Boston is abuzz with speculation as to who will be chosen to succeed
Gary Gottlieb as he steps down from the helm of Partners Healthcare
System. WBUR's Martha Bebinger notes:
Several internal candidates are being suggested to succeed Gottlieb including Mass. General CEO Dr. Peter Slavin, Brigham and Women’s President Dr. Betsy Nabel and Dr. David Torchiana, CEO of the Mass General Physician’s Organization. Dr. Tom Lee, who left Partners last year, and Dr. Mike Jellinek, who moved from Partners to Lahey Health earlier this year, have also been mentioned as possible candidates.
The answer, sadly, whether it is an internal or external candidate, is that it won't matter much. If there was ever an example of "a cost structure in search of revenue streams," Partners is one. As I have noted:
No matter how innovative or entrepreneurial a firm might have been at its start, once it is has been in existence for some time and has an established place in the social economy, its goal in life is to persist. It leaves the world of innovation, often loses its purpose, and exists solely to exist, i.e., to cover its costs. Often this is a reflection of the corporate hierarchy, where, sadly, leaders lose their sense of providing true value to their customers, intent instead on aggrandizing their own position and preserving their status. The firm no longer reflects the creativity of risk-taking, becoming a bureaucratic shell of its former glory.
Especially so when the firm has a dominant market position, aided and abetted by government policy, insurance company timidity, and an apathetic business community.
Perhaps change could come from within, but there is little or no interest in change from the faculty within the large academic medical centers at Partners' flagships, Massachusetts General Hospital and Brigham and Women's Hospital. They are basically content with their exalted status in the world of clinical care, education, and research. Their clinical practices are fed by an extensive network of primary care physicians and community hospitals. Their position vis-a-vis undergraduate education at Harvard Medical School and graduate medical education in their fields is secure. Their laboratories are amply supported by grant funding and/or departmental support from their hospitals.
So, if you are on the board of trustees of Partners searching for a successor, you do not seek an agent of change. You seek another person who will maintain the status quo with regard to market dominance, finances, faculty relations, and state politics.
The only way this organization will diverge from the path it has maintained is if there is decisive action that forces structural change, that recognizes that the current structure is harmful to the state economy, slow moving with regard to advancement of clinical expertise that would reduce harm to patients, and inimical to the advances that would come from real competition. Such action would have to come from the government, the insurers, or the business community--or better yet, all of them together. Until or unless it does, expect a clone to be appointed as the next CEO.
Several internal candidates are being suggested to succeed Gottlieb including Mass. General CEO Dr. Peter Slavin, Brigham and Women’s President Dr. Betsy Nabel and Dr. David Torchiana, CEO of the Mass General Physician’s Organization. Dr. Tom Lee, who left Partners last year, and Dr. Mike Jellinek, who moved from Partners to Lahey Health earlier this year, have also been mentioned as possible candidates.
The answer, sadly, whether it is an internal or external candidate, is that it won't matter much. If there was ever an example of "a cost structure in search of revenue streams," Partners is one. As I have noted:
No matter how innovative or entrepreneurial a firm might have been at its start, once it is has been in existence for some time and has an established place in the social economy, its goal in life is to persist. It leaves the world of innovation, often loses its purpose, and exists solely to exist, i.e., to cover its costs. Often this is a reflection of the corporate hierarchy, where, sadly, leaders lose their sense of providing true value to their customers, intent instead on aggrandizing their own position and preserving their status. The firm no longer reflects the creativity of risk-taking, becoming a bureaucratic shell of its former glory.
Especially so when the firm has a dominant market position, aided and abetted by government policy, insurance company timidity, and an apathetic business community.
Perhaps change could come from within, but there is little or no interest in change from the faculty within the large academic medical centers at Partners' flagships, Massachusetts General Hospital and Brigham and Women's Hospital. They are basically content with their exalted status in the world of clinical care, education, and research. Their clinical practices are fed by an extensive network of primary care physicians and community hospitals. Their position vis-a-vis undergraduate education at Harvard Medical School and graduate medical education in their fields is secure. Their laboratories are amply supported by grant funding and/or departmental support from their hospitals.
So, if you are on the board of trustees of Partners searching for a successor, you do not seek an agent of change. You seek another person who will maintain the status quo with regard to market dominance, finances, faculty relations, and state politics.
The only way this organization will diverge from the path it has maintained is if there is decisive action that forces structural change, that recognizes that the current structure is harmful to the state economy, slow moving with regard to advancement of clinical expertise that would reduce harm to patients, and inimical to the advances that would come from real competition. Such action would have to come from the government, the insurers, or the business community--or better yet, all of them together. Until or unless it does, expect a clone to be appointed as the next CEO.
Unfortunately, the state government, the large health insurers and the biggest employers in MA are all still able to tax enough or charge enough to cover their own costs as well which reduces their incentive to try to shake up the system. Individual patients, for their part, don’t have the political power to do it. It will be interesting to see what happens in the area of healthcare price transparency if Charlie Baker becomes the next governor.
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