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Apathy and Political Agendas Threaten Progress in Public Health

By | April 22 nd,  2016 | climate change, payers, population health, Top 25 Minority Executives in Healthcare, clean air, clean water, Flint, gun violence, lead, Modern Healthcare, providers, Blog, American Public Health Association, APHA, zika | Add A Comment

 

One in a series of interviews with Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016.

 

Georges Benjamin has led the American Public Health Association as executive director since 2002, but he has never been busier or more vocal.

 

“I think we’re in an environment where the forces doing things that are opposed to the public’s health are more active, and so we’re more active,” he says.

 

The issues are numerous, from climate change to gun violence -– and a few things that didn’t used to be controversial at all.

 

“When you look at clean water and clean air, there’s an effort to push back on a lot of the things that public health has done over the years to make the environment safer for us and to make us healthier,” he adds. “We’re having to weigh in on things that, in our minds, were settled.”

 

Some threats he sees as audacious.

 

“The misinformation around the Affordable Care Act continues to be a concern and the lack of national recognition of the prevention aspects of the law are absolutely amazing,” Benjamin says.

 

Others, he says, are the result of apathy and inattention.

 

“We lost 40,000 public health workers across the country through the last recession and they haven’t been replaced,” he notes. “We’re losing programs because the funding has been cut. And then there’s public health preparedness. We spent a lot of money getting ourselves prepared after 9/11. Not only have there been reductions in funding for the preparedness of our nation to deal with biological attack, but our preparedness for everyday emergencies is not as good as it used to be.”

 

Benjamin's words may be finding an audience. On April 19, President Obama appointed Benjamin to the National Infrastructure Advisory Council.

 

The water crisis of Flint, Mich., is one example of the decay of public health, Benjamin says. So is a lack of funding to deal with mosquito-borne disease – not just zika, but dengue and chikungunya. Give him 10 minutes and he can tick off a variety of issues that need addressing, particularly in the corridors of Washington, D.C., where APHA is based. And, yes, he’d like to see hospitals and health systems get a little more vocal and visible on these issues too.

 

“The healthcare delivery side of the house needs to weigh in on a range of things that historically they have not weighed in on,” Benjamin says. “They always show up for the Medicaid hearing or the healthcare financing hearing. But we need them to show up at the hearing for the public health budget on lead, we need them to show up for the hearing on clean water. We need them to spend their healthcare dollars in a more objective way to address climate change.”

 

In many communities, hospitals are one of the biggest employers and have a large footprint. While some have made moves to address their carbon-dioxide emissions, it’s often done from a business perspective to get better energy rates, Benjamin says. “They also need to do it from a health perspective because it makes their community healthier. And they need to see it through that lens.”

 

If providers can become more public-health-conscious, he says, then they can begin to make a difference via population health.

 

“We have to make sure ‘population health’ isn’t just a buzzword and people don’t take what they’re already doing and rename it ‘population health,’ ” Benjamin says. “We want to make sure it doesn’t go the way of ‘managed care’ – the idea of the moment that, when it doesn’t achieve its goals because it wasn’t done right, people call it a failure.”

 

APHA works with payers as well, including partnerships with the UnitedHealth Foundation and the Aetna Foundation, and isn’t shy about criticizing insurers and providers alike. “When we think they’re off-track, we scream and yell and holler at them -– but we generally have the same goals around health and the well-being of our communities.”

 

With that community health in mind, Benjamin says he is glad to see more of his fellow clinicians stepping up to accept the mantle of leading administratively as well. “Having made decisions around patients gives you a unique perspective that you bring to the table. When you’re the COO or the CEO, the buck stops with you and you get to use those skills differently than you would if you were the medical director and in a more advisory role.”

 

But physician executives need to learn that leadership “is not giving people an order and expecting them to follow,” says Benjamin, himself a former military leader. “It’s setting goals, getting people aligned to go in a particular direction, and then giving them freedom.”

 

It’s a far different role than simply being a clinician, he says.

