This article appears in the December 2011 issue of HealthLeaders magazine.
Some people lament the need for a better way. Others seek it out. The inventors, innovators, and iconoclasts see the future and strive to get us there. Determination and a willingness to take a chance are among the qualities we see in our annual HealthLeaders 20 as they set about dedicating their professional lives to making a difference for good in healthcare. Here, we offer profiles of those selected for our 2011 list.
>>See extended versions of these profiles.<<
Getting Better All the Time
Wright L. Lassiter III
In September, Alameda County Medical Center was recognized as a Top Performer in Key Quality Measures by The Joint Commission, which placed the safety-net health system among the top 14% of 3,099 accredited hospitals in the United States.
That distinction marked the latest affirmation of a remarkable turnaround for the Oakland, CA–based, six-facility public system, which only six years earlier had been near collapse. That turnaround trajectory started in 2005 with the arrival of Wright L. Lassiter III as CEO.
Rather than wielding a budget cleaver and chopping staff, Lassiter hired a like-minded C-suite team that engaged staff to find savings across the organization, which would result in fewer job eliminations.
“We used a team approach to garner revenues, enhance cost savings, and find contract savings,” he says. “We also had a [Centers for Medicare & Medicaid Services] survey of our psychiatric facility that happened six days on the job that wasn’t particularly flattering. It was the first time in my career that I had had a survey go that badly. I used that as a rallying cry for the organization, and I challenged the organization. Do we believe we should go from survey to survey riding correction plans, or are we going to focus on creating discipline to demonstrate that we are better all the time?”
Today, the system, which had been losing money, looks to generate between $3 million and $5 million in net income each year; it has whittled down its debt to the county to about $140 million from about $200 million, and plans to repay the debt by 2018.
The son of an ordained minister, Lassiter says he gains spiritual fulfillment from the success of ACMC. “You get great satisfaction creating a high-reliability, high-quality, high-patient-experience organization and one that treats the people who don’t have lots of options,” he says. “So, to take care of this population is one of those things that gets me up in the morning.”
Caring for the Impoverished
Anne Brooks, DO
Anne Brooks, DO, is a doctor, not an artist—but then again, maybe a bit of both. She says too many of her patients at the small Tutwiler (MS) Clinic smoke too much—their skin wrinkled by years of tobacco intake, their lungs brittle. She tells each of them they are having too many cigarettes, and then she takes pen to paper. She sketches their heart and lungs, and writes down how “tar,” that toxic material, ravages both.
“I draw pictures of the lungs and put tar on the alveoli, where the air goes in, and tell them, ‘If you put tar through the air sacs, how can you breathe?’” Brooks says. “They look at me, and we discuss what it means. It dawns on them what is happening to their lungs.”
For 28 years, Brooks, a Roman Catholic nun, has practiced in one of the poorest areas of the country; that’s why she went to Tutwiler in the first place. She spends morning and night working for her patients, and in the process has become a spokesperson for the country’s needy and has been lionized by various groups for her efforts in helping the poor and improving the healthcare needs of diverse populations.
“I set for myself a little higher standard, and that is what I expect my patients to do,” Brooks says. “I try harder, and they try harder. I yell at them louder, and they laugh at me louder.
“Sometimes I get a little dramatic with them, and say, ‘What are you doing to me?’ They get the point.”
Understanding the Patient’s Need for Understanding
Alex Blau, MD, and Brad Cohn, MD
While working the overnight shift at San Francisco General Hospital, Alex Blau, MD, and Brad Cohn, MD, found themselves at the corner of necessity and invention. The two young physicians in training were in their third year of medical school at the University of California, San Francisco, in 2008, and they were frustrated by their inability to communicate with patients from the Bay Area’s diverse racial and ethnic communities.
“In healthcare, your greatest diagnostic tool is your ability to communicate, to obtain a decent history and a physical exam from your patients. This is difficult to do with patients you can’t easily communicate with,” says Cohn, 29, now a resident in anesthesiology at UCSF and San Francisco
So the pair came up with the idea for MediBabble and formed NiteFloat Inc. to produce an iPhone/iPad app that allows clinicians to better communicate with non-English-speaking patients during the initial exam and history taking.
“This was just something we needed, and we were surprised that it didn’t exist,” says Blau, 35, an emergency physician who has since left medicine to develop MediBabble. He is also medical director at Doximity Inc. in San Mateo, CA. “We both had iPhones, and we thought, ‘Why isn’t there an app that helps us?’ … Then we realized that we were perfectly situated to do it ourselves.”
MediBabble—which is free and does not require Internet access once it is downloaded—focuses on the history-taking process during the initial patient interview. Since it was launched in February 2011, more than 15,000 clinicians have downloaded it.
While it’s not charging a fee for MediBabble, NiteFloat asks users to donate money. “We are technically not a nonprofit, but we are also technically not profitable,” Cohn says.
Seeing a Better Way
George Berci, MD
In the late 1950s, Hungarian George Berci, MD, was in Melbourne, Australia, on a Rockefeller Fellowship, and vexed with a major problem in gallbladder procedures. Surgeons could not see inside the common bile duct well enough to remove the stones.
“The stones were overlooked, and approximately 12% of patients had to undergo another procedure to remove them,” he recalls. “I thought it would be nice to insert something in the duct that would let you remove the stones under visual control.”
Berci sought help from a London physicist, and they developed a rod-lens system that vastly improved the visual field for this procedure. “The light was much brighter. And the optic had much greater quality of the image regarding sharpness and viewing angle,” he says.
That was just one of many technical advances Berci has brought to the field of instrumentation in laparoscopy and several other endoscopy procedures during his career.
He helped develop ways to televise surgeries so that physicians were better able to teach medical students how to perform procedures. “We developed the first miniature endoscopic TV camera in 1962.” His innovations helped develop numerous surgical instruments, including cytoscopes, resectoscopes, and nephroscopes.
Berci stopped performing surgery 20 years ago, but at age 90, he continues as the senior director of the endoscopic research laboratory at Cedars-Sinai Medical Center in Los Angeles. He goes in every day around 6:30 a.m. “I run around the hospital,” he says, even sometimes taking the stairs to quickly get up and down the building’s four floors to help active surgeons to observe new procedures, using new modern video endoscopes.