David Hunter, a St. Petersburg, Fla.-based turnaround consultant for troubled academic medical centers, says he has seen both successes and failures with hospitals hiring "superdocs"--high-profile physicians who are expected to enhance the prestige or income of the institution.
Too often, Hunter says, the executives who do the hiring are simply excited about snagging a big-name doctor who is available.
"They'll say, 'Hey, I think we can get so-and-so,"' Hunter says. But he warns: "If you want to avoid failure, you need to think about what your strategy is."
Jon Cohen, M.D., chief medical officer at North Shore-Long Island Jewish Health System in Manhasset, N.Y., says he and other hospital officials had a very specific strategy when they decided to search for a world-class neurosurgeon.
"We wanted someone who did something that no one else in the area did," Cohen says, adding that the goal was to build up the neurosurgery department.
So two and a half years ago, Cohen and other top executives recruited Thomas Milhorat, M.D., a specialist in Chiari surgery, which treats abnormalities of the brain at the junction of the skull and spine.
Milhorat came from the State University of New York at Brooklyn. At NS-LIJ, he founded the Chiari Institute, billed as the only one of its kind in the nation.
Milhorat says the goal was to attract new patients, mostly from outside the state, and "not feed out of the same trough as the others," he says, referring to neurosurgeons already at NS-LIJ.
Health system officials will not discuss the costs of bringing Milhorat to NS-LIJ, but it is easily in the millions. Besides the new $3 million institute, Milhorat says he has been hiring a team of neurosurgeons, neurologists, neuroradiologists, neuro-opthomologists and neuro-otologists to assist him.
Hunter says the total package for a superdoc can be as much as $20 million, which can easily drain a large institution if the choice is not a success. He adds that "if all your other departments are mediocre, the superstar won't have much effect. You cannot win a Superbowl with a world-class quarterback if you don't have good linemen."
Philip Farrell, M.D., dean of the University of Wisconsin-Madison, says he was aware of the importance of his plans to hire a new chairman of the department of neurosurgery when he started to look almost a decade ago.
"I knew it was one of the most important decisions I'll make," he says.
After a search lasting several years, Farrell found Robert Dempsey, M.D., at the University of Kentucky. Dempsey has been at UW-Madison for almost eight years.
"I had to basically commit to him that we'd build up the department," Farrell recalls. The medical school constructed a new floor in the hospital, opened two new ORs dedicated to neurosurgery, purchased new neuroanesthesia equipment and allowed Dempsey to hire several more faculty members.
Dempsey recalls that when he was interviewed for the job, the existing neurosurgery division with just three or four faculty was not yet a full-fledged department.
"It had no space and no facilities for the quality of neurosurgeon that I wanted here," he says. "I made it very clear to the dean where I wanted to go and what I would need."
Now, he says, he has brought the department's faculty complement to 10 neurosurgeons and half a dozen Ph.D. scientists.
UW-Madison officials refused to discuss the costs of recruiting Dempsey or the revenue he has generated for the institution. But Dempsey says he attracts patients from far and wide, which is important in a smaller city such as Madison, population 200,000.
"Neurosurgery is a good field for a center of excellence, because a person would travel across five or six states to find the right place," Dempsey says.
People skills essential
The money and resources given these prize physicians are rare for anyone else to get, which means the newly arrived superdoc can prompt feelings of jealousy among peers that may never go away, Hunter says.
"You bring in this guy who is the favored child, who gets all the ice cream and candy," he says. "You can get some erosion in solid faculty members because of that."
The solution? "You need to recruit a guy who can relate well and be highly regarded so you don't get people (angry) and bitter about this guy," Hunter says.
Seven years after Conemaugh Memorial Medical Center, in Johnstown, Pa., hired hand surgeon Paul Rollins, M.D., other physicians are happy with the choice, says CEO Richard Salluzzo, M.D.
Salluzzo says Rollins is one of the highest paid doctors in the hospital, generating almost $2 million in his own charges each year and bringing quadruple that into the hospital.
Other doctors' feathers aren't ruffled because "everyone loves Paul Rollins," Salluzzo says. "His skill set is remarkable. He is a good surgeon and he is good at customer relations."