Big challenges ahead for new Joslin CEO
New head of center for diabetes treatment will have to cement a place in a field that does not favor specialized clinics
Dr. Peter S. Amenta has been a researcher, dean of a medical school, and head of a doctors group.
He also plays golf, a game that taught him how to forge connections and build relationships with colleagues, associates, and donors.
Amenta, who became chief executive of Joslin Diabetes Center in October, will need to draw on all these experiences as he tries to lead the center through a rapidly changing health care industry that no longer favors small, standalone specialty clinics. Despite a reputation for making breakthroughs in research and providing expert care, Joslin has struggled financially and faces a formidable challenge in cementing a place in a health care landscape increasingly dominated by big players offering comprehensive medical services — including diabetes treatment.
Amenta is the third chief executive in five years to try to meet the challenge. One of his top priorities, he said, is to find new revenues through philanthropy, commercializing Joslin's research, and increasing the center's base of patients.
"We have to raise funds to both support the organization and build programs," said Amenta, 62. "We have to be tireless about it."
Joslin, which employs 525 people and sees about 22,000 patients a year, is not a hospital and does not keep patients overnight. For more than a century, it has specialized in just one disease: diabetes.
But that condition is so common — affecting 29 million Americans — that treatment usually can be found close to home. For many diabetics, if they are diligent about monitoring their blood sugar, there's no reason to go to a specialty clinic like Joslin.
Diabetes typically doesn't require the kinds of expensive treatments or surgeries used to fight illnesses such as eye diseases and cancers. That means Joslin doesn't have the same opportunities to generate revenues as other specialty clinics in Boston, such as Dana-Farber Cancer Institute and Massachusetts Eye and Ear Infirmary.
"Diabetes is not as profitable a market as more procedure-oriented specialties," said David E. Williams, a Boston health care consultant.
Meanwhile, health insurance payments are changing to reward big health care systems that coordinate care for large populations of patients. Whenever possible, health systems want to hold onto patients instead of referring them to specialty clinics like Joslin.
Still, Joslin executives say they offer something other providers cannot: all the services a diabetic patient could need under one roof. The clinic has specialists focused not just on blood sugar, but also on eye problems, sexual function, weight management, mental health, and other areas that can be complicated by diabetes, a disease in which the body does not properly process food into energy, causing sugar to build up in the blood.
If left untreated, diabetes can lead to serious complications, including heart disease, blindness, kidney failure, and leg amputations.
Joslin has dozens of faculty researchers working on more than 200 studies and clinical trials a year. One example is a study following people who have lived with the disease for 50 or more years. Joslin scientists have uncovered characteristics that might prevent people from developing complications, said Tamara Darsow, vice president of research programs at the American Diabetes Association.
"This type of research could only happen at the Joslin," Darsow said by e-mail, "an environment where clinicians and scientist[s] work closely together to address important questions in diabetes."
Amenta became chief executive of Joslin after 26 years at Rutgers Robert Wood Johnson Medical School and University Hospital in New Jersey. He is not a diabetes expert but a pathologist — a doctor specializing in the study of tissues. But Amenta said his experience of running Robert Wood was good preparation for running Joslin, which is similar to a medical school — it has clinicians and researchers — but without medical students.
Amenta is not a stranger to Joslin. In 2010, John L. Brooks III, then the chairman of Joslin's board, asked Amenta to join the board. Brooks became Joslin's chief executive in 2011, and Amenta left the board earlier this year to become a special consultant to Joslin.
In September, Brooks stepped down, he said, under pressure from the board. Board members refused to comment on the reasons. A week later, the board named Amenta as chief executive, opting for a leader with experience in academic medicine to replace someone with a background in venture capital and life sciences companies.
Joslin lost $2.7 million on operations in the fiscal year that ended Sept. 30, 2014, according to tax filings. The previous year, it lost $7.1 million on operations.
Amenta said he is developing a plan to make operations more efficient. Joslin executives are studying how doctors organize their days and looking for ways to change schedules to reduce wait times and accommodate more patients. Executives also are planning to upgrade computer systems so more patients can, for example, easily book appointments online.
"We are going to have to become more efficient, do more with less, and make sure we're maintaining the patient experience all at the same time," Amenta said.
Joslin has affiliations with nearly 30 different health care organizations around the world, but Amenta said he wants to expand partnerships with hospitals, a strategy that might help the center reach more patients and grow revenues. This could include having Joslin's medical staff work as consultants or develop diabetes treatment programs at other facilities.
Such efforts, Amenta said, combined with traditional fund-raising events, like galas and golf tournaments, will help Joslin grow.
"I still believe if you maximize efficiency throughout the organization and have a good strong philanthropic venture," he said, "this organization can thrive."