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Dialysis Discussion => Dialysis: News Articles => Topic started by: okarol on May 13, 2011, 10:58:40 AM
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latimes.com
UCLA Hospital System CEO's prescription for success: Put patients first
David Feinberg has gone from an upstart psychiatrist to leader of a medical empire with more than 10,000 employees by embracing a simple philosophy: Patients deserve respect and compassion.
By Duke Helfand, Los Angeles Times
May 13, 2011
The psychiatric clinic specialized in broken kids.
But there was a big problem: Too many patients never made it through the front door.
Families waited months for appointments at the UCLA facility, and those who nabbed slots often had to arrange their frazzled lives around doctors' morning-only schedules.
Then an upstart named David Feinberg took over.
The 32-year-old psychiatrist made same-day appointments available and handled extra cases. He scheduled visits in the afternoons so troubled youngsters wouldn't have to miss school, and he stocked the waiting room with fresh coffee and Graham crackers.
It paid off. A clinic where fewer than half the patients showed up for appointments suddenly had a full house. UCLA took notice and handed Feinberg job after job.
Almost two decades later, he's in charge of UCLA's entire hospital system, leading an empire with more than 10,000 employees and a reputation for groundbreaking medicine. Over all those years, he's never let go of his philosophy that patients — and compassion — come first.
So it's no surprise to find Feinberg, now 49, putting aside stacks of paperwork and walking the corridors of his hospitals two hours every day, knocking on doors, sitting at bedsides, asking what more his staff can do. He has hundreds of managers doing the same.
While his approach has won admiration from many at UCLA, some workers question his priorities, saying he is more focused on marketing the hospitals than ensuring quality of care.
But to Feinberg, healing starts with doctors treating patients respectfully — introducing themselves, explaining the reasons for their visits and taking the time to listen.
"I want people to be treated like they're a member of my own family," he said.
Feinberg's day had begun with nonstop meetings and appointments at Ronald Reagan UCLA Medical Center in Westwood, the hub of the hospital system. At 1:30, he tucked his cellphone into his suit jacket and slipped out of his first-floor executive suite for the elevators.
"There's a story behind every door," he said, approaching a room in the pediatric intensive care unit.
Inside, Veronica Gallo Ramirez was hovering over a white baby crib. Her 19-month-old daughter Suraya, born missing most of her skull, was fighting meningitis.
"How are you doing?" Feinberg asked.
"It's been so hard, like a roller coaster," Ramirez responded, lifting her eyes from the baby. "Her brain is slowly deteriorating."
Suraya was fast asleep under a knitted blanket but breathing heavily. Bandages covered her head, an oxygen tube fed her lungs. Feinberg admired her thick eyelashes as he caressed her toes. "Sweetheart," he whispered.
Then, turning to Ramirez, he asked, "Is there anything we can do to make you more comfortable?"
Ramirez managed a brief smile. "You guys have been great," she said of the nurses and doctors who had shuttled through the room for two months.
As Feinberg turned to leave, he pulled a business card from his suit jacket and jotted down his cellphone number on the back. He does this with every patient he visits.
"Don't be bashful," he told Ramirez as he headed for the door. "Call me."
Feinberg never got a call from Ramirez. But an average of two patients do call his cellphone each day.
Sometimes they want him to explain what's going on with their medical care or decipher a hospital bill. Other times they complain that their doctors aren't running enough tests. Feinberg takes care of the problems or refers them to his staff, although he can be firm about turning down demands for things such as redundant surgeries.
"Some guy called to see if I really answer," Feinberg joked. "This is my only cellphone, the same one my mom calls me on."
Feinberg wanted to be a pediatrician from the time he was a boy in Northern California. His childhood doctor inspired him with a combination of smarts and kindness.
His philosophy on patient care began to take shape at Chicago Medical School. During that time he shadowed a family doctor who knew something personal about each patient who stepped into his exam room.
"He connected with people in a real human way," Feinberg said. "He was a healer."
Feinberg carried those lessons to his psychiatry training at UCLA, where professors were so impressed that they asked him to run the clinic for children and adolescents after he finished a fellowship there.
"He was the best hire I ever made," said Dr. James McCracken, who leads the division of child and adolescent psychiatry at UCLA's neuropsychiatric institute. "Some psychiatrists are born, and others are trained. David was born."
