Running a Hospital Under Public Scrutiny

Colin T. Son


April 22, 2009

Transparency in medicine can be difficult to achieve. Arguably, there are unique challenges in opening up communication about a topic as personal and private as healthcare. The drive towards this greater openness has been relentless but slow.

One of the biggest advocates for such transparency is Paul Levy, President and Chief Executive Officer of Beth Israel Deaconess Medical Center (BIDMC) in Boston, Massachusetts. He has brought to that position a mindset forged at the top leadership levels of large businesses and public utilities, such as the Massachusetts Water Resources Authority. That mindset included a commitment to bring more openness to a healthcare system that is too often closed to public accountability.

Even Mr. Levy's efforts to reform the culture at BIDMC are transparent. He chronicles those efforts at his blog, Running A Hospital, where his commentary can be somewhat controversial. Consider, for example, his publication of the hospital's infection rates associated with central lines and his commentary on their efforts to reduce such infections. And then there was the subsequent criticism from other hospital administrators that came with the publication of such information.

Running A Hospital hosts Grand Rounds
March 31, 2009

Here, Mr. Levy talks about transparency, accountability, and how he started blogging "on a lark."

Colin Son: What attracted you to running a hospital, specifically BIDMC?

Paul Levy: BIDMC was facing bankruptcy back in 2001, and I thought I might be able to help save it. I had always thought it was an excellent hospital, and I viewed it as a community service to try to help set it aright.

Colin Son: It seems that you've tried to bring a culture of openness and participation to BIDMC -- such as calling employee town halls to address issues important to the hospital.

Paul Levy: I believe strongly in an open and transparent environment, both in administrative matters and the clinical arena. You never improve as an organization if you do not admit your weaknesses, and you cannot admit your weaknesses if people throughout the organization do not have a clear sense of what is going on and why.

Colin Son: Was that partly why you decided to start a blog?

Paul Levy: It was a lark. I thought it would be fun and perhaps interesting for other people to read about what it is like to run a hospital. But I underestimated the breadth and scope of the medium in helping to set a broad public-policy agenda and also as an engagement tool.

Blogging only works for a CEO if the blog is in the voice of the CEO and he or she takes ownership of the content. If the public-relations people and the lawyers are involved, you might as well do something else with your time.

For the CEO of a major hospital to write publicly about his own performance and that of his hospital is a far cry from the norm. That's what makes Running A Hospital such notable reading. This week, in addition to his regular commentary, Paul Levy will be hosting Grand Rounds. Grand Rounds features some of the best medical blogs on the Web, including commentary from physicians, nurses, healthcare administrators, patients, and others with a stake in medicine. It offers readers a chance to sample the medical blogosphere while getting to know that week's host a bit better.