Health Care

Opinion: Trust, Treasure And NHRMC

By Rob Kaiser, posted Aug 27, 2019
(Rob Kaiser)
If nothing else, New Hanover Regional Medical Center’s potential sale is a fascinating leadership test.

Take a seemingly strong, stable community treasure and propose selling it. Watch pandemonium ensue.
What madmen would yell “intent to sell” in a crowded theater?
Before assessing the idea’s merits, we should look at motivations. 
Sales of public companies are often propelled by a “deal fever” fueled with stock options and success fees for executives.
That doesn’t appear to be the case here. NHRMC CEO John Gizdic and New Hanover County Manager Chris Coudriet have said no bonuses or other financial benefits for them are tied to getting a deal done.
More likely, the opposite is true – they’re adding risk to their careers and reputations by stepping before the cameras to push this idea.
Assuming this is the case, Gizdic and Coudriet should get credit for seeking to serve as responsible caretakers of their organizations – even if you don’t agree with their conclusions.
The motivations of the ultimate deciders, New Hanover County’s five commissioners, are more difficult to discern.
How much are they motived by their own caretaker roles? How much are they motivated by having a legacy-enabling $1 billion in the county’s coffers?
As public officials, should they echo and vote along with loud cries of constituents? Do they have a sense of how many people are for, against or undecided about exploring a sale?
Do they already have enough information to stop an exploration process before it starts?
Whether to sell a $1.2 billion medical center is a tough decision for people with decades of relevant experience, particularly in an industry with a murky answer to the most basic business question: What can they charge for their product?
It’s even more challenging for our commissioners – a real estate agent, financial planner, homebuilder and two attorneys – whose day jobs are far from the world of Medicare, capitation fees and health care utilization rates.
Similarly, I have little experience in the health care business so I’ll use an anecdote from my industry.
The Graham family bought The Washington Post in 1933. Through its stewardship, the Post became a model in both the worlds of business and journalism by doing everything from uncovering Watergate to becoming one of Warren Buffett’s successful investments.
Then the internet disrupted its business model. In 2013, Post CEO Don Graham made the surprising announcement that they’d handpicked its next owner, Jeff Bezos, believing his financial strength and tech savvy could best fulfill the Post’s mission.
“We were certain the paper would survive under our ownership, but we wanted it to do more than that,” Graham wrote. “We wanted it to succeed.”
My point isn’t that NHRMC has similar business circumstances as The Washington Post or that there’s a Jeff Bezos-like savior out there.
The point is The Washington Post’s caretakers concluded their community treasure had a better future under different ownership.
NHRMC’s caretakers are saying that may be the case here too, and they want permission to find out.
If I were in a county commissioner’s seat, I’d be hard-pressed to not let them do it – unless I didn’t trust them.
Trust will be a key ingredient in how things move forward assuming the county commissioners approve exploring options.
Coudriet and Gizdic have pledged a transparent process – open meetings, publishing the proposals they receive and public hearings – before a recommendation goes to the county commissioners.
Yet this should go further than the usual standard of openness for public bodies. At the end of this process, people shouldn’t just feel like they’ve been listened to at a public hearing. They should be heard.
Who’s at the table when the RFP is drawn up and proposals are reviewed is particularly important.
Coudriet and Gizdic plan to create an advisory committee to work on these items. Obviously the size of this committee must be manageable.
Like many businesspeople, I only half-jokingly say the ideal size for a committee is one person. But that won’t fly here. In fact, just having one committee isn’t enough.
There are too many stakeholders in this $1 billion decision – including patients, health care providers, the surrounding counties, employers, nonprofits, underserved communities and more.
Each stakeholder group should have its own well-structured, well-led committee providing input to the core advisory committee as well as NHRMC and county officials.
This exploration process won’t just test the leadership skills of Gizdic, Coudriet and the county commissioners.
It’s a test for all of us.
In this age of Twitter declarations and iPhone-induced attention deficit disorders, can we invest the time, care and attention to develop a deep understanding of the issues and opportunities so we reach the right decision?
Rob Kaiser is the publisher of Greater Wilmington Business Journal and WILMA Magazine. He can be reached at (910) 343-8600 x204 or [email protected].
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