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In Defense of Paul Levy

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Paul Levy, the blogging CEO of Boston’s Beth Israel Deaconess Medical Center, found himself in hot water last

month over an inappropriate relationship with a female subordinate. While some of the details of the transgression remain sketchy, I think I now know enough to opine on it. To my mind, Paul has been an extraordinary healthcare leader, and – while the episode represents a lapse in judgment that deserves censure – he should not lose his job.

Let’s start with some background. Paul took the helm of BIDMC 8 years ago. At the time, the hospital – which operates in the shadow of its more storied Harvard cousins, Brigham and Mass General – was in crisis: its staff was dispirited, it was losing a million dollar a week, and it was still reeling from the challenges of blending the cultures of its two recently merged progenitor hospitals, Beth Israel and Deaconess. (Hint: the religious mismatch was only the start of the tsuris.)

Paul was an unusual choice for the position of CEO. BIDMC CEOs have historically been physician-leaders, whereas Paul’s major prior roles had been to teach Environmental Policy at MIT and to lead the Massachusetts Water Resources Board, where he spearheaded the cleanup of Boston Harbor. Some folks wondered whether he was up to the task of being CEO.

But soon after he began, jaws began to drop and many skeptics became fans – this was clearly not your father’s hospital CEO. An extraordinarily hands-on manager, Paul literally gushed with pride over the accomplishments of his physicians, trainees, and nurses; even the housekeepers and transporters. He embraced transparency with bottomless zeal, reporting all of BIDMC’s quality and safety data (good or bad), and challenging fellow hospital CEOs to do the same. He launched a blog, “Running a Hospital,” which became a widely read window into his thinking and management style. Within a few years of assuming his role, Levy had become arguably the best known and most highly respected hospital CEO in the nation.

Sure, it was great theater, but the important thing was that it worked. Last year, I had the honor of being visiting professor at BIDMC, and was struck by the organization’s wonderful people and by their passion for the joint. In the past decade, BIDMC has become a model of innovation, transparency, and collegiality, winning several awards and serving as the subject of a number of case studies regarding hospital quality. When I asked people at BIDMC for their best explanation for the remarkable turnaround, most of them gave the same answer: “Paul Levy.”

There are many examples of Paul’s leadership style and impact, but my favorite happened occurred in 2009, when the economic meltdown pulverized BIDMC’s finances (on top of the usual reasons, some of BIDMC’s key donors had major Madoff issues). Rather than mindlessly triggering scores of demoralizing layoffs, Paul called the entire staff to a meeting in the hospital’s Sherman Auditorium. Kevin Cullen of the Boston Globe described the extraordinary scene:

[Paul Levy] looked out into a sea of people and recognized faces: technicians, secretaries, administrators, therapists, nurses, the people who are the heart and soul of any hospital. People who knew that Beth Israel had hired about a quarter of its 8,000 staff over the last six years and that the chances that they could all keep their jobs and benefits in an economy in freefall ranged between slim and none.

“I want to run an idea by you that I think is important, and I’d like to get your reaction to it,” Levy began. “I’d like to do what we can to protect the lower-wage earners – the transporters, the housekeepers, the food service people. A lot of these people work really hard, and I don’t want to put an additional burden on them.

“Now, if we protect these workers, it means the rest of us will have to make a bigger sacrifice,” he continued. “It means that others will have to give up more of their salary or benefits.”

He had barely gotten the words out of his mouth when Sherman Auditorium erupted in applause. Thunderous, heartfelt, sustained applause.

Paul Levy stood there and felt the sheer power of it all rush over him, like a wave. His eyes welled and his throat tightened so much that he didn’t think he could go on.

That, folks, is what I call leadership.

So let’s get to the problem. Last month, the BIDMC board announced that Paul had demonstrated “lapses of judgment in a personal relationship,” leading it to express its disappointment along with its “unanimous continued confidence” in Levy’s leadership. (Well, not exactly unanimous: one board member resigned.) The board also announced that it was fining Levy $50,000, would be considering the matter in setting his salary next year, and had asked state attorney general Martha Coakley (of How’d-You-Lose-Ted-Kennedy’s-Senate-Seat-To-A-Guy-Driving-A-Pickup-Truck? fame) to investigate. Neither the board nor Levy said more, leading to predictable cries of hypocrisy – after all, here was a CEO who branded himself as being all about transparency, invoking “no comment” – and some calls for his resignation.

