“Marion Mass just commented on one of your Beaumont stories on LinkedIn,” a knowledgeable healthcare source texted me. “John Fox doesn’t want to be on Marion Mass’ radar screen.”
John Fox is CEO of Beaumont Health, whose flagship Royal Oak hospital ranked among the best regionals in the country until the Atlanta accountant was put in charge more than six years ago. Mass had just found a story I previously published about Beaumont’s orthopedic surgeons being pressured to use medical implant devices they considered inferior because the hospital got a volume discount. Beaumont’s orthopedic surgeons are ranked among the best in the country.
My story was yet another example of what Mass sees as fundamentally wrong with U.S. healthcare: Suits telling scrubs how to practice medicine. Mass says the situation has reached dangerous proportions and putting patients at great risk. The Duke-trained pediatrician has made it one of her life’s missions to give doctors the courage to speak out and tend to their patients how best they deem fit and are trained to do.
Mass, 53, is one of five founders of Practicing Physicians of America, a grassroots organization that seeks to empower physicians to fight against the corporatization of healthcare and put patient care and safety ahead of profits. PPA’s founders are among the rare doctors who dare to speak out against the U.S. healthcare establishment, which is dominated by deep-pocketed private equity firms, hospital executives more focused on their personal enrichment, and a host of corporate middlemen who are driving up costs while adding little or no value. Another PPA founder is Niran Al-Agba, whose book “Patients at Risk” I’ve previously written about.
I never heard of Mass until my source flagged her, but in short order I understood why Fox and most other hospital CEOs don’t’ want to appear in her line of sight. Though just over five feet tall, Mass throws a powerful punch, and she doesn’t mince words about healthcare professionals who anger her, even if they work at big and powerful institutions.
One such professional was Laura Forese, a former orthopedic surgeon who is executive vice president and chief operating officer of New York-Presbyterian. In a blog post a year ago last April when the pandemic was in full swing, Mass described Forese as “a prominent spokesperson for the suits in hospital administration” who “left her scrubs behind some years ago for a $3.4 million position in the C-Suite.” Mass was livid about a video Forese made lamenting about how “dispiriting” it was for her and other hospital administrators to receive emails of protest from weary physicians, nurses, and others complaining about a shortage of protective equipment and other Covid-related matters. Forese said the videos showed a disrespect for management.
Here’s Mass in her own biting words:
We note here that Dr. Forese has been adept for years at making high-minded statements about hospital culture. She is a skilled spokesperson for those who decided to lock up the PPE and then retreated to their homes to work in their PJs.
In assessing the words of Dr. Forese, there’s something important to remember. The modern hospital corporation has a public face–the people who speak on behalf of the suits in the C-suites. Those spokespersons are masters of serving up a product marked by what the British euphemistically call “an economy of truth.”
It would not be politic, for example, for such a spokesperson to mention that at least some of the inhabitants of the C-suite have an entirely too cozy relationship with the Group Purchasing Organizations (GPOs), the huge business entities that control the supply chain for PPE and other hospital equipment—a dysfunctional supply chain that now stands fully exposed by the pandemic. The Wall Street Journal and others have reported on the dubious nature of the relationship between hospital C-suites and GPOs, about whom we will soon have more to say in another blog entry.
These relationships between suits in hospital C-suites and GPOs make those suits complicit with the GPOs in creating both the specific dangerous shortages that have been exposed by this pandemic and other shortages in recent years that have received almost no coverage. And this is to say nothing of the decline in the quality of what the GPOs supply to hospitals and other institutions involved in caring for patients.
But this is only one corner of a healthcare economy that has been emitting a stronger and stronger stench with the passing years.
It takes considerable courage for a doctor to speak out against the healthcare establishment. While one might expect that hospitals would encourage doctors to aggressively register their concerns about patient safety and other critical issues, the reverse is increasingly true.
At John Fox’s Beaumont, the head of pediatrics was fired after protesting that budget cuts would harm patient care. The president of the flagship hospital escorted him from the building in front of the doctor’s staff. When another doctor protested the department head’s firing, that doctor was also fired. (A pattern seems to be forming here about pediatricians. In addition to Mass, three of the five founders of PPA also are pediatric specialists, suggesting the sort of person attracted to pediatrics is very different than those who choose to become spine surgeons.)
Not surprisingly, many Beaumont doctors were afraid to sign a petition protesting Fox’s leadership. However, when given a chance to respond anonymously to a survey, the majority of Beaumont doctors said they had no confidence in his leadership.
Mass knows the career risks of her advocacy, and she’s open about the reasons she can take them. Mass attended medical school on a full scholarship, so she isn’t burdened with student loans. As well, Mass’ husband is a surgeon, and she says her family could survive on a single salary. Mass also notes that the management of Children’s Hospital of Philadelphia, where she is a staff doctor, has never objected to her advocacy. CHOP’s only request was that Mass make it clear that she’s speaking on her own behalf, not the hospital’s. I suspect CHOP’s inclusiveness allowing its doctors to speak openly is why the hospital was recently ranked by U.S. News as one of the three top children’s hospitals in the country.
What’s beguiling about Mass is her self-effacing and earthy manner, the latter possibly the result of being an accomplished organic gardener, a skill she learned from her father and imparted to her children. When I emailed Mass on LinkedIn about my source saying she was a force to be reckoned with, she replied: “haha! me? I’m a sweet pediatrician and recovering soccer mom. What harm could little ole me possibly inflict on big bad daddy warbucks CEO? BTW, if you have connection to any of the surgeons/physicians who blew the whistle (at Beaumont), I’d love it. Those are the kind of physicians I aspire to meet!”
Mass’s advocacy began when her mother who was suffering from Alzheimer’s was transferred to an area hospital after becoming increasingly violent at the nursing home where she lived. Mass was appalled by the care – or more accurately the lack of care – her mother received. Mass found it particularly disconcerting that two medical students refused to help her remove her mother’s restraints, saying “it’s not our job.” My guess is that after experiencing Mass’ wrath those two students still tremble when they recall the encounter. Mass wrote about her experience caring for her mother on a popular medical blog.
A practicing Catholic who strives to attend church regularly, Mass says her advocacy is also driven by her faith, and by the example of her mother, who played a leadership role in the rural Pennsylvania community where she grew up. Mass’ father, a rep for an HVAC company, instilled in her and her four brothers the importance of a good education. One of Mass’ brothers is a cardiologist in Georgia.
Mass and her fellow advocates have a formidable challenge reforming healthcare. In an incident reminiscent of Michigan’s Beaumont, doctors at Palomar Health in southern California recently voted they had “no confidence” in management because of a controversial outsourcing decision. Palomar’s board sided with management, as did Beaumont’s.
A decision to outsource anesthesia is what precipitated Beaumont’s implosion, resulting in the exodus of more than a dozen surgeons, half the fellowship-trained anesthesiologists, more than 50 nurse anesthetists, and countless nurses. Fox recently announced that Beaumont plans to merge with Spectrum Health, a health system in western Michigan. He stands to pocket millions because of a “change in control” clause in his contract.
“We need to make healthcare more just,” Mass says. “I don’t know how some people in healthcare do what they do and live with themselves.”
This is the first in a series of profiles I plan showcasing doctors, nurses, and other professionals who dare to speak about the causes and greed that makes U.S. healthcare the most expensive and least efficient in the world. If you know of someone in your community deserving of a profile, please contact me privately at firstname.lastname@example.org