How his health care system’s public-spirited response to Hurricane Katrina and its aftermath helped prompt recognition of UTMB alumnus Patrick Quinlan as ‘one of the hundred most powerful people in health care’ and the nation’s single most powerful physician executive.

By KATE MORAN

When Patrick Quinlan announced last fall that independent, not-for-profit Ochsner Health System would buy three underperforming hospitals from a chain trying to quit the New Orleans market, he marked the occasion as if it were his company’s social debut.

One of the nation’s largest private academic medical centers, six-hundred physician, eighty-two hundred-employee Ochsner has been a fixture in the New Orleans region for sixty-five years. But Quinlan, the chief executive, said it had been a “quiet company” that did good work outside the glare of publicity and rarely meddled in public policy debates. Hurricane Katrina brought Ochsner out of its cloister. The storm despoiled several major hospitals, including the city’s lone Level I trauma center, and it spawned an exodus of health care professionals and much of the city’s privately employed professional base. By stepping forward to buy the three shuttered hospitals, Quinlan said Ochsner helped  bring stability to the medical community and encouraged other businesses to continue  investing in the struggling city. 

Under Quinlan’s guidance, Ochsner was also a leader in providing care after the storm. All but three hospitals in New Orleans and its largest suburb shut their doors during Katrina when their buildings suffered catastrophic flooding or their leaders were spooked by the lawlessness that gripped the city for a week after the storm. Despite suffering thirty million dollars in damage, Ochsner never stopped treating patients—even though 70 percent of its employees lost their homes. When the chaos subsided, Ochsner stretched itself considerably. Quinlan compares its role helping to rescue the community to the ones played by police and firefighters: On the heels of the storm, Ochsner maintained a full payroll and adopted hundreds of additional medical residents who were displaced from other teaching hospitals. Meanwhile, the hospital system began treating thousands of uninsured patients who used to receive free care at Charity Hospital, and it continues to do so.

Those heroic efforts, which have negatively affected Ochsner’s bottom line, earned Quinlan a top spot in Modern Healthcare magazine’s 2006 list of the one hundred most powerful people in health care, where he was in the company of such luminaries as Bill Gates.  And his success leading Ochsner helped propel him to designation last May by Modern Physician magazine as the number one doctor among the “Top Fifty Most Powerful Physician Executives” in 2007. Quinlan insisted that these accolades really belong to Ochsner’s board and talented staff. “Most of my accomplishments are the result of the teams here,” he said, “and what strengths I have are related to identifying team members and building strong teams.”

Patrick John Quinlan, fifty-six, a 1977 graduate of UTMB’s School of Medicine, made his boldest move yet in October 2006. That was when he spearheaded the acquisition of three hospitals from Tenet HealthCare Corporation, a publicly traded system based in Dallas, transforming Ochsner overnight into the largest private health care provider and one of the largest private employers in the state. The move placed control of the hospitals squarely in the hands of a local hospital network, quieting fears in the medical community that a speculator would take over the Tenet properties. It also virtually wiped for-profit medicine out the New Orleans region. Today, medical care in the city is dominated by non-profit, public and university facilities.

Colleagues say that Quinlan could pursue an expansionist agenda because he righted his own house first. Ochsner was founded in 1942 by five innovative Tulane University professors who wanted to create a multi-specialty group practice along the lines of the Mayo Clinic at a time when Southern medicine was dominated by solo practitioners. To satisfy the strictures imposed by Louisiana’s Corporate Practice of Medicine Act, which forbade hospitals from hiring doctors, they split their operation into a for-profit clinic and a nonprofit foundation whose finances were separate but intertwined.  While the arrangement worked initially, Ochsner executives were burdened with two parallel organizations that over the years developed separate needs, goals and visions. Quinlan guided their merger into a single non-profit health system in 2001, a move that helped turn the company’s attentions outward and ultimately gave it the flexibility to respond to New Orleans’s post-Katrina health care crisis as no publicly traded, profit-above-all hospital corporation could have done.

“He was a tremendous visionary,” said Richard Guthrie, Ochsner’s medical director. “We needed someone who could be extremely diligent and persistent in understanding the perspectives of the foundation and the physician group to come up with something that would make sense to them both. Their roles in the institution were so different. After a lot of discussions, a lot of listening, he was able to come up with something that was not anybody’s idea of perfect, but something that everybody could live with.”