 

“One of the reasons I enjoyed being in an emergency position was that, most of the time, you saw results of your work right away. But in management, things are like a big battleship and they don’t turn very quickly. And so the gratification is much more delayed, much more subtle, and you’ve got to really understand what a win is.

 

“Sometimes a win is not what you would like. You have to accept progress and be comfortable with that. And then, realize you have to come back another day and try to move the boat a little further along.”

 

 

Diverse governance is a key to population health

By | March 18 th,  2016 | American Hospital Association, Furst Group, population health, governance, Blog, board of directors, diversity, Trustee magazine, Deanna Banks | Add A Comment

 

Classic content from Trustee magazine and Furst Group:

 

"From allocating capital funds to improving community health status, the diverse makeup of the service area has to be factored into decisions, and trustees steeped in the unique factors of that diversity are essential..."

 

That's the beginning premise of a recent article in Trustee magazine from the American Hospital Association on why diversity in the board room is pivotal for organizations seeking to understand and equip their leadership teams to achieve success in population health.

 

Without diversity, notes Furst Group principal Deanna Banks in the article, "What you get is a group-think. You've got similar-minded people from a singular exposure making decisions on behalf of things for which they lack insight and understanding -- and sometimes empathy."

 

Kelvin Westbrook, chair of BJC Healthcare in St. Louis, shares a memorable experience he had years ago about the "shoe test."

 

"If you look under the table and you don't have a diversity of shoes, you're probably going to get a much narrower perspective on what can and cannot work."

 

To read the complete article, click here.

 

 

Karen Ignagni: The post-ACA landscape offers a blank slate for visionary leaders

By | September 2 nd,  2015 | Affordable Care Act, AHIP, care coordination, consolidation, Healthcare, payers, population health, pricing, Modern Healthcare, pharmaceutical, providers, Blog, CEO, costs, disease management, EmblemHealth, insurers, Karen Ignagni, leadership, transparency, Top 25 Women in Healthcare | Add A Comment

 

One in a series of interviews with Modern Healthcare's Top 25 Women in Healthcare for 2015.

 

The healthcare industry is in a time of historic change. Hospitals and health systems are merging and acquiring each other; health insurers are doing the same. The provider and payer worlds themselves are converging as health systems create their own health plans and insurers are affiliating with providers.

 

But no one should read into what is happening now as a guarantee of what the industry will look like when the tectonic plates stop shifting, says Karen Ignagni, the new CEO of EmblemHealth who recently completed an incredibly influential run as CEO of America’s Health Insurance Plans (AHIP). Ignagni spoke with Furst Group during her final days at AHIP and before taking over at EmblemHealth.

 

“The way to think about convergence is that it’s the beginning of numerous possibilities,” she says, “and how it evolves will be dependent upon individual market dynamics and individual stakeholder leadership.”

 

Despite the uncertainty, it should be an exciting time for innovators, Ignagni notes.

 

“It’s crucial to be open-minded and not think the past is prologue,” she says. “Some folks love that idea; others who are looking to continue a strategy charted some years ago are terrified by it. There’s no handbook for where we are today. As a leader, you need to understand that and be willing to take out a blank piece of paper and create your vision.”

 

Ignagni leaves no uncertainty as to where she stands on that issue.

 

“If you can think about this as the best of times, then you’ll have an opportunity to make an enduring contribution.”

 

She says it was her desire to make a new kind of contribution that led to her decision to leave AHIP, the organization she had forged, and take the reins at EmblemHealth.

 

“First of all, leading AHIP is one of the best jobs in the country with the best team in the country,” Ignagni says, “But I’m excited about this new chapter. I’m thankful to the Emblem board for the opportunity to move from representing what our companies are doing to actually doing the work and taking an operations role in a health plan serving working families, seniors and the medically underserved.

 

“For me, it is coming full circle,” she adds, noting that she worked for the AFL-CIO in the ‘80s, where one of her roles was fighting for health benefits for union members.

