This Part 1 of a two-part interview. Part 2 will be published in Tuesday’s edition.
After his first full week as interim chief executive officer of T.J. Samson Community Hospital, Glasgow businessman Henry Royse – who replaces the recently retired CEO Bill Kindred – sat down this week with members of the editorial staff of the Glasgow Daily Times to answer questions.
Q: What’s been the thing that’s been the most unexpected so far in your new position?
A: I think the most eye-opening thing is there’s 1,200 people who work at the hospital and how much they love what they do. To walk in there in the morning every day at 8 o’clock and see everybody glad to be there, it’s just amazing with all these huge jobs they all have, but they all really like coming to work.
Q: So, morale is good?
A: Yes, everybody really, really seems to enjoy being there. I’ve been trying to come in a little bit different ways because I want to – I just know so many different people and I don’t want to be invisible and it’s just everybody really likes the task at hand of providing health care. I wouldn’t call it unexpected, but I’m saying it’s just nice to see. You don’t see that when you’re on the board because you’re not there on a regular basis.
Q: How long were you on the hospital’s board of directors?
A: Thirteen years.
Q: And how much of that time were you chairman?
A: Four years.
Q: You are interim CEO for up to a year while they do the search for a permanent one?
A: Yes, that’s right.
Q: Has the search committee been formed yet?
Q: Who all is involved with the search?
A: I need to double-check on the names and make sure who the search committee is going to be. I’m on it as a sort of an adviser or whatever to help them kind of coordinate it if they want to do some advertising and stuff like that. To recite to you exactly who’s on it right now, I want to double-check and make sure because there might have been somebody there who I didn’t see or that otherwise was not able to come.
Q: How large of a group are we talking about?
A: About six people, I think. Obviously, I wasn’t the chairman of the board when the decision for Bill [Kindred] to retire – when he made that decision – so I didn’t pick that search committee.
Q: The new chairman of the board is Dan Foutch?
Q: And that change took place in November?
A: Yes. At the end of our fiscal year, which would have been at the meeting in November.
(A later e-mail from Foutch confirmed the search committee members are Mike Bryant, chairman; Follis Crow; Joey Botts; and Dr. Sunil Muppala.)
Q: Is everyone on the search committee a local person?
Q: Is there an outside firm involved in the search at all?
A: Not yet. I think the purpose of the search committee – the original organization of the search committee is to identify sources of potential candidates. It might be through Kentucky Hospital Association. ... Of course, word is out. I mean obviously it’s like the newspaper business or any other business. The word is out because you know Bill was very connected with Kentucky Hospital Association and very well-known and very well-liked. So, there’s just a lot of people who knew he’s gone and everybody’s kind of waiting to see what happens next.
Q: Is this a national search?
A: Well, it could be. I mean, there’s no restriction on it. I can’t tell you that there is any national firm that’s been secured to do this. I think what the committee is doing is identifying – you know, it has to go through Kentucky Hospital Association. It has to go through some people who we have used on a statewide basis before for things.
Q: As far as candidates, they could come from ... ?
A: From anywhere. Right. Sure.
Q: Back to your position this year. What do you see as your primary role during your tenure?
A: Health care is at one of the most important times in the history of healthcare. We’re beginning the [Affordable] Care Act. We’re also beginning the government’s requirement that we integrate electronic medical records, which is crippling healthcare systems across the country. We’ve been involved in it – we’ve been live since April of last year, but it is an ongoing [process] – you know it’s not necessarily something that we just throw the switch and we’re done. And so, my challenge is to make sure we move forward with the electronic medical records because the government is going to require us to have that, but also making sure we have in place all the different people who make whatever the [Affordable] Care Act turns out to be – plug it into our hospital and help us with any problems complying with all that.
Q: Was that one of the primary motivating factors for T.J. Health Partners, for consolidating all those aspects under one umbrella so that it would be more cost effective and affordable for physicians?
A: Physicians were faced with having to comply with the electronic medical records and that compliance was also going to include being able to interface with the hospital’s electronic medical records. You throw that factor in, but you also have to throw in the fact that young physicians are not coming out of medical school wanting to become businessmen. They didn’t want to buy buildings or rent buildings. They didn’t want to hire staff. They didn’t want to pick out furniture. They love practicing medicine. And we all know physicians. They love practicing medicine. Now, in a rural health care setting, one of the responsibilities – I know it’s hard for people to understand this thinking out in front of the curve – but one of the responsibilities of T.J. Samson Community Hospital is to make sure this community has viable healthcare choices and so we have to make it to where we will be able to track bright, young physicians so we don’t wake up one day and we don’t have even family practice physicians. Then the other reason – the other thing – about that is the other piece of that is the hospitalist, which has been very hard to get going. We’ve got it going, but there’s just young physicians who don’t want to be on call 24 hours a day and we’re competing for these young physicians with hospitals that already have employed physicians and medical office buildings and things of that nature. The reason for it is to make sure that we’re able to attract the best there is out there.
