Latest / Becker’s Healthcare Podcast / Hasan B. Alam, Surgeon-in-Chief at Northwestern Memorial Hospital and Chair of the Department of Surgery at the Feinberg School of Medicine at Northwestern University

Transcript

Hasan B. Alam, Surgeon-in-Chief at Northwestern Memorial Hospital and Chair of the Department of Surgery at the Feinberg School of Medicine at Northwestern University · Becker’s Healthcare Podcast

• 0:02
  The most important health care decisions don't happen
• 0:05
  in isolation.
• 0:06
  They happen when leaders come together.
• 0:08
  Becker's sixteenth annual meeting brings together more than
• 0:11
  3,500
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  hospital and health system executives this April in
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  Chicago.
• 0:16
  With 800 speakers from Ascension,
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  Cleveland Clinic, CommonSpirit and more, the conversations get
• 0:22
  real. Leaders will share how their scenario planning
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  for policy shifts, breaking through value based care
• 0:27
  barriers, and building clinical teams that translate
• 0:37
  event
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  details,
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  visit beckershospitalreview.com
• 0:41
  and click on the events tab in the
• 0:43
  upper right.
• 0:46
  This is Laura Dirda with the Becker's Healthcare
• 0:48
  podcast.
• 0:49
  I'm thrilled today to be joined by doctor
• 0:51
  Hassan Alam, who is the surgeon in chief
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  at Northwestern Memorial
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  Hospital and chair of the department of surgery
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  at Feinberg
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  School of
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  Medicine. Doctor Alam, thank you so much for
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  joining us on the podcast today.
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  Well, thank you for inviting me.
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  Absolutely. Now I'm excited for our conversation because
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  I know there's so much happening in medicine,
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  and particularly some of the things that you're
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  doing at Northwestern are really,
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  fascinating
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  and truly, truly on the innovative side. So
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  I'm excited to dig in deeper there as
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  well as get your perspective on the future.
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  But before we dive in, can you introduce
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  yourself, tell us a little bit more about
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  your background as well as some of the
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  things you're doing at Northwestern?
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  Sure. So I,
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  as you mentioned, I'm the chair of surgery
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  at the Feinberg School of Medicine and surgeon
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  chief at the Northwestern Memorial Hospital.
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  The department of surgery is big. So it's
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  10 different divisions,
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  including everything from cardiac surgery to transplant and
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  plastic surgery to
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  vascular surgery and everything in between.
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  We also cover
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  11 hospitals that are in the Northwestern Medicine
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  health system.
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  About 258
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  surgeons,
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  800 different
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  individuals who make up the part, make up
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  the department of surgery.
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  For myself personally, I'm a trauma surgeon by
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  training.
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  I trained in Washington, DC, then I was
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  at
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  Massachusetts General Hospital for about eight years.
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  Then I was chief of general surgery at
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  University of Michigan for about eight years, and
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  then I've been in my present role for
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  about
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  five and a half, six years or so.
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  And just to give you an idea about
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  Northwestern Medicine, it's the largest health system and
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  the third largest city,
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  in the country.
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  As I mentioned, there are 11 hospitals that
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  spread across a fairly large geographical area within
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  the state. So in all, we cover about
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  9.5 or 10,000,000 people,
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  in this area.
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  And that's fascinating to hear. You know? And
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  truly an important,
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  population that you're covering, I can imagine. You
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  know? You'd see all
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  patients from all across the spectrum in terms
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  of,
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  how they're coming in and what types of
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  care that they need. So when you think
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  about the last year, what was the most
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  important initiative that you led? What did you
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  do, and what were the results?
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  Well,
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  you know, the journey that we are on
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  is to,
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  to evolve in the right direction. So department
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  of surgery is now 168
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  years old.
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  It was started in 1851.
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  So it's been around for a long time.
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  We've gone through civil war and two world
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  wars and the great depression and you know?
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  But people are not talking about 1851
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  or 1923.
