By Barry Rascovar
Dec. 18, 2017 — Ron Peterson isn’t your stereotypical leader of a renowned $8 billion enterprise. He’s quiet, reserved, extraordinarily polite and lacking in ego.
Yet time after time he has worked miracles at Johns Hopkins in his 44-year career at the East Baltimore academic medical center, the last 21 running its huge health-care system as well as the famed “mother ship” — Johns Hopkins Hospital.
More than any individual, Peterson has come to embody the spirit and commitment to superior health care envisioned by the founder.
Hopkins Medicine is Maryland’s crown jewel, the most prestigious and best-known enterprise in the state with a world-wide reputation as best in class.
It also is a giant economic engine for the state, encompassing six hospitals, 40 outpatient care sites, home care, managed care insurance, extensive medical activities abroad and a staff of over 40,000.
The place is a booming success because of Peterson’s steadying hand. Had he not been at the helm in 1996, Hopkins Medicine may have imploded.
Hopkins stood on the brink of tearing itself apart. A bitter, angry war had erupted between the hospital system’s assertive CEO and its prized medical staff.
Flash back to those tumultuous times when the managed-care revolution threatened the survival of hospital systems, especially high-cost academic medical centers that specialized in taking on the most difficult — and thus the most expensive — cases.
Block vs. Johns
Dr. James Block, a hard-charging CEO, had been brought in to meet the managed-care challenge, trying to bulldoze through deep budget cuts while extending the Hopkins universe to community hospitals and clinics. Both moves provoked the ire of the Hopkins medical faculty, represented by the highly regarded dean of the medical school, Dr. Michael M.E. Johns.
Open warfare erupted between the hospital CEO and the medical school’s leader.
At that pivotal moment, Block brought in Ron Peterson to act as a stabilizing force.
And why not? He had engineered a remarkable turnaround at the money-losing City Hospitals that today is known as Johns Hopkins Bayview and is ranked high for its expansive research and quality patient care.
Earlier in his career, Peterson had crafted a cost-reduction plan that by 1977 had Hopkins Hospital in the black for the first time in 88 years.
The Block-Johns rift, though, proved impossible to bridge even for a unifier like Peterson.
Johns left in disgust, taking over Emory University’s medical school and hospital (where he dramatically increased the quality of care and research as he became president and CEO of Emory Health in Atlanta).
Then the Hopkins trustees forced Block out.
To no one’s surprise, Peterson was asked to replace Block, but this time in a revised management structure that made it clear the dean of the medical school, not the health system president, would have the final say.
That turned out not to be a problem.
The new dean, anesthesiologist Dr. Edward Miller, impressed the trustees and medical staff so much as interim leader he was named the first Dean/CEO of a novel umbrella entity, Johns Hopkins Medicine.
The Miller-Peterson Era
Miller and Peterson hit it off right away. A bond of trust developed between the two team players, whose modus operandi was consensus-seeking.
Well-liked and respected by colleagues, Miller was a good listener, accessible, decisive and delegated responsibility easily. He believed in the Hopkins culture of collegiality and collaboration. It helped that he looked the part of a presiding officer.
His skills meshed with Peterson’s, who is obsessively detail-oriented, a financial whiz and sensitive to others’ feelings. Miller took care of the medical side and Peterson handled the administrative side of 21st-century health care. They never took major action without talking it over. No bitter rivalries or hard feelings.
They worked in tandem from their new office suites down the hall from one another.
Within a few years, the Hopkins civil war was history, the managed-care threat had eased and Hopkins Medicine enjoyed over a decade of rapid advances in patient care, teaching and innovations on the medical side and a big expansion of medical services, a community-based delivery model and billions of dollars in patient-care and research towers rising in East Baltimore.
Miller retired in 2012 but Peterson stayed on to tutor the new dean, Dr. Paul Rothman, and make sure the Hopkins ship of state was in tip-top shape for his own retirement.
He found an ideal successor to run the mother ship, Dr. Redonda Miller, whose specialty is medical education management and women’s health.
Then last week, the trustees named Kevin Sowers, a longtime executive at Duke University’s medical system as the next chief of Hopkins’ extensive medical enterprise, but still No. 2 within the chain of command.
When Sowers takes over Feb. 1, Hopkins Medicine won’t have Peterson around for the first time in decades.
Indeed, Peterson has been a Hopkins “lifer,” starting as an undergraduate on the Homewood campus (with the unfulfilled goal of becoming a physician) and ending his career nearly a half-century later as “Mr. Hopkins.”
He will leave behind plenty of unanswered questions:
- Will Sowers and the current medical school dean develop the same compatibility as the Miller-Peterson team?
- Or will Sowers, a Duke “lifer” until now, bring a totally different health management style to Hopkins that reignites the old conflict?
- Will the medical staff welcome an outsider (much as they did for Rothman)?
- Or will tensions arise with a health system CEO unimpressed by Hopkins’ engrained culture of collaboration and consultation?
Much is riding on the outcome of this transition.
The initial signs are promising: It was Rothman who suggested Sowers would be a good fit for the job.
Sowers’ background as an oncology nurse (with an R.N. and a masters in nursing), his focus on improved patient safety and bedside care as a Duke administrator, and his teaching and research resume seem ideal for his new role.
Still, these are perilous times for academic medical centers. Under the Trump administration, federal funding for health care — especially Medicare and Medicaid — could be sharply curtailed, in part to pay for the Republican tax cut plan.
Meanwhile, Maryland is trying to convince the administration in Washington to approve an extension of the state’s unique all-payer hospital cost services system, one that places more pressure on hospitals to improve patient outcomes at lower cost.
Peterson has been in the middle of that fight, too.
So while he might be stepping down from his Hopkins duties (though remaining as a special adviser to Rothman), Peterson continues to have an impact in trying to save Maryland’s one-of-a-kind hospital payment system — a huge success story that could become a national model some day.
We may not have heard the last of Ron Peterson when it comes to crafting solutions to health-care problems. That would be very good news, indeed.