from Nick van Terheiden aka Dr. Nick, Director, ECG Management Consultations
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Host of Healthcare upside down – #HCupsidedown
Many years ago I was fortunate to be involved in what was a once-in-a-lifetime opportunity – building a brand new, independent hospital from scratch.
The project started as an empty field and ended up as a 250-bed hospital with 21 operating rooms, 2 CT scanners, 2 MRI scanners and the ability to install an intraoperative MRI – something that was not available at the time, but we wanted for the reliability of the facility. We even added a large hotel to the complex—something that was unheard of at the time, but was a major component of a full-service facility designed to treat patients from around the world.
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The insights I gained from this experience continue to shape my belief that healthcare delivery should benefit the end customer: the patient. Maybe that sounds basic or obvious, but it’s an approach that doesn’t seem to be widely adopted. This may be a result of the move to larger healthcare systems and the challenge of keeping things private as organizations grow in size.
For many patients, these large facilities can be difficult to access due to geography and distance. And as we’ve heard in previous episodes, the local hospital remains a central part of any community.
Dr. David Klein is a general surgeon by training, but he has expanded his role to manage a number of healthcare facilities. He is currently the CEO of MarinHealth, an independent hospital in California, north of San Francisco. In this episode, he talks about the lessons he’s learned over the course of his career—and what independent hospitals can do that many large health systems can’t. Below are a few excerpts.
The role of the independent hospital in society.
I think there is still a role for independent, market-based health systems. Healthcare is truly local. Something I noticed that was part of the larger health systems was that they weren’t as focused geographically on the specific needs of a community as opposed to looking at the whole system. One of the things I enjoy about my current role is that we focus on our community – we respond to the needs of the community, we can be invested in every aspect of the community so that we provide the appropriate care. I think that matters.
Advantages of an independent hospital over a larger system.
I have had the opportunity to work for many large companies, some of the largest both for profit and not for profit. [MarinHealth] is a strong community hospital. In fact, we’re thriving right now in the post-Covid era, where I think some of the larger systems are struggling. One of the things that has always appealed to me is our ability to really be nimble, to make decisions on the fly based on our current needs. It could be decisions about how we spend capital, add service lines, remove service lines, or meet the needs of a sub-segment of the community, which I can decide with the team and the board at some point. When I was working with larger systems, sometimes it took an act of Congress, if you will, to get big initiatives going.
Three secrets to MarinHealth’s success.
“I think it’s simple: always put the patient at the center of every decision. No matter what the decision is – whether it’s financial, a building, adding services – if you always keep the patient at the center of every decision, it will always be right.”
“Always do the right thing for the right reason. Ask yourself, “Am I doing this for the right reason?” If the answer is no, then you probably shouldn’t be doing this.
“Every decision you make has consequences. Some of them have life-saving or life-threatening consequences. There are many, many different people who can be affected by a single decision.
So I go through the decision tree in my head – who will it affect? What are the potential outcomes? It was a really good direction for me.”
About the show
The US spends more on health care per capita than any other country on the planet. So why aren’t we doing better? Why have the principles of capitalism not prevailed? And why do American consumers have so much trouble accessing and paying for health care? Immerse yourself in these and other questions at Healthcare upside down with ECG Director Dr. Nick van Terheyden and guest panelists as they discuss the pros and cons of US healthcare and how to make the system work for everyone.
This article was originally published on ECG Management Consultations blog and is republished here with permission.