Feinberg was named medical director of UCLA's neuropsychiatric hospital in 2004 and three years later, tapped to run UCLA's four hospitals. He was all nerves about the new position, intimidated at the thought of overseeing thousands of employees and a budget with the word "billion" in it.
To calm himself, he visited patients.
He found that doctors and nurses performed medical miracles, but he also discovered that the food was often cold, bathrooms were sometimes dirty, and bed pans and wheelchairs were in short supply. He was dismayed when patients said they would not recommend UCLA to friends.
One case in particular crystallized the problems: A 20-year-old terminal cancer patient who was confined to her room complained that her television was broken, leaving her with no way to stay in touch with the outside world. "That was an ah-ha moment," Feinberg said. "We'd gotten sloppy."
The new chief executive and his team made sure that TVs and other basic equipment worked. They produced training videos and scripts on patient care. Doctors and nurses were reminded to knock before entering hospital rooms, to explain the reasons for visits and to ask permission to conduct exams. Clerical staffers were prompted to answer phone calls within three rings, and to smile and make eye contact when talking to patients.
It has become routine for executives — including those from marketing, accounting and human resources — to visit patients in their rooms. Doctors have come up with their own idea to make a hospital stay more personal: Baseball card-style business cards with their names and pictures on the front, and an explanation of their duties on the back.
Feinberg's attention to patients is not only an effort at good doctoring. It's also smart business.
He rarely misses an opportunity to promote his hospitals. In his pocket, he carries a small black leather case — a "service recovery kit" with vouchers for free coffee, food, valet parking, even massages — doling out the goodies to anyone with complaints, while handing $20 gas cards to visitors who have traveled long distances.
Feinberg had the freebies in his pocket when he dropped in to see 55-year-old Steve Warner, who was recovering from a liver transplant. Warner — his skin yellow, his voice barely audible — nodded off as Feinberg stood over his bedside.
"Mr. Warner, are you in pain?" he asked. "Do you want me to get a nurse?"
Warner shook his head no.
Feinberg and Warner's wife, Sharon, chatted about the couple's life in Orange County. She mentioned that her husband once repaired power tools for a living and coached their two children in baseball and softball.
"We'll get you out of the woods," Feinberg told them. "One day, I promise, you will be home in your own bed."
Then Feinberg's salesmanship took hold. He handed Warner's wife a $20 gas card and said, "The only thing I ask is that you tell your friends."
To which Sharon Warner replied, "We've already done it."
Some doctors and nurses see Feinberg as a one-man marketing machine more intent on generating business for his hospitals than solving pressing issues such as staffing and room shortages.
"There's a lot of pressure to be faster, and faster is not necessarily safer," said nurse Leila Smith, a 23-year UCLA veteran. "I don't feel I have adequate time to talk to the patients."
But Feinberg's bosses are pleased with his performance.
UCLA's hospitals are packed and earning money. Feinberg likes to highlight the results of independent satisfaction surveys. A recent one showed that 84% of patients would "definitely" recommend the Reagan medical center to a friend or family member, up from 66% four years earlier.
For all of this, Feinberg has been richly rewarded. He earns $1.3 million a year, making him the highest-paid medical center executive in the University of California system.
Competitors have tried to lure him away, offering more money. Feinberg said he is staying. He was recently handed responsibility for UCLA's 75 clinics throughout Southern California. He's an associate vice chancellor at UCLA and a professor in its medical school. But the highlight of his day, he said, is the two hours spent in hospital rooms, meeting patients like Dan Fagas.
Feinberg found the Culver City high school counselor stretched out in bed two hours after gall bladder surgery, watching an episode of "Seinfeld" and eager for conversation.
"Can you tell me what room Zsa Zsa Gabor is in?" Fagas asked. "I'd like to stop by and say hello."
Feinberg, mindful of the hospital's past problems with staffers prying into celebrities' files, was polite but firm.
"I don't tell any of that stuff," he said. "We keep our confidentiality."
But then the hospital director, who had visited Gabor after a recent surgery, offered Fagas a tidbit.
"She's in her 90s," he said. "She's still very pretty."
duke.helfand@latimes.com
latimes.com/business/la-fi-hospital-ceo-20110513,0,7692933.story