The corner office: NYC Health + Hospitals' Dr. Ram Raju on the 'essentiality' of public hospital systems

For someone who grew up with aspirations to design buildings, Ramanathan "Ram" Raju, MD, is constructing something else: change in healthcare.

Dr. Raju has served as president and CEO of NYC Health + Hospitals, the largest municipal healthcare system in the nation, since New York City Mayor Bill de Blasio appointed him in 2014. The $7.2 billion health system provides care to 1.4 million New Yorkers every year, including more than 425,000 uninsured, in more than 70 locations across the city's five boroughs.

NYC Health + Hospitals includes a network of 11 hospitals, trauma centers, neighborhood health centers, nursing homes, a large home care agency and post-acute care centers. NYC Health + Hospitals encompasses more than 70 community-based health centers, including Gotham Health, Federally Qualified Health Centers with 36 sites, OneCity Health — the largest performing provider system participating in New York State's Delivery System Reform Incentive Payment Program — and an accountable care organization. NYC Health + Hospitals also owns and operates one of the New York area's largest managed care plans, MetroPlus Health, with nearly half a million members.Dr. Ram Raju

Dr. Raju began his path to medicine and eventually healthcare administration in India, where he grew up, attended medical school and earned a master of surgery degree. Dr. Raju went on to study in England and was elected as a fellow of the Royal College of Surgeons. After arriving in the U.S., he underwent further training and worked as a surgeon in New York City, where he also took on leadership roles at NYC Health + Hospitals/Coney Island. Most recently, Dr. Raju was CEO of the Cook County Health & Hospitals System in Chicago, the third largest public health system in the U.S. There, he led a financial turnaround and spearheaded the creation of CountyCare, an Illinois Medicaid program to provide coverage for low-income adults in Cook County, ultimately leading to healthcare coverage for more than 170,000 residents.

Dr. Raju's dedication to public hospitals, advocacy for the poor and desire to alleviate healthcare disparities has driven him to lead momentous change for two major U.S. cities in addition to all of the lives he touched as a surgeon.

Here, Dr. Raju took the time to answer Becker's Hospital Review's seven questions.

Note: Responses have been lightly edited for length and clarity.   

What's one thing that really piqued your interest in healthcare? 

I came into healthcare by default. I wanted to be an architect, but growing up in India, parents dictate what career one chooses. My dad wanted me to become a doctor.

I no longer practice surgery, because as a surgeon operating on patients, you must be available to them at all times. It is important that you're not just there part-time. It's full-time or nothing.

What do you enjoy most about New York City?

New York City is a vibrant city. I love it for its diversity and culture. It is a city of immigrants — so many languages and cultures, so many ethnicities. It makes the city a very exciting and great place to live. There are also wonderful museums, Broadway, Central Park — everything you can think of.

If you could eliminate one of the healthcare industry's problems overnight, which would it be?

That would be 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. I don't know if I can eliminate it, but that's my desire. We need a healthcare delivery system that eliminates these disparities.

What do you consider your greatest talent or skill outside of the C-suite?

I feel strongly in the essentiality of the public hospital systems. I try to be a spokesperson for them, to articulate to people about how important the public health system is to the ecology of the national healthcare system. They have taken a premier role in taking care of the poor, those who are left behind. They are premier institutions of teaching, research and advancements in medicine. Those things are so important for people to understand and appreciate the need for public systems in the country. We need to cherish them, help them grow and keep them healthy.

How do you revitalize yourself? 

I go to the gym, bike a lot and read a lot of books. I'm a member of a book club — there are a constellation of books I love to read and listen to. I mostly read about history and politics. I love biographies of presidents and other international leaders, books about the Constitution and Civil War biographies.

It is thoroughly fascinating to learn about the fathers of our Constitution. It is amazing how they created a document that still today stands tall. These people were very bright and driven by a great mission.

What's one piece of advice you remember most clearly? 

My dad gave me a lot of advice. When I was young, I didn't understand it or value it, but as I got older I found all his advice to be true. One piece I still cherish today is: "Man's greatest enemy is his own self-importance."

What do you consider your greatest achievement at NYC Health + Hospitals so far?

Well, it isn't really my achievement but the achievement of my team and our employees, because I always say the greatest asset to our system is our workforce. We have some of the most dedicated and compassionate people who work very hard to take care of some of the most complex healthcare issues, and also try to solve social issues, such as homelessness, poverty, illiteracy and social isolation.

I think the fact that we exist and take care of one out of every six New Yorkers and don't turn anyone away is our greatest achievement. We provided services to more than 1.4 million New Yorkers last year and we are the largest provider of mental health services in New York City. We are really the social safety net for New York City. We take everyone and turn no one away. We provide excellent care — we have some of the highest quality indicators in the country. This isn't my achievement, but the group of people who work with us every day and my predecessors who made the system work better.

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