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  We're talking about 2035,
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  and that's what our focus is.
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  Our goal for,
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  for the last ten years or so was
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  to be among the top 10 in the
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  country. That was our goal for 2020,
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  and we achieved that with many years to
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  spare. And for 2035,
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  we're evolving in a direction to be a
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  fully integrated large health care delivery system among
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  the top few in the country.
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  Also has, an international presence and and,
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  presence just outside the region where we are
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  geographically located. So,
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  a lot of work going on in developing
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  collaborations in Florida and London,
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  Middle East, so on and so forth.
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  For me, personally, it was,
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  about
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  recruiting the top talent. As I look at
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  it, a great department's a department that has
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  a great culture
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  and great people. And great people are people
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  who are superbly talented,
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  but also have the right priority system,
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  you know, right moral compass,
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  right personality.
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  So over the last year, we've recruited
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  new leaders for our surgical oncology program, new,
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  division chiefs for our general surgery
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  division. I mean, these are big divisions that
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  are at the center of the department.
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  Just sort of ties in with some other
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  leaders that we had recruited for cardiac surgery
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  program,
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  just before that.
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  So we are in an expansion mode in
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  recruiting new leaders. And then along with these
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  new leaders, we're recruiting,
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  additional faculty and surgeons,
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  not just for our downtown campus, but across
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  the entire health system.
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  So that's sort of, like, the big initiative
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  for the last year was,
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  this expansion and network development.
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  Got it. That's fascinating to hear. And, you
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  know, exciting that you've been able to have
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  that type of growth and expansion within your
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  services and and and network as well. And,
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  you know, when you talk about having a,
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  organization that's got top talent as well as,
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  a great culture, you know, that doesn't happen
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  by accident or very easily at all. And
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  so when you're intentionally building and recruiting top
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  folks as well as trying to maintain that
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  culture, that that will,
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  you know, give you the results that you're
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  looking for. How do you do that? What's,
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  you know, so important about,
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  or or how do you, I guess, build
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  a culture like that and and really maintain
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  it despite all the challenges that are are
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  coming forth as we've discussed?
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  Yeah. I I think that's a very fair
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  question. And I I think it starts on
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  recruiting the right people and having,
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  the institutional priorities,
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  be clear to everyone. So,
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  you know,
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  if you just step back for a second
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  and just think about a larger landscape,
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  research, for example, not just doesn't happen at
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  the medical school level. It happens at the
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  entire university. You may be working with biomedical
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  engineers or business people or ethics people and
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  so on and so forth. And if you
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  make a list of top 10 universities in
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  the country and top 10 hospitals,
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  there are only four or five places
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  that are on both those lists, and Northwestern
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  is one of those few selected,
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  institutions.
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  So we have a top tier,
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  university attached to a top tier health system
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  in the third largest city in the country.
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  So it makes it easier for us to
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  recruit.
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  But we're also in a very competitive market.
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  We have, other academic health systems in the
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  city of Chicago. We have the largest market
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  share, but we don't take it for granted.
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  So our focus is on on providing excellent
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  care that differentiates us from our competitors.
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  Now once you've done that and you you
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  have the right culture, the right people, you
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  you provide, you know, high quality care,
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  then, your market share and everything else,
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  your national reputation ranking, all that is a
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  byproduct of that. So you don't solve to
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  sort of the ranking. Ranking reflect
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  the reality that you've created on the ground.
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  So, you know, we've we focus on recruiting
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  the best people, creating the best possible culture,
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  delivering the highest possible quality care. And then,
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  that's reflected in the ranking part of it.
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  But but I I must say it's easier
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  to recruit people to Chicago than a lot
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  of other places. I mean, it's a it's
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  a big city, but it's one of the
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  most livable big city.
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  It's
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  on the lake. It's beautiful. It's got a
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  airport that's very centrally located. People can fly
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  anywhere they wanna fly.
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  The cost of,
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  living is not as,
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  outrageous as compared to some of the large
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  cities on on either coast.
