Sitting in his vast office his blue eyes lit up with a slight bit of mischief Albert Gilbert, Ph.D., is about to tell a story he doesnt want his listener to misunderstand.
The president and CEO of Summa Health System hasnt been able to contain his enthusiasm about the fact that his hospital was recently named one of the nations top hospitals in four categories in U.S. News & World Reports annual Americas Best Hospitals issue. But hes careful about how much credit hes willing to take.
One doctor minimized it, saying, Thats just a popularity contest. They cant measure quality, Gilbert says. And I said, The hell they cant! They just did! Then Gilbert leans in. And then I said to that person, Its also because of great CEOship.
While Gilbert is compelled to say not once but twice that he was only kidding when he took a bit of the credit, theres no need. From the moment you meet him, its clear that he is not driven by ego.
As he discusses what hes learned on his 25-year journey through the Akron health care system that began in 1974 as CEO of Akron City Hospital and will end with his retirement some time between now and his 65th birthday in April 2002, he continually downplays his success and his position, forcing you to forget how successful he really is.
If you have a huge ego on a job like this, and you let it get in the way of what youre trying to accomplish, you cant be very successful, he says. So Ive always taken a position that if I werent doing this job, someone else would be. Im not whats important. Its what happens as a result of my being here thats important.
And much has happened since Gilbert began.
When he started as CEO of Akron City Hospital, Gilbert had no idea how much change hed see. Only 36 years old at the time, Gilbert had already served as executive vice president of Baltimores Mercy Hospital and earned his Ph.D. in business administration from Georgia State University.
But when asked what his mission was when he started his job, his characteristic modesty comes through.
To tell you the truth, I didnt have a clue, he says with a laugh. At that time, hospital administration was much different. That was before the CAT scan, before the MRI, length of stay in the hospital was around 10 days. Things were much different.
But they were about to change.
In 1983, the federal government introduced a new way to reimburse hospitals. Until then, the federal government and insurance companies reimbursed hospitals for the actual cost of procedures. But under the new diagnostic-related group system known as the DRG system illnesses were categorized and given a cost.
If a hospitals expenses were more than the set cost for the procedure, it had to make up the difference. The result?
Hospital administration and doctors had to come together to figure out how to reduce the costs of caring for patients, because previously, if the patient stayed in the hospital for 10 or 12 days, the government paid for it, Gilbert says. Now, if the patient stayed for 10 or 12 days, youre going to pay for it. As a result, beds emptied out, and the competition came.
Enter marketing plans. And slick ads on TV. And heart centers with catchy names that stick in a patients mind.
We had to begin thinking about marketing our services, Gilbert says. We had to begin thinking about what truly is it that the patient wants and needs? We just couldnt wait for the patients to arrive at our doors.
But the advent of the DRG system changed Gilberts job as well.
Before all of these events, it really was a pretty easy job, he says. You never had to worry about making the bottom line. You didnt have to worry about competition, because competition wasnt a part of it. It was more like running a social-service agency than a business.
While Gilbert acknowledges that thinking of new ways to lure people in his doors provided a stimulant to his work day, an even bigger challenge was on the way. With beds empty night after night, hospitals had to consolidate to survive.
At that point, Gilberts Akron City Hospital and CEO Michael Wests Akron General Medical Center began wooing the then-troubled St. Thomas Hospital to merge. Gilbert won, and in 1989, Akron City Hospital and St. Thomas Hospital merged to form Summa Health System, now the second-largest employer in Summit County.
But the merger wasnt easy, Gilbert says.
Its sort of like a major construction project, he explains. You always want to do one, but you never want to do more than one ... Youve got two different medical staffs, two different employee groups. So it just takes time.
Nobody taught Gilbert how to lead his hospital through these challenges.
Personally, I dont think you change because of your challenges. I think you bring to those challenges whatever attributes you have, and you hope that they match up to the task at hand, he says.
The foundation of communication and trust he had built with his staff is what got him through.
To manage a large organization to try to be successful requires an awful lot of communication and trust and understanding between your constituencies, he says. If thats there, then youre much better able to deal with a change in the environment. If its not there, its very difficult.
And how does Gilbert maintain that trust?
A lot of it is just communication, he says. If you have good communication in good times, when times change and become more threatening, youve got a base for communication in bad times.
Nothing tested that more than two events in the late 90s. In 1997, Summa faced financial challenges that forced administration to lay off approximately 90 employees. While Summas original plan was to lay off about 200, Gilbert says the hospital implemented creative strategies to cut that number in half.
First of all, we didnt want to do it, so we were very sensitive about who it impacted and how it was done, Gilbert says. Secondly, we didnt do it just by seniority. We created a values-based methodology. It was still very hard. ... Until that time, we had never had a layoff, and I was very proud of the fact that we never had a layoff. ... But I didnt view it as a failure, because it was happening in hospitals across the country.
What was even harder was when approximately 500 members of Local 684 of the American Federation of State, County and Municipal Employees went on a 3-month strike in November 1996 over job security issues. While the sight and sounds of nurses aides, orderlies, housekeepers, dietary and maintenance workers and technicians marching before Summas Arch Street headquarters wasnt exactly good PR The Akron Beacon Journal reported that disgruntled employees were seen praying with local ministers on the street and brandishing signs that said, Dr. Gilbert, Tell me again why my family cant have Christmas? the positive side of the situation remains at the forefront of Gilberts mind.
One of the things I discovered is that a group of people will pull together in adversity in amazing ways, he says of the employees who filled in for the striking workers.The people who were left to do the work did it with a great deal of enthusiasm and positiveness. Yet at the same time, there was a lot of sadness, because a lot of their friends were on the street. It was not a pleasant situation.
W hile the strike did end and the union members did return, Gilbert points out that they still dont have a signed contract.
However, Gilbert has made progress in other ways. Summas relationship with The Cleveland Clinic which began five years ago with the formation of the Cleveland Health Network, a consortium of 17 area health systems that work together to get better managed care contracts grew closer with the July announcement that Summa is officially a part of the Cleveland Clinic Health System.
The affiliation not only enables each hospital to share resources, it better prepares Summa to thrive.
Gilbert is happy to report that Summas future will soon be in somebody elses hands. In May, he announced that Thomas Strauss, former senior vice president of operations at Meridia Health System, another member of the Cleveland Clinic Health System, would succeed him as president and CEO of Summa.
While Gilbert says he doesnt plan to officially retire I may not start till noon, but I will do something else, he says with a smile he is surprisingly at ease with letting go of a job hes had for more than a quarter of a century. His reason?
I think it gets back to ego, he says. This job does not belong to me. This is not my company. A lot of things that weve done over the years have enhanced this organization and have gotten us to the position where we get recognition.
But it really belongs to the community. ... Im not saying I wont miss it. But I cant do it forever.
So what are Gilberts plans?
I dont have any plans, he says matter of factly. I think its important for an organization to plan, but Im not convinced its important for an individual to plan. Maybe its because the organization is going to be here forever, but individuals are not. So you dont know what youre planning for, do you?
Im not a fatalist or [a] one-day-at-a-time [person], but I just dont worry about those things.
He grins. Ill have a great time whatever I do.