 

More recently, of course, Ignagni was a pivotal player in the reform debate. Her advocacy was a signature moment in a career that saw her as arguably the most powerful payer voice for more than two decades – she previously led the American Association of Health Plans and guided AAHP’s merger with the Health Insurance Association of America that formed AHIP.

 

Despite the changes that the Affordable Care Act has brought, Ignagni agrees that the entire health care industry still has a long way to go to begin to meet consumers’ expectations.

 

“The health arena has to become much more like Amazon,” she says. “When I go on Amazon, they know who I am, I don’t have to re-enter all of my information, and things come overnight. That’s the customer-service standard that we in the health care arena need to emulate—everything needs to happen in real time.”

 

The status quo, she warns, won’t fly with consumers any more.

 

“Health care stakeholders need to embrace transparency,” Ignagni says. “For example, how much does a drug really cost? Right now, it is a black box of pricing. With pharmaceutical companies, the rhetoric is all about innovation. But how much of the price consumers are being asked to pay is for innovations, marketing and sales, and profit-taking? In the health plan community, consumers know precisely the answers to these questions. Now regulators will use the reporting structure for health plans to ask pharmaceutical companies similar questions.”

 

Payers have outed providers by revealing hospital pricing during the unprecedented wave of health-system mergers, and also has taken the pharma industry to task for what it views as price-gouging, like $84,000 Hepatitis C treatments. Ignagni, as the payers’ chief lobbyist, has led that charge.

 

“Our motivation as health plans is to get the price of the premium as affordable as possible for consumers. That’s a very different objective than a large pharmaceutical company charging whatever it can, or a hospital consolidating so it can raise all of its pricing to the level of the highest priced hospital in the network.”

 

She acknowledges that, under the new paradigm of convergence, payers and providers will need to work together. But payers must be equal partners in the arrangement, she warns.

 

“Health plans have an advantage in population health,” she says. “We’ve already written the book on it. It’s not a future state we’re evolving to -- we're there with our focus on disease management and care coordination. Now the question is, how do health plans bring these skills together with clinicians and hospitals to create new payment arrangements that result in more efficiency and effectiveness for patients?”

 

To get the industry to where it needs to go in these areas, Ignagni says, will take a new level of leadership. Leaders, she says, will need “resilience, agility, and the ability to handle a significant amount of unpredictability, because we are talking about writing a new chapter.”

 

Even with her new role, don’t be surprised if Ignagni is one of the primary co-authors of this next passage for the healthcare industry.

 

 

Profiles in Leadership: Top 25 Minority Executives Ben Chu helps Kaiser Permanente make quality count

By | July 6 th,  2012 | American Hospital Association, change management, Furst Group, Healthcare, population health, health system, hospital, Modern Healthcare, physician, Blog, CEO, diversity, healthcare reform, Kaiser Permanente, leadership, chairman-elect | Add A Comment

Chu

 

One in a series of profiles of Modern Healthcare’s Top 25 Minority Executives in Healthcare (sponsored by Furst Group)

 

Benjamin Chu, MD, MPH, MACP, oversees Kaiser Permanente Southern California and Hawaii as group president. In the seven years since he arrived, Kaiser Permanente has amassed many awards for quality. He also is chairman-elect of the American Hospital Association and will begin serving in that capacity in 2013.
Prior to joining Kaiser, he was president of New York City’s Health and Hospitals Corp., the largest public health system in the country. He also served as associate dean at both Columbia University and New York University.

 

Following is an edited transcript of the conversation:

 

You have a Bachelor’s degree in Psychology. What spurred you to go for an M.D.?

 

I think I always was going to be a doctor. Unlike a lot of people who have a core basic science orientation, I was always more interested in the human side of medicine. Psychology, child development, and anthropology are more in line with things I was thinking about. As you know, in medicine, there are a lot of behavioral and developmental aspects. In order to be effective, you have to understand the cultural determinants of health. All of these factors led me to pursue work in a field where I could actually help people. There is a whole sociology and culture of medicine that one cannot fully understand unless viewed from the psychological perspective.