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  So, we have a lot of advantages as
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  well and some challenges too.
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  Absolutely. Those are all great points and and
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  definitely are helpful and instructive as you know,
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  I I can imagine many leaders are looking
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  to continue to build out and grow their
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  own
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  medical departments and figure out how to create
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  a a similar vibe. Now looking ahead, what
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  are some of the big priorities and headwinds
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  you're focused on for 2026? I know you're,
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  very much so have your eye on 2035,
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  but what are some incremental steps to to
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  get to that big goal of where you
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  wanna be?
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  I think there's some short term
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  challenges
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  that are creating some uncertainties. For example, like,
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  the changes in the health care,
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  reforms,
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  the coverage for our population. I mean,
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  but that they will have a larger segment
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  of our population that will be either uninsured
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  or underinsured.
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  That's an issue. How that's gonna affect health
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  systems is gonna depend on what the demographic
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  makeup of, the population in that area.
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  We have an aging population across US for
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  sure.
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  You know, as the population ages, the medical
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  problems, the comorbidities,
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  all of that,
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  goes up. The cost of care goes up.
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  There are challenges,
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  around uncertainties
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  of what's gonna happen to federal
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  research dollars.
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  NIH is changing some of its priorities,
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  whether the funding for NIH is gonna be
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  at the same level as before, whether it's
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  gonna go up or not. So those are
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  some of those things that that are,
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  adding to the uncertainty,
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  for the in the short term. So those
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  are some of the headwinds.
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  And people who are just starting their academic
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  careers, they want to,
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  establish themselves as,
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  the leaders in the field and they have
• 9:59
  research missions, for example, it it creates uncertainty
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  for them as well. You know, they don't
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  know what the federal funding landscape is gonna
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  look like next year or the year after
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  that. They're not thinking about ten year horizon.
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  They're thinking thinking about over the next one
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  or two or three years, how can they
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  set themselves up? So that's what I think
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  every
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  academic medical center is thinking about and and
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  and trying to sort of figure out how
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  to best position themselves
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  to address their, you know, tripartite mission. We
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  have clearly our
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  core mission is patient care.
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  But adjacent to that is, education, training,
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  and also discoveries and advancing the fields.
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  So
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  we are all focused on that. I mean,
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  every time we have a national level meeting,
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  people are talking about some of those challenges
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  and some of those uncertainties, and and we
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  are no different.
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  That makes a lot of sense. And it's
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  truly,
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  fascinating are
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  navigating this and building the teams that will
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  help them be most nimble no matter what
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  happens or comes down the pipe. And I
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  think to your point, you know, being able
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  to put yourself in the position and leaders,
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  you know, having that mindset of keeping their
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  mission in vision front and center despite
• 11:15
  all of these things, can really make a
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  big difference. I think especially when you talk
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  about the research dollars and and uncertainty with,
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  NIH,
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  how are are you navigating around that? I
• 11:26
  think one of the things I've heard,
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  just on a broad national scale is a
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  concern that, you know, The US will lose
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  some of their best and brightest because they
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  don't have the research funding. Is that something
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  that you are thinking about or experiencing at
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  Northwestern, and have you tried to stay ahead
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  of the innovation curve there?
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  Well, I think we are, again, very fortunate
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  at Northwestern.
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  We haven't seen an exodus of talent.
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  You know,
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  it all depends on what the,
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  future looks like to the most talented people.
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  The way I think about it is the
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  best,
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  ideas
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  will still get funded.
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  The the competition is gonna be more stiff.
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  And the competition is not just
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  at the national level, it's more international level.
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  For example, China is putting in a lot
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  of money into research.
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  I am on editorial boards for a number
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  of,
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  scientific journals. And if you look at the
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  output that's coming from China in terms of
• 12:31
  new discoveries and top tier papers,
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  there has been a dramatic change in the
• 12:36
  last few years. They're doing very high quality
• 12:38
  research that is very well funded.
