11 health system CEOs on the single healthcare problem they want fixed tonight

We asked nearly a dozen hospital and health system CEOs the following question: If you could eliminate one of the healthcare industry's problems overnight, which would it be?

Responses were collected throughout the year for our monthly seven-question interview called Corner Office. Here is what executives had to say.

1. David T. Feinberg, MD, President and CEO of Geisinger (Danville, Pa.)
"I would like to eliminate the waiting room and everything it represents. A waiting room means we're provider-centered — it means the doctor is the most important person and everyone is on [his or her] time. We build up inventory for that doctor — that is, the patients in the waiting room.

To be truly patient-centered, we need to get rid of the waiting room. When your child is suicidal or your wife has breast cancer or your parent fell down in the bathroom and they're bleeding, the last thing you want to do is sit and wait. We need to increase access and availability so we can show people we see it is a privilege to take care of them — to tell patients, 'We are waiting for you.'"

2. Ramanathan "Ram" Raju, MD, President and CEO of NYC Health + Hospitals
"The disparities in healthcare. When I practiced surgery, I was under the impression that we have the best healthcare delivery system in the world because I saw healthcare through my practice lens. I took care of everyone irrespective of their ability to pay, regardless of if they had insurance.

But I soon came to witness unequal treatment. It was clear to me that there are parts of the country and certain groups of people who do not get adequate healthcare, die early due to lack of access to healthcare, and even if they do obtain it, they don't have as good of outcomes as other folks. This disparity exists in different parts of the country. It's something we need to eliminate."

3. William P. Thompson, President and CEO of SSM Health (St. Louis)
"Reduce the administrative burden on the healthcare system. By some estimates, up to 30 percent of healthcare costs are spent to comply with regulatory and other requirements that are imposed upon the healthcare system. The sheer magnitude and complexity of the rules and regulations are mind-boggling and have reached a point where we find rules that contradict each other or that can actually impair our ability to provide high-quality care. Of course, I recognize that a reasonable level of administrative oversight is necessary to help prevent fraud and abuse of the system, but the sheer size of the governmental bureaucracy and the duplication of reviews and audits have led to significant waste. By reducing this waste, we could provide more resources to the actual delivery of care."

4. Michael J. Dowling, President and CEO of Northwell Health (New Hyde Park, N.Y.)
"Reduce the conflicting and over-burdensome array of regulatory demands on healthcare organizations. We are inundated with a plethora of micro-regulations, and that, I think, just makes the business much more complicated than it needs to be. It consumes excess resources and doesn't do enough to improve outcomes for patients. This is not to suggest that I'm against compliance, but the constant development of dozens of regulations on an ongoing basis makes the machinery of progress move much more slowly than it could."

5. Charles W. Sorenson, MD, President and CEO of Intermountain Healthcare (Salt Lake City)
"I'd align incentives for everyone participating in healthcare — the physicians and other caregivers; our patients and people before they become patients; the insurers and other payers; and the hospitals and other facilities — so all would benefit when our population gets healthier. Our current fee-for-service system, while it does have some advantages, provides such powerful financial rewards for simply doing more things — especially expensive things — that we end up with very high cost healthcare that doesn't always deliver the outcomes people really want or need."

6. John Bishop, CEO Long Beach Memorial Medical Center, Miller Children's & Women's Hospital Long Beach and Community Hospital Long Beach
"Just one? I can provide a whole list. What comes to mind is the lack of financial alignment around population health where physicians, health plans and hospitals are incentivized differently. If we could have the ability to align our interests, it would greatly improve the quality of care that we collectively deliver. The sooner everyone in healthcare can be moving in the same direction, the better off we will be as a society."

7. Darlene Stromstad, President and CEO of Waterbury (Conn.) Hospital and the Greater Waterbury Health Network
"There is still a lack of access to healthcare for many people, even if it is only because they perceive they don't have access. There are members of this community that do not know how to use the healthcare system. There are many reasons for that, including socioeconomic and language barriers. Some may be intimidated by the size of hospitals and intimidated to go to the doctor's office. We need to find better ways to bring healthcare to where people live, delivered in a way that is meaningful to them. The causes are complicated, but every day we are taking care of patients whose illnesses are preventable. They are not accessing healthcare in a way that works for them."

8. John Chessare, MD, President and CEO of Greater Baltimore Medical Center HealthCare System
"It would definitely be the patient safety issue. Many hospitals still rely on hard work and good intentions alone. These are absolutely necessary, but they're dramatically insufficient for assuring safe and effective care. Other high-risk industries like  nuclear power and commercial aviation have designed for safety. They assume humans will make human errors, so they've built systems around the humans to keep people safe. We are getting better about this in healthcare, but we still have some work to do."

9. Gary S. Kaplan, MD, Chairman and CEO of Virginia Mason Health System (Seattle)
"This should come as no surprise to people who know me and our work at Virginia Mason, but it's waste. Healthcare is full of waste. The lowest estimate I've seen recently is waste accounts for 30 percent of what we do and how we spend our precious resources in healthcare. That waste comes in many forms, such as wasted time and diagnostic procedures and tests. We believe that by using the Virginia Mason Production System, we can identify and eliminate waste in a very systematic way.

What's so exciting is doing this results in higher quality, safer care and a better patient experience. At the same time, there is a lower burden of work for our team members and lower costs. The mythology that you have to pay more to get better quality has gone by the wayside. By relentlessly and systematically focusing on eliminating waste, we can make healthcare better, more affordable and safer."

10. Susan Ehrlich, MD, CEO of the Priscilla Chan and Mark Zuckerberg San Francisco General Hospital and Trauma Center
"There are two things. I would eliminate inequality and our irrational payment system. We have so many different payers, each of which has different rules about paying, and few of them are really linked to value."

11. Mike Murphy, CEO of Sharp HealthCare (San Diego)
"If I could wave that magic wand, I'd say I'd fix the lack of interoperability. I would want to create a single national medical record that could provide all stakeholders all of the information they need at the appropriate time in a simple and useable fashion."


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