When his colleagues at Massachusetts General Hospital toasted David F. Torchiana’s recent promotion to the top job at Partners HealthCare, they hoisted cans of Coca-Cola.
Not the toast you would expect from a gathering of top medical professionals, but a gesture of respect and jocular affection for the man they call “Torch,” who blends toughness and professional rigor with a regular-guy demeanor — and the beverage to go with it.
The 60-year-old heart surgeon, who doesn’t drink coffee, has been known to “walk into a meeting at 6:30 a.m. with a can of Coke,” said Peter L. Slavin, president of Harvard-affiliated Mass. General.
Torchiana takes over next month as chief executive of Partners, the state’s largest and most prestigious hospital and physicians network, and his style and skills will immediately be put to the test.
Partners last week bowed to pressure to abandon its three-year quest to acquire South Shore Hospital in Weymouth, an unprecedented setback for an organization used to getting its way.
Now, under its new leader, Partners will have to overhaul its expansion strategy while sparring with regulators and rivals as it reassesses plans to take over two other hospitals.
Torchiana, whose imposing 6-foot-6-inch frame belies his usually low-key manner, currently runs the 2,000-doctor Massachusetts General Physicians Organization. He speaks in plainer language but shares the adamant pride in Partners of its departing chief executive, Gary L. Gottlieb, who will step aside to run the unrelated nonprofit Partners in Health.
Those who know Torchiana inside and outside Mass. General say he is at ease talking with and listening to just about anyone — not just fellow doctors, but patients, nurses, janitors, and bartenders. When introduced to other golfers on the links, “He just says, ‘I’m Torch,’ ” said a longtime friend, Peter Sessa. “They’d never know he was chief of cardiac surgery at Mass. General.”
But Torchiana — whose annual salary as Partners chief was set at just over $2 million, the same as Gottlieb’s — didn’t rise to the top because of his easy-going side. Acute and formidable, he has been known to complain in private about what he considers a lack of context in media coverage of health care costs.
He has also been willing to mix it up with public officials when he believes they are taking actions that could hurt his hospital — like Brigham and Women’s, the other Partners flagship, one of the nation’s highest-ranked medical facilities.
Tufts Medical School professor Amy Lischko has seen the more aggressive side of Torchiana. Lischko tangled with him when she was commissioner of the state Division of Health Care Finance and Policy. She said he worked to block efforts to post timely mortality statistics in cardiac surgery, and data on how frequently individual doctors perform surgeries.
Torchiana said the dispute was over which data set to use. While the records Lischko sought were more current, Torchiana believed that they would be misleading without information about patients’ prior health, and might penalize doctors who did fewer but more complex procedures.
“He definitely came on like a bull in a china shop,” Lischko recalled. “He had the Partners mentality that they’re the best place for everything.
“When you’re the market leader like Partners, you have that brand and you feel you have nothing to gain from making that data available.”
In his new job, Torchiana — who is easily spotted in a crowd with his linebacker’s build, trimmed mustache, wire-rimmed glasses, and receding hairline — hopes to present a more welcoming face for Partners. But he will have to convince skeptical regulators, competing hospitals, and budget-minded health insurers that the organization’s motivation for adding more hospitals and doctors is about improving medical care, not raising prices.
Its latest expansion drive centered on a bid to add three more community hospitals to its 10-hospital system. It was billed as part of an effort to better coordinate patient care. But it ran into stiff opposition from critics who feared Partners would use its increased market dominance to boost medical reimbursements that are already among the highest in Massachusetts.
“If we’re perceived as a bully or we’re perceived as arrogant through our actions, I don’t want that,” Torchiana said after being named Partners’ chief, conceding the health care giant had been “chastened” by the bruising South Shore Hospital battle. “We know we have to soften our external relations, and get ourselves out of this place of being a miscreant in Massachusetts.”
Other leaders at Partners hospitals acknowledge that Torchiana will have to mend strained relations on Beacon Hill and in Boston’s Longwood Medical Area. They say he’s up to the task.
“He’s comfortable in his own skin, and he’s the right man at the right time,” said Dr. Patrick T. O’Gara, director of clinical cardiology at Partners-owned Brigham and Women’s, who worked with Torchiana at Mass. General. “We’re in a situation that we’ve got to get out of.”
Torchiana said future growth efforts may be focused out of state and overseas, a departure for a system with 6,000 doctors and 60,000 employees, that stretches from Northampton to Nantucket, and has more than $11 billion in annual revenue.
Alan Sager, a professor at the Boston University School of Public Health and a longtime critic of Partners’ expansion, is not convinced a new leader means a new way of operating.
“I don’t know how much difference one individual can make,” Sager said. “Partners has been saying for 20 years that its mergers would reduce costs and improve quality, and there’s no evidence they’ve done that. . . Now they want to expand to other states, other countries, other planets. That may or may not be good for Partners. But there’s no reason to suppose that would be good for the people who live and work in Massachusetts.”
