CEO John Couris shares his vision for a medical ecosystem in Tampa Bay

John Couris, CEO of Tampa (Fla.) General Hospital, spoke with Becker's Jan. 11 about the organization's completed acquisition of one of the region's largest physician-owned radiology practices, Tower Radiology. He also shared his thoughts on staffing challenges during a pandemic and why price gouging by staffing agencies should be treated like a hurricane.

Question: What are your goals following the completed acquisition of Tower Radiology? 

John Couris: We are an organization that believes healthcare not only needs to produce better quality, better outcomes and better safety for the consumer — and we define the consumer in three different ways: the employer, the payer and the patient themselves — but we also think it needs to be less expensive. It shouldn't be as expensive as it is today. So part of the journey is to create a constellation of services that are price sensitive. These imaging centers are not going to be billed like hospital-based departments. They're going to be competitively priced so we can compete in the marketplace aggressively, and we can pass some of that value onto the consumer of healthcare. It's a novel idea to think that you're going to get great quality at these imaging centers, and the procedures are going to be competitively priced, so the consumer can pay less, and that's a big piece of it. 

We're not absorbing these centers into the big hospital infrastructure. We're keeping them as a standalone business, wholly owned by TGH, but we want to keep it separate because we want to be able to drive quality and cost in a different kind of way. The plan is to continue to grow our imaging platform not just in the Tampa Bay market but across the state of Florida. And we're going to do it in a cost-conscious way so we can pass some of those savings on to the consumer. 

Q: What are your main goals as CEO for 2022?

JC: We're continuing to focus on quality and our journey around being the safest academic health system in the country, and we're well on our way. We have a long way to go, but we're very proud of the work that we've been able to accomplish. Doubling down on our quality journey and what we call our 'zero harm journey' is critically important to us. We're going to continue to grow our platform across the state of Florida and continue to expand in the imaging space, in the urgent care space, primary care and specialty space. 

Our belief is if you're going to ask people to behave differently, to act differently, to engage differently, you have to teach them how. We have a partnership with the University of South Florida Muma College of Business, and we built with them the People Development Institute, which is focused on training and educating people from the boardroom to the bedside, to the surgery suites, to environmental services, to the kitchen — everybody in the organization — and the whole idea is that if we're going to ask people to behave differently, we need need to teach them, we need to develop them and we need to invest in them. So the People Development Institute that we have is incredibly important to us.

And finally, we have been building a medical district inside the city of Tampa. So we have the brand new USF Morsani College of Medicine in the city. We have a 1,041-bed academic medical center in the city, and we're building an acute-care rehab hospital and a proton center. We've built an analytics hub there for informatics. We have our own venture capital group called InnoVentures inside the district. So we're building out this medical district akin to what they did with Longwood Medical [Area]in Boston or Houston Methodist. The idea and the notion is that if we can attract world class clinicians and academics here because of the clinical content, we can attract research, biotech, venture capital and private equity by building this ecosystem. We have a pretty robust portfolio of services already being built inside the city, and we're going to continue to build it. That's a big initiative for us. 

Q: How are you handling the latest omicron surge and how has it been different from past surges?

JC: There is a difference. As of today, we have 168 COVID patients in the hospital, both with a primary diagnosis of COVID and an incidental diagnosis of COVID. When we test a patient before they go in for an operation and we discover that the patient has COVID, that would be considered an incidental finding. About 60 percent of our patients right now are incidental findings, and about 40 percent are primary diagnoses. The difference is the acuity of the patient is lower right now. They are not as sick. Of the 168 patients that I have today, 10 are on heated high flow [oxygen] and seven are on ventilators. Heated high flow is a step away from a ventilator. That's very different from delta. We probably had four times that amount of people on ventilators and heated high flow during the delta surge at this point than we do now in the omicron surge. 

The second difference is staffing. Staffing is a challenge and it's a challenge for every health system. We're not at critical staffing levels yet. Although I'm sure people feel like we might be, we're not. We're taking care of people safely and efficiently, but we're strained. Today, I have 250 people out on COVID protocols right now. That's a lot of people. About 80 percent of our workforce is vaccinated. 

What we're struggling with is these staffing agencies [that] are, quite frankly, in my opinion, price gouging. It doesn't make sense that pre-COVID, we were paying $80, $90 a nurse, and now we're paying upwards of $180 to $190 a nurse. My colleagues tell me that in south Florida, in the Miami-Dade area, they're paying $200 to $210 a nurse. The federal government needs to stop that. 

It's no different than in a hurricane. When Hurricane Andrew came through Florida, we had no protection on price gouging. So necessities like gasoline and water became exponentially more expensive. Our state legislators came in and created rules and laws that prohibited that from happening. The feds need to do the same thing for a national crisis like this. This is crazy. It's killing hospitals and health systems, and there's no reason for it. The staffing agencies will say, 'It's a supply and demand thing.' I'm a free market person, but in a national emergency, they should not be allowed to charge what they're charging. It's wrong, and it's hurting the American healthcare system.

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