Saturday, March 24, 2007

What the CEO said...

I wrote my first family letter on October 20, 2002 (my third week as CEO), and with a few exceptions I’ve been writing my thoughts every Saturday since, e-mailing these letters to departments and posting them on the CGH website. They remain on the website for about six weeks, and anyone can write to me by return mail from the website.

I’ve recently become aware of a hospital CEO who puts these humble letters to shame. He’s Paul Levy, the President & CEO of Beth Israel Deaconess Medical Center in Boston, and he writes a blog.[1]

If nothing else, Mr. Levy’s blog is impressive by its sheer scale. The blog contains about 55,000 words. This letter, for example, is 590 words in length. If I write four such letters a month, it will take me almost 24 months to equal the length of Mr. Levy’s blog – and he’s been writing only since last August! How does he find the time to do it?

But his blog is more than mere words. Mr. Levy discusses everything from his hospital’s infection rates (“We saved one person's life. Can we keep it going?” February 16, 2007) to questions about expensive new technology (“daVinci Uncoded…” February 20, 2007). He’s written about the SEIU union organizing campaign at Beth Israel Deaconess (“Union Issues,” August 25, 2006) and even about his own income (“Do I get paid too much?,” January 28, 2007).

According to the Boston Globe:

There are some things that Boston hospital executives generally believe are best kept quiet. Gripes about competitors are one. The rates of hospital-acquired infections among patients are another, at least at this point.

Then came Paul Levy's blog.

In August, Levy…began writing an Internet blog called ‘Running a Hospital,’ about the inner workings of an academic medical center. Since then, he's broken a few unwritten rules.[2]

Last week another Boston hospital was in the news, again because of something its CEO wrote. Dr. Paul Slavin, CEO of Massachusetts General Hospital (and a competitor of Bet Israel Deaconess), wrote a memo about that hospital’s recent unannounced survey by the Joint Commission.[3] He didn’t post his memo on the web, but when it came to the attention of a newspaper, it was news because Dr. Slavin talked about deficiencies in Mass General’s hand washing (one of my favorite subjects), medical records documentation, pain management, and medication reconciliation.

That memo prompted the Globe to editorialize. “But how does this renowned institution [Mass General] compare with other hospitals?” [4] The paper continued: “Paul Levy, president of Beth Israel-Deaconess, courted controversy on his blog ‘Running a Hospital’ last December when he listed the rate of infections for a common procedure at his hospital. He challenged others, including MGH, to do the same. They haven't done so yet.”[5]

Meanwhile, a blog by the Wall Street Journal (yes, another blog) asked the following question: “What’s your take on Levy’s blog? Self-indulgence? Or a welcome experiment in accountability in health care?”[6] The responses from readers have been generally positive. Some readers pointed out that Mr. Levy’s blog seeks a public relations advantage, others gave Mr. Levy credit for being “transparent” about hospital quality measures, and others said “time will tell.”

In past letters, I’ve written about the many changes affecting doctors and hospitals, about the financial pressures from state and federal budgets, and about the relentless movement toward public reporting of hospital outcomes.

It’s time to add CEO memo writing and blogging to our record of “these changing times.”

[1] Paul Levy’s blog address is: Blogs are an on-line diary or journal in which an individual provides daily commentary on a particular subjects, such as news events or a job or a hobby. The word “blog” is a blend of the words “web log.”
[2] “Blog tests hospital leaders' patience,” Boston Globe, February 23, 2007.
[3] CGH is expecting its own unannounced survey by the Joint Commission any time this year. It could be as early as next month – or next week.

[4] “Improvement time at MGH,” Boston Globe, March 20, 2007.
[5] Ibid.
[6] “Paul Levy, Online CEO,” Wall Street Journal Health Blog, March 16, 2007. The blog entry is available at:

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