The chief executive officer of one of the country’s biggest health-care systems is retiring. Peter Fine will leave his role as CEO of the Arizona-based Banner Health at the end of the month; he’ll then transition into a CEO emeritus role for several months.
Banner’s current president, Amy Perry, will become the company’s new CEO.
Fine has been in his role for 24 years. Before his retirement, he spoke with The Show — starting with how Fine would say the medical landscape has changed over time.
Full conversation
PETER FINE: Oh, very dramatic. Lots of different programs and areas of specialty and, and growth. I mean, I just look at the amount of capital we've spent over that 24 years in building facilities and access points covering everything from inpatient services to urgent care services, to imaging sites, to rehab hospitals, to surgery centers, just covers a wide swath of, of areas of the provision of, of clinical services.
MARK BRODIE: Have you found that the way that health care is delivered has changed a lot too? I mean, in terms of things like hospital groups, for example, buying up medical practices and that kind of thing.
FINE: Oh, no question. Over the years, changes that have occurred in the provision of providing health-care services have been monumental.
BRODIE: One of the other big changes and this is maybe a more recent one is the increase in telehealth, especially since the COVID-19 pandemic. How has that impacted Banner and maybe how has that changed the way that the company and its providers do what they do?
FINE: We've certainly, for the physicians employed by us, we have in almost all of these situations, have put in new access capability to access your physician, either doing it through telehealth or doing it online through our, our portal. You can access physicians and schedule televisits if you don't want to get in.
But remember, those are very limited. The kinds of things that people can actually get in my mind, a satisfactory response to their needs through telehealth is quite limited at this point in time. It's fairly simple things. And in many cases after a telehealth visit, somebody has to come in anyhow, because the physician has to put hands on for an examination.
BRODIE: I'm curious also about the ongoing shortage of physicians, especially primary care physicians but others as well, nurses, other providers, technicians, things like that. Is it in any way surprising to you that over the number of years, this has been an issue that it really has, the problem hasn't really gotten solved?
FINE: It doesn't surprise me, because you're also dealing with population growth. At the same time that you're trying to recruit clinicians to serve that population growth. And then you couple that with a growing intensity of problems that exist that require higher levels of service. And it's not surprising, but in many cases, some of it is limited by, you know, by the government.
We today are capped, what I call a cap on getting reimbursement for the government for graduate medical education slots, which are postgraduate residencies and fellowships and very expensive for providers to try to provide those training slots without some assistance. And the government has provided that assistance through their governmental programs. But there are caps.
BRODIE: What kind of dent do you think that the relationship between Banner and the University of Arizona College of Medicine might be able to put into that?
FINE: University of Arizona has two Colleges of Medicine. They have one, two accredited colleges, one in Tucson and one in Phoenix. And in many cases, it helps us to grow the population of clinicians. But remember growing medical students and medical school doesn't solve your physician problem because after medical school, they have to go into postgraduate training programs of one kind or another.
And so that's where the, the roadblock is if, if we want to keep more transitions in this state, growing undergraduate medical education doesn't allow that to happen. Growing graduate medical education slots, which I previously told you had limitations of funding, that's where you have the ability to keep physicians within the market because in many cases, they will stay within the geography in which they have gone through their graduate medical education training programs.
We fill our slots every year 100% and we get people from all over the country. And so we can bring people here who don't live here or didn't go through medical school training here and, and get them into our GME programs. But we have to be able to expand our GME programs.
BRODIE: I want to ask you lastly about, you know, we've been talking about some of the, the changes over your time at Banner. I'm curious more specifically, the last, let's say, maybe four or five years, what changes that you had to make and maybe what effects that you felt during the pandemic have, have carried over and maybe have changed the way that, that you do your job or that Banner does its job.
FINE: So you, you talked about from ‘20 to the midpoint of ‘22. For us, Banner handled about 45% of all the COVID patients in the state. That was an extraordinary burden on our organization. And in March of 2020 when all of this came to fruition, our board gave management a mandate, and the mandate was save as many lives as you can and protect our people. And that's what we did, regardless of what it cost us to do that and it caused a lot of changes in how you do business.
You did see an increasing amount of video and telehealth opportunities growing and people running and struggling to try to grow those opportunities. You saw people like us put more resources into frontline access points, whether they are urgent care or physician offices. And so it taught you to think differently about it.
And we began to recognize what that meant from a staffing level and how are we going to develop capabilities for the next pandemic when it comes down the pike and be, be prepared for responding and reacting to that and how are we going to run our business differently?
