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Healthcare Honcho
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BJC HealthCare,
a premier medical institution offering the latest in research and
technology, is also the region’s largest employer.
By Pam Droog
When BJC HealthCare President and Chief Executive Officer Steven
Lipstein was a freshman at Emory University in Atlanta, he needed
a job. Emory University Hospital, the largest employer on campus,
hired the18-year-old economics major as a nursing unit clerk.
“I suppose if I’d had another job, things might have been different,”
Lipstein says. As things turned out, he’s been working in hospitals
ever since.
Above: F.
Sessions, Cole MD, Director of Newborn Medicine, (left) St. Louis
Children’s Hospital, one of 4,587 physicians on staff at BJC hospitals,
discusses medical matters with Steven Lipstein, president & CEO
of BJC HealthCare.
Lipstein’s interest in economics and his satisfaction in the hospital
setting led the Wilmington, Del., native to earn a master’s degree
in healthcare administration at Duke University in Durham, N.C.
This was followed by a two-year post-graduate fellowship in health
services administration at the Massachusetts General Hospital in
Boston. Then in 1980, Lipstein went to work for the Johns Hopkins
Hospital in Baltimore, “the premier academic medical institution
in town, just like Barnes-Jewish Hospital, St. Louis Children’s
Hospital and the Washington University Medical School are here,”
he says.
At Johns Hopkins, Lipstein started out as special assistant to the
hospital president, then became the director of program development
in marketing for the hospital, then for the health system. He went
back into operations for a couple of years and eventually became
vice president for ambulatory care, then vice president for administration
of the Johns Hopkins Hospital.
In 1994, Lipstein moved to Chicago as president of the University
of Chicago Hospitals. After three years he also became executive
vice president of the hospitals and health system (“I had title
inflation for awhile,” he says). Two years ago, after an extensive
nationwide search, BJC HealthCare invited Lipstein to move to St.
Louis and assume its top management position.
The Sum of the Parts
Lipstein’s pre-BJC world primarily revolved around academic medical
centers. What he found at BJC was something quite different: an
adult teaching hospital and a pediatric teaching hospital; three
tertiary service community hospitals; three community hospitals
that emphasize outpatient services; four rural hospitals; a rehabilitation
hospital; plus other healthcare service organizations like home
care, workplace health, a medical group, extended care, dental services,
behavioral health and vision centers.
“Each of these organizations is good at something, and actually
they aspire to be the best at something. But each doesn’t necessarily
aspire to the same thing,” Lipstein says.
For example, St. Louis Children’s Hospital offers access to the
latest advances in all disciplines of pediatrics. Adult patients
who seek out the latest research and technology may prefer care
at Barnes-Jewish Hospital. Others may aim for medical care that’s
the lowest cost or highest value—or most convenient. “Not everyone
in a rural area wants to drive two hours to St. Louis for great
medical care, so many patients visit their local hospitals,” Lipstein
says. “These facilities have figured out very ingenious ways to
serve their communities, and that strengthens the intrinsic value
of BJC in the process.”
That aspect of BJC HealthCare—allowing each hospital to establish,
maintain and nurture its own identity and culture—is what excites
Lipstein most. “That’s what the founders of BJC HealthCare created
back in 1993,” he says. “They designed a remarkable organization.
All the building blocks were here when I arrived.”
The Next Level
Because so many key elements already were in place when Lipstein
became president, he believes “what really needed to happen was
for BJC to evolve to a higher degree of performance, to reach the
next level.”
To accomplish that, and to measure BJC’s success, Lipstein and his
management team focus on four key result areas. Clinical quality
is number one. “First and foremost, we want to take very good care
of people for the reasons they came to us in the first place, which
is to receive medical care,” Lipstein says. The second criterion
is service excellence, meaning patient, physician and employee satisfaction.
Third is financial performance. The goal is to generate enough revenues
to pay competitive wages and benefits, and to purchase the necessary
supplies, equipment and instrumentation.
And finally, “We want to have some money leftover to invest in capital
needs down the line and position ourselves for the future,” Lipstein
says. That includes ambitious, recently completed construction projects,
such as the new Center for Advanced Medicine and Alvin J. Siteman
Cancer Center in the Central West End. The 14-story, 650,000-square-foot
Center for Advanced Medicine, a cooperative effort of Barnes-Jewish
Hospital and Washington University School of Medicine, will house
a wide range of outpatient services. It consolidates more than 30
locations where such services were offered previously, and expects
to serve more than 2,500 daily visitors. The Siteman Cancer Center
will be the only National Cancer Institute-designated cancer center
within a 240-mile radius of St. Louis. Its research scientists and
physicians provide care for nearly 5,000 newly diagnosed cancer
patients and follow-up care for 20,000 others annually.
