Landmark Medical Center has a new chief medical officer, effective March 15: Dr. Robert S. Crausman, who for more than six years has been the administrator of the R.I. Board of Medical Licensure and Discipline, and also coordinated the state’s H1N1 response.
A pulmonologist and geriatrician, Crausman will now oversee all aspects of medical care at the Woonsocket Hospital, serve as a liaison between the medical staff and senior management, and help shape clinical programs and promote them to the community.
Crausman answered questions about his career so far and the challenges ahead.
PBN: Tell us more about your background.
CRAUSMAN: I earned my undergraduate and medical degrees at Brown University and completed my postgraduate medical training in internal medicine and geriatrics at Harvard/Beth Israel Hospital in 1992. I then completed further fellowship training in pulmonary and critical care medicine at the University of Colorado.
In 1995, I returned to Rhode Island to direct Brown’s internal medicine residency training program at Memorial Hospital of Rhode Island, where I stayed until 2003. During my tenure, we developed a primary care-oriented program and successfully competed for federal grant funding for our initiatives. I also started and led Memorial’s first “hospitalist” program [training doctors who focus entirely on inpatient care], directed the outpatient internal medicine clinical practice, and later was the chief of geriatrics.
In 2003, I joined the Health Department as chief administrative officer of the Board of Medical Licensure and Discipline. Since 2003, I have also practiced part time as a pulmonary medicine specialist in the context of a small group primary care medical practice, Internal Medicine Health Associates, in Taunton, Mass.
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PBN: What appealed to you about joining Landmark? Are there specific opportunities that you see there that you really like?
CRAUSMAN: Having spent my early career in Pawtucket, I am very familiar and comfortable in the communities along the Blackstone Valley. I was fortunate to work with many of the senior physicians as a student, and more recently to have been involved in the training of many of the younger physicians who choose to remain in the area to practice. I have always been impressed with the strong community support for our smaller, high-quality hospitals. I have found professional satisfaction in building clinical programs to benefit our community.
PBN: What will be your primary responsibilities as chief medical officer? Physician recruitment? Clinical quality monitoring and improvement? Shaping the services that Landmark provides?
CRAUSMAN: Yes, yes and yes. Additionally, as chief medical officer I will work closely with the president and medical staff to assure that Landmark has a bright future providing hospital-level care and ambulatory services to the community.
PBN: Landmark has struggled financially a lot in recent years, and a big part of it is because of its case mix – lots of elderly patients on Medicare, and lots of poor patients who are on Medicaid or uninsured. Will that create special challenges for you? Is it harder to be innovative and/or enterprising in this environment?
CRAUSMAN: Unfortunately, the biggest challenge confronting Landmark at present is financial, bringing to mind the adage, “no money, no mission.”
What is often lost in the discussion across the state is that Landmark has continued to provide very high-quality medical care despite receiving lower reimbursements than any of the larger hospitals in the state. This fact was underscored by the Health Insurance Commissioner’s recent report on hospital reimbursement.
As a state we are at a crossroads. We have long enjoyed a robust mix of community-based hospitals and more centrally located tertiary-care referral hospitals. This has provided the state with easy local access for their general health care needs as well as regional availability of tertiary care. Unfortunately, our community hospitals’ survival is now threatened as the balance has been tilted unfavorably towards more expensive regional tertiary-care facilities.
The future shape and direction of health care in the state is at stake and the time calls for strong leadership at all levels, public and private. We all have a vested interest in the outcome. I, for one, have made my strong professional commitment in support of our high quality, community hospitals in general and Landmark in particular.
PBN: You’re coming to Landmark from a public health and regulatory environment, including the H1N1 pandemic response. How do you expect those experiences to inform your work at Landmark?
CRAUSMAN: Since completing my medical training, I have spent considerable time in both the community hospital environment and in health services regulation. This has provided me a unique opportunity to see many of the issues from “both sides” and provided a true appreciation of the priorities of each perspective. Rather than competing opposites, however, I’ve come to appreciate the self-same goals of achieving high -quality care in a patient-safe environment as common core values of each perspective.
My recent work with our state’s pandemic response only reinforced my clear observation that our state’s hospitals are truly partnered with the Health Department and provide many of the functions of local health departments in other states, all for the benefit of the community.
