giant Ascension is going to build ambulatory surgery centers with for-profit United Surgical Partners, which already has a deal with Baylor, left. "Hospitals are realizing that outpatient services are the future. This strategy is sound," one healthcare consultant said.

The growing importance of IT is reflected in Modem Healthcare's third annual ranking of the 100 Most Powerful People in Healthcare. The person topping the 2004 list is a newcomer who recently vaulted to prominence. Who is he, and what other industry movers and shakers made the ranking.

A cost-effective method of internally repairing pipeline leaks has been developed that – in many instances – eliminates the need for expensive and risky external mechanical repairs. By delivering a pressure-activated sealant between two pigs to a leak site and pressure activating the sealant to polymerize as a flexible solid within the leak path, it is possible to internally repair pipeline leaks without the need for excavating or replacing defective sections with minor leaks.

The daily stresses of managing a hospital or hospital system seem to be claiming more executives, with the recent exit of at least a half-dozen relatively young CEOs of prominent organizations--including Christopher Carney, left, of Bon Secours Health System. "I can think of no time when the demands on CEOs have been greater," says one association executive.

Advanced-degree programs in healthcare are adequately preparing the leaders of tomorrow, industry executives and other respondents indicate in a Modern Healthcare survey. Myron Fottler, left, a professor at the University of Central Florida in Orlando, says programs are becoming increasingly business-oriented to meet the ever-changing demands of the market.

After slipping 16.5% in the past quarter-century, the number of community hospitals is on the rise despite slim margins, lagging reimbursements and a tight capital market. Growth is spurred by the attractive demographics of fast-growing suburban areas, changing consumer tastes and the lure of big business from baby boomers and the elderly. One new facility is Florida Hospital-Flagler, left.

As Denver experienced a population boom during the '90s, hospital construction was at a standstill. Now providers are racing to catch up with demand, reflecting a national trend. Four Denver-area facilities, including Sky Ridge Medical Center, left, are open or under construction. "Right now, there's nothing like this going on anywhere," says Dennis Brimhall, of the University of Colorado Hospital.

Our second annual ranking of the 100 Most Powerful People in Healthcare has quite a few surprises. Readers nominated and voted for the people who move and shake the healthcare industry. The 2003 list of the Most Powerful has 52 names absent from last year's ranking, including a new No. 1. Who are they and who are the repeat winners?

The power of religion and the might of physicians seem to have joined forces against Baptist Health System's proposed merger with for-profit Triad Hospitals. Doctors and employees of Baptist facilities such as Montclair Baptist Medical Center, left, demanded that the system remain faith-based and under local control.

As state lawmakers diluted the impact of certificate-of-need laws last year, more and more CON boards are approving a vast array of projects. Almost one-third of the 27 states that regulate acute-care hospitals gave the OK to every project they reviewed. Condell Medical Center, Libertyville, Ill., shown at left and on the cover, spent $99,300 three years ago to win state approval for its expansion project.

HeidrickStruggles, the nation's largest executive recruiting firm and a staunch champion of the National Center for Healthcare Leadership, is fighting a lawsuit that may test the premise that the healthcare industry lacks future leaders. As far as the placement business goes, Michael Doody, left, a senior vice president at search firm Witt/Kieffer, is confident a hospital's lawsuit alleging Heidrick fell down on the job won't cause irreparable damage.

Several high-profile shake-ups in healthcare exemplify a strategy recently gaining popularity: Keep physicians happy during times of turmoil by making one the boss. Hospital boards find the move to be a magic elixir when trying to build trust with doctors concerned over rocky leadership. Larry Hollier, M.D. (left), chief physician at New York's Mount Sinai Medical Center, was made president to further that trust.