Quinlan was born in New York City, the son of a homemaker and a mechanical engineer. He started polishing his business acumen-—a quality that colleagues say sets him apart from some physician executives—as an economics major at the University of Texas at Austin. He intended to go to law school but, a few months into a one-year fellowship at the Lyndon B. Johnson School of Public Affairs, he decided it was not his calling. He worked as a hospital dishwasher and a scrub technician while he took night classes to prepare for medical school.

Quinlan said he chose UTMB because of its “reputation for collegiality and for training good clinicians.” While some medical schools are ruthlessly competitive, Quinlan said he was surrounded at UTMB by bright students who did not feel they needed to succeed at the expense of their peers. He also praised the sense of teamwork among students and faculty. He recalled one professor, Jay Fish, who would allow students to observe late-night surgeries and would pour them a shot of whiskey to share with the physicians when the procedure was complete.

“When you were on a transplant team, everyone was treated as a colleague. You were treated you as if you were a peer, even though you were the caboose on that train,” Quinlan said. “You were part of the team.”

“He has taken over a facility that has undergone a great deal of change and brought a lot of stability to it through his calm—usually calm—demeanor.”

Quinlan did his residency in dermatology at the University of Alabama at Birmingham before running a dermatology practice in a small Alabama town. He then moved on to the Lovelace medical system in Albuquerque, where he became chairman of dermatology, then chairman of medicine and finally vice president for regional management. He left Lovelace when he and the chief executive disagreed about how the system should be run. As Quinlan tells it, Lovelace needed a new hospital and made what turned out to be a Faustian bargain with a national company to secure the financing to build it. In the process, Quinlan said, Lovelace lost control of its destiny.

“Lovelace lost its way, whereas Ford, Lahey, Mayo and Ochsner really did not,” Quinlan said, referring to other non-profit group practices that focus partly on research and education.

Quinlan arrived at Ochsner as the foundation’s chief medical officer in 1998. Since rising to the post of chief executive six years ago, he has quietly consolidated Ochsner’s position in Louisiana, acquiring hospitals in Baton Rouge and Raceland, in addition to the three New Orleans facilities that Tenet put on the block after Katrina. Under his auspices, the company also divested the Ochsner Health Plan, an insurance vehicle that he said created friction between patients and their doctors, who are supposed to advocate for the best treatment, not consider how to pay for it. The divestiture had the added benefit of helping to recapitalize Ochsner.

“He has taken over a facility that has undergone a great deal of change and brought a lot of stability to it through his calm—usually calm—demeanor,” said Jack Finn, president of the Metropolitan Hospital Council of New Orleans.

Finn and other colleagues cite Quinlan’s equanimity and his diplomatic skills as two factors that have made him a successful chief executive. But Finn said Quinlan can sometimes get feisty, as he did during a recent meeting of the Louisiana Health Care Redesign Collaborative, a group chartered after Katrina to revamp how care is delivered to uninsured patients.

Dr. Fred Cerise, secretary of the Louisiana Department of Health and Hospitals, had just finished his presentation on plans to assign every uninsured patient a primary care provider so treatment needs could be met without a visit to the emergency room. Quinlan, his voice pitched high, seemed to express the frustration of everyone in the room when he pressed Cerise for hard numbers to show how much such a plan might cost. His grilling lasted only minutes during a lengthy and discursive meeting, but it highlighted the strengths—and the intensity— that Quinlan brings to issues that lie at the intersection of economics and medicine.

Quinlan is one of few hospital executives serving on the forty-member redesign collaborative, which also includes physicians, state representatives, and officials from the Louisiana State University system, which runs the Charity hospitals. He said he can make a contribution with his knowledge of how large systems, such as the one Louisiana is trying to implement, work in the real world.

“We have insights and experience with a large primary care base, with electronic medical records, with the management of a large population and a responsibility for the financial and medical outcomes of our system and health plan experience. When you get into projects of scale, ideas that work on a small scale begin to fail when they reach a certain size,” Quinlan said. “The thing now is that the environment is so different and that the morale of the city is so important to the eventual outcome that it is important that we do the right thing.”

Kate Moran is a staff writer at the Times-Picayune in New Orleans.