In 2008, the payroll at Toyota in Georgetown was $537 million.
At Lexington's three big hospitals — UK HealthCare, Central Baptist and St. Joseph — the combined payroll for a year is more than $1 billion. That's without benefits.
A major engine of Central Kentucky's economy — health care is poised for even more explosive growth over the next decade. As each hospital builds new, more sophisticated facilities, the rivalry among them will intensify for patients, for awards, and for the best doctors as health care reform ups the ante on how the market is divided.
UK, building a $762 million, 12-floor hospital tower that it expects will serve Lexington for the next 100 years, is the big dog as the state's flagship educational medical complex.
Even so, says Woods, "We're doing well financially here."
In June, Central Baptist broke ground on a two-story, 20,000-square-foot building in Richmond that will offer primary care physicians, outpatient diagnostic services and clinic space for specialties. That's on top of adding Baptist Urgent Care to its offerings at Nicholasville's Brannon Crossing — which will open Monday.
And Central Baptist is putting the finishing touches on the new HealthworRx wellness center at Lexington Green, in the former CompUSA location. The building is being touted as a preventive-medicine showcase, featuring counseling and exercise.
"We need to be setting the example," says Sisson, Central Baptist's longtime chief executive, striding between the room where the Pilates reformer will live and the one where spinning classes will be held. "We need to be leading."
Central Baptist in November opened a mini-clinic at Lexington's Hamburg Wal-Mart — in a row of businesses that include a bank, eye center, beauty shop, nail salon and Subway sandwich shop. The hospital's parent company will open a similar clinic at the Bashford Manor Wal-Mart in Louisville this month.
Central Baptist already runs a separate diagnostic center at Hamburg.
The hospital says it's going where the patients are, with the services they want.
In 2006, Central Baptist announced plans, still not finalized, to close its Nicholasville Road location and build on 129 acres near Hamburg as "one-stop shopping" for health care, including heart, cancer, women's and children's care, neurosciences and surgery.
The change would ease Central Baptist's access to Interstates 64 and 75 and give it some geographic breathing space from the vast new UK health complex going up a stone's throw away.
The hospital later said it would keep the Nicholasville Road location open and build at Hamburg.
In August, Hamburg developer Patrick Madden said the Central Baptist property, when finally developed, will be "a gem."
But it's unclear when — or if — that will happen.
Sisson says only that the Hamburg property "has been a great purchase," and that an announcement will be made in spring or summer 2010 about Central Baptist's expansion.
Both Saint Joseph and Central Baptist say they're making it easier to get ear infections checked and flu diagnosed at smaller clinics outside their main hospitals.
Sisson, the only CEO of the three who doesn't have a big new hospital currently in the works, deflects the idea that that might put Central Baptist at a disadvantage. "A building is not a hospital," he says. "I don't worry about that."
One reason Sisson doesn't seem worried might be that Central Baptist is doing well in the obstetrics market and is increasing its appeal to patients driven by convenience — those who might think it's too much trouble to go to a doctor's office but will figure it's OK to get that nagging cough checked out if they're in Wal-Mart anyway.
But, whether patients wind up at a hospital, an emergency room or a clinic, the competition is likely to get tougher for all three hospitals because patients are also getting smarter — as St Joseph's Woods points out.
"Now more than ever, patients are rightfully evaluating which hospitals to go to in the same manner that they evaluate other major decisions or purchases in their lives," Woods said, "including researching quality and the overall patient experience."