Paul King has served in leadership roles at some of the country's premier healthcare organizations, including Mayo Clinic and the University of Michigan.
After serving in leadership positions for more than three decades, the new top executive at Stanford Children's Health has a wealth of insight to share about management principles and pediatric care.
In January, Paul King, MHA, was named president and CEO of Stanford Children's Health and Lucile Packard Children's Hospital in Palo Alto, California. He started his career at Mayo Clinic, including working as the operations manager at the Mayo Clinic facility in Scottsdale, Arizona, when it was opened in 1987.
King has worked in pediatric medicine administration since 1996, when he joined Children's Hospital Los Angeles as president and CEO of the organization's Pediatric Management Group. He worked at CHLA for 18 years. Before joining the chief executive leadership team at Stanford Medicine, King led the University of Michigan's C.S. Mott Children's Hospital and Von Voigtlander Women's Hospital as executive director.
HealthLeaders recently spoke with King to find out about his perspectives on pediatric medicine and healthcare leadership. Following is a lightly edited transcript of that conversation.
HL: Why have you devoted the bulk of your career to pediatric healthcare?
King: The ability to have an impact on a child's life is pretty intoxicating.
From a fundraising standpoint, whenever we have an opportunity to meet with some of our supporters, the most powerful moments are when we can bring out a former patient who has an extraordinary story to tell with some sort of health condition. Then there's a tearful moment, when they introduce their family. They bring out their babies and their children. You see the full circle of life—we were able to intervene in a meaningful way to change their lives to the point where they have a family of their own.
Another attractive part of pediatric medicine is the sharing of knowledge. Compared to adult care, there are higher rates of cure and faster rates of improvement in pediatric medicine. In the pediatric space, we tend to share with each other. When we find something that works—we share that broadly with everyone.
HL: What is the most daunting challenge in pediatric medicine?
King: When we think about kids, they are a small portion of the national spend on healthcare. And when you are talking about pediatric care, you are often talking about Medicaid. We all agree healthcare needs to be reformed. The challenge for us in children's healthcare is to make sure that as healthcare is reformed it is done in a way that does not harm kids.
At most children's hospitals, close to half of their patients have their bills paid for by government programs—primarily Medicaid. So, the top 20 children's hospitals such as Stanford have a significant part of their budget supported by the government. Here at Stanford, about 40% of our budget is supported by California's version of Medicaid: Medi-Cal.
So, when you think about the best children's hospitals in the country, they are good because of the fundamental supporting structure that is provided by the government. That is not exactly intuitive when you think about the Medicaid program—most people tend to think about that program as being for poor kids. But it provides an infrastructure that supports all kids. We think that is a message that resonates whenever we get in front of our legislators—the unraveling of the public safety net can lead to the unraveling of the entire healthcare system.
HL: What is an emerging area of pediatric healthcare that you find most exciting?
King: One area where Stanford Medicine would like to carve a niche and make us more distinctive is precision medicine. We can look at a patient's genome and figure out a specific disease such as cancer and how we can customize an intervention or a care plan that is unique to the patient's genetic makeup. A traditional medication may be effective for a high percentage of patients across a population, but it may not be effective for specific individuals.
For example, with precision medicine you can create an intestine in a test tube, then provide medications and interventions to that organoid rather than having to put the patient through treatment directly. We think that precision health is the future of medicine, particularly as more and more organizations learn about genetics. That's an area for children's health that is very exciting.
HL: What is a primary area that needs to be addressed to improve maternal mortality?
King: The good news is that here at Stanford some of our staff members and researchers have been leaders in this space. Also, California has been bucking the trend that has been seen nationally. While maternal mortality rates have gone up nationally, California has been reducing maternal mortality rates.
One question is why the doctors at Mayo or Stanford are better than doctors elsewhere. It's not that they are better—it's that practice makes perfect. Most of the better health centers have higher volumes, so they are used to seeing complications and they can recognize them more easily.
One of the factors to improving maternal mortality is making sure the data generated from high volumes of activity is shared broadly, and we need to engage as many partners in that improvement process as possible. You get better performance by sharing your results with others. Then, when those other centers share their results, it becomes a virtuous cycle.
HL: What advice do you offer to emerging healthcare leaders?
King: I have been very blessed to have been recruited to every job I have had in 35 years in the healthcare field. The main factor that contributed to my good fortune was my willingness to be curious, and my willingness to pursue opportunities that may not have appealed to me right out of the gate.
It's also important to surround yourself and expose yourself to people who are different than you. When you think about diversity, equity, and inclusion, you can't limit yourself to the workplace. You should be thinking about these areas more broadly—this kind of education doesn't just happen in the classroom or the workplace. It's about how you live your life.
HL: Why is exposure to diversity so important for healthcare leaders?
King: For example, there is the inequity in the issue of maternal mortality for African Americans. When you think about the healthcare access barriers for the different populations in this country to get prenatal care, there are social determinants such as economics and culture impacting the kind of experience that a patient will have when they come in for care. They will ask unique questions of their care providers, and there will be different power differentials created when they are interacting with their care providers—these will be different with different patient populations.
The more experience you have with a diverse group of colleagues, the more you will learn that people don't look at the same issues in the same way. Men and women are different. There are different cultures. Diversity is more than skin deep. It's diversity of thought and diversity of economic background. All of those things bring a richness of experience to solving problems that a singular way of thinking just does not provide.
Christopher Cheney is the senior clinical care editor at HealthLeaders.
Paul King, the new chief children's health executive at Stanford Children's Health, says compared to adult care there are higher rates of cure and faster rates of improvement in pediatric medicine.
Financing is the most daunting challenge in pediatric healthcare, while precision medicine is the most exciting development in pediatric care, King says.
To address the country's rising maternal mortality rate, he says it is essential for healthcare organizations to share data and best practices.