The CEO of Hospitals Throughout California

THERE ARE FEW subject matters in this country as tempestuous and emotionally wrought as health care. Mark Laret serves as chief executive officer of UCSF Health, one of the premier medical systems in the United States. He oversees UCSF Medical Center in Parnassus Heights, Mount Zion, and its new site in Mission Bay. He also oversees UCSF Benioff Children’s Hospital San Francisco and, with the recent affiliation with Children’s Hospital of Oakland, the renamed Benioff Children’s Hospital Oakland. Combined, the hospitals serve more than a million outpatient visits a year. A 30-year veteran of health care management, Laret went from leadership positions at UCLA Medical Center in Los Angeles to the position of CEO at UC Irvine Medical Center. He was able to turn around business there in a way that resulted in improvements in quality of care, patient satisfaction and financial performance. That led him, in 2000, to accept the challenge of moving to Northern California to take over the mammoth job of heading up the UCSF Medical Center. Working in San Francisco, Laret and his family — wife Jan, son Parker and daughter Casey — call the Strawberry area of Mill Valley home.

What are the most attractive things about being the CEO of UCSF Medical Center?

It’s very rewarding. It’s challenging. It’s intellectually stimulating. But the best part of it is working with people who are truly committed to helping others. That elevates you in a way.

So you’re in a position to help people who are helping other people. Was that part of the drive — to help others?

It’s more about making the health care system work better. You probably remember — it wasn’t that long ago: what the doctor said, that was the rule. You saw the doctor when the doctor was ready to see you. So the “power relationship” was completely on the side of the medical establishment. What I like to think I bring is the perspective of the community.

What were the chief factors involved in this shift from the doctors being in charge of the relationship to the community moving into the “power position”?

As individuals started to pay more for their own health care, they started to be a little more assertive about, “Why am I paying for this?” and “’Why don’t I understand that bill?” and “Why are you charging me $20 for an aspirin?” So I think it’s come together to create an environment where there’s a lot more accountability, which I think is very healthy for the industry.

How harmful or helpful has the Internet been in terms of informing or misinforming patients — information that they then relay to their doctors?

It’s made the interaction between the patients and physicians a little more complex. On the other hand, I almost always have to side in favor of the argument that people being more informed is a good thing. It’s actually, in its own way, improved accountability, so when that patient shows up with that WebMD article it does require the physician to have at least read and thought through the article and be able to discuss this with the patient.

You’ve been in the University of California system for 30 years. How does that health care system operate compared to the private sector?

First is the deep intellectual challenge. When you work in a teaching hospital, it’s characterized by having a lot of really smart learners around, asking the physicians, “Why are we doing this?” or “What about this research?” or “What about that approach?” It adds a level of intellectual rigor about how health care is delivered. It’s just a privilege to be part of something this important.

Besides the intellectual rigor you talk about, how else does a teaching hospital vary from a private facility?

There are a lot more physicians around 24/7 because we have trainees, residents, fellows — all different levels of training there, participating in the care of patients. UCSF has done more kidney transplants than any center in the world. It’s one of the original centers of excellence in women’s health and in end-of-life care. There’s a huge cancer center, so it tends to be at the forefront of health care at that level. And also there’s a high level of research that goes on, into even simple things like how to deliver primary care more efficiently or effectively and at a lower cost.

How does that level of service manifest?

There is a public service part of the mission that is very meaningful. Two years ago we completed this affiliation with Children’s Hospital Oakland. Children’s Hospital serves 70 percent Medi-Cal patients. It serves many people in the disadvantaged community and it’s been one of the most important things in my career to be associated with — to help an organization that helps kids who might not otherwise get a chance.

Is a lot of your attention focused on fundraising, where that money is coming from, things like that?

I never really raised any money before. I didn’t quite know how to think about it. But there are a lot of people who, for whatever reason, whether they’ve built it or inherited it, they have means. And many of them are looking for a good place to invest their money and as much as anything it is letting people know here’s an opportunity to touch many people’s lives. Our new hospital in Mission Bay was a $1.7 billion project.

What’s the payoff for those looking to throw their financial support behind UCSF?

The people who help support building Mission Bay Hospital, all they need to see is some of those kids in the Benioff Children’s Hospital or the moms who are delivering there, or the cancer patients there, and they say, “You know what? This is all worth it.” I always say there’s no better thing than to give to UCSF.

Any big celebrities you can talk about who come to either visit the kids or give regular donations, or make other kinds of contributions?

We’ve been so fortunate to have great support from many people. People like Ronnie Lott and many of the 49ers. Steph Curry has been over to visit. MC Hammer’s always been around, ready to help. It’s also many individuals in tech and, of course, the Benioffs are right at the top of that list. And then they invite their friends. Just this last year we separately had both Bill and Hillary Clinton come visit.

How has the Affordable Care Act, or “Obamacare,” affected things at the hospital?

If you want to know what I’m asked most at cocktail parties, it’s about Obamacare: “Is it a good or is it a bad thing?” My answer is we supported it, and I still support it, but it’s a work in progress and it needs to be modified over time. But in general the theme is trying to move away from this fee-for-service medicine — so the more you do, the more you get paid — to a population health management model where our hospital and our health system is responsible for the patients and our goal is to keep them healthy.

If people want to help out, but they don’t have a lot of money, are there other programs they can get involved in at the hospital?

We have very strong volunteer programs and people can do a variety of things. Many people who have had a particular experience in the health care system come in to be an ambassador to other patients going through the same thing. For example, when my wife was diagnosed with breast cancer about six years ago, it was a different experience for me. I’d been around breast cancer patients and I’ve been around the breast cancer program and so forth. But you realize how different it is dealing with it in the abstract over here, versus when it comes home. It was very helpful for her and for me to get the feedback and experience from people who had lived through it.

What sorts of things do you enjoy doing around Marin?

For years I did Hit the Hill, which was a boot camp program. I’m clearly not in that kind of shape right now. But I’ve spent a lot of time up on Mount Tam, including Railroad Grade, and that is just magnificent. I have a dog, a yellow lab named Buddy — Buddy and I spend a lot of time on Ring Mountain. I just like getting out. This environment is amazing.