His job: Guiding St. Mary's growth

Q. What convinced you to take on the job at St. Mary's and move your family from Indiana?

A. In 2004 I was called by a recruiter about the opportunity at St. Mary's. They had begun their search for Jerry Lefert's successor. The first couple of times she called I wasn't that interested. We had been here once before. Our daughter, Lindsay, had been accepted (at UW-Madison). ... We really saw how great Madison was but we weren't sure we wanted to move (from Fort Wayne). Cindy and I had thought about it and that we'd been in one place for 22 years. We had been in a discernment process for two years where we knew that I had enjoyed the work I had done for a period of time there, but I had this feeling there was something more appropriate for me to do professionally. ... The recruiter called and said "just come take a look at it."

They had us at "hello" when we came here. It was a bitterly cold February day and I see this young man, his name is Ben Peters, in a red jacket running back and forth to get people their cars. And I saw the way he was interacting with the people (as a St. Mary's valet). I watched him for about 20 minutes and he finally had a breather. And I said, "I'm here visiting Madison and I'm pretty impressed with your work." He said, "Well, I'm the first person that most people encounter at St. Mary's and I'm the last person they encounter when they leave. If they don't have a good experience with me they won't think well of St. Mary's." I thought, wow, great attitude. I like that. ... I was impressed with the culture and compassion that people demonstrated here. We wanted to be part of an organization like that and a community that was going to be positioned to create what's next in health care in this country.

Q. What is next in health care in the United States?

A. We need health care that is safe. We need health care that is accessible and equitable and we need transparency. People, as they choose their health-care provider, need to have information about the quality, about the safety, about the cost. One of the things we found very quickly, as we looked into coming to St. Mary's ... is that Wisconsin and Madison have been leaders in patient safety, leaders in transparency and disclosing quality information.

Q. Why is this community positioned to be a leader?

A. We have what I view to be the premier health information technology company based right here in Verona, Epic. And we're all partnering with Epic, both on the inpatient and outpatient side. We are positioned to have records that you can get to wherever you are. That's our responsibility. Some people thought that in the past you would come to them to get your health care because you had their electronic health record. Well, who owns your health record? You do. So it's our responsibility to do everything we can to get your record where you are, where you need it.

Q. What is the most challenging part of your job right now and the most challenging thing for the hospital?

A. We are in the midst of several initiatives that are what I describe as "You bet the future" initiatives. Number one is our expansion. We are building an expansion that is designed to be flexible and adaptable to treat patients we can't even imagine today, with technology that hasn't been invented yet. So, we've designed this facility with that in mind and to be an integral part of the community. So that's a key challenge. Designing and building it was the easy part, activating it and delivering the care is the hard part. ... The second thing is our migration to the electronic health record, which is essential. One of the things that attracted me here was the commitment to getting out in front of the electronic health record issue. Health care, regrettably, has under-invested in information technology. We're 15 years behind industries like banking.

We've hidden behind excuses, like our transactions are more complex. I'm sorry to tell you, but I've seen a lot of complex transactions in other companies and other industries I'm associated with. So that's an excuse. The good news is we're catching up and this community and our organization, our Dean and St. Mary's family, is going to be a leader. I also have the good fortune that the physicians are leading this. Rather than some other parts of the country, where the doctors are dragged into the electronic world, our doctors have already not only excepted and embraced but implemented it in their ambulatory setting. And what they've learned is being transferred to our implementation on the inpatient side.

Q. Hospitals seem to do a lot of marketing. Don't people just go to the hospitals and doctors covered by their insurance? Why is marketing so important to the industry?

A. I think people are not going to go, regardless of their insurance restrictions, where they don't want. Sure, their insurance card might say one thing. But if they're not confident in and trusting of the caregivers who are going to provide care, they'll make other arrangements. Second of all, consumerism is the most important, or certainly one of the top two or three most important trends in health care in this decade. And it will only increase.

We want people to know who we are and what we do and we want them to think of us when they need health-care services. That's one of the reasons we're reaching out a little bit more than in the past. And marketing is not just some TV commercials and some billboards. There is so much more than that. We have an outreach coordinator in our public relations department, Stephanie Johnson, whose job is to go out and meet people where they are. The days of building a hospital and saying, "We have what you need. Come on down," have long since passed.

Q. What happened to force that change?

A. First of all, there wasn't a whole lot people could do. You come to the hospital for bed rest for nervous exhaustion or traction if you had back pain. Now, there's so much that can be done and it's so technical. Secondly, we're not just about "OK, we're a hospital and if you get acutely ill, come and see us." We're part of an integrated delivery system with distributed access points throughout 18 counties. We approach the people we serve as a system, not as isolated, discreet, unconnected events.

Q. When mistakes are made in the hospital and people are injured or die, how does a hospital recover from that?

A. Our first concern whenever there is a mistake, especially a mistake with harm, is for the patients and families who are affected. And we do everything possible to support them, beginning with informing them. Our policy is one of disclosure and transparency. While its difficult, it's the right thing to do. That's step one.

Step two is to learn everything you can when a mistake occurs and do everything possible to prevent this from happening. As a practicing physician as well as a health-care leader, I've had the duty to dispense bad news from time to time to patients and families. And the common theme from everybody I talk to is: What can we do together to make sure this doesn't happen again or doesn't happen to somebody else. And so, that's what our commitment is. That's how you recover. That's how you heal. That's how an organization heals.

Q. What does it take to run a hospital well?

A. Nobody runs a hospital. No one person runs a hospital. I can say most days I feel like the hospital runs me. (The writer and management consultant) Peter Drucker said, probably 15 years ago, that the modern hospital was the most complex organization that he had ever studied. And it hasn't gotten any less complex since professor Drucker said that. What it takes is this, you have to start with great people who are passionate about and dedicated to their work and are focused on serving the people who depend on it. You have to have clear goals, and we do. And clear expectations and everybody has to know what their part is.

You have to kind of break down whatever mentality that might exist and think of things as a system. We have a thing here that we use at SSM called the passport. In the passport, we have not only our mission and values, but also our overall goals as a system. Our entity goals and then what our personal part of that is. ... We believe that everyone is a leader and that everyone has good ideas and, frankly, accountability. So, we have a very advanced shared decision-making process where the people who are doing the work have input into what the work is and how the work should be done and what resources are needed.

Q. Do you ever miss just being a doctor?

A. Every day. I love the work I do now. I love the people I work with. And I love the fact that my job is to support the people who do the real work at St. Mary's. ... It is very meaningful to me. But there is nothing in administration that offers the immediate personal satisfaction and gratification of the caregiver/patient relationship. At the end of every day in my office in the (intensive care unit), I could reflect on who I could help. The immediate personal satisfaction that you get from that is ... it's a sacred trust and an honor to be in that position where people entrust their health care to you. And I miss that every day.