I’ve wanted to comment on the Levy situation for weeks, but it was difficult to do so without knowing more about the specifics of the “lapse.” Although we still don’t know everything, last week (after obtaining the BIDMC board’s permission) Paul opened up to the media, giving interviews to two Boston newspapers and one TV station.

Apparently, the story is that soon after he became CEO, Paul gave a job to a “very close friend,” a woman who began an administrative position at BIDMC’s main campus and was later transferred to the hospital’s suburban Needham site. Paul, who is married, has declined to specify the precise nature
of the friendship, it’s clear that it is substantial, and that the woman
spent considerable time with the CEO at work.
This was a poorly kept secret for years, and several colleagues urged him to sever the relationship or end the woman’s BIDMC employment. Finally, earlier this year, she did leave her job at BIDMC, accompanied by a severance package.

Clearly, the optics on this aren’t good and the episode demonstrates a lapse in judgment – both in hiring the woman and in failing, for years, to listen to colleagues who asked him to end the relationship or let her go. On the other hand, there is no evidence that the woman was unqualified for her role or was paid above market rates (her yearly salary was about $100,000), that the relationship compromised Levy’s performance, or that Levy profited in any way from it.

While the situation calls for criticism, it also begs for perspective. Paul Levy has transformed the quality, safety, and efficiency of patient care at BIDMC, a $1.2 billion organization that cares for hundreds of thousands of patients each year. Moreover, his openness has inspired other healthcare leaders to be more courageous in their approach to safety and quality. In the process of making some hard decisions in a very public job, Paul has amassed some enemies – particularly local unions like the SEIU – who are likely behind more than a few of the vitriolic comments about him that have recently appeared on various Boston-based message boards. That, of course, is their right.

As for me, I’m hoping that the BIDMC board, which showed great courage in hiring Paul Levy and allowing him to make safety, quality, and transparency into signature issues, will show similar courage by retaining him as their leader. He deserves it.

More importantly, so do the hospital’s patients.

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LoriLeejdrespect allpraetoriusEsther Buddenhagen Recent comment authors
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LoriLee
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LoriLee

It’s a shame to see so many professionals so willing to condemn someone without all the facts in hand. I wonder, is this how you practice medicine? If so, I would be very concerned to walk through your door for treatment. I am not from the medical industry, I don’t know any of the above authors and heck, I don’t even live in the same state. However,I do believe facts should speak for themselves, and void of fact, you are simply guessing. Given the accomplishments of this man, does your envy so supercede your good judgment that you are willing… Read more »

jd
Guest
jd

If there was no sexual relationship, why is the gender of the subordinate mentioned in every article about this? What does gender have to do with it at all?

Ellen Kagan
Guest

ExhaustedMD, you are terrific!! You say it like it is and I am in total agreement with you.

ExhaustedMD
Guest
ExhaustedMD

Really, what is the difference between smiling and grinning mischeviously? Intent! Can’t you tell the difference between an honest smile and a facade? Maybe that is his look. But, years of dealing with those who are not honest but have mastered the facade, one has the right to be cautious and wary. That is my take. So you have yours. And stop insulting me about how I practice. My patients who are interested in treatment seem to like and appreciate me, for one reason is my honesty and directness. How many physicians practice that these days? How many patients smile… Read more »

bev M.D.
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bev M.D.

Exhausted;
Well, I hope none of your patients come into your office smiling; they might be judged!

respect all
Guest
respect all

Paul Levy is a self-centered man who cares more about his mistress than his wife and daughters. He has violated his marriage and family by his ongoing affair. He has violated those who work for him by his deceit. It this the type of guy that should be leading the BIDMC?

praetorius
Guest
praetorius

Exhausted,
You now know why he has a perpetual smile. It is the opposite of why cows faces are so long.
Bob,
You make some interesting suck up comments. Is his hospital all that safe? What has he done to foster safety, actually? His blogging is a facade, hiding his true character, as witnessed by recent events. He blames his evasiveness on the BOD. Sure.
It is one thing to violate his family, but it is another to elevate the mistress rather than another employee equally or more deserving.
I have lost respect for you.

