The changing face of health care

President and CEO of the Cleveland Clinic Regional Hospitals discusses recent trends in health care

By Richard Heck

Feb. 3, 2009

With our current economy, the health care industry has a new stewardship role: the preservation of jobs, said Fred DeGrandis, J.D., president and CEO of the Cleveland Clinic Regional Hospitals and past chair of OU-HCOM’s Centers for Osteopathic
Research and Education Board.

“That motivates us to work harder to support people, their families and keep driving the economy. One foot on the brake and one on the accelerator,” DeGrandis said during his recent OU-HCOM visit, when he presented on “The changing face of health care.”

DeGrandis explained that, with the rampant merging of hospitals into regional health systems during the 1980s and early 1990s, many medical institutions now rank among the largest employers in their respective communities.

“We are, all of the sudden, Cleveland’s top employer and one of the most important players in the community,” DeGrandis said of the various community hospitals that form the Cleveland Clinic Health System—two of which, South Pointe and Fairview Hospitals, are CORE members. “It’s not a position of power, but a position of responsibility and stewardship.”

DeGrandis also discussed how, at their best, such hospital mergers can better leverage resources and integrate care.

“We see the Cleveland Clinic as a group practice that owns a health system, not as a health system that owns a group practice. We are run by doctors, not by suits,” he said. “I’ve seen both kinds of systems, but this is one where the physician is the lead at the table, and that grounds the organization in a significant way.”

When physicians take a more active role in managing health care facilities, they can better utilize human resources. “We are moving to a model that is physician-driven and patient-focused: a health system where we focus on strengths and excellence.”

In other words, the system assesses which of its hospitals excels at which services, directing patients to the best possible care, DeGrandis said. Instead of each hospital taking a “general store” approach, the Cleveland Clinic can easily refer patients to its leading specialists.

Technology also will change the face of health care, DeGrandis said. So far, the United States health care industry lags behind other developed nations in the use of information technology, such as electronic medical file sharing among physicians. “It would revolutionize medicine,” DeGrandis said, if physicians—especially in the emergency room—could instantly access a patient’s relevant medical history.

In the meantime, DeGrandis noted how the Cleveland Clinic’s affiliation with the CORE has helped the institution better serve its community. “Medical education lifts up the hospital. It challenges us to stay at the forefront,” he said. “The doctors really come alive and become more engaged by the teaching process.”

Students and residents also help support the clinic’s service mission. “(The Cleveland Clinic) partners with other organizations to offer community health screenings, which provides another training process for CORE students and residents.”

Moving beyond current trends in health care, DeGrandis challenged students to constantly remind themselves of why they chose medicine. “Your job is improving the quality of life for your family, friends and neighbors. … That is the calling of health care,” he said.

DeGrandis has been a leader in hospital administration for more than 30 years, serving as legal counsel, president and CEO of various health care institutions in the greater Cleveland area. In addition to the Phillips Medal, he has received numerous awards, including the All Ohio School Board Award, the 2004 Meritorious Service Award from the Ohio Osteopathic Association and the 2006 Exemplar Award for Community Service.