← Becker’s Healthcare Podcast
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- [00:00]
A
This is Laura Deardle with the Becker's Healthcare Podcast. I'm thrilled today to be joined by Dr. Steve Gordon, President and Chief Executive Officer at St. Charles Health System. Dr. Gordon, it's a pleasure to have you on the podcast today.
- [00:11]
B
Thank you, Laura. It's a pleasure to be here.
- [00:13]
A
Absolutely. Well, I'm looking forward to digging in and really gaining your perspective on some of the big things that are happening in healthcare and how you're thinking about the future. But before we dive in, I'm wondering, can you introduce yourself and just tell us a little bit more about St. Charles Health System?
- [00:26]
B
Yeah, happy to. So, Steve Gordon, I'm a physician by background. I've been president and chief executive officer of St. Charles for three years now. But my, my experience with St. Charles actually goes back about 11 years because I was a, a member of our board of directors since 2014, and then in 2022, I transitioned from being a. Being a board member to being the chief executive officer. So I've had eyes on and helping to guide and serve the organization for 11 years. And for the listeners, St. Charles is a rurally based multi hospital, multi clinic health system in central Oregon. And that's important because there is a beautiful mountain range, the Cascade Range, that separates central and eastern Oregon from the more populated western third of the state. And we are the sole provider of hospital and acute care services and specialty care services in an enormous geographic area in central and increasingly in eastern Oregon. Really our primary service area is the size of South Carolina, just for comparison. And we've got four hospital campuses. And I lose track. I think we're up to 30 or 40 different ambulatory and specialty care clinics and services, and recently even community pharmacy. So we play a very, very central role in the communities and the region that we serve, because if folks can't access the care that they need and we're not able to provide that, especially highly specialized and acute care folks have no choice but to drive or fly hundreds of miles for that care. And yeah, the mountains are beautiful, but if it's your family, and particularly if the weather's bad, those are really challenging geographies to navigate. So we take that role really seriously. And I think it's a defining characteristic of who we are and the relationship we have with our community.
- [02:56]
A
That makes a lot of sense. And, you know, like you said, a really, really important community to serve and a unique one as well. From your perspective, what's your biggest winner success story from the last year?
- [03:08]
B
Yeah. So probably want to go back a couple of years in Oregon and certainly in central Oregon, not unlike other parts of the country. But we have witnessed a gradual deterioration in, I'm going to broadly describe it as the supply of necessary and essential health care services, whether that's physicians, physician practices, ambulatory clinics, primary care, behavioral care, you name it. We have had static and deteriorating overall capacity in our delivery system, broadly defined. And at the same time, we are the most rapidly growing community and region in Oregon and almost in the whole country. Here in central Oregon, it's a very, very popular destination for retirees, for new families. We have a huge and growing recreational and outdoor industry with a lot of tourism. We are home to Mount Bachelor, the premier ski and mountain resort in the Pacific Northwest. So as a region, our nich need for services has been growing and growing and accelerating. And for a whole bunch of reasons over the past at least 10 years, our growth in healthcare services has been stagnant. And so that mismatch has created long waits for almost everything. It is really hard to find any service where the needs of the community are well met. So that's really important. Content, context. Because your question was about the past year and, and wins and this past year I would say that we as we as St. Charles and we frankly as Central Oregon feel like, I feel like we're finally turning the corner on, on beginning to close that gap, to bring those trend lines back, back in, in sync. We got a long way to go, but, but three things that I would highlight. The first is we successfully integrated the remaining orthopedic group in central Oregon. We lost about 25% of our total orthopedic providers over the past couple of years. The remaining group approached us and said we need help. Could we integrate with you? Long standing relationship, could we integrate with you? And we said yes and got a lot of community support to do so. We got a lot of regulatory challenges from the state which took a while to work through. But last March we successfully completed our integration and we have seen a dramatic uptick in recruitment and we've already closed about half of the gap that was present here from the deterioration of services and folks leaving the region. So that was a big win. We've stabilized orthopedic and some neuro, neurosurgery and physiatry care in a new service line for ourselves and service to our region. So that's a big win. We made enormous investments in our workforce. Nurses, medical office assistants, technicians, pharmacists, you name it. And we have gone over the past three years from a 30% vacancy rate to a 3 to 4% vacancy rate. And our clinical teams are fully staffed and stable and have moved into a mode of really collaborating. We're at the storming phase, so we've turned the corner on our workforce and we've turned the corner on community support. We've seen a really nice and wonderful uptick in philanthropic support from our community and collaboration as well. I mentioned Mount Baptist Bachelor ski area a moment ago, and we recently announced a new partnership with Mount Bachelor to, to provide urgent care in a, in a mountain clinic located at the mountain. And that's going to be a better experience for our tourists, better experience for our community, helping folks get back on the mountain or if they need. If they need urgent care or referral to specialty care to help them along the way. So those are just a couple of examples, but fundamentally, really feeling proud of turning the corner, turning the corner on a extended period of pretty extreme scarcity in this region and, and getting ourselves grounded to, to continue to fill those gaps and, and grow. Grow with. With the region in service to the region.
