LEWES – Dr. David Tam was scheduled to become Beebe Healthcare’s new president and CEO on April 1. Tam, 57, most recently served as the chief operating officer at Providence Saint John’s Health Center, an acute-care hospital with 266 beds that serves the west side of Los Angeles. Tam took the reins at Beebe two weeks early though to help Beebe through the coronavirus pandemic and in advance of a period of great change that includes a new surgical hospital campus off Route 24 and a new emergency department and satellite cancer center in Millville. Tam retired as a captain in the U.S. Navy after 24 years of service. Before Providence, he served as the chief administrative officer for the San Diego Public Health System, and chief operating officer for the western region of TriCare, the U.S. military’s health insurance program. He was also the deputy commander, chief operating and strategy officer at Naval Medical Center in San Diego, the military’s largest academic tertiary medical center. He outlined his reasons for arriving early, his early perspective on dealing with a pandemic, and his vision for the hospital with Editor Peter Osborne on April 7. This interview was edited for length and clarity.
As I was contemplating the next step in my career, I was looking for an opportunity to lead an independent, community-based health care organization like Beebe Healthcare. After accepting the position, I decided to drive a U-Haul across the country over 10 to 12 days, getting up early in the morning and stopping early in the afternoon. I was going to listen to books on tape, read in the afternoon and journal, and finalize my 100-day transition plan as I wrapped around this incredible new opportunity.
Two days into the trip, my wife called and told me the coronavirus crisis was blowing up. I hadn’t heard much although I did know what was happening in China. I listened to her, went online, and realized this was expanding and evolving so I decided to start early. I asked my wife if she was OK with that, then called Dave Herbert, our board chair, who agreed. The 10-day trip turned into five, and by the time the trip was over, I had certainly seen the impact of the pandemic in terms of traffic on the roads and people in restaurants and the fear and anxiety starting to build in our country.
I had the opportunity to really think about the “non-pandemic” Beebe Healthcare, and the pillars of strategic execution I was contemplating were still applicable in terms of how this organization is responding to this pandemic. I wanted to look at how to transform the delivery of health care by expanding our footprint in ways other than building more brick–and–mortar buildings. We needed to look at innovating our processes to improve how health care is delivered in our diverse community, and we had to concentrate on the services of greatest value to our community. Those were the areas I wanted to work on before there was even a pandemic. That said, it turns out that these pillars of execution are also applicable in how Beebe Healthcare responds to the COVID-19 pandemic.
Forces beyond anyone’s control forced me to modify my 100-day plan. But the three pillars remain the same:
- Innovate processes. I was going to focus on how we innovate processes like scheduling appointments, billing, and improving efficiencies in places like the operating room or the emergency department. With the COVID-19 pandemic, we are researching and executing innovative processes to address the potential shortage in personal protective equipment (PPE), should the surge be as significant as New York City or Seattle. How do we ensure the safety of our caregivers and preserve our capacity to care for patients? And how do we use innovative tactics like video town halls to share with our community as much information as possible and engage them in important things like social distancing and hand–washing so that we can “flatten the curve.”
- Develop clinically relevant programs to meet the specific needs of our community. I wanted to look at the needs of our community and develop programs unique to their needs. What are the diseases and ailments that affect a population with many retirees, older patients, as well as families who visit for a portion of the year from other places? And now, with the pandemic, how do we plan for the potentially greater level of illness because of the same vulnerabilities our patients have? I have been amazed at the collaboration between the health systems and Gov. John Carney’s office in terms of addressing the unique challenges of our resort/vacation community and how to decrease the spread of the virus.
- Expand our platform. Beebe Healthcare has had to react quickly to address the diversity and geography of our community. We established drive-thru testing sites as soon as we could to expand our footprint. We have developed new modalities for tele-health that allows patients to interact with their doctors’ office without physically coming in. And we have used our own ability to obtain testing data and, working with the Delaware Division of Public Health, create a predictive model for what we could see in various stages of the pandemic surge, and what resources we will need to respond appropriately. Based upon the best data we have, we believe we have the ability to expand our inpatient capacity to around 250 beds, if needed, using our current resources. We have worked with the Delaware Emergency Management Agency (DEMA) to expand further if needed, provided we are allocated further resources.
I’ve had to evacuate hospitals and manage in crisis situations before – right after 9/11 and with wildfires in California. But there’s a fundamental difference between those kinds of disasters and a pandemic. I knew I was coming to a great place, but I’ve been blown away by our staff and caregivers. They’re all so friendly and willing to help. I showed up in my U-Haul to our empty house. I went to Walmart on my first weekend and they didn’t have any toilet paper. I was doing rounds in the emergency room and mentioned that I was down to my last roll. The next day, I walked into my office and there’s a 12-pack of toilet paper from an ER nurse who I just met and a note that said, “So you can do your business at home” with a smiley face. I’ve been in hospitals for 40 years and never had that kind of experience. That’s the Beebe difference. I call it #TeamBeebe.
I’m the first-born son of a Chinese immigrant and was expected to become a physician when I grew up, so I began working in hospitals early. I started as an orderly and worked in just about every job in a hospital. I think I have an advantage in this job being a physician. It’s accelerated my onboarding because I am comfortable going anywhere in the hospital or the outpatient clinics. During this difficult time, I’ve helped transport a patient or clean a room – it’s not my place to jump in and do the work for others. It’s my job as the CEO to see whether things can be done differently to make it easier for caregivers and patients and then work with the leadership team to execute those changes.
My predecessor, Jeff Fried, built a great team so the transition has been great. It has given me the opportunity to focus on what I think is the role of the CEO in a crisis: Communicate, communicate, communicate. Beebe Healthcare is the community’s health system, so communication is really a bilateral process – we need to understand what people need, and then communicate how we will work to meet that need. It’s hard to do in a time of social distancing, but new technologies have helped us make that happen. Both my caregivers and the community need to know I’m listening. I monitor Facebook, Twitter, and other sources so I can learn what our caregivers and community members are concerned about.
This pandemic doesn’t hit every community at the same time, but it will hit here in the next one or two weeks. This is my 22nd day on job and I made one difficult decision early on. Volume was going down because the surgeon general said we should postpone elective surgeries and medical procedures. In other places, hospitals have started furloughing or reducing hours for caregivers to address the financial challenges of managing revenue and expenses. I kept us at a normal level of staffing because I wanted to make sure all our employees were given the opportunity to cross-train so when the pandemic surge hits, we could be agile and execute responsively. People who work in outpatient clinics are learning how to input information into different inpatient systems. That way, they’ll be able to supplement our in-patient team when the surge comes.
There are many questions and concerns that keep me up at night. Of course, the financial impact of maintaining staffing and purchasing needed supplies to care for our patients and protect our staff when we are also not generating revenue is big. My finance team is creating some models for us using the latest projections and information regarding the benefits of the federal CARES Act and how we can access funds, as well understanding changes in Medicare reimbursement policies to address the COVID-19 pandemic. But at the end of the day, I rely on my training as a physician and a naval officer that the focus is on the mission – taking care of the people in our community and the Beebe team that is committed to doing so, and working hard to continue improving how we operate to be good stewards.
You asked how it feels to jump into the deep end. I immigrated to this great country with my family when I was a kid. I joined the Navy who put me through school and served for 24 years. I have learned that it’s important to be comforted by the past when the future feels uncertain. Beebe Healthcare has been here for 104 years; I’m looking out the window of my office at one of our buildings that was built in 1921. We survived the Spanish flu pandemic in 1918, and we will survive this and anything else that comes at us over the next 100 years as long as we remain focused on serving our community.