• 12:41
  So the the talented people now are looking
• 12:45
  not just at institutions within The United States,
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  but, you know,
• 12:50
  the,
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  they may also start looking at,
• 12:56
  options and opportunities
• 12:58
  beyond, the borders.
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  But I think it's these things don't happen
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  very quickly. So it's not that you have
• 13:05
  one year of uncertainty and people will suddenly,
• 13:09
  change their mind or change their focus,
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  but it's just a matter of how the
• 13:13
  trend is gonna be. So to your point
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  about how Northwestern is is
• 13:19
  dealing with it. One is that we will
• 13:20
  continue to focus on supporting,
• 13:23
  recruiting the best talent,
• 13:25
  supporting them,
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  but also then diversifying our portfolio. So
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  not just looking at NIH funding, but also
• 13:32
  looking at philanthropic
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  sources.
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  There are a lot of foundations that are
• 13:37
  interested in different diseases.
• 13:39
  There are a lot of,
• 13:42
  really committed,
• 13:43
  philanthropic organizations who wanna,
• 13:46
  fund and who have funded,
• 13:48
  Northwestern very generously over the last so many
• 13:51
  decades,
• 13:52
  relying on those partners a little bit more
• 13:54
  heavily. So,
• 13:56
  just sort of looking at a entire research
• 13:58
  portfolio and trying to make sure that it's
• 14:00
  diversified enough, that we can
• 14:03
  tolerate the ups and downs in federal funding,
• 14:06
  without compromising the quality of research.
• 14:10
  That's such helpful perspective. Thank you so much
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  for,
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  digging a little bit deeper there and sharing
• 14:16
  some of the thoughts that you're having in
• 14:18
  conversations and and things that you're seeing. Now
• 14:21
  when looking at 2026 as well, what do
• 14:23
  you think the hardest thing you'll have to
• 14:25
  do will be?
• 14:27
  I think for us, at Northwestern,
• 14:30
  capacity is an issue for us. So we
• 14:32
  are located in Downtown Chicago.
• 14:37
  We we are a big health care
• 14:40
  system,
• 14:41
  and our downtown campus is actually fairly big.
• 14:45
  But there is definitely a flight to excellence.
• 14:48
  So we have a large market share that
• 14:49
  is growing. So patients wanna come to us.
• 14:52
  And we see that,
• 14:54
  in terms of,
• 14:56
  providing access. So our
• 14:58
  wait times in terms of getting into the
• 15:00
  clinic,
• 15:01
  the capacity issues and crowding in the emergency
• 15:04
  department,
• 15:05
  lack of, hospital beds if we want to
• 15:07
  accept a transfer,
• 15:09
  from other, hospitals in the region.
• 15:12
  Those are all real issues for us,
• 15:16
  that are getting more,
• 15:19
  pressing
• 15:20
  as more patients wanna, get access to Northwestern.
• 15:24
  So in many ways, we are victims of
• 15:26
  our own success.
• 15:28
  We are,
• 15:30
  addressing that. We're adding more beds to the
• 15:33
  existing,
• 15:35
  towers that we have on the downtown campus.
• 15:38
  We're building,
• 15:39
  another brand new tower, on our downtown campus
• 15:42
  that'll have another 225
• 15:44
  or 230 beds with more operating rooms. It'll
• 15:47
  be focused on mostly cancer care, but also
• 15:50
  on transplant and,
• 15:52
  neurosurgery.
• 15:54
  But I think in 2026,
• 15:56
  we will see our,
• 15:59
  capacity issues get worse before they get better.
• 16:02
  This new tower is is gonna take a
• 16:03
  few years for that to to be finished.
• 16:07
  We're adding, 11 more operating rooms in the
• 16:09
  existing, tower and adding some more hospital beds
• 16:12
  as well. But even that's gonna take about
• 16:14
  eighteen months or so. So I think in
• 16:16
  2026,
• 16:16
  we will focus on using our existing resources
• 16:20
  in the best, most efficient way possible
• 16:23
  to serve as many patients as we can.