Q: In your current hospitalist program, how many physicians are actually in the hospital seeing patients as part of that program?
A: The hospitalist program is run by Dr. Bill Travis and a full complement of hospitalists would be six and we have a couple we have been using what they call locum tenens. We’re waiting for a couple of the hospitalists to actually finish their residency and be available and we think in May we’ll have the full complement.
Q: So now you have Dr. Travis overseeing four and then two more are coming?
A: Yes. Dr. Travis has observed the first two people we contracted with and plugged what our needs are locally and he’s brought – the purpose of the hospitalist is to allow the physician to admit someone to the hospital knowing that they’re going to get care and have them monitor the care. Dr. Travis being the person who is well-versed in where they’ve been, in other words, the primary care provider. He has a unique perspective of what the hospitalist should provide when you go to the next level of care.
Q: This is in no way a mandatory program? Physicians can go to the hospital and admit their own patients if they want to?
A: Sure. And we have a number of them who do. But again, it’s looking at the future of health care. A young physician coming out of school [says,] “They don’t have a hospitalist program and I have to go out and rent a building because they don’t employ physicians. I’m not going to consider them.” I think the community might not understand it now, but if on down the line if they don’t realize that we did this in advance of knowing what the future was going to bring.
Q: There were misconceptions in the community about T.J. Health Partners. Can you explain the difference between “buying their practices and their physical buildings” and what happens when physicians who have their own practices join the partners group and no longer have individual practices?
A: We don’t buy practices. We employ physicians. If you stop and think about it, that is a definitive difference in the way we do things because we are looking for good physicians and it needs to make sense for these physicians to step out of their established practices and become an employed physician of T.J. Health Partners. As far as buildings go and things of that nature, obviously part of the economy of scale is to have the physicians where that we – for the purpose of things in the future known as bundled payments – that we have to have kind of a one-stop, walk across the hall and get an X-ray done, walk across the hall and get an EKG done, I’m going to a neurologist, I need to have KUV done. It’s all done right there. Now, the impetus for that goes back to one of the early Accountable Care Act indications that under the new laws they’re going to pay us one check. It’s called bundled payments. You come in with pneumonia. They’re going to give us X number of dollars to cure your pneumonia, so to speak. And that has to cover the drugs. It’s got to cover the tests. It’s got to cover the hospital stay. … It’s one check and so who’s going to outsource that? Who’s going to subcontract or whatever with the lab and all that sort of stuff? And it just made sense for us to try to have as much of that as possible as we could. Now obviously, we have some physician practices that are employed by T.J. Health Partners, but they’re not over here at the pavilion. Some of that is because we have space restrictions right now. We’ve plumbed the third floor, but we haven’t finished the third floor thinking about the future growth. So we do have, for example, the OB/GYN practice with Drs. Dirig and Craddock. It’s a huge practice and we leased the building from Dr. Bravo while we were trying to, in other words, I don’t know, it’s not a real long lease, but we needed a place to have them and that was going to be the simplest – like I said, their practice is huge and we needed to have stability right there for that.
And we’ve got a surgery clinic with Dr. Klapheke and Dr. Peterson. We’re still leasing that building right now. It’s only because there was no [room]. It was never part of the negotiations for somebody becoming a partner. That was just to have a place to house them so they could practice medicine while we were trying to make sure we had a [place]. ... It would look like out goal would be to have offices under one roof. That’s certainly not the case because it makes more sense for some than others to be underneath when you’re talking about tests and things of that nature. But it was truly a space problem where we weren’t going to finish out the third floor, which would have been a good place to have taken OB and those kind of things. So, to answer your question about the building situation. If a physician had a building, that was still going to be their building and they can do with it whatever they want to do with it, but there’s no requirement on either side.
Q: In the finished parts of the pavilion, are you pretty much at capacity?
A: Yes. On the medical office building, yes. We’ve got primary care downstairs and we have specialists upstairs. It’s retrofit quite nicely for both of those. … I would be honest in saying it was amazing how quickly it grew. And it’s the situation where we had specialists available to us who wanted to be a part of medical community coming at us faster than we thought and that’s a good thing.
End of Part 1
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