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By Andis Robeznieks 
Posts tagged Hospitals
The brave new worlds of healthcare and healthcare economics got me thinking about legendary University of Alabama football coach Paul "Bear" Bryant.
First I was assigned to write an article on voters' approval of a local ballot measure in California that capped executive pay at the public healthcare institution in Google's hometown, El Camino Hospital in Mountain View, Calif., at twice that of the state's governor. The El Camino Hospital pays CEO Tomi Ryba a $695,000 base salary to run its 361-bed, two-campus institution, and—eight days after the election—its board approved a $137,815 performance bonus (PDF) for her. In contrast, Gov. Jerry Brown makes almost $174,000 as the state's CEO, but the California Citizens Compensation Commission—as part of state austerity measures—has knocked that down to $165,000 starting next month. The hospital board has authorized taking legal action to challenge the ballot measure's directive, which would reduce Ryba's salary to $330,000.
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Although they face significant obstacles, physician hospital investors will likely succeed in the end because they have a history of doing so, a crowd of these investors was told at the Physician Hospitals of America annual conference in Austin, Texas. The opening keynote speaker, futurist Jim Carroll, first voiced the message, which was later echoed by healthcare consultant Kevin McDonough.
Carroll's general theme was nothing new, and it reminded me of Alvin Toffler's book Future Shock, which I was assigned to read in my high school sociology class more than 30 years ago. But the more he tailored his message, the more Carroll's words resonated. "There is so much opportunity in front of you, it's staggering," Carroll said, adding that—even though the Patient Protection and Affordable Care Act restricted business opportunities for physician-owned hospitals—growth was still possible with a change in mindset and a change in business models. McDonough, a senior manager with Dallas-based consultants VMG Health, and VMG Health manager Sarina Hickey offered some specifics. "Margins have remained remarkably stable" for physician-owned hospitals, Hickey said. She added that doctor owners have been "adept at controlling costs," and, while legal and market challenges are daunting, "survivors will emerge stronger." McDonough noted that the ACA's limits on growth may increase the value of existing physician-owned hospitals because they have been made a "limited commodity."
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Pathologists are integrated thoroughly into patient care at Cooper University Hospital, Camden, N.J., and this is by design—architectural design, that is.
The new $163.7 million Roberts Pavilion at Cooper was one of 105 entries in the 27th annual Modern Healthcare Design Awards contest. It was one of 11 winning designs, and EwingCole architects took home a Citation award for their work. What caught my attention, however, was that the architects said that special care was taken to locate the "clinical and anatomic pathology departments to enhance increased involvement of pathologists in the patient treatment stream, a fundamental shift in the role of pathology." "We love it, it's gorgeous," said Dr. Roland Schwarting, Cooper's pathology department chairman and chief. "What I love about it is it's an integrated design.” Schwarting explained how, typically, pathology departments and hospital laboratories are fragmented into various silos, hindering communication and collaboration. He said that on paper, it would amount to a very confusing "spaghetti diagram," with arrows pointing every which way to connect the various functions. One can still use a spaghetti diagram to illustrate the department's operation at Cooper, but "the noodles are not as long," Schwarting said.
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Physician Hospitals of America says that by supporting the Republican opponent of the junior senator from Montana, it's hoping to send a message to the state's senior senator, Democrat Max Baucus, that "anti-competitive healthcare" will no longer be tolerated.
The PHA, an association for physician-owned hospitals, is backing GOP Congressman Denny Rehberg over Democratic incumbent John Tester in the Senate race and is planning to host a breakfast fundraiser for him in Austin, Texas, on Sept. 22—the morning after it concludes its annual conference. The PHA also hopes to slice away at the Democrats' Senate majority helping to keep Baucus in the Senate Finance Committee chairman's seat. In an e-mailed news release promoting the Rehberg fundraiser, the PHA says Baucus "has time and time again blocked the necessary reform needed to provide relief for physician-owned hospitals." The group has been at odds with Baucus for several years over the senator's opposition to physician-owned hospitals. Since the PHA was unable to get rid of Section 6001 through litigation, the strategy makes sense—but doctors don't always get what they want from politicians they support. Case in point: Jim Bunning, the Hall of Fame baseball pitcher and former GOP senator from Kentucky who was re-elected 51-49 in 2004 thanks in part to the financial support he received from physicians to defeat another physician, surgeon Daniel Mongiardo. Six years later, Bunning was filibustering to allow a 21.2% Medicare physician payment cut called for by the sustainable growth-rate reimbursement formula.
