While the health care environment can be increasingly complex, Elliot Health System CEO Doug Dean has long followed a simple mantra when it comes to mission: it’s all about patient care.
“All of what we do, our investments and resources, has to be focused on our patients and delivering the best care possible,” stated Dean. “That is what drives all our employees, no matter what part of our system they work in.”
Dean spoke with Medical Matters recently on a number of topics, among them the current combination agreement with Southern New Hampshire Health (SOLUTIONHEALTH), trends in health care in the state, the growing health care needs of NH’s aging population and the failed Optima Healthcare merger in the late 1990s.
A native of Buffalo, NY, where his mother still resides, Dean came to Manchester in 1998 to take the helm of Optima Healthcare – a merger of Manchester’s two hospitals — Elliot and Catholic Medical Center —along with St. Joseph Hospital in Nashua. When Dean arrived in the Queen City, the four-year-old merger was facing several challenges, among them community advocates who were opposed to the merger fearing the loss of services and local identity for their hospital, those on both sides of the ideological divide around reproductive health care and challenges to the system’s charitable mission and status by the state of New Hampshire.
The system was ultimately dissolved, and Dean was tasked with re-establishing Elliot Hospital and Elliot Health System as independent community entities.
“By the time I arrived here, Optima was already in flux,” he recalls. “People certainly meant well (in bringing the hospitals together), but they weren’t as sensitive as they needed to be to the local communities and the ownership they had in each facility. There was a real rift between the system and the community.”
Dean laments the amount of money spent during the merger and dissolution that didn’t go to clinical care. “That’s the real regret and missed opportunities there,” he said.
Ironically, prior to coming to the Granite State from Chicago, Dean had presided over a successful health care merger — West Suburban Health Care Corporation- that included a Catholic and non-Catholic hospital.
“Each affiliation and merger in any community is unique,” Dean explained. “But at the end of the day, it comes down to local health care delivery in the community and that can’t be compromised.”
Fast-forward two decades and Dean and Elliot Health System are in the midst of what he hopes are the final stages of SOLUTIONHEALTH, the combination agreement with Southern NH Health of Nashua. The two systems, each of which has roots in NH that date back to the 1800s, hope to create a regional health care system better equipped to meet the changing and increasing complex health care challenges facing providers in New Hampshire.
Elliot had previously been part of affiliation conversations with Dartmouth-Hitchcock, NH’s largest health system, but the two sides ended that discussion last year.
Dean says that there are no parallels between the failed Optima merger and SOLUTIONHEALTH.
“I think there were certainly lessons learned, I know I learned a lot,” Dean said. “But this agreement is different, and each system will retain its own identity while we work to improve the health of those we serve. We will be unified, but not uniform”
The new system will have its own CEO who – along with the system board — will be responsible for developing the leadership structure and strategic priorities of the system, explained Dean.
In early March, NH Attorney General Gordon J. MacDonald announced that the state’s Charitable Trust Unit and Consumer Protection and Antitrust Bureau had completed their respective reviews of the proposed transaction. The next steps will be for both entities to address conditions imposed by the state “to ensure that the best interest of the communities is properly addressed in the transaction,” according to a news release issued by the AG’s office.
For the new system to flourish, Dean noted, there needs to be a common culture of care and he said that is most definitely the case with Elliot’s prospective partner.
“I have a great deal of regard and respect for Mike Rose (Southern New Hampshire Health System CEO) and that feeling translates to their leadership team and board. We have two great hospitals and strong mutual respect. Our missions align and collectively we feel we can enhance access to affordable care that is of the highest quality,” Dean said.
During the hour-long interview, the 66-year-old Dean also touched on several other topics.
On health care affiliations: “Hospitals and providers should be looking to collaborate on behalf of their patients, there are far too many silos out there.”
On NH’s aging population: “We think their medical needs will triple in the next 10 years. We need to look ahead and anticipate the needs of our older residents -health care, skilled nursing care, housing and other services. And its not just the services and programs, it is ensuring that we have the medical professionals and specialists to care for this important population.”
On the health care employment landscape: “There is indeed a crisis of labor in the health care field – providers, technicians and other support services. It’s incumbent upon health care providers to collaborate with higher education and others to address this issue.”
On the growth of free-standing, provider-owned health care centers: “The trend of taking tax exempt health care and converting it to for-profit medicine is troubling and creates an uneven playing field. While a non-profit facility must take all patients, regardless of ability to pay and provide uncompensated care, the free-standing facilities can pick and choose.”
On what brought him out of retirement last year to re-join the Elliot: “It was the opportunity to work with this wonderful team and make a difference. The Elliot has been part of my life for the past 20 years and there’s no place I’d rather be.”
As the interview wrapped up, Dean was asked how health care has evolved over the course of his career. The gregarious Dean chuckled and said, “It used to be that your job as a CEO was to fill hospital beds and that was a measure of success. Now our job is keep those same beds empty through wellness promotion and other interventions. And that’s a good thing!”
Chris Dugan is Principal at Dugan PR, where he provides strategic communications, public relations and marketing/communications support to a broad range of non-profit and for-profit clients across New Hampshire. Prior to starting his consulting practice, Chris held senior leadership communications roles at Anthem Blue Cross Blue Shield, the American Lung Association of NH, Optima Health and St. Joseph Hospital. A New Hampshire native, Chris is an active community volunteer and is a member of the Queen City Rotary Club, where he chairs the Marketing/Public Relations Committee. He has been recognized by the American Academy for Health Services Marketing and the NewEngland Society for Health Care Communications. He is a graduate of Leadership Greater Manchester and Leadership Greater Nashua. He can be reached at firstname.lastname@example.org.