• 16:25
  And part of that is gonna be also
• 16:27
  looking at
• 16:29
  delivering care across the entire health network that
• 16:31
  we have with 11 hospitals
• 16:33
  rather than trying to get, most of the
• 16:35
  patients to come downtown.
• 16:38
  So we need to have,
• 16:39
  the hubs and spokes model doesn't work in
• 16:41
  this capacity constraint as, setting. We We need
• 16:44
  to have hospitals north of us, West, and
• 16:47
  South of us that are regional receiving hospitals
• 16:50
  that are receiving patients from that region. And
• 16:52
  that's what we have been investing in over
• 16:54
  the last many years,
• 16:56
  with Central DuPage Hospital, for example,
• 16:59
  West of Fear and Palos Hospital and Lake
• 17:00
  Forest Hospital. So, I mean, these are large
• 17:02
  hospitals,
• 17:03
  and we're adding more capacity to these hospitals
• 17:05
  so we can just work as a seamless,
• 17:07
  fully integrated health care delivery
• 17:09
  network
• 17:10
  rather than just
• 17:12
  patients traveling,
• 17:14
  long distances just to come to downtown.
• 17:17
  So that's that's the challenge that we're all
• 17:19
  looking at and and every day,
• 17:22
  trying to figure out, like, you know, how
• 17:23
  we can
• 17:24
  be more efficient, more nimble, more streamlined,
• 17:27
  and, and improve access for the patients.
• 17:32
  That's fascinating to hear. And, you know, I
• 17:34
  I think looking at those accessibility
• 17:36
  and capacity
• 17:38
  it
• 17:39
  is a huge, huge challenge. And so it's
• 17:41
  great to hear that you've got a plan
• 17:42
  and especially,
• 17:44
  bringing more care closer to home. I I
• 17:46
  think when you're making those kinds of connections,
• 17:48
  what is the role of technology,
• 17:51
  in some of those spaces, whether it's the
• 17:53
  way that you connect with patients or helping
• 17:56
  to streamline operations? How do you
• 17:59
  decide what's been most helpful in that transition,
• 18:01
  and and what are you continuing to invest
• 18:03
  in for the next year?
• 18:05
  Yeah. I think
• 18:06
  that technology is a clear,
• 18:08
  value added,
• 18:10
  aspect of just delivering care.
• 18:12
  As everyone realized during the pandemic,
• 18:15
  you know, we can do a lot of,
• 18:18
  patient interaction
• 18:19
  remotely.
• 18:20
  It's not a solution to everything. But, you
• 18:23
  know, a lot of patients were just coming
• 18:25
  in,
• 18:26
  sitting in the waiting area, coming in for
• 18:28
  an appointment that you realize that can
• 18:31
  be easily
• 18:32
  more efficiently, and patients prefer it as well
• 18:35
  to be done remotely.
• 18:37
  Now that's sort of baked in into practices.
• 18:41
  And this is true not just for Northwestern
• 18:42
  but for most health systems.
• 18:44
  But I think the next frontier is gonna
• 18:46
  be using,
• 18:47
  big data and artificial intelligence tools
• 18:51
  to figure out how we can be even
• 18:53
  better. So a lot of these inefficiencies,
• 18:56
  you know, how to schedule patients for,
• 19:01
  for the next for the for the
• 19:03
  quickest possible appointment, for example.
• 19:07
  And it may not be in the downtown
• 19:08
  campus.
• 19:09
  It could be at a
• 19:11
  different
• 19:13
  hospital in the network.
• 19:16
  But using,
• 19:18
  AI tools to
• 19:20
  match the patients and their needs
• 19:22
  with geographical location of where their residence is
• 19:26
  to the nearest hospital and doing it in
• 19:28
  a quick and efficient fashion.
• 19:30
  It's the same thing for identifying patients who
• 19:33
  would benefit from
• 19:34
  additional,
• 19:37
  resources before discharge so the patients can do
• 19:39
  better at home and have a less chance
• 19:41
  of bouncing back to the hospital or getting
• 19:43
  readmitted.
