Jim Citrin Leadership by Example

In 2006, Bill Gates was at the top of Modern Healthcare magazine's annual survey of the 100 Most Powerful People in Healthcare, in recognition of his innovative work through the Bill and Melinda Gates Foundation.

This year, a lesser-known executive received a similar honor in a related annual ranking by the magazine: For his leadership during and after Hurricane Katrina, Dr. Patrick J. Quinlan, CEO of New Orleans-based Ochsner Health System, was named the Most Powerful Physician Executive.

A Commitment to Help

In the tragic aftermath of Katrina, Ochsner (pronounced "ox-ner") was and remains a bright spot. Dr. Quinlan and Ochsner's employees provided uninterrupted service during the hurricane, and in the 24 months since the organization has played a key role in the recovery of the New Orleans medical community and economy.

Ochsner Medical Center, located in Jefferson Parish, was one of only three hospitals to keep its doors open both during and after Katrina, despite the devastating conditions of the storm and the floods unleashed by breached levees. Not only did Ochsner continue to care for all its own patients, it also opened its doors to anyone in need.

Today, Ochsner -- the largest private employer in the state of Louisiana -- is repeatedly ranked as one of the best U.S. hospitals by various publications, including U.S. News and World Report. Ochsner is an independent nonprofit organization made up of 7 hospitals and 32 clinics employing over 9,000 people, including over 600 physicians in 80 medical specialties, generating $1.1 billion in net patient revenues.

Ochsner's performance-oriented culture, disaster preparation, and unique institutional history helped Dr. Quinlan keep the organization focused and operating during Katrina, and allow it to fulfill its commitment to helping the battered region recover from the storm.

Local Pioneers

In 1939, Alton Ochsner, director of surgery at the Tulane University School of Medicine, earned his place in medical history with his discovery of the link between tobacco and lung cancer. An innovator who was frustrated with the disjointed nature of medical care, Ochsner wanted to pioneer the kind of group practice exemplified by the renowned Mayo Clinic in Rochester, Minn. for New Orleans.

So, in 1940, Ochsner and four colleagues on the Tulane faculty began planning a clinic where they could integrate their combined expertise and apply it to the most complex cases. They approached Tulane about hosting the clinic, but not only did the school's dean rebuff them, they were socially ostracized as "traitors to the medical profession" for establishing a for-profit venture.

The five founders forged ahead with plans for a private clinic, which opened in January 1942. The original clinic had gained enough traction by January 1944 that the founders were able to establish a nonprofit foundation dedicated to research, education, and the treatment of patients who couldn't afford private medical care.

The Ochsner specialists continued to operate the clinic as a for-profit enterprise, and they poured their earnings into the foundation to establish and subsidize a hospital. The hospital opened in June 1954, and it's never stopped growing. Today, it's matured into the sprawling Ochsner Health System, with holdings that include seven hospitals and over two dozen neighborhood clinics.

A Culture of Preparedness

When I interviewed Dr. Quinlan recently, he described how Ochsner's preparation and culture enabled the organization to perform when it counted most. "Our team turned out to be nimble in making decisions and solving problems during the crisis," he says. "Katrina wasn't the first time we prepared. Hurricanes are a part of life here, and we've practiced for disaster recovery as a team.

"You don't know when or how often the hurricanes will come or how bad they'll be when they get here," Quinlan adds. "But you do know that they're coming. So we've prepared through planning and drills. In my opinion, the hallmark of a good plan is that it's linked to action. If you don't practice, you don't have a plan."

Dr. Quinlan stresses that it's the job of management to support the decision-making of employees on the frontlines. "Fear robs people of their ability to make decisions," he said. "If they feel they'll get in trouble, people will avoid making decisions, leading to inaction. But at Ochsner, whatever we do has a common path. There are no recriminations.

"When the crunch time came [during Katrina]," he continues, "our people exercised calm courage and selfless behavior. They saw problems and owned them. Their attitude was, 'We're just doing our jobs,' and 'What can I do to help?'" What did Dr. Quinlan himself do to help? For one thing, he led from the front. "You have to be there with your people. I stayed in the office for seven weeks straight."

Renewing an Investment in New Orleans

Ochsner recently announced the purchase of three New Orleans hospitals from Tenet Healthcare Corporation for $55 million.

When Tenet made its intention to pull out of the New Orleans market public, it seemed to signal another nail in the coffin for the city's economic recovery. But Ochsner's purchase improved the outlook for health care in the area, and is seen as a local institution's renewed confidence in the region.

Quinlan's decision to increase Ochsner's holdings when Tenet was going the other way reflects the company's focus and purpose. As he put it, "New Orleans is our home. We have no other interests or options. We have a local knowledge and local focus that Tenet -- a national system -- doesn't.

"We're a part of the community," he concludes. "The future of New Orleans is our own future."