Becker's Hospital Review

35 35 CEO/STRATEGY 18 states with the highest hospital CEO turnover By Emily Rappleye E ighteen percent of hospital CEOs le their roles in 2018, a rate that has been steady for the past five years, according to data from the American College of Healthcare Executives. While elevated, this rate of turnover is still be- low that of 2013, the record year for hospital CEO turnover, at 20 percent. High turnover in healthcare is due to organizational restructur- ing, CEO movement within health systems and retirement, ACHE President and CEO Deborah Bowen said in a press release. Based on ACHE data, public data and data from the American Hospital Association, here are the 18 states with the highest turnover rates for hos- pital CEOs in 2018: 1. Vermont — 36 percent 2. Hawaii — 30 percent 3. Massachusetts — 26 percent 4. Oklahoma — 26 percent 5. Wisconsin — 25 percent 6. Texas — 24 percent 7. Utah — 23 percent 8. Mississippi — 23 percent 9. Arizona — 23 percent 10. Connecticut — 22 percent 11. Missouri — 22 percent 12. Kansas — 21 percent 13. Arkansas —21 percent 14. Tennessee — 21 percent 15. Nebraska — 21 percent 16. Iowa — 20 percent 17. Rhode Island — 20 percent 18. Alaska — 20 percent Data is based on nonfederal, general medical and surgical hospitals. n Physician viewpoint: Hospitals exploit the goodwill of physicians, nurses By Emily Rappleye A s healthcare becomes increasingly corporatized, administrators lean on the good faith of clinicians to get the job done — and they may be leaning too hard, according to an op-ed published in The New York Times by Danielle Ofri, MD, PhD, an attending physician at Bel- levue Hospital in New York City. Physicians and nurses almost always do what is right for patients, even if that means working extra shifts or putting in hours at home to log EHR data. "I've come to the uncomfortable realization that this ethic that I hold so dear is being cynically manipulated," Dr. Ofri wrote. With productivity maxed out, administrative creep sets in, so going above and beyond has become the norm for most clinicians, according to Dr. Ofri. "If doctors and nurses clocked out when their paid hours were finished, the effect on patients would be calamitous. Doctors and nurses know this, which is why they don't shirk. The system knows it, too, and takes advan- tage," Dr. Ofri wrote. This workload is unsustainable: Dr. Ofri pointed to high and rising levels of burnout among physicians and nurses. The solution, she wrote, is to cut administrative positions — which outnumber physicians 10-to-1 — and use those salaries to hire more clinicians. n Mike Pence's quiet takeover of HHS: 3 things to know By Morgan Haefner V ice President Mike Pence may be quietly influencing HHS' policies on family planning and religious protections for healthcare work- ers through top-level appointments and other ties to the agency, according to Politico. Three things to know: 1. Several of HHS' top leaders, including Secretary Alex Azar, Surgeon Gen- eral Jerome Adams, MD, and CMS Administrator Seema Verma, are linked to Mr. Pence and his home state of Indiana. For example, Mr. Azar was a top executive at Indiana-based drugmaker Eli Lilly when Mr. Pence served as gov- ernor of the state, and Dr. Adams is a former Indiana public health official. 2. In addition, Ms. Verma was Mr. Pence's health adviser in Indiana. Her deputy chief of staff, Brady Brookes, served as Mr. Pence's former Indiana legislative director. Likewise, Rebekah Armstrong, who oversaw domestic policy for Mr. Pence at the beginning of his tenure as vice president, now holds an office in HHS' legislative affairs office, according to Politico. 3. While there are links between Mr. Pence's anti-abortion agenda and the administration's changes to federal family planning programs through Ti- tle X funding, multiple standing and former officials told Politico the vice president is not directing policies at HHS. "There have been many staff level meetings on pro-life issues with HHS. He and the president will always advocate for pro-life policies," a White House official told Politico. n

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