Methodist Hospital: Bruce D. Begley, Chief Executive Officer

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With uncertainty and instability in healthcare, the experience of leadership can make a difference in how a healthcare organization addresses the future. At Methodist Hospital in Henderson, Ky., Bruce Begley has held the role of chief executive officer for 19 years and been with the organization for 27 years. His experience has given him a unique perspective on healthcare reform, and he approaches organizational change with a view of the positive.

“My first endeavor into healthcare was in 1975, and adequate reimbursement was one of the main concerns,” he said. “Here we are, more than 30 years later, and it’s still the main concern.”

He recognizes that there is only a limited amount of money in the system, but part of the problem is that the money is viewed from two completely different perspectives.

“The first is that there is a sense of entitlement,” he said. “We live in one of the greatest countries in the world, and we feel we should be able to get healthcare with no questions asked. Most people feel as though healthcare is a right; however, it is financed like a privilege. We have to bring those two views more in line before we can reach some of the goals we’re aiming for as a whole.”

Focusing on the positive aspects of change

All healthcare organizations are concerned about having enough money to continue providing services to their communities. But, Begley reminds us that there are positive changes coming from reform, primarily in terms of moving from a corrective-care model to a preventive-care model.

“It’s positive to move toward being more involved on the front end and helping people live a healthier life,” he said. “Very few people get to be part of such change, and it’s exciting to work with people in the community to bring about that change.”

Methodist Hospital operates 28 healthcare facilities in three counties of western Kentucky. This includes a 209-bed hospital, a critical-access hospital, nine family-practice clinics, six specialty offices, and 13 affiliated services such as Home Medical Equipment and the Advanced Wound Healing Clinic.

Methodist has been a part of the community for more than 60 years and values its role in providing care for people locally. In fiscal year 2011, the hospital expended $1.9 million in charity care, $6.9 million on bad debt, and $21.8 million in community-benefit activities that are provided by the Methodist system.

During the same fiscal year, the hospital also served 88,000 people across western Kentucky, southern Illinois, and southern Indiana through a variety of screenings and educational activities. It served 2,715 patients of limited financial means and chronic conditions in its Continuity Care Clinic; treated 1,718 children with medical needs through its CATCH Program; helped 122 women and their babies with its lactation and breastfeeding services; sponsored and provided physician speakers for the 350 people in attendance at heart disease, breast cancer, colon cancer, and stroke prevention “Lunch and Learn” events; screened 101 men for prostate cancer at the second annual “Know Your Stats” event; provided free diabetes screenings and counseling to 80 people on Diabetes Alert Day; sponsored 70 local youth sports teams, non-profit events, and community fundraisers; and provided free health screenings at over 40 local fairs, festivals, senior centers, and annual meetings.

This community involvement is what drives Methodist’s future initiatives regardless of what reform holds.

Three areas that need to change

Looking toward the future, Begley said whether reform comes about or not, the three goals Methodist and most hospitals are focusing on will not change–increased quality of care, improved patient experience, and decreasing or bending the cost curve.

“There is no way to continue to pay for healthcare and keep doing what we’re doing for the next 15 years,” he said. “There have to be different ways of doing things.”

Methodist is working on getting medical staff on board to ensure that everyone has the same goals and objectives, with everyone taking accountability for quality, patient experience, and cost containment. Part of the values Begley encourages in his staff is to put themselves in the patient and caregiver’s shoes.

“It’s important to understand that we deal with people’s lives every day,” Begley said. “It’s not always life or death, but we should try to put ourselves in our patients’ shoes and those of their caregivers. Staff should say, ‘If it were me on the receiving end, what would I expect?’ If my staff can confidently say they did for a patient what they would want done for themselves, then they have probably followed every policy we could dream up.”

Despite challenges and fear over reimbursement, Begley continues to maintain a positive attitude about the future and encourages other organizations to do the same.

“If we aren’t going to be positively involved in change, then who is?” he said. “We know our communities better than people in Washington, and I encourage everyone to look at the positive things we do to provide services to our community and continue to attack them with a can-do attitude. If you only focus on the financial piece, it will discourage you too much.”

But any change takes time, especially culture changes in healthcare. Begley encourages small changes over time to improve cooperation with staff. It may not feel as though the organization is making a lot of progress, but five or 10 years later, looking back, one finds that the organization has come a long way.

-by Patricia Chaney

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