Kevin Tabb, M.D., takes over as president and CEO of BIDMC
Kevin Tabb, M.D., acknowledges that his path to becoming Beth Israel Deaconess Medical Center's new president and CEO was not entirely traditional. "I have what I would call an eclectic background," says Tabb, "which certainly allows me to bring my own unique perspective and experiences to the table." Raised in Berkeley, Calif., Tabb made good on a personal pledge to move to Israel at age 18 and sign up for mandatory military service. A chance assignment as a medic, which exposed him to hands-on interactions with patients, made becoming a doctor a foregone conclusion. "You might say medicine chose me," he notes.
But while Tabb was drawn into medicine by the gratification of caregiving, he stayed engaged because of the reward of consensus building. After his return to the United States in 2000, his career would take a decidedly administrative turn, stretching from big industry to small start-ups to academia. "In my previous job, much of what I did was to serve as a translator, not between Hebrew and English, but rather between the clinical world and the business world," he says of his prior position as chief medical officer at Stanford Hospital & Clinics. "And I still see myself as able to fill that role even though I'm now CEO. I'm serving as a translator between the world of an academic medical center, which includes clinical care, research, and education, with the world of running a large enterprise."
Today, Tabb's management savvy combined with his medical degree puts him in an ideal position to not only bring people together but to play a crucial leadership role in bridging the fields of health care and big business. Having to make these fields constructively intersect has become essential for a hospital in a rapidly evolving medical environment and consumer-driven marketplace, and Tabb knows that for BIDMC it will mean moving away from business as usual. "The question of how an institution prepares itself to adapt to significant changes in the market is not a unique question and not one that only health care needs to deal with," he says. "There are lots of examples of companies, of other businesses, that did this really well, didn't do it at all and fell off a cliff, or waited too long to do it. And we can certainly learn a great deal, both positive and negative, from the experiences of industries like the automotive or airline."
Tabb believes that achieving a positive outcome in health care requires being less insular and looking for answers beyond the traditional boundaries to embrace new ideas like technology-based health monitoring, less hierarchical and more interdisciplinary clinical structures, and an increasingly proactive role of patients. He notes that because Massachusetts is already years ahead of the rest of the country in terms of responding to health care reform, opportunities abound for making these changes work to everyone's benefit. "There's never been a time when the forces of public policy, reimbursement, and health care delivery have aligned as they do at this moment," says Tabb. "But there is also the fact that we will need to partner with others in order to take advantage of that. Perhaps we will need to show some level of humility in understanding that there are others who might know more about how to do some of these things than we do."Not surprisingly then, Tabb, who joined BIDMC in October 2011, was intent on reaching out to others in the Boston community during his first few months as CEO. Aside from recognizing the importance of this strategy to BIDMC's ongoing success, Tabb also points out his comfort level in making it his initial focus because of how well positioned the medical center was upon his arrival. "Our future direction will be directly influenced by what is happening externally, so it's important to gain as many perspectives as possible on the landscape," he says. "And I've been at every hospital in Boston, small to large, those who are tightly aligned with us and those who are competi-tors, all of whom have welcomed me warmly and had honest and candid conversations with me."
From colleague to competitor, the theme consistently running through these discussions was the idea of change, according to Tabb. But "change" is such an ambiguous concept and once applied to an ambitious idea as health care reform, we're left wondering exactly what it means for the hospital. In some ways, it's too early to tell, but Tabb notes that some universal truths are already rising to the fore. For one, despite this change, he stresses that BIDMC will never abandon its fundamental mission of providing the highest level of patient care grounded in world-class biomedical research and medical education. Instead, the organization will need to expand these areas of excellence to a broader market. "The key to our success will be our ability to morph from an institution that takes care of people when they are sick and happen to show up on our doorstep into a place that thinks about people across the continuum of care," he says. "Most importantly, we need to think about people not only as patients but also as people we need to keep healthy."
This fundamental shift will require an increasing reliance on primary care, the expansion of health care networks and partnerships, the empowerment of patients, and the adoption of innovative technologies and systems-all of which Tabb sees as both unavoidable and potentially advantageous. What energizes him is the fact that BIDMC already excels in all of these areas, which means his faculty and staff can be on the leading edge of actually implementing change, both internally and externally, rather than having it thrust upon them. "There's a great deal of high-quality health care that can and should be delivered in the community where people live," he says. "It's better for the patient, and it's often also more cost-effective. It's not often that those two goals align, but I think we have begun to see this kind of alignment in health care. It's challenging and very exciting."
However, laying the basic groundwork to address these challenges will not come without a price. Creating and implementing new systems of care-no matter how cost-effective they may ultimately be-will have upfront expenses, and transferring care to the community will initially strain medical centers' bottom lines with lower volumes and reim-bursements. Not to mention still having to keep up with the rapid pace of medical progress in research and technology. "There is no great academic medical center that can thrive without philanthropy," says Tabb. "Now is the time that we will need philanthropy the most to do the things that are unique and special to our institution."(See President's Innovation Fund below.)
Tabb says capitalizing on those unique and special strengths to realize BIDMC's promise is the reason he's here. He relishes the thought of applying his broad expertise to help bring the community's hopes and dreams for the institution to fruition. "Great ideas can-and do-come from anybody," he says. "So I am trying to spend time, as much time as I can, outside of this office, out on the floors, in the clinics, talking to people, hearing what concerns them, what would they like to see happen." He says that the sense of openness and commitment that permeates the culture at BIDMC is not something he takes for granted. "It's the little things," Tabb muses. "I will get stopped in the hall, and people will tell me, 'I've been working here for 35 years, I was born here, my mother worked here.' These are people who never left, through hard times, through good times, who love this place. There are a lot of people like that. And that's a wonderful thing to have."