 

You spent most of your life out East before moving to California. What spurred that move, and has it worked out as you expected?

 

I was running the NYC public hospital system under Mayor Bloomberg. It was an incredible experience and an incredible job. We were doing very innovative things in that system. It is a huge system that cares for 1.3 million NYC residents. When the opportunity arose to move to California and run a large chunk of Kaiser Permanente, the prospect piqued my interest. How far can you take a systems approach to delivering on improving the health of the population under the care of a large system? In Southern California, Kaiser Permanente has 3.6 million members, three times the size of the population we were caring for in NYC. The nice part about it is that the components and pieces are linked in a large multi-physician group that only works with the health plan and the hospitals. The health plan allows for pre-payment for care of the population. There is an entire delivery system under us that allows us to decide how to parcel resources in order to achieve the goal of maximizing the health of the population we serve.

 

How do you get a big system like KP to deliver on its promise and to take healthcare to a whole different level?

 

That was both the challenge and the fun part of coming to KP & California.
I didn’t know many people when I was coming to Kaiser – primarily George Halvorson [chairman and CEO] and Ray Baxter [senior vice president for Community Benefit, Research and Health Policy]. It’s been an incredibly rewarding experience. We had to put systems in place – our electronic health record and other systems – to allow us to look at our performance in a very open, honest, and critical way. We had to reconfigure the system. KP had been better than average on quality and outcome for our members. Now, because of what we’ve been able to do with tools, reconfiguring our system, and getting complete alignment of our systems, components and people (including the 60,000 employees in Southern California), we are pretty close to leading the country on many metrics.

 


From Leapfrog to NCQA, KP across the board has achieved some remarkable ratings for quality.

 

There has been a steady progression over the last half dozen years. We’ve taken a systematic approach. We engaged every member of our staff, from doctors to non-doctors and from professionals to frontline workers, to get to that point. It has been very rewarding and a lot of fun to do.

 

The last six years coincide with your arrival. What role did you play in these changes? What role did you leadership team play? What did you look for when bringing a new leader on board?

 

To tell you the truth, I don’t think I have brought anyone new in, believe it or not. I spent time getting to know the people here. We have a wonderful leadership group, and there have been very few changes. The changes were largely to replace people who left. What would be the key to our success? It hovers around getting complete alignment over what we wanted to do.

 

Much of the alignment was around trying to make sure we did everything possible to benefit our members. It was not a financial decision. While financials are important, they aren’t driving our goals at this point. The larger point was to make sure everyone understood that at the end of the day, it is our members and patients, and how we perform for them, both in the individual aspect and aggregate aspect.

 

People rallied to this message of reaching for the higher mission. It’s hokey to think about in that way, but you’d be surprised. Everyone comes into healthcare to make a difference in another person’s life. One of the things we did as a leadership team was to galvanize everyone’s desire to make a difference and reminded people of this. I think this is the key to leadership overall. I am blessed to have a lot of incredible people working with me on much of this.

 

Obviously we had to put in the systems to give us the information to know if we were making a difference in people’s lives. Once we got that in place and held that mirror up, the ideas came flowing out, and we could tap into this wellspring of creativity and desire to do the right thing. I am a doctor by training in a non-clinician role right now, but it is a pleasure to see that marriage of clinical outcomes and my public health background on population health outcomes come together in a delivery system.

 

As you look at your role at the American Hospital Association as chairman-elect beginning in 2013, do you get the sense that part of what they are looking to you for is to help other hospitals across country pick up on what Kaiser has done and get the quality scores up and make a difference nationally?

 

If you actually talk to the hospital leaders and members of the boards across the country, there is an enormous amount of energy working to find ways of taking care of their communities. Part of this is the quality agenda. Thousands of hospitals have joined the hospital engagement networks that are forming right now and are trying to learn from each other and optimize the quality of care given in the hospitals themselves. Hospitals are beginning to see that they play a pivotal role in their communities.

