An effort to mend rocky relations between Alegent Health and its doctors has contributed to a sizable management overhaul at the Omaha, Neb.-based health system, which will pare down its leadership but may boost the ranks of Alegent's physician executives.
Wayne Sensor, who arrived at Alegent in June to replace retiring Chief Executive Officer Charles Marr, unveiled the overhaul Oct. 15 by announcing the Oct. 22 departure of Alegent's chief financial officer, three vice presidents and two hospital administrators. The not-for-profit also trimmed its executive leadership to nine people from 23, including the CEO and the newly created position of chief innovation officer.
Among the remaining executive positions is a revamped chief medical officer, Sensor said. "I think we, like many health systems across America, were errant in the way we looked at that job in the past," he said. Too often, chief medical officers "sell" hospital changes and policies to doctors, rather than representing practicing physicians' concerns, views and experience to governing executives, Sensor said.
Alegent's incoming chief medical officer should instead be a conduit for "unfiltered" information and comments from medical staff and executives, he said. Alegent employs 120 doctors and has 1,200 physicians on its medical staff. The position has been vacant since May, when Donald Manning resigned to pursue other interests. To that end, Alegent will consider hiring full- or part-time physician-executives who will "live and work" at each of the health system's nine hospitals to provide additional comment. Sensor said the plan is contingent on discussions among administrators, doctors and the chief medical officer, once hired.
Physicians sharply-and publicly-criticized Alegent's leadership for alienating its medical staff in two separate complaints filed with Nebraska health officials and the Joint Commission on Accreditation of Healthcare Organizations in September 2003. Sensor said repairing that rift has been his top priority since arriving. He even stressed engaging physicians prior to his arrival on the job, citing regulatory and financial pressures as reasons for poor relations between U.S. hospitals and physicians (April 19, p. 32).
The recent changes were not directly related to the complaints, which have been resolved without regulatory action, Sensor said. "The complaints are moot in light of the management changes," said Nick Niemann, an attorney who represents medical staff at Alegent's Bergan Mercy Medical Center, Omaha. Niemann, who is with the Omaha firm of McGrath, North, Mullin & Kratz, declined to be more specific.
Michael McNamara, an Omaha surgeon on the Bergan Mercy medical executive committee, was among those who filed the complaint after Alegent moved to contract emergency room care to an outside company without involving Alegent's medical staff in the decision, he said.
Alegent's restructuring, an emphasis on charity care and physicians' increased access to Alegent's top executives have improved relations, McNamara said. "(Sensor's) accessible. He's not trying to run nine hospitals from a corporate boardroom," he said. "He's going to bring people in that share his philosophy and empower them with the ability to run their hospitals from their hospitals."
Four of Alegent's nine executive council positions are open as a result of the shake-up and reorganization, and other posts once included on the council have been shifted elsewhere in the organization's management. Of the eight executives who report to Sensor, two, the chief medical officer and the senior vice president of Alegent Health Clinics, will represent medical professionals, Sensor said. The scaled-down executive group and emphasis on innovation will make the health system more responsive and nimble, he said.
The departing executives are Dwight Youngman, chief financial officer; Robert Azar, vice president of legal services; Mark Thomas, vice president of human resources; John Enright, vice president of cardiovascular services; Mike Tiesi, Bergan Mercy administrator; and Jim Kelly, Midlands Hospital administrator.