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With the recent passing of Jerry Nelson, the voice of Sesame Street's Count von Count, I'm compelled to note that the 2012 edition of Modern Healthcare's 100 Most Influential People in Healthcare list had 18 first-timers, eight 11-timers, 78 men, 22 women and 25 doctors (20 men and five women).
No doctor is on the "perennial" list of eight people who made the list all 11 years of its existence. In order of their appearance on this year's list, here are the names of the 25 physicians, followed by their titles and the number of times they've appeared on the Most Influential list: No. 3, Dr. John Kitzhaber, governor of Oregon, (1); No. 17, Dr. John Noseworthy, president and CEO, Mayo Clinic, (2); No. 20, Dr. Regina Benjamin, U.S. Surgeon General, (3); No. 21, Dr. Delos "Toby" Cosgrove, (6); No. 26, Dr. Atul Gawande, professor, Harvard Medical School, (1); No. 29, Dr. Gary Gottlieb, president and CEO, Partners HealthCare System, (6); No. 32, Dr. Carolyn Clancy, director of HHS Agency for Healthcare Research and Quality, (10); No. 34, Dr. Farzad Mostashari, national coordinator for health information technology, (2); No. 41, Dr. Gary Kaplan, chairman and CEO, Virginia Mason Medical Center, (4); Dr. Susan Turney, president and CEO, MGMA-ACMPE, (1); No. 46, Dr. Thomas Frieden, director, Centers for Disease Control and Prevention, (3); No. 50, Dr. Risa Lavizzo-Mourey, president and CEO, Robert Wood Johnson Foundation, (7); No. 51, Dr. Mark Chassin, president of the Joint Commission, (5); No. 53, Dr. Glenn Steele Jr., president and CEO, Geisinger Health System, (4); No. 58, Dr. Margaret Hamburg, Commissioner, Food and Drug Administration, (3): No. 60, Dr. Francis Collins, director, National Institutes of Health, (3); No. 63, Dr. Harvey Fineberg, president, Institute of Medicine, (4); No. 64, Dr. Eric Topol, chief academic officer, Scripps Health, (2); No. 68, Dr. Bruce Siegel, president and CEO, National Association of Public Hospitals and Health Systems, (2); No. 75, Dr. Ralph de la Torre, chairman and CEO, Steward Health Care System, (1); No. 80, Dr. Georges Benjamin, executive director, American Public Health Association, (6); No. 85, Dr. James Madara, executive vice president and CEO, American Medical Association, (1); No. 88, Dr. Richard Gilfillan, acting director, CMS Center for Medicare and Medicaid Innovation, (2); No. 94, Dr. Darrell Kirch, president and CEO, Association of American Medical Colleges, (5); and No. 97, Dr. Charles Sorenson, president and CEO, Intermountain Healthcare, (2). Congratulations one and all. Was there an influential physician you thought should have been on the 2012 list? Let me know at arobeznieks@modernhealthcare.com. Follow Andis Robeznieks on Twitter: @MHARobeznieks.
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The reader comment sections on news websites and the Twitter-sphere can be nasty places. Unfortunately, it took the untimely death of Dr. Donald Liu to demonstrate that those electronic opinionators can be used for better purposes.
Liu, 50, was the surgeon in chief at the University of Chicago's Comer Children's Hospital since 2007, and he drowned in Lake Michigan on Aug. 5 after helping save two boys who were struggling in the water.
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