 

Rather than be passive and wait for people to get sick and come in, there is a role to be played more upstream – to make a difference in the community’s fabric and in its health. Some of it has a lot to do with impacting the developing ACOs. It is an often misunderstood, yet often used, term. The idea is to get an organization and care delivery system to care for a population and try to go as upstream as possible to find strategies that lead to good health and mitigate things that lead to bad health, not just treat emergency situations. It means partnership with providers who work in the upstream levels. Doctors who see patients in an outpatient setting tied to the hospital or in their practices – we need to link the two together.

 

There is a lot of energy in the hospital world. One of the reasons I was asked to chair in 2013 is that there are tremendous, yet uncertain, changes that are happening. There are also these powerful positive forces that can help hospitals and health systems come together in a better way to take better care of their communities. I think I was asked to chair so we can engage in a system-wide and country-wide dialogue to help each other overall.

 

Given the uncertainty around reform – does that make leadership harder for you and the people running hospitals round the country?

 

It depends on what you mean by harder. It certainly makes it much more interesting. The pathways to choose are much more ambiguous. In uncertain times, leadership needs to focus energy on the right things. I think that is why the AHA is working with our member hospitals to determine the higher-order outcome. If we dive into the weeds and get into the arcana of legislation and stay there, we will get lost. That is not to say reimbursement and policy changes aren’t important, but if that is all we think about, there is no ability to guide organizations through a field of uncertainty.

 

If you can’t pick up your head to see where you are going, you cannot mobilize physicians and institutions to move in the same direction, and we will be mired in the field and will not get anywhere. That is the difference between someone who is good operationally and a leader who can engage people in dialogue to get everyone to a place where we want to be.

 

There seems to be a growing consensus among healthcare leaders that we are on a course of change that will continue whether mandated or not.

 

I think that is absolutely correct. Healthcare is changing in a good way, I think. I know people worry about losing the good things in uncertain times. When you think about what we are capable of doing and how many people we are capable of doing things for, I am convinced that with a little change in perspective and focus, we can utilize the dollars we spend in healthcare and create a lot more healthy communities. It is a journey in a lot of ways – a very uncertain journey. I think the focus is changing. Payment reform is happening. A lot more transparency is coming. There will be changes to tell us how we are really doing. Once you are confronted with that information, it is a compelling force driving changes that could get us to a better place.

 

I think that in the best framing of what is happening now, that is the direction the country’s healthcare systems is headed. Probably the direction the world’s healthcare system is headed. Even though we are making a difference, how do we know we couldn’t be making a bigger difference? When you think of disparities in healthcare and how uneven results are, I think in this day and age, there is little the systems cannot tackle. We won’t all get there at the same time, but if we focus right, there’s a lot more good that we can do.

 

There seems to be an increasing interest in physician executive leadership. As a doctor and physician yourself, what is your take on that?

 

The lesson we’ve all learned is that in order to take on the larger tasks, the triple aim, all of the key pieces must be aligned. Physicians and other healthcare professionals have to be integrated into the whole system. We are trained to be separate. Even though hospitals are a part of the action where people are treated and where doctors do what they do, they are still only a piece of the puzzle. To integrate the perspectives, many places are looking towards physician leadership, whether as an administrator or at a Medical Director/CMO level.
We need voices there and to be open and honest about the larger goal. We cannot just see hospitals as a doctor’s workshop. That will only get us so far. Obviously, we want someone to care for patients and bring their expertise. However, it is not just a single doctor, but multiple healthcare professionals. We want to see the larger role for the community.

 

We need to make decisions on the deployment of resources and make a bigger difference than just delivering the best care in the ER. I’m not saying the best care shouldn’t be delivered in the ER, but when you think about it, it may not be the optimum expenditure of resources if you only concentrate on the ER.

 

In my opinion, there should be more doctors at senior levels of health systems. Having everyone’s perspective is important and makes a difference.

