Inside story of big leadership change at Baptist Health
Brian Keeley, president and CEO of Baptist Health South Florida, will retire next year after almost 50 years with Baptist. He began in 1969 as an administrative resident at Baptist Hospital. He was named assistant administrator in 1973, became Chief Operating Officer in 1979 and CEO in 1986.
Since then, he has overseen hospital openings and mergers, the opening of an academic facility, the opening of the Miami Cancer Institute, storms and hurricanes, and most recently, a pandemic.
Mr. Keeley leads South Florida’s largest healthcare organization, with a budget of $4 billion, 24,000 employees, more than 4,000 affiliated physicians and more than 1.5 million patient visits yearly.
The biggest achievement of his career, he said, was Baptist being named by Fortune magazine as one of the 1,000 Best Companies to Work For. “There are like 300,000 companies in America and to be in the top 100, I think it says an awful lot.” The second biggest was being named one of the most ethical companies in the world by Ethisphere (in 2020). “I think we’ve had that award for about seven or eight years.”
The reason for that accomplishment, as Mr. Keeley said, at Baptist Health “you always do the right thing. “It’s sort of like the golden rule. Do unto others as you as you would have them do unto you.”
Q: How do you feel about retiring?
A: It’s a strange feeling because I’ve been there so long, 50 years. I’ve never been through something like this. It is bittersweet in the sense that I can’t believe that I’m going to be making that transition. Now, my retirement was announced, but it doesn’t occur until next year.
There’s a transition period. But I live with the fondest memories. You know, people ask me and I say Baptist has been a job. It’s been my vocation and my application. And I spent my entire career here with the exception of being in the Navy for four years. So, this has been the love of my life for so many years. It’s hard to separate from it.
Q: How is the transition occurring?
A: As we go into a fast growth mode, it is important to bring new leadership, promoting Bo Boulenger from the chief operating officer (COO) position. He is going to be moving into the president position.
What we ended up doing was, based on our consultants’ recommendations, I gave up half my position, which was the president’s position, and I kept the CEO position. So, on a going-forward basis, I’ll be the CEO of Baptist Health and Bo Boulenger just got promoted to the president and COO.
During that period, I’ll be focusing on mergers and acquisitions in terms of bringing other people in the Baptist system; we will be focusing on philanthropy; we will be focusing on innovation, which is something that we want to be really pushing on; and then finally, I’m going to be focusing on working with the board in terms of education and development and recruiting new board members. So that’s how I’m going to spend my time.
I’m going to be really focusing on the outside and Bo will be focusing on day-to-day operations and everything that is occurring internally.
The reason we did that is because we’re probably the most stable organization in the United States. With me being here 50 years, most of our executives have been here 30 years, we have very little turnover, and when we do that, we want to make sure it’s done in a seamless fashion.
Q: You must have a lot of experiences at Baptist, but which was the most challenging?
A: The last pandemic we had was a Spanish Flu [in 1918]. When I started reading that we were going to be going to a global pandemic, I said this is going to be very, very serious. I think the only thing that comes close to the pandemic was Hurricane Andrew in 1992.
We never had anything like Hurricane Andrew. It hit, and I got up the next day and I said to myself, it looks like Hiroshima. It looks like somebody dropped an atomic bomb on Miami to see all the trees blown down and all the homes blown away, the roofs blown away and all the homeless people. I thought naively that in another month or so we’ll get through it. Two months later, I didn’t see any improvement whatsoever. I remember, the federal government was going to send FEMA down. They never showed up.
And I learned a very, very valuable lesson: when you have a national catastrophe like this, you can’t count on the federal government or the state government or the local government, you have to count on yourself. I think that helped us prepare for the pandemic.
I remember that in January we knew this thing was coming.
I gave a call to our supply chain management guy, that’s our purchasing individual, and I said “George, go out and buy as much PPP [personal protective equipment] as you can.” And he said, “What’s the budget?” and I said we’re on no budget. “So how much are the spaces?” he said. Again, I said “buy as much as you can because we’re going to have a global shortage of this stuff.” And that’s exactly what we did.
The reason we did that is because I knew that, just like when the hurricane hit, that this is going to be a very, very difficult situation. So, when we were a couple of months into the pandemic, some hospitals were telling their staff they had to use the same mask for three or four days. With Baptist, we didn’t do that; we gave a new mask every time they came in.
So, going back to the hurricane, that was a great preparation for 30 or 40 years later for the pandemic.
Q: During the pandemic what was the most difficult decision you had to make?
A: When we were given the directive of the federal government to close down all of our elective procedures. That dropped our income by 40% when we first got into the pandemic. The result was that we lost a half a billion dollars. I never thought Baptist Health would lose half a billion dollars in one quarter. And that’s exactly what we did. That was a very, very difficult decision. But that mandate was actually coming from the government.
Q: What do you consider is your legacy?
