Elliott C. Roberts Sr. has faced some tough odds in his 30-plus years as a public healthcare administrator. And, for the most part, he's managed to stare them down.
Roberts, 71, has had some of the most challenging jobs in healthcare management. His resume includes stints as chief executive officer at several major inner-city public hospitals. He has taught at nearly a dozen universities. He is a sought-after speaker and consultant. And from 1982 to 1984, he was chairman of the board of the National Association of Public Hospitals.
Throughout his career, advancing public health has been his mission.
"Roberts always thinks from a public perspective -- how (issues) affect people, not necessarily on how (they) affect the bottom line or just his institution," says Jack Finn, president and CEO of the Metropolitan Hospital Council of New Orleans, an association representing 30 hospitals in the area. "If you took a needle or a knife to cut him, he would bleed public health."
Public-sector hospitals, which serve mainly charity cases, often face many challenges including financial difficulties. "There's no question that (public hospitals) are not easy to run, but that in itself was a challenge," Roberts says. "There's a pleasure in seeing when programs that were being planned are launched successfully."
Another cause close to Roberts' heart is that of the Institute of Diversity in Health Management. As an African-American, Roberts knows firsthand what it's like to be a minority in healthcare. He says his own career would not have been possible "except for those who had seen something valuable in me and who assisted me in my own career development."
Since 1994 Roberts has been chairman of the institute, which recently co-created a $50,000 scholarship in his honor.
Early years. Roberts was born the eldest of three sons to Charles and Margiana in Baltimore on Jan. 20, 1927. His father owned a number of small businesses. Roberts wanted to follow in his father's footsteps, so he earned his bachelor's in business administration from Morgan State College in Baltimore in 1951.
As a budding accountant, he was required to work for two years before he could take the certification exam. He began working at Provident Hospital in Baltimore in 1953, and that stint forever altered his career path. "It did not take me long to notice that (accounting) was not where I wanted to be," he says.
After several years he became Provident's assistant administrator, a post he held until 1959. The administrator at the time, Theodore Perkins, persuaded him to get a degree in hospital administration.
So in 1960, while holding various posts at Crownsville State Mental Hospital in Annapolis, Md., Roberts began taking night courses at George Washington University's new hospital administration program. He earned his master's in business administration-hospital administration in 1963, and over the next decade or so, he served as executive director at Mercy Douglass Hospital in Philadelphia, Harlem (N.Y.) Hospital and Detroit General Hospital.
At Detroit General, Roberts led the planning process for the reconstruction and reorganization of the antiquated hospital in a joint project with Wayne State University Medical School, Detroit. Roberts, who at the time also was Detroit's hospital commissioner, went before the City Council and hospital boards to get the plan approved and to solidify multiple sources of funding. Through the reorganization Detroit General would become part of Detroit Medical Center and the city's major emergency trauma unit.
In 1980, after three years as CEO of Charity Hospital in New Orleans, Roberts moved to Chicago with plans to change careers. He joined the consulting group Hyatt Medical Management Services as vice president and associate project director.
The career switch was short-lived, however. Cook County Hospital asked him to be interim CEO while it looked for a replacement. Three months later the hospital board decided Roberts was the best man for the job, and he agreed to stay. He held the post for four years.
In 1984 Charity Hospital asked him to return to Louisiana. He remained CEO of the state-controlled system for the next 10 years through three different governors.
Strength of character. Diligence, integrity and respect for others are Roberts' keys to success, say his colleagues.
Roberts never gives up a fight. "We must recognize that Rome wasn't built in a day," he says. "Individuals that take hard issues don't change them overnight but don't give up until the objective is reached."
He spent a lifetime testifying before state legislatures, informing the government about the problems facing public healthcare, getting backing for bills to solve these problems and requesting more funding for his hospitals.
"Running those institutions takes running against almost insurmountable odds," says Gail Warden, president and CEO of Detroit's Henry Ford Health System. "Here's a guy who did the best he could, hung in there and kept working on these issues. He made them visible and made the government and other organizations aware of what the problems were, and he had an impact in trying to solve some of those problems."
Roberts says his greatest legislative impact was the creation of the Louisiana Health Care Authority, which took four years to be passed into law. Created in 1992, the authority switched control of the Louisiana public hospital system from the state government to a nonpolitical organization. The law resulted in more flexibility for hospitals in managing day-to-day operations. The authority was abolished last year because of political squabbles, and control of the nine-hospital system was transferred to Louisiana State University.
Roberts also constantly fought to keep his hospitals accredited by the Joint Commission on Accreditation of Healthcare Organizations. In 1989 Charity lost accreditation but regained it within two years. He rallied the internal organization and called in outside reinforcements.
"He commanded a focused, no-holds-barred effort," says David Page, president and CEO of Houston-based Memorial Hermann Healthcare System. Page was executive vice president of Ochsner Foundation Hospital in New Orleans while Roberts was at Charity.
More specifically, Roberts trimmed Charity's bed size, corrected safety code violations, added fire exits and reorganized medical records clerking.
Despite the political and financial pressures, Roberts always kept his spirit, wit and pride. "The man reeks of integrity," Finn says. "Even in stress, and I've seen him in very stressful times, he never loses his composure.
"I've seen him being berated publicly by the Legislature for doing things (it) deemed inappropriate. Frequently, he may not have done it. Although it may have been the responsibility of a subordinate or superior, he would never shift the blame to the other party."
Mentoring. Because most of his hospitals were affiliated with a medical school or university, Roberts also played a hand in mentoring many administrative residents.
"Roberts was very open to having his residents involved in all the processes that were going on," says Eleanor Tinto, who is now in charge of the home- and community-based services unit of the District of Columbia Government Commission on Health Care Finance. During her residency, Tinto served as acting director of the OB/GYN clinic. "I had opportunities handed to me as a resident because of the interest that Mr. Roberts takes in people, in seeing what their skills are, using them and pushing them to do their best."
For the most part, Roberts teaches by example, but he also offers advice when asked.
"Although a lot of people can teach you to do well, Elliott taught me that I can be idealistic as well as grounded in reality," says Sherif Ebrahim, who completed his administrative residency and a fellowship at Charity. Ebrahim is now president and CEO of Strategic Management Group in New Orleans.
Roberts always respects everyone's opinion and thus "inspires confidence in the people who work for him," says Lewis Hughes, assistant administrator of nursing at Medical Center of Louisiana at New Orleans, formerly known as Charity Hospital. "He allows you a lot of latitude to grow and try new things but helps you back up when you stumble."
Roberts takes these ideas to the classroom at LSU Medical School, where he has been a full-time professor in the department of public health and preventive medicine since 1994.
Roberts created and co-directs the school's dual master's program, through which students receive a medical degree and a master's in public health. The program, which began officially in September 1997, allows future physicians to concentrate on management skills, particularly useful since physician executives are now in high demand.
"(Teaching is an) opportunity to share with future healthcare executives my perspective as well as what I have experienced," he says. "I hope they find some kernel of advice as they pursue the field."