 

You spent time working in the office of Sen. Bill Bradley. What insights from that time guide your perspective in today’s healthcare climate?

 

I’m not sure there is a tremendous amount of insight but, when I worked for Senator Bill Bradley, it was one of the last times for major Medicaid expansion. The American with Disabilities Act was passed the year I was there; we passed the Medicaid Best Price legislation for pharmaceuticals, and expanded Medicaid to children up to 133% of the poverty line and pregnant women up to 185% of poverty. That was really the last big expansion before the children’s health program came in.

 

When I think of that era, it was a time of greater bipartisan collaboration. I worked for a Democratic senator when the first George Bush was president. There was a lot more collegiality. That’s not to say that cannot happen again, but I’m hoping after the upcoming, probably raucous, presidential campaign, that people will be more realistic in looking at the problems of our country and figure out how to solve them.

 

Even if we concentrate on legislation, that’s not always where the action is. Many core changes are already starting to happen. Core systems changes are being worked on. I don’t think there is a way back. From the hospital perspective, one of the opportunities was finally being able to count on some sort of payment for care of the significant portion of uninsured patients that would come in to the ER and hospitals. This includes upstream care and hospitalization. From the community and hospital point of view, that was one of the best parts of healthcare reform. I hope that will continue. I know it presents problems for many aspects of the healthcare world, the Medicaid expansion, as well as the exchanges, but I hope that some sort of increase in uninsured care will continue. We will always muddle our way through. We always have muddled our way through, based on my experience with Senator Bradley. It was not always clear then (1989-1990).

 

Healthcare organizations, particular in the inner cities, are creating senior housing, opening banking centers, farmers’ markets, and developing other innovative systems and ideas such as free surgery day. Some might think it’s a bit far afield of healthcare, but it seems to be a growing part of preventive care. Is this part of the equation at Kaiser Permanente as well?

 

Every one of KP’s medical centers runs a farmers market. In fact, we run the only farmers market in Los Angeles. This is illustrative of what I was talking about earlier – the tremendous amount of energy spent in the hospital world trying to figure out how we go upstream. The medical model is individual – one person at a time. When someone is sick, you care for them and send them back out. This is an important function for every community. The underlying premise is that the sum of all the good one-on-one work will translate into a healthier community. Clearly, this model leaves huge gaps. The medical model really is not directly focused on the population’s and the community’s total health.

 

There is a broader understanding that what makes a person healthy or not is as much about the health of the community and total health of the environment as it is to prescribing the right medicine. Eighty percent of the determinants of health are not linked to care. Smoking, exercise, drug use – these are things people need to think about if we are going to make a greater impact on the community and population health.

 

At Kaiser, we have a theater troupe that goes into grade schools to do thousands of performances on healthy eating to influence kids on eating habits. Collectively, if 5,000 hospitals and health systems can get it together and start moving upstream together, it could be a very powerful force. To become a vibrant part of the community is key. We helped invest in parks. We have beautiful weather in Southern California, but unless you have good outdoor spaces, people will stay in their homes or in their cars to go from place to place. The built environment in the community makes a difference. Do people have the choice to make better decisions? We need to provide spaces to make better decisions.

Profiles in Leadership: Top 25 Minority Executives Sam Ross just wanted to be 'the black Marcus Welby,' but life had bigger plans

By | May 22 nd,  2012 | Bon Secours, population health, health system, hospital, physician, Samuel Ross, Blog, CEO, leadership | 2 Comments

 

One in a series of profiles of Modern Healthcare’s Top 25 Minority Executives in Healthcare (sponsored by Furst Group)

 

As a young man growing up in Texas, Samuel Ross says he wanted to be “the black Marcus Welby,” a family physician who returned to his hometown and found great success, just like the ‘70s TV doctor portrayed by Robert Young.

