A Discussion with Gary Gottlieb, MD, MBA, BWH President- BWH Bulletin - For and about the People of Brigham and Women's Hospital
A Discussion with Gary Gottlieb, MD, MBA, BWH President- BWH Bulletin - For and about the People of Brigham and Women's Hospital
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December 27, 2002
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In This Issue:
A Forecast for the Future of Health Care
A Discussion with Gary Gottlieb, MD, MBA, BWH President
Hospitals and Health Care Workers Not Immune to Current Incoming Challenges
New President Provides Long-Term Outlook for Partners
New Leader Sheds Light on MGH’s Upcoming Challenges, Opportunities
The National Face of Health Care
Modern Challenges of Medical Education
After only two decades, BWH has proved itself as a renowned, dynamic force in the industry. Due in large part to the strength and reputation of its predecessor institutions, BWH has grown to employ nearly 12,000 people, attracts patients from around the globe, continues to be fiscally sound despite challenging financial times, appears or is mentioned in hundreds of national media stories a month, recruits some of the brightest minds in medicine, and serves as the health care institution of choice for thousands of patients each year. So, what’s next? After 10 months at the helm of the organization, BWH President Gary Gottlieb, MD, MBA, shares with Bulletin his perspective on how the Brigham and Women’s/Faulkner Hospitals (BW/F) family is forever anticipating, reacting and changing to maintain success as the health care climate continues to reinvent itself time and time again.
In what areas do you see Brigham and Women’s/Faulkner Hospitals taking a lead over the next five years?
Gottlieb
: I believe that BW/F will be the academic and community teaching hospitals of choice with the most distinguished caliber physician and professional health care staff creating the highest quality of patient-focused care. Our research and training programs will continue to flourish and attract leading scientists from around the world. I foresee oncology, neurosciences, cardiovascular services and our work in musculoskeletal disease reaching new heights. Our unique approach to Women’s Health will reinforce our leadership in this area. And, our strength in population- based medicine and disease prevention in all areas will strengthen each of these efforts.
What factors are you most concerned about in the coming year and which offer the most promise?
Gottlieb
: There are a number of critical challenges facing hospitals in general and BW/F in particular. The demand for our services has never been greater, complicated by the closing of hospital beds throughout Massachusetts over the course of the last decade.
At BW/F, we must simultaneously manage our financial health and expand our physical space to meet the demand for our services. Therefore, in addition to our financial health, space is a major concern. We continue to make difficult decisions as we implement our growth plan. Compared to other institutions of our size, we do not have comparable square footage. As a result, we are forced to be creative with existing campus space as well as space at off-site locations.
Another concern is having the available resources to effectively sustain the programs and service lines in which we have invested. We must pursue new technology that expands the promise of medicine and continue to secure funding that expands medical research. We must also continue to rededicate ourselves to the drivers of patient satisfaction and quality care and stay true to our academic mission and our commitment to the community.
And finally, I worry about our NIH funding—not our ability to secure grants (we continue to be a leading recipient of federal funding), but the NIH’s ability to sustain their level of funding to all grant recipients, including BWH. The economy has taken its toll on their budget as well.
How well positioned is Brigham and Women’s/Faulkner Hospitals to succeed in the next several years?
Gottlieb
: BW/F is extraordinarily positioned to thrive. Together, we are integrating services across the BW/F continuum of care, transitioning to a system of care characterized by innovative models and discovery, and best practices of patient care delivery. We remain loyal to our mission, which includes our deep commitment to our community; to translating great science into the highest quality of patient care, producing the highest caliber of research and training the next generation of leaders in health care. We continue to forge and maintain successful clinical and community partnerships, and we have solidified key clinician relationships with HVMA, the Dana-Farber Cancer Institute, Faulkner clinicians and members of the Brigham and Women’s Physicians Organization. All factors are essential in productively and efficiently managing ourselves as a health care leader.
How will Brigham and Women’s/Faulkner Hospitals contribute to the continued success of Partners?
