Sources Revealed
Julius Spears prepares Providence Hospital for the future
Washington Business Journal - by Tierney Plumb Staff Reporter
Julius Spears has been chief executive officer of D.C.'s Providence Hospital since 2005. The New Orleans native's love for Southern cooking and the outdoors are telling him to become a food critic and golfer when he retires. But for now, he often clocks 12-hour days making sure the District's oldest hospital is ready for the future -- then winds down at home with "American Idol" and his 90-year-old father-in-law.
What major health care facility issue will you be facing in the next five years? One has to do with volume. We are seeing that, in D.C. in particular, inpatient volumes are starting to decline. We are all trying to get a handle on what is causing it. We saw this in the mid-'80s when those who came for their services waited until an illness became more acute and then they would show up in the emergency room. So in some cases health care becomes secondary and tertiary in setting priorities. We are unique in that we are a community facility that is expanding in terms of patient base. We have some programs that are becoming natural draws for different populations.
So how do you expect to control that growth? We are trying to partner with the D.C. Primary Care Association because there's an issue about access -- especially access to specialists. They have a lot of primary care physicians, but the idea of getting specialists to come into the community so patients can get that one-stop-shopping type experience is what we are going to be working to develop with them. The idea is, if we can literally put specialists in the community, even if it's two days a week, it's easier for someone living in that community to get there than find transportation to get to us.
If you could change something about Dimensions Healthcare System's management to make the troubled Prince George's County hospital more efficient, what would it be? I really think it's the funding mechanisms that are problematic. I think it's the appropriate allocation of resources to support the public system and, unfortunately, it's not unique to Prince George's County. I came from Grady Health System in Atlanta, which is going through something similar in terms of adequate dollars to care for patients showing up. When more people don't have insurance and they're waiting until they're sicker before showing up, the requirements for caring for that acute illness are a whole lot more than if there were preventative programs in place in the first place. Right now a lot of dollars go toward hiring physicians because the patients coming in there aren't paying patients. You need to find mechanisms to entice physicians to practice in your facility, and that's a struggle for them at this point, especially when you're not investing in technology and IT infrastructures.
Providence and your parent, Ascension Health, have been conducting due diligence on whether to buy Dimensions. What is the update? The reality is, the due diligence piece was never really to look into buying. Unfortunately, between the county and the state, they were looking for someone to acquire. They weren't looking for a management agreement. The state and county said they want out of the business. They want someone to offer to buy the facilities.
So are you out? Our due diligence process has ended. We did help them think through some of what's going to be needed if it's going to be a successful system. I think we are out once someone has actually acquired it or some final decisions have been made. I say that because if, in fact, the Prince George's system doesn't work and it goes under, we are in trouble. Because we will, by default, become the safety net for P.G. County. And that means a whole lot more uncompensated patients coming to our facility.
Are there potential buyers out there? It depends on how that RFP will be looked at. I'm sure some venture capitalists have some interest in the real estate. How many are really interested in the health care piece is yet to be seen. I'm optimistic there's someone out there who sees the big picture and is willing to work with the state and county to come up with a plan that will benefit P.G. County.
What's your idea of winding down at home in Gaithersburg? My father-in-law from New Orleans lives with us. [He's] a Hurricane Katrina evacuee. He's 90 years old and likes to watch "Dancing with the Stars" and "American Idol." It's funny because he keeps saying, "You need to see this!" When you're around someone who's lived that long, they all have stories, so you benefit from that.
When your own father lost a battle to lung cancer at 66 from smoking three packs a day, you made your hospital the first in the District to go have a smoke-free campus in January 2007. What effect have you seen, a year and a half later? When I first got here, the emergency room area was where you put cigarettes out. People were anxious and would chain smoke outside the ER. Now when you go to the ER you seldom see that. At one point, when we first started this, we had some backlash from the community because people would go across the street and stand in front of our neighbors' homes and smoke. So we are fairly aggressive to let associates know that's not acceptable.
What was one challenge you had in making it campus wide? We have Seton House, which takes care of psychiatric and substance abuse patients who have mental challenges. We got our psychiatrist leaders to buy into it and know smoking wouldn't be tolerated. Our medical director literally said, "Tell me the benefit of allowing them to smoke." There isn't.
What are some other improvements you're making at Providence? The whole idea of transparency --if someone goes to one of the clinics, being able to shift some of their information to the hospital so when they get there it's not reinventing the wheel. One of the challenges for us was we were a little behind the curve in terms of some of the technology investment. Now with the corporate support and recognition of how far behind we really are, we are starting to be able to invest in technology. We had been keeping up with the clinical investments, but with business systems we've fallen a bit behind. Luckily, we are catching up.
Do you see your proximity with the biotech bubble in Maryland as an opportunity for advancement? I think because of the bubble and our interest in now fostering different types of research, that will put us in a good place. That also becomes an income stream for our physicians. If some want to get published, we can help them do that through some research they do here. There is cutting-edge technology out there, and if we are able to capitalize through research and getting some of that here and allowing our patients to benefit from it, then it truly becomes a win-win.
Is the health care job industry being affected by the economy? Let's wait and see. We are seeing our nurse vacancy rate go down. That's a plus because we are using our nurses, not agency nurses or traveling nurses. I say wait and see because we are hearing there are a number of hospitals nationwide that are really looking at the need to downsize, or right size. We did that in 2005. It's not something we are proud of, but we had the first RIF [reduction in force] in this hospital's history. My commitment is if we manage according to standards and fluctuate when our volume fluctuates, hopefully we will never have to have another one.
What's the best medical success story you've heard this hospital carry out? Some of our own associates have been here, and with everybody not knowing who they might be, they report back they received top-quality care. It's a sense of the mystery shopper-type program. The good news is we have foundation board members who use our facility and are proud of it. These are people who have the ability to go somewhere else.
What's one of your favorite aspects of D.C.? Home for me is New Orleans, so good food is just expected. I am surprised at how many good restaurants there are. I like Acadiana and Bombay Club. I think my next job will be a restaurant critic so I get to try them all. I like to eat, and I don't apologize for it. I definitely try to be sensible. We talk about being health conscious. It's like, what would I look like rolling out of here?
So how do you stay in shape? My workouts during the winter don't exist. We are on the fourth floor, so I always make it a point to walk up and down all four flights maybe twice a day. But as it warms up, my exercise will hopefully be on the golf course. Let me tell you, I'm not a good golfer, but I'm passionate about it and I am determined to improve. Being outside is a pleasant reprieve from being here in the hospital.
E-mail: tplumb@bizjournals.com Phone: 703/258-0830
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