Another example of positioning for the future is the Charles F.
Knight Emergency and Trauma Center at Barnes-Jewish Hospital, which
replaces three separate emergency care areas. It will serve more
than 80,000 plus emergency patients annually in a comfortable, private
facility the size of a football field.
Other examples include the new north building at Missouri Baptist
Hospital. Future plans include expanding ambulatory care, diagnostic
and procedure facilities over the next two years at several locations,
specifically building new outpatient surgery and imaging centers,
expanding operating room capacity and adding to inpatient bed capacity
at Barnes-Jewish and Missouri Baptist Medical Center.
But Lipstein finds the present as intriguing as the future. “This
is a very exciting time for healthcare and healthcare institutions.
Advances in medical science and technology are creating all kinds
of possibilities for what’s available for healthcare needs,” he
says. “Those possibilities create new opportunities for us. But
they also create real challenges.”
Specifically, healthcare institutions need certain things to take
care of people, Lipstein notes. Above all are human assets—a quality
work force. Equally important are physical assets—buildings, equipment,
instrumentation and more.
Perhaps the biggest challenge is how to finance it all. “Healthcare
is a very capital-intensive industry. It’s very expensive to provide
our caregivers with the tools and resources they need to do their
very best work,” Lipstein says. To keep up, BJC spends about $400
million on supplies every year and another $400 million on capital
expenditures every two years.
Half of BJC’s $2.2 billion in revenues comes from the federal government,
through Medicare and Medicaid. The other half is from private health
insurance. “Part of what we do is try to make sure we can take very
good care of the people we serve within the revenues we take in
from government and the private sector,” Lipstein says. “There obviously
are some key economic constraints. But I feel we do an exceptional
job of stewarding the resources we have.”
Others agree. John Dubinsky, chairman of the BJC HealthCare board
of directors, says, “At age 46, Steve Lipstein has done an extraordinary
job of leading BJC to its rightful spot as one of the finest healthcare
systems in the country.”
People & Money Matters
Ultimately, Lipstein believes, “we as a society are going to have
to figure out the best way to finance the American healthcare system.”
Currently, 44 million Americans are uninsured, he notes. “That’s
a big issue. Most of the uninsured are men, and most of them have
jobs. Eighty percent of uninsured persons live in a household with
at least one working adult.”
As a result, every year, BJC’s hospitals and other hospitals across
the nation provide care for which they are not compensated. “But
that’s what we’re here to do,” Lipstein says. “You know, hospital
management is as much about human service as it is about business
administration.”
Regarding human services, Lipstein notes, BJC’s staff of close to
26,000 people—making BJC the City of St. Louis’ and the entire region’s
largest employer—is a diverse group, ranging in education from grade
school to 10 years of post-graduate education. “All of them are
motivated to take care of other people at a time of great need,”
Lipstein says. “I think this type of work is very important and
I’m very proud to be a part of it.”
Yet at the same time, Lipstein says, “BJC HealthCare is a $2.2 billion-revenue
enterprise, and we have to manage the organization in a financially
responsible way. We focus very hard on operational efficiency. We
do whatever we can to streamline spending, so we can devote the
majority of our resources to patient care.”
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Vital
to the Region
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According to the St. Louis Business
Journal’s Book of Lists, BJC is the St. Louis metro area’s
largest employer, with close to 26,000 full- and part-time
employees. Although its primary goal is providing quality
medical care services, it is also a huge economic presence
in the region. Bryan Bezold, the RCGA’s economist, estimates
that the total direct and indirect economic impact of BJC
is approximately $3.9 billion per year. The indirect economic
impacts of BJC include an estimated 19,000 jobs throughout
the region dependent upon BJC’s presence here.
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Word from the Top
Although Lipstein tops the BJC organizational chart, each hospital
and business unit has a president or executive in charge who communicates
directly with employees. However, when there’s an issue to address
or an accomplishment to note, Lipstein sends a letter to every employee,
or writes a column for the BJC newspaper. He also schedules annual
CEO briefings at each hospital and meets with employee groups throughout
the year.
In particular, as a healthcare CEO, Lipstein balances several responsibilities.
First is “to put the right people in the right roles,” he says.
“So part of what I do is to build an outstanding leadership team
with the management capability, intellect, values and personal styles
that really serve the needs of our institutions and the people they
care for.”
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BJC
Member Organizations
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Missouri
Hospitals
Barnes-Jewish
Hospital
(including the Siteman Cancer Center)
Barnes-Jewish St. Peters Hospital
Barnes-Jewish West County Hospital
Boone Hospital Center
Christian Hospital
Missouri Baptist Medical Center
Missouri Baptist Hospital–Sullivan
Parkland Health Center
St. Louis Children’s Hospital
The Rehabilitation Institute of St. Louis
(co-owned with HealthSouth Corp.)