Gottlieb
: Clinically speaking, BW/F will continue to work with institutions across the Partners system to provide the right care at the right place at the right time, all the while focusing on our shared priorities, including the highest quality of patient care and safety. Also, our collaborative research programs across the system reflect our drive to prevent and cure illness and expand knowledge and discovery.
How will our affiliation with Faulkner Hospital progress?
Gottlieb
: As I mentioned, we share a vision of together being the academic and community teaching hospitals of choice. While we have just begun to scratch the surface, our future is reflected in the recent success resulting from the new HVMA neurology practice, the new joint Radiology Service, which will open on January 1, and many other progressive collaborations between BWH and Faulkner clinicians. In addition to the joint service lines and programs now located at Faulkner’s Jamaica Plain campus, two new operating rooms are slated to open and seven psychiatry beds will be added to Faulkner’s facility. Faulkner’s campus plays a critical role in a multi-site space planning process now underway.
As a renowned medical center, what do we bring to Boston? The region? The nation? The world?
Gottlieb
: Our delivery of world-renowned tertiary and quaternary care benefits our local neighborhoods, our city, the nation and patients across the globe. Earlier this year, we reinforced our reputation, becoming the only hospital in the world to perform a quadruple transplant from a single donor – for the second time. As an employer, we are very fortunate to attract bright, young, innovative people, who have a positive impact on our community. In addition to providing jobs for more than 12,000 people in the city and region, we offer the most advanced research, which strengthens the biotechnology industry drawn to this area. Essentially, we are a key institutional and economic driver of Boston’s mission to continually attract the highest caliber of talent across a wide spectrum of industries. We continue to provide and nurture leadership in the scientific interface with such companies and academic institutions in Boston and the region.
How will BWH evolve as an employer in the years ahead?
Gottlieb
: Our human resources department has spearheaded the staff survey and other valuable tools to take the “pulse”of how you felt as employees. As a result, existing quality of worklife initiatives were tailored and others were created. I am committed to seeing us continue on what we’ve started—building an environment that is supportive and a culture of learning and growth for all employees. Making jobs and responsibilities more meaningful and empowering employees to be successful at what they do are key goals.
Furthermore, I am committed to the ongoing development of leaders throughout BW/F and the values inherent in leadership. We cannot afford to tolerate mediocre performance and behavior inconsistent with our mission or customer service standards.
How will the hospital’s teaching and research missions evolve in the years ahead?
Gottlieb
: Teaching and research are important legs of our tripartite mission. The advanced science taking place in the laboratories at BWH is extraordinary and will lead to discoveries that will expand the treatment and cure of disease. As we focus on the processes of disease, we are able to work toward generating new tissue and organs, drastically changing the future approach to treating those with organ failure. In addition, our new tools in imaging have launched us into a new realm of biological research. Partners continues to set the pace for Genetics and Genomics research. The BW/F teaching programs, both clinically and scientifically-based, have grown to be more multidisciplinary in nature. In a dynamic labor market, bright and innovative physicians and scientists are looking for innovative programs, like those offered at BWH. I see us continuing to be able to attract the brightest medical and scientific minds across the country.
If federal and state reimbursement rates continue as is, what is the prognosis for the health care industry?
Gottlieb
: Medicaid reimbursement rates that are between 60 and 70 percent of our costs are worrisome. And, as 50,000 former Medicaid patients shift to the already wilted free care pool, there is reason for concern. Of equal concern is the fact that the Department of Public Health, Department of Mental Health and other state agencies are being called upon to do more, but have less resources, due to the shrinking state budget. This translates into a crisis in the safety net. Additionally, cuts in Medicare reimbursements to physicians and reduced payments to teaching hospitals imperil our mission.
What are your thoughts on working with both a new Partners CEO and new president of MGH?
Gottlieb
: I have tremendous admiration and respect for Drs. Mongan and Slavin and very much look forward to working with them to build on the legacy Partners has built over the past eight years. I think our unique approaches, when blended together, will benefit Partners as a whole.