Scott Parker always knew he wanted to lead hospitals. But he never envisioned spending 23 years as the founding president of one of the first and most successful integrated healthcare delivery systems and becoming a national and international leader during challenging times for the profession.
"I wish I knew. It's a mystery to me," Parker says, when asked how his ambitions evolved. "You look back at the end of your time of service and say, `the heavens aligned from the beginning'. ... It's just a gradual progression of opportunities that come."
Colleagues and friends from Salt Lake City-based Intermountain Health Care-which Parker led as it expanded to a peak of 22 hospitals and formed its own insurance company and physician division-say he blended wisdom and humility. He listened to all points of view and recognized when others knew more than he about a given subject, but he also could assert himself, without fanfare, when necessary.
"It was his foresight that made (Intermountain) into a meaningful geographic healthcare system," says William Nelson, president of the system, which now has 20 hospitals in Utah and Idaho; he was chief financial officer and executive vice president under Parker. "It was his vision that created the health plan and the employee physicians group."
"By anybody's measure, it's one of the top two or three integrated delivery systems in the country," adds Stanley Nelson, Parker's first boss and chairman of the Minneapolis-based Scottsdale Institute. "Scott's a very modest guy, but he's very competitive. ... He's kind of like Cal Ripken: He was never spouting off, but he just went out there every day and played superbly."
Sensitivity and toughness
Parker, 69, spent 13 years as a healthcare executive in Minnesota, Arizona and California before joining Intermountain at its inception in 1975. He worked as assistant administrator at Northwestern Hospital in Minneapolis from 1962 to 1967, where he had previously served his administrative residency during graduate school at the University of Minnesota.
"We kept him on because we liked what we saw," says Stanley Nelson, who was CEO. "You were immediately impressed by his personal characteristics, in terms of his integrity, his intelligence, his modesty, his persistence, and also maturity beyond his years." Parker also had "a nice balance between his sensitivity to people in a stressed situation and the necessity of making tough decisions."
When Parker left for Southside Hospital in Mesa, Ariz., where he served as administrator until 1971, "I encouraged him, with great reluctance, because it would have been neat to keep him at our organization," Nelson says. When Parker arrived in Mesa, he faced a small hospital with obsolete facilities in a rapidly growing community.
Drawing from his experience in Minneapolis, where Nelson had orchestrated a merger between Abbott and Northwestern hospitals, Parker approached what is now called Banner Good Samaritan Medical Center in Phoenix. The hospital's leadership accepted the idea and built Banner Desert Medical Center, and from 1971 to '73 he stepped up to become administrator of the flagship Phoenix hospital as well as vice president of Samaritan Health Services, then a four-hospital group based in Phoenix.
"After two years, I felt the urge again to be in an independent position as CEO. That took us to Newport Beach, Calif.," another commun-ity that needed a newly built hospital, Parker says. He became administrator of Hoag Memorial Hospital Presbyterian, and "We thought we would be there for, probably, the rest of my career."
But Parker, his wife, Sydne, and their then-growing family of four children, Jennifer, Thomas, Michael and Sara, were fated to move once more. The Mormon church, of which Parker always has been a member, decided in 1974 to divest its 15-hospital system and turn it over to a newly created not-for-profit organization, free of charge.
Parker had family roots in Utah and had attended the University of Utah as an undergraduate, but he also saw a unique opportunity when offered the chance to lead an organization that had "wonderful facilities and a wonderful staff of professionals" but lacked bylaws, organizational structure and a mission.
"I would have gone to that organization had it been anywhere," he says. "We had a clean slate. We could take it wherever we decided we could take it. Out of that came a very early mission statement that is still in play today-that set the bar pretty high-that we would become truly an integrated healthcare system that would centralize as many administrative functions as possible if they made economic sense."
Those early deliberations in 1975 produced other touchstones for Intermountain: a focus on quality measurement, the promise to make services available to all regardless of ability to pay, and a commitment to be "good community citizens" in the broader sense, working with other not-for-profits to assist the disadvantaged.
Intermountain in its earliest days faced two major capital challenges: Most facilities needed major refurbishing, additions or total replacement, and growing communities kept approaching the group about building a hospital in their towns, Parker recalls. The church's original estimate of $100 million in capital needs "turned out to be five times that much," he says, in part because the system quickly grew from 15 to 22 hospitals.
"We also had in that (mission) statement that we would have state-of-the-art facilities and that our prices, charges, to our patients, customers, would be lower than like hospitals," he says. "That was a real test: to rebuild the system, to initiate the quality programs, and yet still have the charges 10% to 15% lower than like hospitals."
By the mid-1980s, Intermountain foresaw another challenge: the growth of managed care and resultant health decisionmaking in conjunction with insurance companies. Under Parker's leadership, the system launched its own insurance arm, which now provides half of the insurance coverage for the residents of Utah. "What that did is truly brought the whole decisionmaking process and the quality thrust into a unity between doctors, and hospitals and insurance," Parker says. In the early 1990s, Parker piloted the creation of Intermountain's physician division, which invited doctors to join the system and take on management and board roles. That led to quality improvement and efficiencies, Parker says, such as integrating information systems among the hospital, doctors' offices and the insurance company. "It eliminates redundancy, broadens communication and eliminates confusion, making the whole process more user-friendly for the patient."
Cecil Samuelson, who served on the management team at Intermountain from 1990 to 1994 and is now president of Brigham Young University, first worked with Parker on another front when the former served as dean of the University of Utah School of Medicine. The two men brokered a deal between competitors to move Intermountain's Primary Children's Medical Center to the university's campus, improving patient care by creating direct access to physicians from the university's Department of Pediatrics.
"The hurdles all had to do with making the public and community interests paramount over the parochial interests," Samuelson says.
Parker is quick to say that his many achievements were "not a one-man show," and in particular he points both to current Intermountain President William Nelson and to David Jeppson, who served as chief operating officer and executive vice president from 1975 to 1995 and is now a senior healthcare adviser to both Intermountain and Sutter Health, Sacramento, Calif.
Searching for consensus
"It certainly wasn't genius, that's for sure," Parker says of his own contribution. He does credit himself with "a natural inclination to engage in consensus building, a participatory approach to management and a certain amount of patience for the process."
"He was fabulous as a boss," Nelson says. "He demanded good results, good work, but I always felt like he was my greatest supporter and wanted me to succeed."
Jeppson praises Parker for steady leadership during turbulent times that have included "several attempts" to dismantle Intermountain on monopolistic grounds. "He's been through some lonely moments," Jeppson says. "His personal integrity has been assaulted at times by people who want to discredit him and discredit the organization because of its success. He's just weathered the storm well."
Such challenges continue today. Recently Intermountain has been facing a mounting political backlash over what critics have called its near-monopolistic market clout.
Parker says he believes his leadership roles in the industry-which have included stints as chairman of the American Hospital Association and president of the International Hospital Federation-have proved invaluable.
"Stan Nelson, my mentor, taught me early on that you never find a fresh and new idea without looking for it. They don't just drop," Parker says. "Having exposure that comes from sitting at an AHA board table and traveling around representing the AHA, it never failed that I'd come back to IHC with a good idea for something."
Parker, who retired from IHC in 1998, credits two other anchors for his successes: family and faith. "Both of them were and have been safe harbors from the pressures of corporate responsibilities, tensions and stresses," he says. "They also provided comforts, regeneration of body, mind and spirit and perspective: what really matters."
Ed Finkel is a freelance writer based in Evanston, Ill. He can be reached at [email protected]