A: In terms of a philosophical base, leaving the world a better place than you started. I think that’s an amazing humanitarian goal. And I think that I’ve helped to hopefully make the world a better place.
In terms of Baptist Health, it grew from a single hospital to the most preeminent healthcare system in South Florida. Our service here is no longer Miami, it goes from Palm Beach down to the Keys.
But I think that one thing I was able to accomplish is to develop Baptist as the most preferred health care system in South Florida, and it’s all about people. In terms of the tremendous pride I get, it’s winning the Fortune 100 best company to work for. We’ve done that 22 years in a row.
The defining characteristic of Baptist Health is people and we’ve done an amazing job with that, being able to attract 24,000 wonderful, dedicated, passionate, compassionate people that work for us. If you come into any of our facilities, you might see our beautiful facilities and the technology, but what you’re going to first notice is people. They care, they smile, they are devoted to provide superior care to everybody that comes in the doors.
Q: What is going to be the biggest challenge Mr. Boulenger will face?
A: Well, we are going to be working side by side into the next year. We have been together for like 25 years. We work extremely well together. I am very, very bullish on the future… I am bullish on Baptist Health. We’re in a better position, one of the best physician hospitals in the entire United States and now we are moving ahead very aggressively with our growth plans.
Bo is an extremely capable person. He’s got all our other executives that have been with us for years and years. We have a well-oiled team that is exceptional in terms of performance and I don’t think we could have a better team in charge. Even though in my absence, as I begin to phase out, I am totally confident we will continue to be the most preferred healthcare system in South Florida.
But one of the things, what we thought was really unforeseen, is the number of people who are choosing not to come back to work in healthcare. I’m talking about nurses; some would rather work in an environment where they don’t have to take care of a deadly illness and take care of people that are dying. They prefer to leave healthcare. We’re having a critical shortage of nurses right now.
We thought all these people were coming back. They’re not. So that’s one of the things that we did not anticipate whatsoever, having enough people.
We just increased our minimum wage from $12 to $15. I think we are the first healthcare system in Florida that did that, and I hope that other hospitals and healthcare systems fall in behind this because the lower-paid people can’t afford to live in Miami. Miami is just too expensive. Bringing them up to $15 an hour is going to make their lives an awful lot easier.
Q: What do you consider the major opportunities of medicine within five to ten years?
A: When I look at technology and at telehealth and virtual health, we never thought we could treat people over Zoom and over the phone. All of a sudden we find out we can, and it dramatically improves access. We found that we went from like 5,000 to 50,000 patients a month because they could use telemedicine. I think it is in terms of how we are going to leverage technology to improve care, to improve access and reduce the cost.
What is going to happen is that we are seeing a profound change in the US healthcare delivery. A lot of that was caused by the pandemic when everything fell apart, and we found that we can leverage technology and we also found out how expensive healthcare is.
Now, the important thing here is that we keep people healthy and we focus on prevention and chronic disease management. We are going to keep them out of our expensive hospitals and out of our expensive emergency departments. At least for Baptist, we are going to be focusing on changing the center system for our physicians and our executives for the hospitals to treat people on an outpatient basis, to focus on prevention and wellness.
If you look at our growth over the last 10 years, the vast majority has not been inpatient hospital settings. It’s really been diverting from inpatient to outpatient setting with ambulatory surgery centers and ambulatory freestanding imaging centers. The transition we’re making now is to telemedicine; we are going to be treating people at home.
This transition is titled value-based care. And what value-based care is, it’s better care and better outcomes, higher level of patient engagement or satisfaction at lower costs. When you add it all together, that’s what this whole thing’s about.
Q: At the beginning of your career did you imagine you Baptist would achieve this success?
A: When we started, we were building a 270-bed hospital on Kendall Drive… This goes back to the ’60s and ’70s and you have to realize that Kendall Drive was the road to nowhere. Back then I said “we just want to have a good hospital, you know, we just want to have a really good hospital.” And then, all of a sudden, when Miami started growing around us, we were getting bigger and bigger. More and more hospitals were coming into town and there was a tremendous amount of competition.
In the ’80s, we made the determination that we didn’t want to be big, but more importantly, we wanted to be the best. So back then we thought we could be probably a billion-dollar company; and of course, today we’re a $4 billion company. But then again, we never – and I underline never – wanted to be big, we just wanted to be great. That was the goal that we have articulated, probably since the mid-1980s.
Q: Now that you are retiring, what is going to make you get out of bed every morning?
A: As we do this transition, I’m going to be working on mergers and acquisitions, and long-term planning on what we have to do. But after I retire, and I’m no longer getting compensated, I’m going to volunteer to serve on the board. I’d like to be one of the voluntary board members to make sure that Baptist continues to be very successful in the future.
But I won’t be an employee, I won’t be the CEO and I won’t have an official position. I’ll just be one of the 30 board members that are volunteers that are just wonderful people, and the reason they do it is because they want to give back to the community.