David Shulkin knows a little about sea change.
The healthcare quality expert has surfed the dot-com wave and landed back safely on the shores of hospital administration. A patient-safety expert, physician-executive, hospital administrator and entrepreneur, he has paddled through healthcare quality issues with almost every stroke imaginable.
Shulkin, 48, has never been afraid to swim upstream it seems. As an undergraduate at Hampshire College, he got his feet wet by designing his own pre-med curriculum because the college had no formal courses or grades. As chief medical officer at the University of Pennsylvania hospitals and chief quality officer at the University of Pennsylvania Health System, Philadelphia, he made a splash by initiating a quality report card system—linked to pay—that graded staff from the chief executive officer on down.
In 1999, frustrated at the inability of providers to improve quality from within, he hatched an idea in his basement home office to create an online source of information on quality and safety for consumers, providers and purchasers. And now, as the president and CEO of 794-bed Beth Israel Medical Center in New York, he has “brought a renewed, invigorating focus on quality and service and patient satisfaction,” says Shulkin's boss Stanley Brezenoff, president and CEO of the Continuum Health Partners system, based in New York.
In 1997, when Shulkin was named an Up & Comer, the 38-year-old was chief quality officer of the University of Pennsylvania Health System and CMO of the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center. He was among the pioneers in the use of disease management to improve clinical outcomes by standardizing best practices across the continuum of care.
During the decade between his tenure at the Pennsylvania system and his current position at Beth Israel, Shulkin dove into the dot-com pond and emerged the wiser for his experience, he says.
DoctorQuality.com, which billed itself as one of the first quality benefits management companies, was founded in 1999 by Shulkin and a few fellow quality gurus. Shulkin served as its CEO and chairman before stepping down in 2002 after the investors who financed the venture decided to break up the company.
“All of us who had founded the company went back into healthcare smarter and more passionate about quality, and the venture capitalists sold the company for the financial returns. And I don't regret the experience,” he says now.
So what's Shulkin's position on whether quality is best addressed within hospitals or outside them? “I've always thought that people on the inside need help from the outside,” he says. “In other words, that's why I truly believe the transparency of making quality data public is one of the most powerful ways of incentivizing and motivating those of us in healthcare.”
After he left DoctorQuality.com, Shulkin took leadership positions at the Drexel University College of Medicine, the Medical College of Pennsylvania and Temple University Hospital, all in Philadelphia. But his current job marks his first foray into the hospital CEO role. “Every day is a learning day for me,” he says. When he arrived at Beth Israel, he made no secret of his passion for quality. “It needs to be an integral concept in the way you manage an organization, and it really does need to be owned by the top management.”
As for Shulkin's stated goal of creating the safest hospital in the nation, he's not there yet, but he's hopeful. And his boss, Continuum's Brezenoff, says so far so good. “For a guy from Philadelphia,” Brezenoff says, “he's doing pretty well in New York.”