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Weinstein to Step Down at Dartmouth-Hitchcock

  • James Weinstein is retiring after five years as president and CEO of Dartmouth - Hitchcock. Weinstein is interviewed at Dartmouth Hitchcock Medical Center in Lebanon, N.H., December 5, 2016. (Valley News - James M. Patterson) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com.

  • Dartmouth - Hitchcock Trustee Chairwoman Anne-Lee Verville is interviewed at Dartmouth Hitchcock Medical Center about the departure of President and CEO James Weinstein in Lebanon, N.H., December 5, 2016. (Valley News - James M. Patterson) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com.



Valley News Staff Writer
Tuesday, December 06, 2016

Lebanon — Dr. James Weinstein, CEO and president of the Dartmouth-Hitchcock health system, announced on Monday that he will retire next year after what will have been a six-year run at the helm of the Upper Valley’s dominant medical provider.

Weinstein, an orthopedic surgeon who served the health system for two decades, oversaw its expansion through affiliations with hospitals nearby and elsewhere in the Twin States, as well as recent budgetary crises that posed challenges to the system’s credit and the confidence of its employees.

The Dartmouth-Hitchcock system comprises five hospitals and Dartmouth-Hitchcock Clinic’s six main locations, as well as many other smaller affiliates. D-H brought in $1.8 billion in revenue in fiscal year 2016; employs more than 9,000 people; and, according to the organization’s website, serves a population of about 2 million.

In a interview on Monday at Mary Hitchcock Memorial Hospital, Weinstein said the health system had weathered its recent financial troubles, built a wide and strong base of community health services and was ready for whatever may come next.

“One of the reasons that I can now retire is I feel good about where we’re going,” he said, “and I’m excited about Dartmouth-Hitchcock’s future, and for the patients and the community that we represent.”

He is scheduled to step down in June, after completing his current two-year contract.

Anne-Lee Verville, chairwoman of D-H’s board of trustees, said Weinstein had broached the idea of retiring about a year ago.

“We (the trustees) spent a lot of time,” she said, asking Weinstein: ” ‘Jim, is this really what you want to do?’ ”

Although there are no predecessors to whom Weinstein can directly be compared — before him, the presidents of Mary Hitchcock Memorial Hospital and the Dartmouth-Hitchcock Clinic co-governed the organization — Verville said his performance had been “excellent, of course.”

“Jim’s been a great leader,” she said. “We’ve certainly had our issues — you know that, and Jim would be the first one to tell you that — but he’s a visionary.”

State Rep. Sharon Nordgren, D-Hanover, said Weinstein’s departure may benefit the institution in the long run.

“I guess I think his tenure has been fine, but things are changing so rapidly in the health care industry that I think Dartmouth needs some new thoughts to bring them up to speed with what’s happening nationally and around the country,” she said.

Nordgren, a senior Democrat overseeing health care funding on the House Finance Committee and the spouse of a retired pediatric neurologist at Dartmouth-Hitchcock Medical Center, also said she has been hearing from veteran employees who feel they “can’t voice their concerns” about management practices at the Lebanon-based hospital.

“I think there needs to be a big turnaround,” Nordgren said. “I know so many people who have left DHMC because they can’t deal with it anymore. Not just the layoffs, but the morale issue.”

At the same time, Nordgren credited Weinstein for negotiating well with state officials to ensure that DHMC is “treated fairly” in Concord, helping expand the use of telemedicine in the state, and building relationships with the smaller, rural hospitals it added to its network.

“One of the important things is to be considering the plight of those critical-care hospitals, and how they mesh with DHMC, and still be able to carry out a mission of their own, and I think he has been very helpful with that process,” Nordgren said.

Bruce King, a Dartmouth-Hitchcock employee who has served as president and CEO of New London Hospital since 2003, said Weinstein has been a “very approachable and affable” leader who helped New London offer D-H specialists in such fields as dermatology and rheumatology a couple of days a week, among other improvements.

“In the four years we’ve been affiliated, we’ve been able to establish clinical programs that are meeting the region’s needs,” King said.

King, who started at D-H in 1987 as a vice president of finance, also acknowledged that the hospital system traditionally has had a model of having both a clinical leader and a leader with management experience.

“Health care is a difficult business these days. Nobody is coming in and saying they want to pay hospitals more. You have to make difficult decisions,” King said.

“He’ll be missed, in terms of a leader,” King said of Weinstein. “My hope is we’ll find a new leader focused on moving Dartmouth forward and continuing the regional development of our system.”

Verville, the trustee chairwoman, said the board soon would form a search committee, which she, who once held high-level technology and financial management positions at IBM, and William Conaty, a former senior vice president of corporate human resources at GE, will chair.

The committee likely will include doctors, nurses, trustees and officials from affiliate hospitals, Verville said. A job description will be ready no sooner than the end of January, she said, and Weinstein will remain on hand to facilitate his successor’s transition.

The 66-year-old was D-H’s most highly paid employee in 2014, the latest year of financial statements that the health system has released. He received a $1.5 million package that included about $1.1 million in compensation, $209,000 in retirement and other deferred pay, and no bonus.

A spokeswoman for D-H on Monday declined to provide figures on Weinstein’s current compensation.

During his time as CEO, Weinstein kept an eye on where health care was headed nationally, Verville said, positioning D-H before many other providers to move away from a fee-for-service payment model, among other innovations.

