Becker's Hospital Review

20 POPULATION HEALTH 20 CEO / STRATEGY 'Corporate leadership must go. All of them': Physician urges Beaumont to oust top execs By Ayla Ellison R obert Safian, MD, a cardiologist at Southfield, Mich.-based Beaumont Health and a professor at Oakland University Beaumont School of Medicine, sent a letter in November to the health sys- tem's board of trustees urging them to oust Beaumont's top executives. Dr. Safian, who came to Beaumont in 1991, began his letter by praising past and current physician leaders at the health system. e letter, obtained by Deadline Detroit in No- vember, goes on to say that corporate leader- ship "has created a culture of fear and intimi- dation" over the last five to seven years. "is toxic culture has been progressive- ly worsening over the last few years, yet the turmoil has peaked in the last few months as a result of two separate events: the proposed sale of Beaumont to Advocate Aurora and a looming crisis in the Department of Anes- thesia that is now spreading to other depart- ments," Dr. Safian wrote in his letter. "As a result of the toxic culture, in 2020 alone, over 100 physician-leaders at Royal Oak will have relocated outside southeastern Michigan, provided verbal or written intentions to leave Beaumont, or will remain on staff but move substantial portions of their practices to other local institutions." In June, Beaumont announced that it hired NorthStar Anesthesia to provide anesthe- sia and pain services at the system's Grosse Pointe, Royal Oak and Troy, Mich., campuses beginning Jan. 1, 2021. Dr. Safian described the "crisis" in the anes- thesia department as one "created by corpo- rate leadership in a gamble to prioritize profit over patients." He said the decision will re- sult in lower quality specialty anesthesiology services in 2021 and "has upset the personal and professional careers of hundreds of Beau- mont anesthesiologists and CRNAs." Dr. Safian ended his letter with a call to ac- tion: "Corporate leadership must go. All of them." In a Nov. 16 statement to Becker's Hospital Re- view, Beaumont said it had received Dr. Safian's letter and will meet to discuss his concerns. "is has been a very challenging year for many reasons," Beaumont said of 2020. "We are proud of our physicians, nurses and staff that have continued to provide extraordi- nary care, every day at Beaumont through- out this pandemic. We also deeply value the contributions that donors provide to Beaumont Health." In October, Beaumont and Advocate Auro- ra Health, which has dual headquarters in Downers Grove, Ill., and Milwaukee, called off plans to merge. e merger plan faced criticism from some Beaumont physicians, nurses and donors. e deal was canceled aer a survey, completed by 1,500 of the system's 5,000 physicians, revealed a lack of confidence in Beaumont's leadership and concerns about its proposed merger with Advocate Aurora. n What the 'health system of the future' means to Sutter, Temple execs By Morgan Haefner T he rise of retailers and a transition to outpatient ser- vices are just two realities that will shape the health system of the future. That's a consensus Rishi Sikka, MD, the president of sys- tem enterprises at Sutter Health in Sacramento, Calif., and Larry Kaiser, MD, the former president and CEO of Temple University Health System in Philadelphia, shared during a panel session at Becker's CEO + CFO Virtual Event Nov. 12. The panel was titled, "What does the successful system of the future look like? Strategies to continue, or changes that need to be made for system success." Here is an excerpt from the conversation, lightly edited for clarity. Question: How would you define the health system of the future? Dr. Larry Kaiser: No longer is the centrality of medical care the inpatient setting. For those of us who've run sys- tems, that's where we generate the most margin, but it clearly is not where we're going to be concentrating in the future. You have to look at more disseminated mod- els, including the outpatient and home settings. We need to look at the rise of retail, at players like CVS basically entering the market, combined with changes in the payer landscape. It's not unreasonable to think that most of us on the delivery side will be working with the payer side as we move forward. Dr. Rishi Sikka: We're seeing the collapse of our business model, which has been based on cross subsidization. Cross subsidization has covered losses from government payers with what's generated in commercial reimbursement. Stud- ies have highlighted just how large this cross subsidization is. Honestly, I think a portion of the electorate doesn't really buy into this cross subsidization model anymore. To deal with that cross subsidization issue, health systems of the future will need to focus on health and avoid utilization and acute episodic illness. n

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