The career of the new Dartmouth-Hitchcock CEO, a specialist in pain management who runs the huge Lahey Hospital in Massachusetts, reflects both the promise and peril of changes that are coming to health care.
The promise involves changes to the old model of concentrating health care inside hospitals, while the peril involves the inadvertent creation of the opioid crisis by medicine’s focus on managing patient pain.
Dr. Joanne Mather Conroy, whose appointment to head Dartmouth-Hitchcock was announced Thursday, will be moving from being head of a 343-bed hospital to head of a health system that includes an even larger hospital – the 417-bed Dartmouth-Hitchcock Medical Center – as well as a sprawling network of providers and clinics throughout New Hampshire and Vermont.
One of the lessons Conroy can bring from Lahey is the push to change where health care is received.
Conroy said that 78 percent of Lahey’s revenue comes from services outside the hospital, “the highest figure in the country,” and is reflective of an ongoing industry shift.
“Health care is less about what’s going on inside the walls of the acute-care facility, and much more how we’re delivering care out in the community,” Dr. Conroy said in a Thursday interview.
Conroy, 61, is familiar with the Hanover area because she received her bachelor’s degree in chemistry from Dartmouth College in 1977. She said she was drawn by D-H’s reputation for tackling this and other changes in medicine, as reflected in such things as creation of the related Dartmouth Atlas of Health Care.
“When I was in Washington, D-H and the Dartmouth Atlas were unique, bringing data to the conversation about how much care is the right care, can we deliver too much care, could an intervention be harmful, and bringing concepts that health care should be paid on outcomes rather than volume,” she said.
Anne-Lee Verville, chair of the board of trustees that chose Conroy out of dozens of applicants, pointed to Dartmouth-Hitchcock’s push into tele-medicine, using internet connections to provide diagnosis and care to patients in remote locations, as an example of this push.
Conroy received her medical degree from the Medical University of South Carolina, and is board-certified with the American Board of Anesthesiologists and is a diplomate with the American Academy of Pain Management.
This specialty of pain management is at the heart of the biggest challenge facing medicine now. The way an increased emphasis on helping patients deal with pain inadvertently created mass addiction to opioids, indirectly breaking one of the basic rules of medical ethics: “First, do no harm.”
Conroy, 61, was trained as the medical profession started giving more attention to patients’ pain and how to treat it.
“I grew up in a system where we were still very, very, very reticent to put people on opioids long-term. I can tell you that when some of the narcotics came out – aerolized, lollipops, patches – a lot of anesthesiologists struggled with that. We know how addicting those drugs can be, wondered what long-term effect would be,” she said.
She said Lahey – which, among other things, gives grants to police departments to help deal with overdose victims – is struggling with the “incredibly difficult problem” of how to ease pain without fueling addiction, and that D-H is doing the same.
“We have to be committed to create the infrastructure to manage pain effectively,” she said. “We have to train providers to manage the benefits of these powerful drugs and also to manage the drawbacks.”
Conroy replaces Dr. James Weinstein, who retires at the end of this month. Weinstein became the first CEO and president of Dartmouth-Hitchcock in 2011, after it dropped a system in which the presidents of Mary Hitchcock Memorial Hospital and the Dartmouth-Hitchcock Clinic co-governed the organization.
Dartmouth-Hitchcock said it does not disclose employee compensation and wouldn’t say how much Conroy will be paid.
Weinstein’s 2014 total compensation, including a $1.1 million salary, bonuses and retirement package, was $1,455,405, according to the group’s tax records. Conroy’s total compensation at Lahey in 2014 was $412,742, according to tax records.
Conroy will assume her job on Aug. 7. Between July 1 and Aug. 6, Dr. Edward Merrens, chief clinical officer, and Stephen LeBlanc, chief administrative officer, will hold the titles of co-interim CEO and president.
Prior to her leadership role at Lahey, Conroy served for more than five years as chief health care officer for the Association of American Medical Colleges in Washington, DC. Before that, she was Chief Medical Officer and held other positions at the Atlantic Health System based in Florham Park, N.J., a not-for-profit Atlantic system that operates three acute care hospitals.
(David Brooks can be reached at 369-3313 or dbrooks@cmonitor.com or on Twitter @GraniteGeek.)