Weinstein left an endowed professorship at the University of Iowa health system to join Dartmouth-Hitchcock in 1996, and rose to become director of The Dartmouth Institute for Health Policy and Clinical Practice in 2007.

Later, he became president of the Dartmouth-Hitchcock Clinic before his appointment in 2011 as president and CEO of the entire system.

Along the way, Weinstein helped found the High Value Healthcare Collaborative, a group of providers serving patients in all 50 states that works to lower the price of health care while improving its quality.

Among many programs he founded at D-H are the Department of Orthopaedics, where he served as chairman for seven years; the multidisciplinary Spine Center at Dartmouth-Hitchcock Medical Center; and the health system’s Center for Shared Decision Making.

On Monday, Weinstein said he was proud of several accomplishments during his tenure as CEO, including D-H’s ability to care for some of the sickest patients in the country; the health system’s high ranking in New England for quality and safety of care; and the affiliations that D-H has made with other hospitals in the region.

Under the “affiliation” framework, D-H has expanded through the Upper Valley and beyond using agreements under which the health system acquired the assets of smaller hospitals and assumed control over their upper-level management decisions.

Those have included affiliations with nearby Alice Peck Day Hospital in Lebanon; Mt. Ascutney Hospital in Windsor; New London Hospital; and Cheshire Medical Center in Keene, N.H.

A D-H spokeswoman on Monday said the health system is currently engaged in talks with Elliot Hospital, a sizable medical center in Manchester, New Hampshire’s largest city.

D-H also recently has seen a run of financial difficulties that resulted in layoffs.

The health system posted a $39 million operating loss in the fiscal year that ended June 30, according to financial disclosures made to the federal Municipal Securities Rulemaking Board. Total revenue that year was short of expenses by $45 million, when counting investment losses and the value of newly acquired assets, according to the filing.

In September, Weinstein announced that D-H was anticipating laying off between 270 and 460 employees, or between 3 and 5 percent of its workforce. By the following month, that number had been trimmed to 84.

D-H appeared to have narrowed the gap in the most recent financial quarter, posting a 0.1 percent operating margin of about $589,000 in the three-month period that ended Sept. 30. Following those results, credit rating agencies Fitch and Standard & Poor’s removed D-H from their credit downgrade watchlists.

This fall’s employment losses took place six months after D-H absorbed about 300 employees from Dartmouth College’s Geisel School of Medicine in a restructuring plan to address a $30 million deficit at the medical school.

One aspect of that plan became the subject of political debate during this past election cycle: D-H’s bid to take over a program that staffed New Hampshire Hospital in Concord with Geisel’s psychiatrists.

About a dozen Geisel employees, fearing what their employment transition might bring, resisted the handover; gubernatorial candidates used the dispute as a symbol for New Hampshire’s larger troubles with mental health services, and Weinstein found himself stuck in the middle.

The controversies around layoffs and New Hampshire Hospital appeared to have stung Weinstein, who said on Monday that news reports about the original projection of hundreds of lost jobs were “unfortunate” because they had “scared a lot of people.”

Weinstein noted that his appointment as CEO in 2011 had come soon before the announcement of up to 100 layoffs across the D-H system, and called any such trimming a “travesty.”

“There’s always a tension,” he said. “Can you build a building? Or can you do that and retain a lot of people?”

The Geisel restructuring and the New Hampshire Hospital deal, he said, had presented him with a dilemma. “Do you give up 300 people and jobs and not have a mental health service, or do you take that on and hope that you can figure out the rest?”

“In my mind, that’s not a question,” he said: he took on the psychiatrists’ contracts. “That’s a solution you have to find.”

Those Geisel employees banded together to attempt to stop the transition to D-H. They gained the support of New Hampshire Executive Councilor and now Gov.-elect Chris Sununu, who attempted to reopen the bidding for the contracts. State officials approved the deal nevertheless.

“If we didn’t take on the New Hampshire Hospital, there would be no care for those patients — despite all the news stories about the contracts,” Weinstein added. “They wrote the wrong story. I get it, that’s politics, but my job is to take care of patients, so I don’t respond to those stories.”

He also said the health system’s affiliations hadn’t been created solely for reasons of expansion or revenue, but rather to improve patient care.

“The notion that bigger is better is not true,” he said. The goal of the affiliations, he said, is “that there’s coordinated care ... from hospital A to hospital B to hospital C, so the patient and their families can feel assured that if they’re in Mt. Ascutney or New London or Manchester, and they end up at Dartmouth-Hitchcock, the consistency of their care and the outcomes are likely to be the same because of the coordination.”

“As a not-for-profit, my motivation is not how much money or what our margin is,” he added later.

The outgoing CEO plans to retain his academic and clinical positions in the D-H and Geisel departments of orthopedics, as well as his endowed chair in evaluative clinical sciences at Geisel.

Weinstein also will remain involved in such national organizations as the High Value Healthcare Collaborative, the National Academy of Medicine Board for Population Health and the VA Special Medical Advisory Group, according to a Monday news release from D-H.

“I’m excited about the people and the things that we do,” he said in Monday’s interview. “I love the community that we get to represent, and so I think I’ve just been really privileged. So no regrets.”

News staff writer John Gregg contributed to this report. Rob Wolfe can be reached at rwolfe@vnews.com or 603-727-3242.