Practice Economics

Four Hospitalists Retrace Path to C-Suite Executive Ranks


Dr. Steve Narang

CEO, Banner Health’s Good Samaritan Medical Center, Phoenix

Path to the C-suite: Medical school at Northwestern University; residency at Johns Hopkins; pediatric hospitalist at Children’s Hospital of New Orleans; medical director of Pediatric Hospitalists of Louisiana; master’s in healthcare management from Harvard; chief medical officer at Banner Health’s Cardon Children’s Medical Center

As a resident at Johns Hopkins in pediatrics, Dr. Narang wasn’t always pleased by what he saw—too many process errors and patient safety gaps, and too much waste. Healthcare resources were not being spent in the right way, he discovered.

“I was struck by [the fact] that we spent a lot of our resources in publishing more articles about what’s new, and what the coolest drug is,” he says. “I saw very little of that [relating to] what does this mean in terms of value?”

He became a hospitalist because he saw it as a role in which he could “really touch everything” if he chose to do so and work within the system to improve it.

“The hospital could use a partner,” he says. “One of the biggest challenges we have in healthcare is hospitals and physicians are often not working together to add value, and they’re subtracting from value, and they’re competing with each other.”

If doctors make the effort to learn the management aspects of working in a hospital, they can put themselves in a great position to take on big leadership roles, Dr. Narang says. He says hospitals are seeing the value in having physicians in those roles.

“If you can find the right leader and it happens to be a physician, if it happens to be a physician who can speak that language—and find a sweet spot for independent physicians, employed physicians, and hospitalists to deliver value, which we have to now I think it’s the best way to go,” he says. “I think you’re going to see a trend moving forward to this as more physicians become more interested in this track.” —TC

Being a hospitalist was a key strength of my background. Hospitalists are so well-positioned…to get truly at the intersection of operations and find value in a complex puzzle. Hospitalists are able to do that.

—Steve Narang, MD, a pediatrician, hospitalist, and the then-CMO at Banner Health’s Cardon Children’s Medical Center in Phoenix

Dr. Brian Harte

President, South Pointe Hospital, Warrenville Heights, Ohio

Path to the C-suite: Resident at University of California San Francisco; private practice hospitalist in Marin County, near San Francisco; hospitalist at Cleveland Clinic; program director of hospital medicine at Cleveland Clinic’s Euclid Hospital; chief operating officer at Cleveland Clinic’s Hillcrest Hospital For about two hours a day, Dr. Harte makes his way through South Pointe Hospital—to see and to be seen. Before he started doing this as president of the hospital, he underestimated how important it was to stay visible to everyone—nurses, doctors, housekeeping, and so on.

“The impression that makes surprised me,” he says.

He’ll ask what people need to do their jobs better. He’ll also pop into patients’ rooms, introduce himself, and ask how their experiences have been. Then he takes that feedback and incorporates it into his planning.

Dr. Harte says he likes to have an “open and transparent” relationship with physicians and lists his credibility, both as a physician and a person, as a top attribute for a leader. For those embarking on leadership roles in a hospital, he says it’s a must to have a “strong mentor that you can go to.”

He also says a supportive environment is critical.

“You must work in an organization that is a resource to help you succeed, because when you move out of the purely clinical or clinical administrative jobs like division chair, department chair, program director, even CMO or VPMA [vice president of medical affairs], those are doctor jobs,” he says. “When you really become a doctor doing administrative work, unless it’s in your background and in your skill set, I think it’s important to work in an organization that is going to support you in your continued growth.

“Because these are jobs that I think you grow into.” —TC

I think one of the things that makes hospitalists fairly natural fits for the hospital leadership positions is that a hospital is a very complicated environment. You have pockets of enormous expertise that sometimes function like silos. Being a hospitalist actually trains you well for those things.

—Brian Harte, MD, SFHM, president, South Pointe Hospital, Warrenville Heights, Ohio, SHM board member

Dr. Nasim Afsar

Associate Chief Medical Officer, UCLA Hospitals, Los Angeles

Path to the C-suite: Residency at UCLA; advanced training program in quality improvement at Intermountain Healthcare Dr. Afsar wasn’t aiming for a top administrative job in a hospital. But, during her time spent working as a hospitalist, she started noticing trouble within the system. Eventually, she wanted to try to solve problems in a way that would have a ripple effect. Inspired, she ventured into quality improvement.

“I’m very passionate about helping the patient in front of me, whether it’s helping them get better or helping them during a really challenging time of their life,” she says. “But there’s something about feeling that the improvements that you make will not just impact the person in front of you, but the thousands of patients that come after them.”

Part of her job is instilling in other healthcare providers the sense that they themselves are agents of change. One big difference in her administrative job and clinical work is how to gauge success.

“The job is a lot harder than it seems. In our clinical world, I know what constitutes a good job. I know that when I’m on service, I get up early in the morning, I come in, I pre-round on my patients extensively, I read up on a couple of different things, I go out onto the wards with my team,” she explains. “This type of leadership role, I think, is more challenging. Initiatives that you do to improve care in one area could have detrimental or challenging impacts on another set of stakeholders or care area. You’re constantly navigating the system.” —TC

By nature when you’re a hospitalist, you are a problem solver. You don’t shy away from problems that you don’t understand.

—Nasim Afsar, MD, SFHM, associate chief medical officer, UCLA Hospitals, Los Angeles, SHM board member

Dr. Patrick Torcson

Chief Integration Officer, St. Tammany Parish Hospital, Covington, La.

Path to the C-Suite: Residency at Ochsner Clinic in New Orleans; private internist; director of hospital medicine at St. Tammany Parish Hospital Dr. Torcson recently became his hospital’s first chief integration officer, a job in which he promotes clinical quality and service quality using information technology.

But it was never about a promotion, he says.

“It’s really been more about just trying to provide quality care and make contributions to fixing a broken healthcare system,” he says. “Staying focused on that personal journey has really brought me to where I am.”

A good leader within a hospital is a “systems-level thinker,” not one focusing on a specific agenda. And, prioritizing important items is crucial to success, he notes.

“We all have a limited amount of energy. If you can pick three to five things that are really important and prioritize them and they turn out to be important, that’s going to facilitate your success,” he says.

He can’t emphasize “clinical credibility” enough. That’s where it all begins, he says.

“Your leadership is facilitated if you’re seen as someone that takes good care of your patients,” being the doctor that other doctors would want themselves and their families to go to. “That’s huge.”

Also, he says, running out and getting a master’s degree in business management and then applying for positions around the country is probably not the best approach to seeking out leadership positions, he says.

“I don’t think many people are put in a position where you’re just asked to pull a sword out of a stone and you’re suddenly chief of something,” he points out. “Leadership is home-grown, and you work your way up.” —TC

I don’t think many people are put in a position where you’re just asked to pull a sword out of a stone and you’re suddenly chief of something. Leadership is home-grown, and you work your way up.

—Patrick Torcson, MD, MMM, FACP, SFHM, vice president and chief integration officer, St. Tammany Parish Hospital, Covington, La., SHM board member

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