• 19:46
  You know, we started a program, for example,
• 19:48
  like, you know, social work,
• 19:50
  consult for the patients at the time the
• 19:52
  surgery is being booked. Patients who are considered
• 19:54
  to be high risk,
• 19:55
  You plan in advance rather than just once
• 19:57
  that are in the hospital after the surgery,
• 20:00
  try to address the social needs. But maybe
• 20:02
  you should do it proactively.
• 20:04
  Now how do you find those patients? You
• 20:06
  can't do it for everyone. But using AI
• 20:08
  tools that look at social determinants of health,
• 20:10
  patient's age, comorbidities,
• 20:13
  their socioeconomic
• 20:14
  status, and so on and so forth, we
• 20:16
  can identify cohorts that are much more vulnerable
• 20:19
  that would benefit from these interactions or these
• 20:21
  interventions.
• 20:23
  So I think we are, also focusing very
• 20:26
  heavily on, optimizing these AI tools
• 20:32
  that can be embedded and streamlined and integrated
• 20:35
  with our electronic medical record.
• 20:37
  So you can,
• 20:39
  you can do these interventions,
• 20:42
  in a seamless fashion. I think that's gonna
• 20:44
  gain momentum over the next year or two.
• 20:48
  For sure, we are very heavily focused on
• 20:50
  that.
• 20:53
  That's great to hear. And thank you so
• 20:54
  much, you know, for for sharing some of
• 20:57
  those things because it's such a a, you
• 20:59
  know, noisy world other thing, especially with health
• 21:01
  care technology and AI. But to have that
• 21:03
  kind of focus and understanding where it's gonna
• 21:05
  be most beneficial and how it actually ties
• 21:08
  back into that patient care. It seems very
• 21:10
  critical.
• 21:11
  Before we wrap up here, I am curious,
• 21:13
  where do you see some of the best
• 21:14
  opportunities for organizational growth?
• 21:17
  Yeah. I think the
• 21:19
  this is a
• 21:20
  very interesting question, and I think every organization
• 21:23
  is looking at it slightly differently depending on
• 21:26
  what their big challenges are and where the
• 21:28
  opportunities will grow.
• 21:30
  We will continue to focus on recruiting the
• 21:33
  best and top talent.
• 21:35
  We will continue to work on
• 21:39
  improving patient access.
• 21:41
  And then at the same time, we are,
• 21:43
  also looking at how do we think about
• 21:45
  our regional network, and then we'll be more
• 21:49
  of a national and international network,
• 21:52
  collaborating with health systems,
• 21:53
  across the country,
• 21:55
  that would be mutually beneficial for for Northwestern
• 21:58
  Medicine and for those health systems.
• 22:01
  And then,
• 22:03
  a more of international presence as well.
• 22:06
  So those are all things that,
• 22:08
  a part of our NM
• 22:10
  twenty thirty five vision,
• 22:13
  is
• 22:14
  excellence in patient care,
• 22:16
  improving access,
• 22:19
  new discoveries,
• 22:21
  population health, and then,
• 22:23
  really, focusing on how to,
• 22:26
  develop release,
• 22:27
  networks that work
• 22:29
  in a seamless, fully integrated fashion.
• 22:34
  Fantastic. Doctor Allen, thank you so much for
• 22:36
  joining us on the podcast today. This has
• 22:37
  been,
• 22:38
  an interesting discussion, and, certainly, I have learned
• 22:40
  a lot of new things, and so I'm
• 22:42
  excited to,
• 22:43
  continue on this conversation. I know you'll be
• 22:45
  at the annual meeting, in April. You'll be
• 22:48
  speaking on a panel. And so it'll just
• 22:50
  be really cool to hear from you and
• 22:52
  and,
• 22:53
  see you in person there.
• 22:55
  Well, thank you, Laura, for inviting me. It
• 22:56
  was, it was great chatting.