A champion of the movement to place physician-executives at the helm of individual hospitals is taking his own recommendation.
Richard Afable, M.D., executive vice president and chief medical officer of 31-hospital Catholic Health East, will start Aug. 15 as president and chief executive officer of 342-bed Hoag Memorial Hospital Presbyterian in Newport Beach, Calif., according to a public announcement made today.
An Afable plan to combine traditional CMO duties with those of top finance and operations officers in directing nine CHE hospitals and place three seasoned physician executives in those expanded positions was the subject of an October 2001 Modern Physician cover story.
"In many ways this has distinct elements of that vision I and others put forth four years ago," Afable said. "I've wanted to be in a decisionmaking role more directly related to improvements in healthcare delivery. This hospital has a desire to be very innovative in safety and quality, in physician-hospital relationships and community benefits, all of the areas in which I have a keen interest. It's a good fit."
While in the 1990s he was CEO of Preferred Physician Partners, a Cincinnati-based physician management company, this will be Afable's first turn as a hospital CEO.
Afable has been the top doc at the Newtown Square, Pa.-based CHE since 1999.
"It's been a wonderful experience and we've done some very good work but it's time for me to move into a CEO's role," Afable said. "While the senior management team role that I had was quite influential in setting priorities and decisionmaking for the entire system, I was not in a decisionmaking role when it came to the actual implementation at the various sites."
Among the challenges ahead, some are unique to the location, while others are not.
"Certainly a challenge that's not unique to California is the significant stress on resources at the state level and the federal level for healthcare organizations to become more effective -- to add value without adding to costs or complexity," he said.
"The other thing that's interesting about California, as a relative outsider looking in, is (it is) coming out of an era of aggressive managed care," Afable said. "The collaboration between hospitals and physicians is a new era that the rest of the country has been involved in for about eight years."
Richard Ortwein, a former Navy officer and banker and now an Orange County real estate developer, chairs Hoag's board of directors. Ortwein said the decision to hire Afable ended a search that began last June.
"We went through something like 340 resumes and we interviewed a good number."
Afable will be walking into a hospital with an enviable income statement. For the fiscal year ended Aug. 31, 2004, the hospital posted gross patient revenue of slightly more than $1 billion, net revenue of a bit less than $500 million and net income of $86 million, of which almost $55 million was investment income and nearly $36 million was adjusted operating income.
Hoag, Ortwein said, is a hospital "blessed by being in a community that embraces it very closely. It has a lot of resources. We're just able to attract the very best there is and we spent a long time looking."
Afable impressed not only the board, but also the medical committee and other top administrators, Ortwein said.
"We're a faith-based hospital and Rick came from a system that was certainly faith-based. One of the things that caught the search committee, was he said, 'I don't look at this as a job, but as a continuation of a calling.'
"He just fit the criteria perfectly," Ortwein said.