Carolinas HealthCare System

Roger Ray, MD

Issue 6 – January 2015

I recently came across a quote by Greek philosopher Epicurus:

“You don’t develop courage by being happy in your relationships every day. You develop it by surviving difficult times and challenging adversity.”

I think about where we are today in medicine, and how one can apply such wisdom to not only our personal lives, but our work lives, as well.

First, I believe there are times when a bit of courage is required by physicians, given how our field has been radically altered over the past few years. I know it has not been easy, as most of us have had to adapt to changes at an unprecedented pace. I find that a basic element to navigating these changes is effective professional relationship development. These effective relationships – those that are bidirectional, and not one-sided–  are some of the keys to our adaptation if we are to truly collaborate and thrive as a unified medical community on behalf of our patients.

I think there are a number of clear examples of courage and good relationships at work within Carolinas HealthCare System.

As you know, last January, we presented the first budget projection in recent memory that included an operational deficit. However, there is good news now. Based on third quarter financial reports, we know that financial results for 2014 are, in fact, going to be strong.

I believe a potent factor in this year’s success was a concerted effort – by physicians, providers and employees at all levels of responsibility – to work differently and do different work. One thing that is clear – as a part of the new healthcare paradigm – is that all providers must do more for patients at a lower cost. We all recognize that when you create that expectation, there’s always the possibility of an adverse staff reaction.

However, in our case, the exact opposite has been true. The response within the System is a great validation of the organizational culture and positive relationships we have nurtured over the years.

Moreover, our positive outcomes this past year are representative of a thoughtful, comprehensive, long-term strategy to invest in new services – including many high-level services – that meet emerging community needs. At the same time, our clinical leaders have had tremendous success in recruiting highly talented specialists from some of the most well-recognized medical centers in the country.

Among the highlights:

Primary Care: We saw the fruits of a long-term strategy to invest in new programs and services that better meet the needs of patients “where they are.” In particular, we benefited from heavier-than-expected utilization of our many new urgent care centers and freestanding emergency departments during 2014.

In addition, our primary care patients responded extremely well to a number of new, consumer-driven capabilities, including shared medical appointments, virtual visits and online services.

Cancer Care: Levine Cancer Institute attracted two new affiliates, while adding a broader mix of treatments and clinical trials. For example, we projected 20 procedures this year in our new adult bone marrow transplant program; the actual total is approaching 50.

Women’s and Children’s Center: We opened a new $57 million Women and Children’s Center at Carolinas HealthCare System Union in November. It has 24 labor/delivery/recovery/postpartum suites, which accommodate a number of sophisticated treatments that previously would have required transfer to a larger medical center. This project is a great example of the trend we’ve been talking about: delivering care where people are.

It is clear that providers and leaders in the System are keeping patients first, despite any industry adversity or challenges. 

Following the busy pace of the holiday season, after we have gathered with family and friends, there are often moments when we wish that things could just remain the same, or at least slow down a bit. In healthcare, while we are accustomed to change, there is similar affection for the status quo. Fortunately, many of you are helping our organization transform since the status quo is no longer a viable path to success. As our leaders have well-articulated, we are well positioned to exceed expectations by keeping patients as our first priority.

I am grateful to each of you who make daily sacrifices for our patients. Because of our collective talent, determination and a shared purpose to care for patients, I believe no other healthcare organization is better positioned to continue to succeed on behalf of patients and the community in the years ahead.