- [08:22]
A
That's amazing to hear. And you know, what a huge success story when you think through, you know, just starting the strategy, identifying the big challenges that you were facing, then being able to actually pull that through and make a difference for access to care within the broader community, and then bringing in additional clinicians to strengthen that clinical team. Now, looking ahead, what do you see as being the top two to three issues you're focused on right now? What is top of mind for you?
- [08:47]
B
Yeah, if you just think about what I was just referring to, it's really an unusual time here at St. Charles and here in central Oregon and maybe for the whole country. On the one hand, when I look at things internally to the organization, as I mentioned, we've got some, we've got some amazing momentum. You know, our, our clinical services, our quality, our metrics of quality, our. Our people metrics. We're really humming and proud and proud of the work. And at the same time, you look outside, you look at the environment we are in, and it doesn't look so good. I know many of your other guests on this podcast make mention of the challenges that we're facing as a country and the deterioration of federal financing and at least in Oregon, the deterioration of state financing and deterioration of the economy, deterioration of the business climate. There's a lot of things to be worried about in the years ahead. So lining those two things up, I think is probably top of mind is how do we grow to meet our regional need. And how do we. How do we adjust to a time where maybe for the first time in a long time, we can't take for granted, and this is the royal we as citizens, we can't take for granted that public financing, government financing, is adequate to meet the needs that we're going to have to rethink the fundamental relationship between our care systems and our patients and our communities. And I don't know what that all means yet, but the writing is on the wall that we just can't rely on government programs to take care of everything. And we're going to have to really rethink our fundamentals. And I think that's a great challenge in many ways, but it also can cause a little heartburn.
- [10:52]
A
Oh, absolutely. I can imagine, you know, especially given, as you were mentioning, just being in a rural setting and certainly trying to make sure that, you know, you have yourself set up for success in the future and being able to continue to provide this very necessary service to the community. And I know you mentioned you're seeing an uptick in philanthropy to some degree. Is that something that you're planning on continuing to pursue or how else are you thinking about the financial future? As you mentioned, not being able to necessarily rely on the same funding sources or government programs that you have in the past?
- [11:32]
B
Yeah, we like to talk about finances. Last, the first thing we'd like to talk about is the impact that we make in our community, the care that we provide. We have a region of about quarter of a million people or so, rapidly growing. As I mentioned, just in the past year, we served more than 187,000 people. And served can mean something as simple as a lab test or an extended cancer care treatment program or anything in between. Our impact is critical for us and how we do that in terms of clinical and operational excellence and an amazing experience, the compassionate human touch and supporting our people. And that's never ending because it's that personal touch that makes all the difference. That's kind of the intrinsic work that we do. And the DNA, the financial consequences of that are just that they're consequences. The fact that our citizens are wonderful and their friends and neighbors, it's not anonymous, it's our friends and neighbors. And they see the need. They appreciate the service. They see the importance of having local access and they want to help. And so philanthropy for us, yes, is a critical differentiator. It is really going to make a big difference in terms of our financial health. But the fact that people want to do that is an indicator that we're making good strides in, in maintaining and growing and nurturing trust and confidence and collaboration with our community. And I think that, I think that's. Well, I know that's important for us. And when I think about many of my peers and organizations in the rest of the state and frankly in the country, I think we need to get to re. Engage with the people that we fundamentally serve and to rethink how do we differentiate ourselves. So for us, philanthropy is both a differentiator for the future, but it's also a success indicator. So we're. And it's fun. Honestly, it's fun. Let me tell you a quick story if I may. Yesterday we were in the middle of it's strategic planning season. So we are having a, an all leadership half day planning session to update our service line plans and a lot of our plans. And, and in the middle of this several hour meeting, which several hour meetings can be sometimes fun and sometimes a little bit less fun, get an email from our philanthropy team in our foundation office that they had just received a phone call from a patient, one of our cancer patients. And this gentleman, been in the community for more than a dozen years and out of the blue, at least to us, decided that he wanted to make a sizable, very generous contribution to our cancer center. And it just so happened that he was in active treatment and was scheduled for an infusion in the cancer center yesterday afternoon. This is yesterday morning. He's calling in to let us know of his transformational gift and he's coming in for infusion in the afternoon. So with our senior medical director of our oncology program, our cancer institute, we went over and met this gentleman in the infusion center. He was a little surprised to have the CEO and the cancer institute medical director come see him. But when I asked him why today and what motivated him to make this such a meaningful gift, he said, you know, I have been in cancer care for, for quite some time. And I split my time between here in central Oregon and, and, and another part of the West, I won't say where. And, and I get infusions here and I get infusions when I'm at my other home. And the other home is in a big urban environment with a big nationally, internationally recognized medical center. And getting care there feels like, feels like a factory. It just feels like a factory. I know I'm getting the right care, but it's just not the same. And I come here and your team is amazing. They are compassionate, they are friendly, and it is just a world of difference. And I wanted to recognize you and I want to recognize the team, and I wanted you to know how much I appreciate the care and the compassion that you provide. So that's a lengthy story, but it illustrates that relationship between the community and our delivery system and our team and our people, and the critical role that philanthropy can play, both for our success, but also as an opportunity to strengthen those bonds and strengthen that connection in everything that we do.
