What ails Partners HealthCare?
People who work there have a reason to jump out of bed every morning. Doctors, nurses, and researchers walk the halls of some of the world’s greatest hospitals. They save lives, find cures for deadly diseases, and stand on the brink of other scientific breakthroughs.
But these days, there’s a growing strain of unhappiness infecting the state’s biggest hospital system, which has more than 60,000 employees.
Public criticism and a barrage of bad headlines about a planned expansion are weighing on once proud workers, some of whom are starting to ask themselves: How did our prestigious organization become the pariah of Boston?
Partners was formed in 1994 to save two struggling teaching hospitals, Massachusetts General and Brigham and Women’s. Today, they are stronger than ever, and while they remain the heart of the system, Partners has grown to 10 hospitals. The proposal that’s generating so much controversy would add three more.
At times, the mission can feel like it’s less about patients and more about growing the empire and containing the collateral damage that comes with claiming more territory.
Getting Partners’ chief executive, Gary Gottlieb, to go was seen as a way to ease the pain. Gottlieb, 59, said last week that he will leave next summer to run Partners in Health, a separate nonprofit aimed at providing medical care to impoverished countries. The former Brigham and Women’s president has led Partners HealthCare since 2010 and had four years left on a five-year contract.
Gottlieb championed ways to grow Partners. On his watch, the organization added Cooley Dickinson Hospital in Northampton and got into the insurance business with the acquisition of Neighborhood Health Plan.
His biggest coup would have been — in spite of a joint antitrust investigation by Attorney General Martha Coakley and US Justice Department — to add South Shore Hospital in Weymouth and Hallmark Health System hospitals in Medford and Melrose.
A proposed settlement with Coakley to allow those deals to go forward drew a chorus of criticism, ranging from competitors to academics to politicians.
They argued that Partners already wields too much power and could raise health care costs for everyone by becoming mightier still.
You can even add some Partners’ employees to the list of people objecting to the Coakley pact, which is under review by a Superior Court judge who will decide whether to accept it or reject it.
They worried the organization conceded too much to regulators in agreeing to price caps and other limits intended to hold down costs and foster continued competition. Partners says it wants to build out its network to deliver better, more efficient care.
The news media have been particularly brutal. In July, a New York Times editorial called the original Partners merger, in retrospect, “a serious mistake.” What’s happening now, the Times wrote, is “a cautionary tale” for the rest of the country about the risks of big hospital mergers.
More recently, Don Berwick, a former gubernatorial candidate and former administrator of the Centers for Medicare and Medicaid Services, ranted against Partners in a Globe opinion piece. A bigger Partners, he said, is “a very bad idea.”
The high-minded doctors and researchers at Partners aren’t used to the public glare. They looked to Gottlieb to defend Partners’ reputation, and some believe he fell short.
For his part, Gottlieb reminded me that he did not make Partners into a Goliath. When he became CEO, the attorney general had already started her antitrust investigation, soon to be joined by the Justice Department.
Gottlieb said he understands how difficult it is for employees to work at a place that is under scrutiny.
“Is it on me to have spun that better? I don’t know the answer to that,” Gottlieb said in an interview last week. “We worked very hard to try to give a clear voice to what we’re doing, to try to explain the vision that we have to transform the way health care is delivered.”
His predecessors, Jim Mongan and Sam Thier, each arrived with a political pedigree, having spent part of their careers in Washington. Perhaps Gottlieb just doesn’t have the same touch.
He acknowledged he didn’t anticipate the blowback from the settlement, largely because Partners did a lot of work beforehand in soliciting everyone’s views on it. But he’s not sure if Mongan or Thier would have fared any better.
“The political challenges are probably hotter now than they were during their times,” Gottlieb said.
Memo to the Partners board: The next CEO should come with flak jacket and helmet.
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