 

While Ross did indeed become a family physician in private practice, real life had different plans for him. He eventually served as chief medical officer, among other jobs, at Parkland Hospital & Health System in Dallas before becoming CEO of the Bon Secours Baltimore Health System. He also oversees Bon Secours’ Kentucky facilities and its system-wide Supply Chain.

 

And, far from the middle-class patients Welby tended to, Ross’ experiences in the poor neighborhood surrounding Bon Secours sometimes have less to do with the medicine he studied, and more to do with population health. In the last twenty years, including time under Ross’ watch, Bon Secours has built apartment buildings for seniors and opened a banking center for the community. They don’t teach much about that in medical school.

 

“These ideas came from the community,” noted Ross. “I’ve been influenced by the concept of Community-Oriented Primary Care that came out of South Africa by Dr. Sidney Kark. He built a number of facilities with the notion of one-stop shopping for the poor related to social determinants.”

 

Bon Secours was on the brink of closing a couple years ago. Its safety net for the poor was fraying badly as residents without insurance comprised a disproportionate amount of the patients. In fact, Ross determined that 50 patients alone accounted for 2,287 visits in a three-year period.

 

The state of Maryland came through with funding to right the ship, and Ross and his organization have done the rest. Ross is putting a focus on patient safety and quality and has announced plans to hire more physicians and other staff to develop a “primary care medical home.” Bon Secours has invested many dollars and a lot of hours in the community. “This is about the charism of the Sisters of Bon Secours to extend healing and compassion and liberation,” Ross said. But Ross is far from done and is determined that Bon Secours make a lasting impression, because the hospital – and West Baltimore – have been down this road before.

 

“A lot of people and foundations and government agencies have come in before and tried to make things better for the community,” Ross said. “But when the money runs out and the programs go away, a lack of trust develops in the community. We need to be partners working with them, not doing it for them.”

 

The needs are great in Baltimore, where the Sisters of Bon Secours came more than a century ago to begin to care for the sick. A study by the city of Baltimore and Johns Hopkins determined that life expectancy for a resident of West Baltimore is 20 years less than someone who lives in the affluent neighborhood of Roland Park.

 

“That’s unacceptable,” Ross said.

 

So Bon Secours went to the neighborhood and asked the residents what their needs were. The response wasn’t what the hospital expected.

 

“Getting rid of rats and trash – that’s what people said was important,” Ross related. “There were a lot of vacant houses where those things were a problem for the whole neighborhood. So we helped the community get rid of those houses and build community gardens. Housing was a major concern too, and that’s where the senior apartments came from.”

 

Ross hopes he and his staff have learned from their own and previous generations’ mistakes.

 

“Oftentimes, we go in to the community with our statistics and say, ‘Here’s what the stats say your problems are.’ But the people don’t always agree. You can talk about heart disease and diabetes all you want, but first you have to get rid of the rats and trash.”

 

Yet in the boardroom and in the community, Ross says he draws many lessons from his days as a family physician – he was a solo practitioner for five years before friends at Parkland convinced him to create a primary care clinic.

 

“The life of a family physician is really about right relationships,” Ross said. “It’s through those relationships that opportunities and success come. You can’t accomplish anything alone. Communication is critical, especially when you’re trying to impact an organization and a community.”

 

Ross says he was an accidental leader at first, but has grown to embrace the role.

 

“I didn’t want to become an administrator,” he said. “People saw leadership things in me that I didn’t necessarily see in myself. But administrators and clinicians do speak a different language, and I saw that as a physician leader I had the ability to translate for them. I was able to discern the interests of both sides.”

 

The obstacles Ross has faced in Baltimore are a long way from the made-for-TV crises that Marcus Welby faced each week, but Ross sounds a bit like his hero as he assesses the challenges, not only in Baltimore but in the industry as a whole.

 

“I’ve heard it said that leadership is optimism beyond the available data,” he said. “If you look at the situation here in the U.S. with all the uncertainty around healthcare reform, you could become paralyzed in the face of the facts. But if you’re doing the right things with patients and their families in mind, you should be in a good position to adapt to whatever comes along.”