Strategies for Hospital C-suite Organization

Philip Betbeze, for HealthLeaders Media , September 14, 2010
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Harris Nagler, MD
Beth Israel Medical Center
New York, NY
Years as president: 1.5 (one year interim, named permanent president March 2010)
Operating entities: Beth Israel
Medical Center (1,106 staffed beds). Beth Israel is part of the four-hospital system Continuum Health Partners, which also owns and operates
Roosevelt Hospital, St. Luke's
Hospital, Long Island College
Hospital, and the New York Eye
and Ear Infirmary
Number of employees: 7,460

* * *

The Higher Power

Of course, the hospital CEO is not always the last word—even at the flagship hospital. At Beth Israel Medical Center in New York, some decisions are made above the pay grade of the president, at Continuum Health Partners, the corporate entity that governs its four hospitals and multiple other facilities.

"We're part of Continuum, so in a sense, we're the meat in the sandwich. In terms of strategic planning, it comes from both directions," says Beth Israel President Harris Nagler, MD.

Nagler offers one recent example, as a pancreatic center of excellence was up for grabs after Manhattan's St. Vincent's Hospital orphaned the pancreatic cancer center. A corporate policy meant that Beth Israel would not compete with other members of the organization for pieces that one of the others might already have. But at times, a decision has to be made on whether such a business line is best suited for one organization or another.
"There was a large pancreatic cancer center at St. Vincent's which was attractive to us, and we integrated that in our organization after some discussion," says Nagler.

Still, Beth Israel had to deal with competing interests among a variety of physicians who do research and admit to the center. 

"The construct we came up with allowed us to integrate different practice patterns, including a traditional academic model and voluntary private practice model into one unit. The success of this demonstrated the value of collaboration to both groups."

To explain, prior to acquiring

St. Vincent's pancreatic cancer center, Beth Israel, a major teaching hospital, had recently recruited a world-class head of its gastrointestinal division who was interested in pancreatic issues.

"That group had as their clinical focus the area I was trying to bring in from a different institution, who would have been looked at as interlopers," he says. "But we created a structure that gave the new people the opportunity to have leadership roles and maintain some degree of independence where the product was greater than the sum of its parts."   

Philip Betbeze is senior leadership editor with HealthLeaders Media.
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