ExhaustedMD
Guest
ExhaustedMD

Bev MD: there you go again! “When the situation calls for criticism, it also begs for perspective.” What?! That line alone is a red flag. When a situation calls for criticism, it should beg for reflection, and tough review. Begging is a sign for sure guilt, and mercy, like trust and respect, is earned, not just granted because you did some good things. Here’s a question I would like to hear readers consider: can one bad thing erase a strong history of good things? It depends on what is bad. Life is about consistency, and I truly believe people are… Read more »

Esther Buddenhagen
Guest

Good grief. That this exemplary manager would be raked over the coals for a long-lasting friendship whether with or without sex, one which, it seems clear, does not constitute any harassment and which has not interfered in exemplary on-the-job performance whatsoever is unconscionable. Issues are between him, her and his wife. When I worked, my fellow workers and I were always aware of “relationships” going on, rules or no. The idea that somehow people can steer clear of meaningful relationships which may have sexual content to them at the places where they spend most of their working hours is ridiculous.… Read more »

Margalit Gur-Arie
Guest

Seriously??? The guy had an affair, or not…. I don’t see what this has to do with his job performance and/or his judgment. As far as I know, BIDMC is not a subsidiary of the Vatican. Maybe everybody should just mind their own glass houses and leave other people alone.

bev M.D.
Guest
bev M.D.

Tim;
I think “the problem” is as Dr. Wachter states:
“Clearly, the optics on this aren’t good and the episode demonstrates a lapse in judgment – both in hiring the woman and in failing, for years, to listen to colleagues who asked him to end the relationship or let her go.”
Since his interview states they were friends for 15 years, I don’t see how sexual harassment even enters in.
So, Exhausted, still mad at me for the Ronald Reagan crack?

ExhaustedMD
Guest
ExhaustedMD

The best defense is one that can maintain the best air of unbiased and objective perspective, not friends, colleagues of close nature, or family, and certainly not people who profit from the accused’s actions. The way this post comes across, it seems to be a premptive shot across the bow to try to deflect/deter/diminish attacks that could have at least some credibility to present. Rule number one in life: be honest and direct, and if you innocently and unintentionally made a mistake or had the random chance lapse of judgment, admit it, fix it, learn from it, and move on.… Read more »

Tim
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Tim

Bev, Good questions. Now I’m really puzzled. If the relationship was not sexual, I actually don’t understand what the problem was. She was his friend? So? Was she qualified for the job? Was she paid appropriately? That he was her “acknowledged mentor” makes the hiring more legitimate, not less. Unless there are details we’re not hearing. You read more into my word choice than I do: I’m not interested in the sex, I’m interested in the possible sexual harassment. The first is between Mr. Levy and his wife; the second between him, his employer, and the Federal Courts. That would… Read more »

Lew
Guest
Lew

I must say, this situation does not seem to follow basis principles of crisis management. First, get all the facts out; second, the Board Chair or designee must take charge of communications on behalf of the institution, not Mr. Levy. Third, Mr. Levy, who seems to be a capable leader who has made some errors in judgment (magnitude unclear) should ask himself some hard questions e.g. “what is best for the institution”?; “am I capable of continuing to effectively lead given what’s happened”?

bev M.D.
Guest
bev M.D.

Tim; Since you used quotes from my comment, I will assume you are disagreeing with me, so I take exception to your remarks. First, from all public evidence the relationship was not sexual, and also he actually was her acknowledged mentor prior to either of them coming to BIDMC. Second, I wonder what other things you would call a “sin.” Is habitual vicious abuse of nurses and other subordinates by physicians not a sin? Is an administrator who colludes with a cardiologist to put stents in normal patients not committing a sin? (see Dr. Wachter’s May 14 post).Where are you… Read more »