Russell M. Howerton, Senior Physician Executive, Atrium Wake Forest Baptist Health
May 24th, 2022 by Vizient
Tom Robertson, Executive Director of the Vizient Research Institute is joined by Dr. Russell Howerton, a surgeon and long-time Chief Medical Officer at Wake Forest North Carolina Baptist, now Atrium Wake Forest Baptist Health. Russ and Tom discuss everything from shared experiences with bygone general practitioner physicians to the effects of modern era mergers and acquisitions. Along the way, they tackle issues ranging from the balance between autonomy and systematic reliability to the economics that influence the delivery of care.
Russell M. Howerton, MD, FACS
Senior Physician Executive
Atrium Wake Forest Baptist Health
Vizient Research Institute
[00:50] Advice to give a young Russ Howerton
[01:40] Father exemplified individual accountability, autonomy model of medicine
[02:25] Trained under Lucian Leape, author of “To Err is Human”
[06:27] There’s variation of service with any sized system, and scaling it up with a merger won’t change that
[11:15] There’s some debate that a highly skilled, low-volume surgeon will be better than a low-skilled, high-volume surgeon, but probably little debate that an institution has systems and processes in place better when doing high volume.
[12:30] The financing and provisions of the infrastructure to deliver health care is complex – it’s like a Jenga puzzle to manage it
[15:00] Society doesn’t want to see market failure in health care where people can’t get service when they need it at a micro level
[22:00] Thoughts on price parity for patients
[22:50] Price parity would free us from “segregating" patients by their payer status
[23:54] Payer parity is different than global budgeting. It puts pressure on the current pricing model and wouldn’t survive indefinitely in society because many valued services would be hard to support.
[26:50] Atrium Wake Forest Baptist wants to be a regional leader in converting to a value-based care model, but still can’t keep the lights on without focus on the volume-based model.
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