Theresa Larivee: The woman who runs the oldest hospital in America

In 1751, the United States of America had yet to be founded, skirmishes between England and France were building up to the French and Indian War, and Benjamin Franklin and a physician named Thomas Bond founded Pennsylvania Hospital in Philadelphia.

During the American Revolution, PAH cared for both Continental and British soldiers, leading prominent Quaker Board memberstheresalariveecrop to exile the institution and leave it suffering financially for subsequent years. A member of the hospital's medical staff — Dr. Benjamin Rush — wrote a definitive treatise on military medicine, soldier health and patient care called the Directors for Preserving the Health of Soldiers that went on to serve the nation until the Civil War.

PAH was also in the forefront of the first hospital service units established in World War I, which sent medical personnel to spend 21 months of service in France. During World War II, PAH's 52nd Evacuation Hospital saw action in the Pacific Theater.

Since its establishment, PAH has been the home to many medical "firsts," including the first American Medical Association-designated medical library (1847), the first training school for male nurses (1914) and the first hospital-based day care for disabled and chronically ill older adults (1965).

More than 260 years after PAH was founded, Theresa Larivee rose to the helm of the nation's first hospital as executive director. Ms. Larivee succeeded R. Michael Buckley, MD, in 2014 after serving as the vice president of financial operations and budget for the University of Pennsylvania Health System since 2008.

Here, Ms. Larivee discusses what it's like to run the oldest hospital in the country, which now stands at roughly 520 beds, and how she balances PAH's history with staying at the forefront of medicine.

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

Question: Did PAH's long history have any influence whatsoever on your choice to join the hospital?

Theresa Larivee: Pennsylvania Hospital, the nation's first hospital, certainly had a positive influence on my decision. The initial mission of the hospital — "To care for the sick-poor and insane who wander the streets of Philadelphia" — remains at the core of our modern day mission to provide high quality, individualized, compassionate care. Linking our founders' vision to our modern day goals provides a wonderful foundation to build upon. In addition to being executive director of a healthcare enterprise, I am accountable for preserving the historical buildings, artifacts, artwork and collections, which I consider a wonderful attribute of the position.

Q: How do you balance the hospital's legacy with remaining relevant and cutting-edge?

TL: The original structure — the historic Pine building — the medicinal gardens, the 1803 hand pump fire engine and our buildings remain as a constant reminder of our past for all to tour and enjoy. Our patient care settings for ambulatory, inpatient, diagnostic and treatment are regularly invested in to keep them at current standard and provide for cutting-edge care.

It's important to note that the original hospital building is not a museum. The whole complex is a living, breathing enterprise. The original, historic sections of the hospital are in daily use either for administrative offices, conference space and events, or open to the public for both private and self-guided tours. Our archives and historic medical library are accessible to researchers. These records and book collections are historically significant and relevant today because they were never created as a collection of rare artifacts or books — but as a working library in a working institution that was and is treating patients — as well as teaching future generations of care providers.

Q: Do you see the hospital's reputation as one of the oldest hospitals in America as being a strategic advantage in any way? If so, how? Is it ever a disadvantage?

TL: Being the nation's first hospital is a wonderful recruitment tool; again linking the long history and rich tradition of innovation and compassionate care to our current business development goals. There is a long and growing list of "firsts" for Pennsylvania Hospital. I remind the PAH community that we must carry on that tradition of innovation.

As for recruiting physicians, it's important that we convey to them that "old" doesn't mean "old-fashioned." Being a part of Penn Medicine — including the Perelman School of Medicine — helps us ensure that Pennsylvania Hospital remains at the forefront of medical care, research and education.

Q: How does this hospital's history impact its culture?

TL: There is a deep-seated pride at Pennsylvania Hospital that certainly is rooted in the historic significance of the organization, but there is also modern day esprit de corps that our physicians and staff bring to bear each day. Our patients, families and visitors are enveloped in the tenets of the Pennsylvania Hospital seal of the Good Samaritan: "Take care of Him and I will repay Thee."

The story of the Good Samaritan was purposely chosen in 1751 by our hospital's co-founders Benjamin Franklin and Dr. Thomas Bond, to be the official seal. Their views ushered in a new attitude of social responsibility, one that we're proud to maintain to this day.

We also celebrate the hospital's May 11th birthday each and every year with a cake and party for hospital staff, employees and volunteers.

Q: As executive director, what would you like your legacy to be at PAH?

TL: I would like my legacy to be one in which I provided an environment that stimulated and encouraged physicians and staff to be modern-day innovators who yield improved approaches to treating ailments in a seamless, highest quality, compassionate and patient-centric manner.

Q: If you could serve as executive director for PAH in any time period (other than current day) when would it be? Why?

TL: Given my appreciation for the vision of Dr. Thomas Bond and Benjamin Franklin, it would have to be at the inception of the idea for the nation's first hospital. A problem was identified and I would have welcomed to be part of the solution.



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