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The Ruling and the Rearview Mirror

By Dr. David C. Pate, News and Community
January 28, 2014

On Friday, we received the long-awaited opinion in our antitrust lawsuit. 

This case is being watched across the country by legal experts and leaders in the healthcare industry because many health systems have pursued strategies similar to St. Luke's. 

More than 9,000 people visited the blog Friday and through the weekend to learn about the decision and offer their support and encouragement, and I heard from others through my Twitter account (@drpatestlukes) and other social media. There was lots of interest expressed through our St. Luke's social media sites, and I received many private notes of support as well. 

The vast majority of feedback has been very sympathetic and very supportive of our efforts, and strongly encourages us to appeal the decision. Of course, there have been some negative comments, and that is to be expected. 

I want to share with you some of the comments and notes I have received. This note, from one of our St. Luke’s Health System board members, is especially meaningful:

"While disappointed in the decision, I am even more convinced that we have the correct vision and strategy. I view this as a speed bump on the road to the Triple Aim goals we have.

In my experience in the technology industry, in my 30 years at HP, entrenched competitors, the courts, and the federal government too often look in the rearview mirror when making policy and defending the status quo. We will find a way, as most successful tech firms have, of keeping our vision looking forward.

As a mentor and friend at HP, Ray Smelek, often said, 'There is a reason the windshield is bigger than the rearview mirror.' Let’s keep looking and moving forward together."

I have received many notes of encouragement and support that indicate the same sentiment – that this challenge has only solidified and galvanized our commitment to our vision and strategy of transformation.

Here is a message I received from a physician executive who has been working for years to achieve many of the same things we are striving to achieve in a very different, much larger market, with a nationally recognized health system:

"David, I admire and respect your response to the court’s decision and your resolve to persist in your commitment to those served by St. Luke’s. The economics of health care are making the advent of population health management inevitable, and fortunately, it is the right thing to do anyway.

Managing the health of a population of people is something that cannot be done by a hospital system acting alone, nor by various groups of independent physicians, irrespective of the quality of the work done by each. It can only be done by a large organization comprised of facilities, infrastructure, technology, people, and healthcare providers acting together in a common commitment to keep people healthy and happy with their health plans, doctors, other providers, and hospitals.

That is accountable care; it is the right vision and it clearly remains the vision of you and your organization. Best wishes. I am rooting for you!"

Here is part of a note I received from a colleague who is the president and chief executive officer of a large health system who has been through a somewhat similar challenge:

"David, I saw the news today and wanted to drop a note of encouragement. This is not the end, only the beginning.

… The precedent this outcome sets is bad for an industry that MUST consolidate to survive.  Having been in your shoes … keep the faith, celebrate all of the good work your team has done so far."

The judge’s opinion clearly commended us for our efforts to fix a broken healthcare delivery system.  Here are two excerpts:

  • Fixing health care “will require a major shift away from our fragmented delivery system and toward a more integrated system. … St. Luke’s saw this major shift coming some time ago. And they are to be complimented on their foresight and vision.”
  • “The Acquisition was intended by St. Luke’s and Saltzer primarily to improve patient outcomes.  The Court is convinced that it would have that effect if left intact, and St. Luke’s is to be applauded for its efforts to improve the delivery of health care in the Treasure Valley.”
St. Luke’s will remain strong. The welfare of our friends and colleagues with the Saltzer Medical Group, their physicians, employees, families, and patients, weighs heavily on my mind.

I am disappointed, and the board and I will seriously consider appealing this decision. We are doing the right things for the right reasons. Our board members know it and support us. The Saltzer group knows it and has been grateful for our commitment. 

I want to thank St. Luke's many supporters in the community and around the country, and those who took the time and made the effort to write in.

 There are two other groups of people that I want to thank. One is the leadership team of St. Luke's Health System that is leading the transformation of health care and working hard every day to develop the competencies and capabilities for St. Luke's to be able to be accountable for the outcomes of care and the costs of that care for the populations we serve.  These leaders have remained committed and dedicated to this work even in the midst of this lawsuit. 

I also want to give a special thanks to the outstanding legal team that represented us, including St. Luke’s attorneys led by Christy Neuhoff, our local counsel Walt Sinclair, and our Sidley Austin attorneys, led by Jack Bierig. 

The work we are doing is far from over and remains vitally important for the people of Idaho.  They are depending on us to improve their health, provide better care, and lower healthcare costs. 

We knew transformation would not be easy. We also knew we would need to persevere. As one of our board members stated, this is a speed bump on the road to our Triple Aim goals. It is a road worth travelling, and St. Luke’s could not have better traveling companions than those whose support has been so meaningful, particularly over the past few days. Thank you!

About The Author

David C. Pate, M.D., J.D., is president and CEO of St. Luke's Health System, based in Boise, Idaho. Dr. Pate joined the System in 2009. He received his medical degree from Baylor College of Medicine in Houston and his law degree from the University of Houston Law Center.