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Levy's Cautionary Tale: Don't Call for Transparency When Your Windows Are Dirty

John Commins, for HealthLeaders Media, May 10, 2010

If you're in healthcare—or if you're just a scandal fan—you've probably been following the imbroglio surrounding Beth Israel Deaconess Medical Center CEO Paul Levy.

Levy, an avid blogger, media darling, and outspoken champion for transparency in hospital quality and costs, has been downright opaque in his public response to what he called "lapses in judgment" and what the Boston newspapers are calling an improper personal relationship with a female subordinate.

For brevity's sake—and to deflect accusations that I am piling on—I refer you to the local media, and note only that the board at Beth Israel Deaconess this month fined Levy $50,000 for his still-undisclosed lapses. They said they were disappointed in his conduct but still support him and that the matter is now closed.

So why has this scandal gotten so much attention? First, Levy is the CEO of a powerful and trusted institution. By the nature of their jobs, all hospital CEOs are held to a higher standard of conduct. As Spiderman's Uncle Ben told the super hero, "With great power comes great responsibility."

Second, Levy's calls for transparency—whether unfairly or not—raise expectations that Levy should have nothing to hide. There may be valid reasons why Levy hasn't detailed his lapses, but that doesn't quell speculation about what he did, and who he did it to, no matter how much the hospital board tells the rest of us rubberneckers to keep moving folks, show's over, nothing to see here.

Levy's lapses don't necessarily demonstrate that he is a bad guy or an incompetent leader—only that he is human. But those lapses provide us with a cautionary tale about the double-bladed nature of transparency. Don't call for transparency if your windows are dirty.

The real harm in these lapses, however, is that they corrode institutional trust from within. The public will quickly forget this relatively mild scandal, as there is always a steady stream of men behaving badly in the media: Mark Sanford, Tiger Woods, Jon Gosselin, Ben Roethlisberger, Charlie Sheen, John Edwards, David Letterman, Jesse James, etc. Take your pick.

Employees at Beth Israel Deaconess won't be so easily distracted. The Boston Globe reported that Levy's favorite female subordinate had a good job while she was with the hospital, and collected a nice severance package when she left. Of course, that has prompted grumblings–as noted by the Globe—about how this person got her job, and whether the severance package was due in some way to her relationship with Levy. I have no idea if any favoritism was shown, but those questions should be expected given the circumstances.

Levy apologized on his blog, Running a Hospital, and said he hoped "this series of events and revelations will not undercut the importance or validity of what I have been saying. I especially apologize to you if you feel that I have let you down and, in so doing, in any way weakened the case I have been making.''

Somebody told me once—on an unrelated topic—that while healthcare workers might forgive, they never forget. Could you blame any employee at Beth Israel Deaconess for being just a wee bite skeptical the next time Levy talks about the hospital's values, its openness, or its healing mission?

Levy can never again make the call for transparency and openness in healthcare with the same authority and not run the risk of ridicule. If he isn't more specific about the nature of his lapses, such as what–for example—prompted him to pay a $50,000 fine, he should probably abandon the whole "transparency" argument. Hand it off to someone who is more transparent. It's an important issue and the case must continue to be made.

Now, when Levy talks openness, it's no less true, but it's not believable.


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John Commins is a senior editor with HealthLeaders Media.

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