Leaders on a quest to improve patient safety, quality of care

Modern Healthcare's 11th annual ranking of the 50 Most Influential Physician Executives and Leaders in many ways reflects the transformation of healthcare over the past several years.

This year's roster highlights the growth of efforts to improve patient safety, with three of the seven first-time honorees in positions focused on quality of care. That trend starts at the top of the list with patient-safety expert Dr. Robert Wachter of the University of California at San Francisco.

“The amount of attention on quality and safety over the past 10 to 15 years has certainly increased, as well as the level of expertise we all have in terms of how to actually improve quality and safety,” said Dr. Tejal Gandhi, CEO of the National Patient Safety Foundation, who made this year's list for the first time. “The priority level of quality and safety work is continuing to grow,” she said.

Gandhi, at No. 29, is one of nine women on this year's list, which includes fellow newcomers Dr. Lynn Simon, president of clinical services and chief quality officer for Community Health Systems, Franklin, Tenn., No. 17; Dr. Elizabeth Nabel, president of Brigham and Women's Health Care in Boston, No. 22; and Dr. Barbara Levy, chair of the American Medical Association/Specialty Society Relative Value Scale Update Committee (RUC), an advisory panel to the CMS, at No. 43.

“Even though everyone (in a healthcare organization) plays a role that touches a patient, physician leaders are uniquely positioned to lead these safety and quality efforts,” Simon said. “The clinical aspect of what we do and our experience allows us to engage other practicing physicians in these quality efforts.”

Other names new to the list include U.S. Surgeon General Dr. Vivek Murthy, No. 16 and Dr. Ronald DePinho, president of MD Anderson Cancer Center in Houston, ranked at No. 30.

This year marks a return to the list of a number of physicians who have been honored in the past but were not included in 2014. Among them is author and researcher Dr. Atul Gawande, professor of surgery at Harvard Medical School and an endocrine surgeon at Brigham and Women's Hospital, who last made the list in 2013 when he was ranked No. 38. Gawande has risen to No. 4 this year, likely in part for his work to promote a national discussion on dying and end-of-life care with his best-selling book Being Mortal.

“It's really about having discussions with patients and families about their goals for care besides just living longer,” Gawande said. “The goal is not a good death; the goal is how people can have as good a life as possible all the way to the very end.”

Murthy, who took office last December after a contentious Senate confirmation process, is among four physician leaders who work for the federal government. Joining him are Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, who moved up from No. 18 in 2014 to No. 3 this year; Dr. Karen DeSalvo, HHS' national coordinator for healthcare information technology, who rose from No. 41 in 2014 to No. 8 this year; and Dr. Patrick Conway, deputy administrator for innovation and quality and chief medical officer for the CMS, who moved from No. 6 in 2014 to No. 11.

Absent from this year's list is Food and Drug Administration Commissioner Dr. Margaret Hamburg, who has been a perennial honoree since first appearing on the list in 2010 after her appointment the previous year. She ranked No. 4 in 2014. Hamburg announced she was stepping down from her post at the end of March.

Another past honoree who did not make this year's list is former Oregon Gov. John Kitzhaber, who resigned as governor in February in the middle of an ethics scandal. A former emergency medicine physician, Kitzhaber topped the list in 2013 after Oregon launched a $1.9 billion federally funded Medicaid transformation program in 2012. Kitzhaber was ranked No. 7 in 2014.

More than half of the physicians included on this year's list represent hospitals and health systems, filling six of the top 10 spots.

Topping this year's rankings is UCSF's Wachter, a professor and chief of the division of hospital medicine at the university's health system. He was among the first physician leaders honored when the rankings debuted in 2005 and has been named to the list each year since 2008.

Ranked No. 2 this year is Dr. Richard Gilfillan, CEO of Livonia, Mich.-based Trinity Health, who last year was named the most influential physician executive, marking the second time he was ranked No. 1. Gilfillan, who first topped the list in 2011 when he was acting director of the CMS Innovation Center, has made the list five times.

Others in the top 10 include Dr. Jonathan Perlin, president of clinical services and chief medical officer at Nashville-based HCA, at No. 5; Dr. John Noseworthy, president and CEO of the Mayo Clinic, Rochester, Minn., No. 6; Dr. James Madara, executive vice president and CEO of the American Medical Association, No. 7; Dr. Charles Sorenson, president and CEO of Salt Lake City-based Intermountain Healthcare, No. 9; and Dr. Gary Kaplan, chairman and CEO of Seattle-based Virginia Mason Health System, No. 10, marking his 10th time on the list.

Another perennial honoree is Dr. Gary Gottlieb, president and CEO of Partners HealthCare in Boston. He announced in November that he would step down and take over as head of the nongovernment organization Partners in Health in July. Gottlieb, No. 37 this year, is the only physician to have made the list all 11 times.

Dr. Risa Lavizzo-Mourey, CEO of the Robert Wood Johnson Foundation, makes her ninth appearance on the list this year at No. 34. Other repeat honorees include Dr. David Blumenthal, president of the Commonwealth Fund, at No. 21; Dr. Robert Wah, chief medical officer at health IT company CSC and president of the American Medical Association, at No. 24;Dr. Bruce Siegel, CEO of America's Essential Hospitals, at No. 40; and Dr. Georges Benjamin, executive director of the American Public Health Association, at No. 47.

Also returning to the annual rankings is Dr. Benjamin Chu, executive vice president of Kaiser Foundation Hospitals and Health Plan and Kaiser Permanente group president for Southern California and Georgia. Chu, at No. 26 this year, was among the physician leaders honored in the initial ranking of the 50 Most Influential in 2005.

Chu said there has been a big shift over the past decade in how providers perceive the role of inpatient acute-care facilities. Once viewed as revenue generators, they are now seen as cost centers, prompting medical leaders to put a greater focus on reducing costs and improving patient-centered care. His organization, Kaiser, has been a leader in this process.

“We have a common purpose in trying to keep people as healthy as possible,” Chu said. “The doctors are intimately tied to our structure and our success.”