Gary Malaer, a Texas native who came here from Florida, likes what he sees at Carolinas Hospital System.
When he took over as chief executive officer to supervise close to 300 physicians and 1,500 employees, Malaer was impressed with the “big, beautiful building,” and its 396 beds, but was far more impressed with the folks running the show.
“Our number one asset is our employees – from housekeeping to nutrition to diagnostic imaging to the phlebotomist,” he said.
An older man recounted to Malaer how a food nutritionist sat on the edge of his bed and held his hand.
“I love to hear those stories,” he said. “And what we do, when we hear that, we go recognize those employees because it’s contagious. A smile goes a long way and a friendly face, and holding someone’s hand, well, it means a lot. I wish we could take credit for that but you can’t. It’s a gift — that personal touch.”
A busy hospital
Malaer, 48, spoke to the Rotary Club of Florence on Monday and also discussed with the Morning News his new role and the challenges that lie ahead in health care.
He grew up surrounded by thousands of acres of cotton, and his parents still farm, he told the Rotarians. He learned early on the value of a hard day’s work and reaping those rewards while knowing there are factors beyond your control, such as the weather.
He and his wife, Debbie, have two daughters, Britney, 15, and Taylor, 12.
The mission statement of Carolinas is to exceed customer’s expectations, and that can be a tough goal, but it sets the hospital apart, he said. Being committed to patients, their families and the employees is part of the credo of continuous improvement, he said. One thing that also separates Carolinas from other hospitals is the recent collaboration with the Mayo Clinic Care Network.
“It’s easy, at our fingertip, at our phone access,” he said.
Since he came aboard at the beginning of the year, the Mayo connection has been used many times to ensure that decisions made about patients are backed up by world-class health-care providers.
“At the end of the day, our goal is to provide the best medical care for the patients who walk through those doors,” he told the Rotary Club.
And there are plenty of folks who walk through the doors.
In 2016, there were 49,000 visits to the emergency room, he said, with over 11,000 admissions and 289,000 outpatient cases. There were 730 babies born at the hospital last year, he said. The payroll was $107 million, he said, and $6 million in capital improvements flowed toward renovating and upgrading the facility. About $3.2 million was spent on property tax and sales tax and the hospital had $163 million in charity and uncompensated care, he said.
There is active recruitment to make sure the needs of the community are met, and though he wants people to be impressed with the power washing and painting going to improve the aesthetics, he’s more concerned with the staff providing excellent care and services, he said.
Investing in the community
Malaer is proud of his Lone Star state roots. He earned his bachelor’s degree from Stephen F. Austin State University in Nacogdoches, Texas, and his master’s degree from the University of Dallas. Florence has been very welcoming, he said, and he likes to reciprocate with visits to the staff and patients so he can get to know everyone on a first-name basis.
The big effort right now is a floor-by-floor capital improvement project aimed at the infrastructure and aesthetics. Countertops, wall protection, flat-screen TVs, new furniture, new paint — it’s a pretty extensive endeavor that should conclude by mid-year, he said in an interview.
Employee forums last week provided a chance for department heads to meet and talk about what was accomplished last year and “where we’re going in 2017,” he said.
“We have a beautiful campus — it’s not just the bricks and mortar. I tell them this is their hospital,” he said.
Deepening involvement in the community is another goal for 2017, he said, through financial contributions as well as volunteer efforts. Expanding service lines — whether general surgery or services for women — is on the list of initiatives as well, he said.
What will this year bring with Trumpcare vs Obamacare?
“I think it will be a year of change,” he said.
When he went through the implementation of the Affordable Care Act while working at Wuesthoff Medical Center-Rockledge in Florida, “it wasn’t a big change for us,” but simply led folks to make decisions on buying insurance through exchanges. The idea itself sounded great on paper but perhaps wasn’t executed in the best way possible, he said.
He’s seen an increase in the utilization of services across the country because of the ACA and, realistically, hospitals will take care of patients whether they’re insured or not. Insurance companies need regulation, like “everyone,” he said, and he doesn’t see them as having too much power.
They’re in the business of insuring people, he said, and employ actuarial tables to deduce as best they can what out-of-pocket expenses might be. From a business aspect, one needs to think about whether someone simply needs medical care or hospitalization, and the future will likely see more emphasis on wellness and preventative measures as people “need to take ownership of their health,” he said.
“There will come a day when hospitals are only caring for the sickest of the sick,” he said, with more people using outpatient services and home health options.
If you look at a total knee replacement, for instance, patients who are healthy might be discharged a few hours after post-operative care, he said.
“We don’t want to hold someone here who can recover in their own environment,” he said.
With Carolinas, having the main hospital and the surgery center offers “the best of both worlds,” and there will probably be continued investment in the surgery center, he said.
Continued improvements in technology are not just to provide better patient outcomes, but to increase efficiency, he said, noting a $1.5 million server upgrade in the works at the hospital. As for the collaboration with Mayo Clinic, it’s about being 100 percent confident in the outcome. Malaer gives Costa Cockfield, the chief nursing officer, much credit for being instrumental in the success of the partnership.
“She understands the value from a clinical aspect,” she said. “Most of the time, their care plan, you’re right on line, and they say — don’t change a thing.”
Consulting with Mayo Clinic providers doesn’t cost anything for patients, he said. “It’s merely a free second opinion.”