Tenet Doctor Probe Widens

At another Tenet hospital, in fact, such "problems" have already triggered punishment.

Ending a lengthy kickback investigation, the Justice Department announced in March that it had levied a multimillion-dollar fine against Tenet's North Ridge Medical Center in Fort Lauderdale, Fla. The government had accused North Ridge of improperly rewarding a number of doctors -- including three medical directors -- for their patient referrals.

For example, the government's complaint stated, North Ridge agreed to pay one of the doctors $25,000 to replace a director who had received nothing for filling the same post previously. The complaint went on to say that the hospital paid another doctor the same amount -- on top of a $225,000 salary -- to serve as "director of international marketing" for promoting the hospital's services in the Caribbean islands.

Young recalls worse. In the past, he says, companies have offered such frivolous directorships that some people used to joke that hospitals would "appoint someone director of the ingrown toenail center" if it meant boosting patient referrals.

In the end, the feds singled out just one of the North Ridge directorships as improper. But the government spotted problems with 10 other physician contracts and secured a $22.5 million fine -- the highest of its kind -- from the hospital.

Some former Tenet employees foresee bigger penalties to come. Specifically, they view Century City Hospital -- among the first of many California facilities Tenet recently shed -- as a source of major exposure.

Gil Mileikowsky, a fertility specialist who practiced at the hospital for years, claims that Century City paid some of his competitors $5,000 a month for "totally phony" directorships. Indeed, he says that the vast majority of the physicians practicing in a building adjacent to Century City received some kind of financial assistance "in exchange for bringing in patients."

Joel Bergenfeld, who once steered the hospital for Tenet, is now running Century City for its new owners. Bergenfeld did not return a phone call seeking comment for this story.