he spotless, brightly lit corridors of Bostons Massachusetts General Hospital are filled with the ebb and flow of the human condition people from around the globe and around the corner who come here seeking the best possible care for themselves and their loved ones.
In the hustle and bustle of the hallways, patients and their families mingle with physicians in loose-fitting scrubs making their rounds, earnest administrators with armfuls of files, busy nurses, and other hospital personnel who team up to make MGH a world-famous institution.
Deftly guiding a visitor through all this activity, Dr. Peter L. Slavin (MBA 90) nods toward a long line stretching back from a gourmet coffee counter. Thats one of our most utilized facilities, he says with a smile. The joke around here is that the hospital operation is a loss leader for the coffee shop and the parking garage. Revenues and finance, it seems, are never far from the minds of anyone in health care these days, even at fiscally sound MGH, the Harvard-affiliated teaching hospital that is recognized as an industry model. Indeed, with its conflicting mix of human needs and financial limits, the U.S. health-care system which comprises some 14 percent of the nations economy continues to present persistent, complex, and often painful dilemmas that affect virtually every citizen.
All of which makes Peter Slavins credentials especially valuable. With expertise in medicine, business, and management, Slavin is chairman and CEO of the Massachusetts General Physicians Organization (MGPO), which supports its seventeen hundred members with a range of financial and business-related services for physicians in group and individual practice. The MGPOs mission is to offer the highest quality patient care, educate future academic and practice leaders, and advance medicine through excellence in biomedical research.
A native of Malden, Massachusetts, and a 1984 graduate of Harvard Medical School, Slavin knows exactly when he first became interested in medicine. I had a severe case of pneumonia when I was five, he says, and it wasnt clear that I would survive. From that point on, I always talked about being a doctor. I remember being mesmerized by the technology around me and by the kind and helpful nurses and doctors at Boston Childrens Hospital. Its not uncommon for physicians to have had profound health-care experiences at an early age, due to either an illness of their own or that of a close relative.
My family was politically active, Slavin continues, and I worked on health policy issues one summer in college for Congressman Ed Markey. During my residency at MGH, I realized that health-care management involved issues such as access, cost, and quality. I saw my two passions medicine and public policy combined in a single field. A nudge toward that realization came from former HBS Dean Lawrence Fouraker, who, while a patient of Slavins at MGH, urged him to consider business school. At the time, Id never heard of a physician doing such a thing, Slavin recalls.
Slavins specialty is adult internal medicine, which keeps him involved in everything except children and surgery. Its deeply satisfying work, he says, to harness the art and science of medicine to make people well, and to experience the personal bond that often develops between doctor and patient. The relationships you build with patients are surpassed only by those you have with family members or close friends, Slavin says. When people take you into their lives and put their faith and trust in you, its extremely rewarding and a big responsibility.
But Slavin, who also teaches a course in health-care management at Harvard Medical School, devotes the great majority of his time at the MGPO to administrative matters. Now in his second year at the helm, Slavin previously spent two years as president of a 1,150-bed adult teaching hospital in St. Louis; prior to that, he had been chief medical officer at MGH and a medical director of the MGPO. Recently, he played a key role in winning for MGPO doctors and health-care providers higher reimbursement rates and more timely payments for their services. Doctors and hospitals must be fairly compensated in order to supply first-rate patient care, Slavin emphasizes. Doctors are seeing more patients than ever, and in some specialties, reimbursement has fallen by 50 percent. But I think the pendulum may be swinging the other way, and with the advances in medicine and patient care that are on the way, were having no trouble attracting talented young people to the profession.
As for the health-care systems ills, Slavin is cautious about private-sector solutions. For one thing, he notes, health care has so many ethical and societal ramifications that need to be dealt with as public policy. As for the notion that private-sector efficiency automatically reduces costs, consider that most private health insurance companies spend 10 to 30 percent on administrative expenses and profits before they start paying for health care, whereas governments administrative costs for Medicare are only about 5 percent. And Im not sure that untrained consumers can ever become sophisticated enough to make truly informed choices about their medical needs, a scenario that some tout as a way to reduce costs through increased competition. Complicating matters is what Slavin sees as a fundamental discordance at the heart of the health-care dilemma: People generally opt once a year for the lowest-priced insurer, he observes, but when they actually need care, they want the best money can buy.
With his hectic schedule and the pressures of his job, Slavin is emphatic about the importance of spending time with his wife and two young sons. The best advice I give my students and residents is that they be sure to set limits early in their careers, he says. In my own case, I view my professional life as the icing on the cake my family life is really the cake.
Garry Emmons (send e-mail to the author)