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March 24, 2018 12:00 AM

George Caldwell

Taking a holistic approach to reshaping healthcare

Matthew Weinstock
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    Whether thinking about the patient or the healthcare ecosystem, George Caldwell saw the whole picture.

    Those who knew him well say it was a combination of instinct and foresight that led Caldwell—who began his 40-plus year career as a hospital administrator in the 1950s—to be an early adopter of such innovations as patient-centered care, hospital-physician alignment, integration of behavioral and physical healthcare, and more.

    Caldwell's actions had a lasting legacy on communities in Illinois, Washington, D.C., and beyond, not to mention the countless people he mentored along the way. In recognition of that legacy, Caldwell, who died in 2016 at the age of 86, was named a 2018 inductee to the Health Care Hall of Fame.

    “He was a visionary. He was a collaborator. He was a guy who brought people together to do things better,” said Steven Seiler, a former hospital executive who got his start in healthcare thanks to a not-so-gentle nudge from Caldwell. It was the summer of 1961 and Seiler landed a summer job on the groundskeeping crew at Lake Forest (Ill.) Hospital in north suburban Chicago. While mowing the lawn one day, Caldwell—the hospital's CEO—initiated what would become a career and life-changing conversation.

    “He walks up in his coat and tie and wingtip shoes and asked, 'What are you going to do with your life?' ” Seiler recalled. “I said, 'I am mowing the lawn.' His reply was, 'I'm serious. What are you going to do?' ”

    Selected Career Highlights

    1979-90: President and CEO, Lutheran General Health System, Park Ridge, Ill.

    1973-79: President and CEO, Greater Southeast Community Hospital, Washington, D.C.

    1961-73: President and CEO, Lake Forest (Ill.) Hospital

    1954-61: Associate director, Rockford (Ill.) Memorial Hospital

    Awards, boards and more

    2004: Outstanding Alumni Award, University of Iowa School of Public Health

    1982-89: Member of Joint Commission advisory committee on quality and patient care

    Founder: Greater Southeast Community Center for Renal Disease

    Lecturer, adjunct faculty: University of Chicago and University of Iowa

    Caldwell would eventually go on to mentor Seiler, first during an internship and then when Seiler began his career in hospital administration. Seiler had a front row seat as Caldwell propelled Lake Forest Hospital into such areas as home health and long-term care, services that were not historically in the hospital's domain.

    “He told me that the job of the CEO was to lead the board without them feeling like they were being led,” Seiler said. “He became as much of a force in my life as my father.”

    Seiler took over as CEO of Lake Forest Hospital in 1973, when Caldwell decided to uproot his family and move to Washington, D.C., to become CEO of Cafritz Memorial Hospital.

    One of Caldwell's early goals at the struggling hospital was to reconnect its mission to the community, something he was hailed for in Lake Forest. A first step in that journey was changing the name to Greater Southeast Community Hospital, the operative words being “Greater” and “Community,” according to James Caldwell, George's son.

    James Caldwell said that one of his dad's favorite expressions was, “When you arrive somewhere new, first thing, paint the lobby.”

    But his work at Greater Southeast was not just about aesthetics. It was somewhat of a calling, James Caldwell said of his father's transition from Chicago's wealthy North Shore to D.C.'s inner city and his help restructuring the health system.

    “He had very strong, deep-held beliefs,” Seiler said. “You could question some of his decisions, but never the ethics or behavior that drove him.”

    James Caldwell said blending a strong business acumen with compassion is what made it possible for his dad to lay the groundwork for Greater Southeast to address what at the time was referred to as human ecology, a precursor to today's patient-centered care.

    Caldwell helmed Greater Southeast—now United Medical Center—for six years before returning to Illinois and taking over as CEO at Lutheran General Health System.

    It's at the Park Ridge, Ill., hospital, in Chicago's northwestern suburbs, where Caldwell's talents and vision fully blended and, the case could be made, he had the greatest impact.

    As James Caldwell pointed out, when his dad arrived at Lutheran General in 1979, the economics of healthcare were changing drastically. Managed care was creeping into the vernacular, thanks largely to the Health Maintenance Organization Act of 1973. Controlling costs was paramount.

    Recognizing the challenges that were coming, Caldwell was instrumental in integrating physician and hospital services. In 1980, he launched a medical management group with roughly 40 physicians.

    “That was cutting edge at the time,” said Jim Skogsbergh, CEO of Advocate Health Care, which is based in the Chicago suburbs and now owns Lutheran General. “It may not have been the first physician-hospital organization, but he was part of the early thinking in new corporate structures.”

    While there was some angst initially among physicians about the medical group, it ultimately turned into a true partnership, added Dr. Lee Sacks, who was Lutheran General's chief resident of family practice at the time.

    “Back then, it was called a hospital-physician organization, but we decided to put 'physician' first. Physicians appreciated the support that George and the hospital leadership were willing to put into the organization,” Sacks said.

    Lutheran General and Evangelical Health System merged in 1995 to form Advocate Health Care, which today boasts a physician group of more than 1,500 employed doctors.

    Although he retired five years before the merger, Caldwell's thumbprint is all over Advocate Health Care, Skogsbergh added, including medical education.

    When Caldwell arrived at Lutheran General, the hospital already had a couple of residency programs.

    “He had the vision of us being a major teaching hospital; taking a community-based medical staff and creating a real culture of learning,” said Sacks, who now serves as Advocate Health Care's executive vice president and chief medical officer. Sacks said that Caldwell was able to develop new funding streams to support the growth in residency programs, as well as recruit top-notch faculty and, importantly, develop a supportive infrastructure.

    And as he had done at Lake Forest Hospital and Greater Southeast, Caldwell never lost sight of the patient, according to people interviewed for this story and those who submitted letters of support for his Hall of Fame nomination. He continued to push for expanded services in mental health, substance and alcohol abuse, long-term care and more.

    “He believed in helping others. It was that simple,” James Caldwell said.

    –Matthew Weinstock

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