Interview with Gary Kaplan, MD

Immediate Past CEO Virginia Mason Franciscan Health & Senior Vice President Common Spirit Health

“In addition to being a people business, we’re also an information business”

What drove you to pursue a career in healthcare?

Growing up I worked in my father’s hardware store. I worked very closely with customers and one of the things I began to appreciate were service and relationships.
When I was 14 years old one of our customers who was a family physician invited me to join him for rounds at the hospital. During that day I went into the operating room with him. I stood on a platform and saw him performing a tonsillectomy. There was a lot of bleeding and the next thing I knew I woke up on the floor with the nurses giving me smelling salts and compresses and helping me back to my feet. Despite passing out, it was a very powerful experience for me that day. I came out of it believing that I could make a difference and wanting to be in a service industry where I could really help people. That’s how I decided to go into medicine.

When I first entered medical school I thought I wanted to be a psychiatrist but I fell in love with anatomy and physiology and I made a decision to become an internal medicine doctor because it meant that I would be in continuity rather than episodic relationships with patients and their families. And last year, after 44 years of seeing patients, even as a CEO, I stepped away from clinical medicine for the first time.

I think about it often because there are these inflection points in one’s life when you make choices and those choices have tremendous influences on your life, and I have no regrets.

What are the top three challenges Healthcare is facing these days?

I think healthcare is under tremendous challenge right now. There were many challenges prior to the pandemic but given the pandemic, we’ve seen an acceleration in those challenges and new challenges added to the mix.

“No matter how we leverage technology, healthcare, in my opinion, will continue to be about people taking care of people.”

The number one challenge we’re facing today in my opinion is staffing and human resources. The people that we need both today and for the future. We have critical shortages in staffing, and no matter how we leverage technology, healthcare, in my opinion, will continue to be about people taking care of people. We need technology and innovation but we also need the people. We need to inspire the next generation to go into medicine and we need to repopulate our pipeline of nurses and other key positions. It’s a major challenge for us at Virginia Mason Franciscan Health in Seattle, and it’s a major challenge throughout the U.S and I believe around the world.

When you look at the demographics of healthcare practitioners, I am proud and pleased to see more women going into healthcare. It has gradually changed over my career, both nationally and internationally and even in our organization where more than half of our physicians are now women.
The demographics is such that more women are choosing primary care, gynecology and pediatrics. That’s good too because we have shortages in these areas. But I also think that having more women in medicine will be much better for men as well. We need more balance, collaboration, teamwork and relationships – all of which are skill-sets that I think women colleagues are better at than we men are.

“The cost of care is a tremendous burden on our society and the biggest source of unnecessary cost is waste.”

Another challenge that has been present with us for quite a long time, is that we have an environment full of waste that drives up costs. The cost of care is a tremendous burden on our society. In the United States, we are so proud of our health system, but we have 30 million people who are uninsured. We have the employers bearing a huge cost which is threatening their global competitiveness as they pay for healthcare. And the biggest source of unnecessary cost is waste; unnecessary testing, unnecessary treatment, end-of-life care, waste in our supply chain, and in all of our processes. This includes waste in the flow of information which is one of the most important things we need to do in healthcare today. Because in addition to being a people business we’re also an information business, and there’s plenty of waste there as well.

“We’re running the risk of having the technology run our processes instead of our processes driving technology.”

The third major challenge is how to leverage technology appropriately. Science and technology infrastructure are moving so fast but we’re also running the risk of having the technology run our processes instead of our processes driving technology. And I worry that if we deploy our technology in the wrong way, we will depersonalize healthcare, we will accelerate the bad processes and could lose the essence of the profession. So I think technology is critically important for the future but how we leverage it is an important topic for the future of healthcare.

Can you share a specific challenge you or your organization have been dealing with?

We need to ensure that we have a modern value proposition for our people. Because not only are we competing with other healthcare organizations or health care related companies but we are also competing with other industries. Here in Seattle, for many entry-level management positions, we are competing with Amazon, Google, Microsoft, and even companies like Starbucks. These industries are nimble, they don’t have the type of regulations we have to live with, there’s more money, and you can bring your baby to work and even your dog. It’s hard to compete with that.

“Our challenge is to create a management system within an organization that empowers team members to identify waste in their workflows and redesign the work.”

This is why we have to focus on our value proposition. And this actually ties to the second challenge I spoke about; waste in the workplace. Our challenge is to create a management system within an organization that empowers team members to identify waste in their workflows and redesign the work. It doesn’t have to come from the C-suite. And it is true for the critical care unit, for the ambulatory, f areas or the operating room. For every unit within the organization.
This is what my work has really been about. We try to apply innovative solutions, training people all over the U.S. and in other countries in these methods.

“Technology is critically important for the future but how we leverage it is an important topic for the future of healthcare.״

What’s unique about the FOH community?

The FOH is international and multi-sector. I’ve been part of it from the beginning, and I had fun watching it grow. I value the exposure to leaders and innovative thinkers from around the world that are either in healthcare or are influencing healthcare. The FOH is also very forward-thinking, and it’s about innovation but it’s grounded in reality. In our workgroups we have thinkers from academia but also people like me who live in the trenches of healthcare delivery. Meeting people from other parts of the healthcare ecosystem is very very valuable.
There’s a good balance and I find those interactions very stimulating because you have people pushing you to think outside the box but at the same time, you have to make sure that it’s “fit for purpose”, that it works for the reality we’re trying to create. It’s quite unique in that regard.