Illinois Hospitals
Alton
Memorial Hospital
Clay County Hospital
Fayette County Hospital
BJC Extended Care Facilities
Barnes-Jewish
Extended Care
Village North Retirement Community
Village North Manor
Eunice C. Smith Nursing Home
Fayette County Long-Term Care
BJC HealthCare Services
BJC
Behavioral Health
BJC Community Health Services
BJC Corporate Health Services
BJC Dental Plan
BJC Medical Group
BJC Vision Centers
Care Partners
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Second, Lipstein says, “A CEO provides focus, so while we’re not
necessarily prescriptive about how each institution should achieve
results in our four key areas, we expect each hospital to develop
and execute an agenda for continuous improvement.”
Lipstein also believes a CEO should be the advocate for his organization
among the general public as well as political, civic and community
leaders. “In that regard, I’m very proud of BJC HealthCare, and
I think within our organization are great people and great institutions,”
he says. “My family uses BJC HealthCare facilities, and I feel I’m
a pretty informed consumer of healthcare services. I have great
confidence in our people to take care of other people in the St.
Louis area.”
Finally, Lipstein says a healthcare CEO must make sure the public
is aware of what determines good health and what are the risk factors
associated with poor health. That’s why BJC HealthCare spends more
than $1 million a year on, school, workplace and community outreach
programs that promote good health.
“The bottom line is, I see myself as helping to mobilize the resources
of all of our institutions to yield a greater good for the people
we take care of,” he says. His efforts are succeeding. Dr. Alan
Schwartz, chief of pediatrics, St. Louis Children’s Hospital, says
Lipstein “is an energetic and dynamic leader and most effective
administrator of a very large and complex healthcare organization.”
Out and About
Another thing a CEO does is attend many meetings, and Lipstein is
no exception. Usually they start at 7 a.m. and end after 6 p.m.
However, “one thing I like about working at BJC is the days are
never long,” Lipstein says. “I always seem to run out of time before
I run out of things to do.”
Even away from work, Lipstein has plenty to do. Mainly he enjoys
spending time with his wife, Susan, a pediatric physician assistant
who’s involved in the Parents As Teachers program, 15-year old twins,
Ross and Greg, and 13-year-old Kate. He bicycles, runs and swims.
He’s equally active in community endeavors, as honorary chairman
of the Multiple Sclerosis Walk for two consecutive years, and as
a board member of Washington University and each BJC hospital. “Steve
Lipstein has a passion for improving the health of our community.
In his short time in St. Louis he has already made a substantial
difference. St. Louisans today are better off in their healthcare
resources because of Steve Lipstein,” says Schwartz. Adds Dubinsky,
“In just three years in St. Louis, Steve is already one of our notable
civic leaders and foremost corporate citizens. He is a real asset
to our community.”
The Lipstein family truly enjoys living in St. Louis. They’re big
Blues, Rams and Cardinals fans, and, unlike native St. Louisans,
praise the weather. “You really get a lot of outdoor time here,”
Lipstein says. “All of April is a spring month, and all of October
is fall.”
Though he has lived in St. Louis only two years, Lipstein brings
a lot to the RCGA board. Naturally his focus is on healthcare—improving
access to it and eliminating service inequities.
Lipstein says recruiting new managers from other parts of the country
has been easy. “The region has some terrific assets,” he says. “And
BJC HealthCare outside St. Louis is viewed as a national leader
in health services delivery.” That’s because inside the complex
organization is “a little piece of everything in American healthcare,”
he says. “That diversity is a real strength of the organization
and something the rest of the country views as very creative and
innovative. The fact that we’re here almost 10 years after the original
merger, thriving and growing, is something that makes us unique,
and we’re very proud of that.”
Another source of pride is BJC’s strong financial performance. “More
people seem to be showing confidence in the services we provide
by seeking us out in increasing numbers,” Lipstein says. And of
course Lipstein and his team are proud of Barnes-Jewish Hospital’s
listing in U.S. News & World Report’s Honor Roll of the nation’s
best hospitals.
“It’s great whenever you’re recognized by independent third-party
sources,” Lipstein says. “But to be honest, the most gratifying
recognition is in the testimonial letters I get from patients and
families, moms, dads, brothers and sisters. I read one or two at
the beginning of every senior leadership group meeting to remind
us, this is what BJC is all about.”
Free-lance writer Pam Droog is a frequent contributor to St. Louis
Commerce Magazine. |
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