Blog Post

Healthcare Upside/Down: Patient Experience is Key

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ECG’s radio show and podcast, Healthcare Upside Down, offers unfiltered perspectives on what’s working in US healthcare and what’s not. Hosted by ECG principal Dr. Nick van Terheyden, each episode features guest panelists who explore the upsides and downsides of healthcare in the US—and how to make the system work for everyone.

Many years ago, I had the fortune of being involved in what was a once-in-a-lifetime opportunity—building a brand-new, independent hospital from the ground up.

The project started as an empty field and ended up as a 250-bed hospital with 21 operating rooms, 2 CT scanners, 2 MRI scanners, and the capability to install an intraoperative MRI—something that was not available at the time, but we wanted to future-proof the facility. We even added a large hotel to the complex—something that was unheard of then but represented an essential component of a full-care facility designed to treat patients from around the world.

Joining us on episode 46 of Healthcare Upside Down is David Klein, MD, Chief Executive Officer of MarinHealth.

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The insights I gained from that experience continue to shape my belief that healthcare delivery should benefit the ultimate customer: the patient. Maybe that sounds basic or obvious, but it’s an approach that doesn’t seem to be widely adopted. This may be the result of the move to larger healthcare systems and the challenge of keeping things personal as organizations grow in size.

For many patients, these large facilities can be difficult to access because of geography and distance. And as we have heard in previous episodes, the local hospital remains a central part of every community.

Dr. David Klein is a general surgeon by training, but he expanded his role to run a number of healthcare facilities. He is currently the CEO of MarinHealth, an independent hospital in California, north of San Francisco. On episode 46 of Healthcare Upside Down, he talks about the lessons he’s learned over the course of his career—and what independent hospitals can do that many major healthcare systems cannot. Below are a few excerpts.

The role of the independent hospital in the community.

I think there still is a role for independent, market-based healthcare systems. Healthcare is really local. Something that I noticed being part of the larger healthcare systems is that they weren’t quite as focused geographically on the specific needs of a community versus looking at the entire system. One of the things that I’ve enjoyed in my current role is that we focus on our community—we meet the needs of the community, we can be invested in every aspect of community so that we provide the appropriate care. I think that makes a difference.

Advantages of an independent hospital over a larger system.

I’ve had the opportunity to work for very large companies, some of the biggest on the for-profit and not-for-profit side. [MarinHealth] is a strong community hospital. In fact, we’re thriving right now in a post-COVID era, where I think some of the larger systems are struggling. One of the things that has always appealed to me is our ability to truly be nimble, to make decisions on the fly based on what our current needs are. It could be decisions on how we spend capital, add service lines, take away service lines, or meet the needs of a subsegment of the community, which I can decide along with the team and the board at a moment’s notice. When I was with larger systems, it took sometimes an act of Congress, if you will, to get major initiatives done.

Three secrets to MarinHealth’s success.

“I think it’s simple: always put the patient at the center of every decision. No matter what the decision is—whether it’s financial, a building, adding services—if you always keep the patient at the center of every decision, it’s always going to be right.”

“Always do the right thing for the right reason. Ask yourself the question: ‘Am I doing this for the right reason?’ If the answer’s no, then you probably need to not do that.”

“Every decision you make has consequences. Some of them are life-saving or life-threatening consequences. There are many, many different folks who can be impacted by a single decision.

So I go through a decision tree in my head—who’s it going to impact? What are the potential outcomes? That’s been really good guidance for me.”

On the podcast, Dr. Klein talks more about the role that independent hospitals play in their communities and why he urges his workers employees to reflect on the lives they touch every day.

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Edited by: Matt Maslin