While health care professionals are thus subject to increasingly burdensome oversight by managers and administrators, it is not clear that those managers and administrators are taking their own medicine. At best, they seem only accountable to each other. And thus, their pay and power seem disconnected from any rational notion of their performance.
I recently stumbled upon a story illustrating how top health care managers can repeatedly get hired again and again despite major questions about previous performance.
A New CEO Position for Michael Covert
In June, 2014, the Houston Chronicle announced Mr Michael Covert as the new CEO of the Catholic Health Initiatives (CHI) St Luke's Hospital System, and a new Senior Vice President of CHI. It included the typical praise from top CHI leaders and stewards.
'Michael has the qualities, skill and professional background to help lead CHI through the many dramatic changes occurring today in health care,' Michael Rowan, Catholic Health Initiatives' president of health systems delivery and CEO, said in a written statement.
Leonard Tallerine, [apparently the former CEO of GoldKing Energy, which is currently in bankruptcy] chairman of the CHI St. Luke's Health board of directors, agreed.
'Michael's depth of experience has honed two key skills: communication and collaboration,' Tallerine said in a written statement.
I confess I missed that article, but I did see an article from mid-September, 2014, in the Chronicle documenting a rather uncritical interview with Mr Covert. He did manage to boast of his previous success:
Q. What makes you the right guy ...?
A. It's because of my past experience. I've worked in an academic setting. I've worked in a Catholic hospital setting. I have run systems. I've worked for physicians. I've been doing it for a while. And I've had the fortune of some good success.
He also decried excess regulation in California ("we were so regulated"); promised to "develop relationships with our physicians that are strong"; promised "It's not going to be all about buildings"; boasted about "teams I've created"; and proclaimed "it's important for us to be strong on our quality, our finance, our patient engagement, our employee engagement."
So far, here we have yet another new top hospital system manager who seems to be a fount of excellence, at least according to those to whom he is supposed to be accountable.
However, the name Michael Covert rang a bell, and quick search of Health Care Renewal, plus Google revealed that his record is not quite as pristine as portrayed above.
The Covert Record
Million Dollar Plus Compensation Questionable Celebrity Endorsements, Quality Problems
Mr Covert first lit up the Health Care Renewal radar screen in 2010 because of his relatively large compensation, greater than $1 million per year, for the CEO of a not very large, nominally public hospital system, Palomar Pomerado. At the time, the usual explanations were provided by the hospital district chairman, who happened to be a former hospital executive. It later turned out that Mr Covert was the second most highly paid public official in the state of California.
As Mr Covert's pay became the subject of wider discussion, the hospital nurses' union weighed in with charges that Mr Covert had irresponsibly spent money on celebrity endorsements, particularly from a well known athlete who soon left California for New York. (Look here.)
Also, in 2011 the San Diego Union-Tribune reported that the two hospitals Mr Covert lead had been fined for significant errors/ quality problems in 2010, and had been fined before for such problems.
These facts did not seem aligned with the claims by the district hospital board that Mr Covert was a "phenomenal," "excellent" or "top" leader. They also seemed to belie Mr Covert's recent discussion of being responsible about finance, employee engagement, or quality. On the other hand, one can see why he dislikes regulation.
Alleged Obstructed Investigation of Murderous
Later in 2011, a little big of digging on the internet suggested that Mr Covert had a long history of issues. In 2008, the local Community Paper did an extensive investigation into his past. We summarized it here. First, the article charged that in the 1980s, as a top manager at the Ohio State University Hospital System, Mr Covert impeded the investigation into Michael Swango, a
At that time, Mr Covert seemed not so interest not merely in regulation, but in the laws of the land.
Illegally Revoked a Physician's Hospital Privileges in the 1990s
The Community Paper also found that the Sarasota Memorial Hospital illegally revoked a physician's privileges. At the time, Mr Covert was CEO of that hospital. The Community Hospital also alleged that Mr Covert's testimony at that trial was "thoroughly impeached."
What was that about strong relationships with physicians?
Alleged Misrepresentation of Facts About Hospital Bond Issue
The Community Paper reported in 2007 that Mr Covert misrepresented facts in his advocacy for a large bond issue to support building a new hospital for the Palomar Pomerado Health District.
Responsible about finance?
Dictatorial Management Style
The Community Paper interviewed multiple health professionals at Palomar Pomerado uncovering multiple charges that Mr Covert was a manipulative, egotistical and dictatorial leader.
Was this a way to develop wonderful teams?
Another Lawsuit Claiming Improper Termination of a Physician's Privileges
Later in 2008, the Community Paper noted a lawsuit filed against Palomar Pomerado by a staff physician who also alleged that the hospital had improperly terminated his privileges. I cannot find any record of how this was resolved.
Again, what was that about relationships with physicians?
Palomar Pomerado Left in Debt
Mr Covert resigned from Palomar Pomerado in mid-2014 to head to his new position as CEO of Catholic Health Initiatives St Luke's Health System in Houston. At that time, the San Diego Union-Tribune reported that after building an expensive new facility, Mr Covert would be leaving a hospital system deep in debt and with substantially worsening financial results.
Moody’s Investors Service, the bond rating agency that warned twice in two years of Palomar’s declining financial health, most recently in March. 'PH’s debt measures are among the weakest in Moody’s portfolio of rated public and not-for-profit health care organizations (debt measures exclude GO debt),' the agency said.
ADDENDUM (29 September, 2014) - Thanks to the comment by Dr Howard Brody below, I corrected the statements about that Michael Swango was a fake doctor. He did in fact have a real MD degree.