Arthur Porter, the hard-nosed president and chief executive officer of Detroit Medical Center, resigned last week after a four-year tenure that reshaped the inner-city healthcare system and helped renew debate on access to care for the poor and uninsured.
Porter's resignation wasn't a surprise, although he had dismissed rumors of his departure (Aug. 4, p. 16).
"I have achieved what I wanted to achieve and now DMC needs a different sort of a leader, not someone who is controversial and aggressive, but someone who can build bridges, work in a new environment and allow healing to take place," said Porter, a radiation oncologist who took over the 10-hospital system in 1999.
In the most recent controversy involving Porter, one of relatively few black executives heading a major U.S. healthcare system, Porter vowed to close two hospitals and lay off more than 1,000 workers if local, state or federal governments didn't come up with additional assistance to offset DMC's growing uncompensated-care costs. By July, Michigan's governor and Legislature had agreed to a $50 million bailout for DMC and the creation of a public health authority to absorb some responsibility for providing care to the area's uninsured.
"Would we have had the public health authority and the $50 million if we hadn't pushed so hard? I think the answer is probably no," Porter said. "But now that we've reached that stage, I think it's time for new leadership, and it's very important that we don't let our foot off the pedal."
Porter, 47, is the second physician chief executive to leave a well-known healthcare system in recent weeks. Thomas O'Donnell, the CEO of Tufts-New England Medical Center in Boston, earlier this month announced plans to retire once his successor is named (Aug. 4, p. 17). Unlike Tufts-NEMC, which is looking for a nonphysician to replace O'Donnell, DMC is considering all of its options, officials said.
Porter said after his resignation becomes effective Sept. 30, he will be a consultant to the system and practice radiation oncology there. His departure means DMC's executive suite will have a whole new look. The system's chief financial officer, a senior vice president and board chairman also recently left their positions.
Porter was head of DMC's radiation oncology department when he was named to the system's management team in 1998 as part of a turnaround effort led by the Hunter Group; he became president and CEO the following year. Porter almost immediately sold DMC's physician practices and an HMO, eliminated 4,000 jobs and outsourced information systems. Still, losses over five years tallied $400 million amid an economic downturn and growing charity care.
Although he's acted aggressively, the Cambridge-educated Porter, a native of Sierra Leone, is known for his charm and geniality. The DMC board expressed disappointment at his resignation. "Arthur has challenged us all to a new way of thinking and a new way of delivering healthcare," new board Chairman Chuck O'Brien said in a written statement.
While Porter no longer will be DMC's chief, his presence will be felt in the continued debate over access to healthcare for the poor and uninsured, said Fernando Diaz, the system's chief medical officer. "The impact of what he started here in Detroit is already cascading through communities across the country," Diaz said. "We are in his debt."