The middle of three children, Torchiana was born in Evanston, Ill., a college town far from the Boston medical establishment. His father Donald T. Torchiana, also known as “Torch,” was a professor of Anglo-Irish literature at Northwestern University, specializing in William Butler Yeats and James Joyce. His mother, Magarida, was an educator focused on early child development. His father collected 20,000 books and permitted no television in the home.
Because his father sometimes taught and conducted research as a visiting professor at universities in Galway and Dublin, the younger Torchiana divided his school years between Ireland, where he played rugby and a billiards game known as snooker, and Evanston, where he developed a passion for the Chicago Bears.
He has since switched his NFL loyalties to the New England Patriots, whose owners, the Kraft family, are Partners patrons and represented on the Mass. General and Brigham and Women’s boards.
Torchiana, who typically reads two to three books a week on subjects ranging from Cape Cod dunes to British academic life to the Indian underworld, had a restless intellect and a wide range of interests even as a child.
It wasn’t until he was a college junior that he considered a career in medicine. After graduating from Yale University in 1976, he spent a year at Cambridge University in England on a Churchill Scholarship studying preimplantation embryology under Dr. Robert G. Edwards, a pioneer in the field of in-vitro fertilization.
Then it was on to Harvard, where Torchiana earned his medical degree in 1981 before completing residencies in general surgery and cardiothoracic surgery at Mass. General. He joined the hospital’s department of surgery in 1989, and rose steadily through the Mass. General ranks. He became chief of cardiac surgery in 1998, and chief executive of the physicians group in 2003. He is also an associate professor of surgery at Harvard Medical School.
Most of his hospital colleagues think of Torchiana as, at his core, a doctor, not an administrator.
“He’s a clinician in his soul,” said Jeanette Ives Erickson, chief nurse at Mass. General. “He is a very reflective person. Sometimes you can actually watch him think. He’s always trying to figure out what’s best for the patient, no matter what the problem.”
Torchiana and his wife, Lisa, who formerly worked as a nurse in Mass. General’s intensive-care unit, live on the North Shore and have a son and daughter in high school. Torchiana also has a grown son from a previous marriage.
More than 25 years of practicing medicine has defined Torchiana’s identity more than anything else he’s done. And the lessons learned have served him well as a manager, he said.
Being a physician has “molded the way I think,” he said. “Doctors learn a way of thinking where you’re always sorting through ambiguous information and trying to make decisions on which of it is most reliable. That’s good training for life in a complex organization.” Another lesson from practicing medicine is “you’re fallible,” he said. “Things don’t always go the way they should.”
But for Torchiana, things went as they should most of the time at Mass. General.
“Everything he did, he did well,” said Dr. W. Gerald Austen, who was chief of surgery when Torchiana came to the hospital, and later was founding chief executive of the physicians group. “He was an outstanding surgeon and an outstanding teacher. It was clear to many of us that he had the potential to be an excellent leader.”
Colleagues often asked him to operate on their own relatives, a sure sign of confidence. Deborah G. Colton, senior vice president at the physicians group, said Torchiana performed surgery on her mother three or four times over two decades, including a mitral heart-valve replacement.
“She was not an easy patient, and there was no one else who would operate on her,” Colton said of her mother. “And she didn’t trust anyone but Torch.”
Torchiana has been a friend and mentor to a generation of surgeons at teaching hospitals across the city and beyond. Among them was Ralph de la Torre, chief executive of community hospital chain Steward Health Care System, who trained under Torchiana at Mass. General.
“He had a significant role in teaching me cardiac surgery,” said de la Torre, who has kept up a decadeslong friendship with Torchiana, and frequently golfs with him on Cape Cod during the summer.
“You bond with someone when you spend 10 hours a day with them over an open chest. . . He doesn’t put on airs,’’ de la Torre said. “There’s a very small number of people who I would do a deal with based just on a handshake, and Torch is on the top of the list.”
Unlike many physicians, who disdain the business aspects of their jobs, Torchiana was attracted by the intellectual challenge of understanding the changing health care landscape, which was being reshaped by everything from medical advances to public policy.
But he thought long and hard before accepting the job running the physicians group a dozen years ago. The post was viewed within Mass. General as equal to the hospital’s president but with a lower public profile, which suited Torchiana. “My ego gratification comes from what’s happening around me,” he said, “not what falls to my credit.”
He continued to practice as a surgeon for several years — in essence, working two full-time jobs — but ultimately let his medical license lapse.
“Not being a heart surgeon any more, that was a real hard decision,” Torchiana said. “It was like losing a parent when I stopped going’’ into the operating room.
Colleagues said Torchiana applied the same energy and curiosity to running the physicians group as he did to doctoring, creating proactive support programs and championing incentives for providing more efficient care while holding down expenses. In a move that was not popular with some doctors, he also used a small pool of money from the fees they paid to the organization for bonuses to those in specialties that are less well compensated.
Torchiana makes no apologies for Partners’ past moves, saying it has been “a fantastically effective organization.” Still, he said, the organization needs to reach out to the medical community and the broader public around shared health care goals.
And though it may be wishful thinking, he’d prefer not to do it in a headline-grabbing manner.
“The purpose of the organization is to make care better,” he said. “I’m not all that interested in being in the limelight, and having Partners in the limelight.”