- [17:06]
A
What a fantastic example of everything that we've been talking about today and certainly an amazing relationship that you've built there in the department. To have that type of experience and have someone really, you know, be motivated in order to support what you're doing is really fantastic to hear. Now, when you look ahead, where do you see some of those additional big growth opportunities over the next few years?
- [17:31]
B
Yeah, so we're. Yeah, we got a lot of growth to, to pull off, as I, as I mentioned, but it's not growth for growth sake. So we tie our growth plans really to community need and we don't have to look very far. So with our aging population and our growing population, we've big gaps in heart care, we've got big gaps in cancer care, we've got big gaps in orthopedic and neurosurgical care. So most of our specialty service lines, but we also have really big gaps in primary care and behavioral health and our capacity, maternal and child health, our capacity to be not just a provider of specialty services and primary care services in our primary region, but also we are very cognizant of the risks to more remote and frontier communities in more distant parts of central and eastern Oregon. So we're paying close attention to that and doing everything we can right now to grow and frankly to grow aggressively because we don't know. We don't know what comes next. So we're being thoughtful about it, that growth needs to be sustainable. So it's incremental and we're going to test and adjust along the way. But we are laser focused on our regional needs and making it possible for people to get the care here so they don't have to go far away if they can get far away. As I said at the beginning, so we have no shortage of growth opportunities. The challenge is execution, and the challenge is navigating what's to come from a state and federal funding and regulatory. And frankly, our overall payment system in our country needs some serious, serious rethinking. So we got our work cut out for us, but we are, we're plowing.
- [19:33]
A
Ahead absolutely that makes a lot of sense and, you know, truly seems like a great goal and plan you've laid out here in terms of just making sure that you've got that aggressive growth, but meaningful growth in a way. That is what the community is, you know, really demanding. It will be most beneficial for them. Before we wrap up here, I wanted to ask about leadership. What do you think it will take to lead a thriving organization in the next five years, especially given all the things we talked about today in terms of challenges as well as opportunities and ways that you'd like to keep expanding your services and care?
- [20:06]
B
Yeah, there's so many different dimensions to leadership these days. I think a couple that I'll call out. For us, clinical leadership is more important than ever, and that's both physicians and providers, but it's also nurses and pharmacists and all clinical areas. We want to make sure that we are allowing clinicians to set the vision and those in administrative roles are supporting and collaborating and doing everything we can to get out of the way and let amazing people to do amazing things. I think stability is also. Is also critical. I know a lot of organizations who are suffering with a great deal of burnout and turnover. And this is not a time to. This is not a time to underinvest in the humans and the human dimension of leadership. We are very fortunate to have a very stable leadership team that continues to grow and develop. And so I think stability is going to be really important, but fundamentally, it's also keeping everyone's eyes on the patient. When I was a medical student and a resident, I was reminded over and over again, as complicated as hospitals are, as complicated as healthcare is, as complicated as all of the different emotions and technologies and therapies, as complicated, all that is if you just keep your eye on the patient, keep your eye on the patient, it cuts through so much of the additional challenge. So I think that patient focus, that compassion is as essential, maybe even more essential, than ever when it comes to healthcare leadership in this time of immense, immense challenge and immense opportunity.
- [22:05]
A
I love that. Thank you so much, Dr. Gordon, for joining us on the podcast today. This has been a really inspiring conversation, and I look forward to connecting with you again soon and keeping the conversation going.
- [22:14]
B
Thank you, Laura, so much.