He expects to take a proactive approach toward health care reform
As the clinical practice's first full-time CEO and a deputy dean at Yale School of Medicine, Paul Taheri, MD, is responsible for more than 1,000 physicians, a number he expects will grow.
Paul Taheri, MD, MBA, arrived in New Haven on March 1 to take over as CEO of Yale Medical Group (YMG), and lead the practice into a new chapter as it adjusts its direction, sharpens its focus and strengthens its position in anticipation of health care reform. He moved into his office on a Friday and his schedule was filling up by Monday.
Dr. Taheri left Shelburne, Vt., a suburb of Burlington, where he served as CEO of University of Vermont (UVM) Medical Group, for a new challenge. “Yale is certainly a bigger enterprise,” said Dr. Taheri. It’s also in a location in the middle of powerhouse medical centers in New York and Boston, placing it, he said, in a “hotbed of innovation and health care delivery.”
As the clinical practice’s first full-time CEO and a deputy dean at Yale School of Medicine, Dr. Taheri is responsible for more than 1,000 physicians, a number he expects will get “a fair bit bigger.” In Vermont, he led a 500-physician multispecialty group, and was credited with preparing the group for the future of health care reform. He established the Fletcher Allen Center for Health Care Management to provide business training to physicians, nurses and administrators, and led the UVM Medical Group Revenue Department to achieve national ranking among its peers.
He described his leadership style as “informal, not particularly rigid.” He said, “I try to be pragmatic,” and noted that it may help that he has raised four children. “Generally speaking, I tend to listen, am thoughtful and patient, and fairly process-oriented.” During an interview to discuss his short and long-term priorities at Yale, he was animated, energetic and optimistic.
What to expect in his first ‘100 days’
With the changes ahead, Yale Medical Group will need to make many important decisions fairly quickly, so an immediate focus will be more centralized leadership for the practice. “YMG is still largely department-centric,” Dr. Taheri said, adding that this approach helped drive a decade of major expansion. But now, “the reality is to move toward a more centralized function. Figuring out how we govern ourselves will be a very big issue. Ultimately things have to come to some sort of pinnacle where a decision is made by the group.”
He naturally expects to meet frequently with the chairs, who will be “the key players in all of this. The faculty at large is also very important. We must have the faculty engaged in this transformation. We need them to be open and thoughtful about this, because things are going to change. My view is that we need to be proactive—it’s better to manage change yourself.”
Importance of standardization
Standardization in the way patient care is managed was an important focus for Dr. Taheri at UVM, and is a major goal at YMG in the next year. “How does registration work? How are patients brought to the room? Which person is doing what in the clinic?” he asked. “Whether they go to New London or Bridgeport, it should be the same experience. There are huge benefits to standardization.”
Standardization could mean redefining job descriptions to make sure each member of the team is clear about his or her role, or completing much of the necessary workflow in advance of seeing a patient.
Yet another goal is to find a way for YMG to take a lead role in filling the growing gap in primary care in Connecticut. “I think most of us have experienced it—you can’t get an appointment for six weeks,” Dr. Taheri said. “From what I understand of YMG, primary care is a clear deficiency here as well. Primary care is where the volume is. I suspect that is where the practice will grow.”
Physician capacity and other issues
Meanwhile, President Obama’s health care reform takes effect next year with anticipated cuts in reimbursement from Medicaid and Medicare, as well as other changes in the financial model of medical practice. All of this will drive YMG in the future. “Obamacare aside, the biggest issue is around physician capacity,” Dr. Taheri said. “There is a shortage of physicians around the country, whether you look at the region or the specialty. As we age, we’re adding 10,000 people to Medicare every day, and they consume a lot of health care. Access will be a problem. From a practice standpoint, in the next five years or so, it’s going to look different.”
But Dr. Taheri believes YMG is well-positioned to weather any coming storms. “I think Yale is in a great spot,” he said. “You have world-class faculty. You have a great brand. You still have leverage with the payers. As long as we are data driven, thoughtful, methodical, we can manage the changes and balance all the missions of the enterprise, and come out more able to bear risk. Quite frankly, being inside a large enterprise is the place to be in the new world of health care reform.”
Growth in the last decade
Dr. Taheri succeeds David J. Leffell, MD, director and later CEO of YMG who led a phase of unprecedented growth and transformation for 15 years, while continuing to direct the Section of Dermatologic Surgery and Cutaneous Oncology. Michael Berman, MD, who directed the initial restructuring of the practice, oversaw its operations as interim director and CEO during the past year, and will continue to support the practice as a consultant.
Dr. Taheri was born and raised in Buffalo. He completed his medical degree at New York University and surgical residency at Tulane University Medical Center, then joined the University of Michigan, where he also completed his MBA. Now he is looking forward to living in Connecticut, where he will be closer to his wife’s family in Ridgefield, and his children, three of whom are either in college or graduated.
A former vice chair of surgery for University of Michigan, he also plans to practice trauma surgery in Yale-New Haven Hospital’s operating suites.