SALT LAKE CITY — For the past 18 years, Dr. Charles Sorenson has been running operations and performing operations for Intermountain Healthcare. For eight years, he has been president and CEO, and for a decade he had been chief operating officer, a title that had double meaning.
Throughout it all, he traded his tie for green scrubs and performed urologic cancer surgery on a weekly basis, just as he always had before he was coaxed into administration.
That’s like Bill Gates leaving his office once a week to work on laptop repairs in the Microsoft shop.
“I never planned or wanted to be an administrator,” Sorenson says. “It just happened.”
He broke into the medical field as a teenager by washing dishes at LDS Hospital, which is where he would begin his surgical career. He was a full-time surgeon for 16 years before he was asked to serve as executive VP and COO. He agreed on one condition: That he would be allowed to continue as a surgeon.
“I did it for selfish reasons,” he says. “I just like being there with the team. I like tracking our outcomes. I like trying to improve.”
There was another reason, as well: He figured it would be beneficial to see health care and the workings of the company from the frontlines. “People feel comfortable telling me what they think,” says Sorenson.
He also makes monthly hospital rounds to hear the observations of those in the trenches. “I’ve always emerged from those visits energized and positive because there are so many good people who want to do the right thing,” he says.
Sorenson, a tall, slender 65-year-old, will step down as CEO on Oct. 15 to take on another administrative role (as well as continue his surgical duties). He is going to start an executive training program that, unlike traditional university-based business schools, specifically targets those in the medical field. To prepare for his new role, he has sought advice from Harvard Business School and Dr. Brent James, an internationally renowned figure in the movement to improve health care from within and the subject of a New York Times Magazine cover story.
“As I talked to others I found that there is not a place that is focused on the kind of decision-making that is needed in health care,” says Sorenson. “You can’t run it like another business. This is about people’s lives. Sometimes you have to make investments that don’t make business sense, just because it’s the right thing to do.”
His company decided to make just such an investment, he says. Doctors learned that one of their surgical patients had subsequently been diagnosed a year later with a rare disease as a result of being exposed to microscopic prions present on surgical instruments (they are resistant to traditional sterilization methods). They worried that other patients might have been exposed to the infectious prions via the same surgical tools, although such an occurrence would be extremely rare.
They consulted several government health organizations to ask if they should notify the other patients. They were told no, because the risk of exposure was so small. They warned the patients anyway and volunteered to test them for free, risking cost and bad publicity. No one else tested positive.
“When you’re in health care, if people can’t do the right thing, how can they trust you with their lives?” says Sorenson. “Health care has to be run at a different standard.”
Sorenson wants to bring change to the health care business. He notes that the U.S. has some of the best outcomes in the world in medicine but also overprescribes costly treatments and tests that don’t contribute to better outcomes.
“There are some reports that up to one-third of health care doesn’t contribute to better health,” says Sorenson. “It just drives up the cost. … It’s driven by fee-for-service medicine. It provides powerful economic incentives to do stuff, especially expensive stuff — imaging and scans, for instance. You have to ask if it is really needed.”
Sorenson notes that three years ago his company’s doctors conducted a study of their own use of expensive tests to see how often they contributed to better outcomes.
“We reduced the number of those tests,” says Sorenson. “It reduced revenues by $15 million.” He continues, “Utah has the most affordable medicine in the country, but it’s still too expensive. We’ve got a lot of work to do. We’ve got to start with doing everything patients need that contribute to better outcomes and not doing anything that adds costs and risks that don’t contribute to a healthier life.”
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Sorenson’s passion for medicine was probably fated from birth. His parents, C. Wallace and Chris Sorenson, were a doctor and a nurse, respectively, and raised their family three blocks from LDS Hospital. As a teen, Sorenson had few interests besides medicine and his studies.
“I always wanted to be a doctor,” he says. “I thought medicine was intriguing and challenging.”
He recalls staring up at the sixth-floor windows at LDS Hospital, knowing that’s where surgery was performed. When he turned 16 he applied for a job at LDS Hospital, explaining that he was willing to do anything but hoped to be an orderly on the sixth floor. When he showed up for his first day of work, he was handed a gray uniform — not the green scrubs he coveted — and told to report to the kitchen on the first floor. He washed dishes for a summer.
“I advanced quickly to pot-washer,” he says wryly.
He took an undergrad degree at the University of Utah, and studied medicine at Cornell. Along the way, he had two mentors who impacted his career. One was Homer Warner, a nationally renowned cardiologist who pioneered the use of computers in medicine. Sorenson worked for Warner while attending the U.
“He was a pioneer,” Sorenson says. “When I went to school in New York, people were talking about the work he did.”
Warner wrote Sorenson’s letter of recommendation for Cornell. During Sorenson’s second year of medical school, he told Warner he wanted to shadow a surgeon for a summer in Salt Lake City. Warner made arrangements with Dr. Russell M. Nelson, a nationally renowned cardiothoracic surgeon who would become a general authority in the LDS Church.
“I spent a lot of time with him,” says Sorenson. “He was one of my models. He was very orderly. He didn’t vary things. Dr. James says unwarranted variation is the enemy of quality. (Dr. Nelson) did things the same way every time. And he didn’t get rattled when things got stressful like some doctors. I never saw him throwing things or swearing, and I’ve seen surgeons do that.
"He let me scrub in and hold stuff for him and observe. He let me learn. He showed me how to close the skin and let me close arterial openings. He was great. Later, I was scrubbed in at a New York hospital, and (during the surgery) I asked the surgeon a question. He asked, ‘Why do you ask that?’ I told him I had spent some time with a cardiac surgeon. When I told him it was Dr. Nelson, he stopped what he was doing and looked up at me and asked, ‘You worked with Russell Nelson?’ When I said yes, he said, ‘Well, what would he do here?’”
After completing his medical studies, Sorenson and his wife, Sharee, whom he met in New York, returned to Utah in 1982 and began working at LDS Hospital. He did full-time urologic surgery until 1998, when he was made COO and asked to lead an effort to change the way the company did business. At least in the view of Intermountain Healthcare, too many resources were being plowed into building more and more surgical centers, each requiring its own equipment, all of which increased the overall cost of medical care without really improving quality. All of this was the result of doctors competing against doctors.
“Instead of having them compete with each other, we hired a team of doctors and started our own facility,” says Sorenson.
After stepping down as CEO in October, he will face a new challenge in educating leaders in the medical field. He will also continue to perform surgery, but he’s not sure for how long. He worries about the inevitable decline of his skills as he ages. He recalls when a fellow surgeon surprised him with his resignation. When Sorenson asked him why, he said: “I have seen surgeons who stay on too long, and I don’t want to do that. I want to retire at the top of my game.”
Sorenson has made a pact with other surgeons to whom he is close that they must inform one another if they see one's skills slipping.
“It’s hard to see yourself not at the same level,” says Sorenson. “This job takes a lot of energy. I’ve tried to guard against the erosion of skills. I perform with the same team and we try to minimize variation. We track our outcomes closely. We’re doing fine, but that’s a concern. I don’t want to stay in the operating room too long.”
That’s another reason he’s stepping down from his CEO position. Like an aging quarterback, he’s not sure how much longer he can remain at the top of his game. He picked Oct. 15 as his retirement date years ago: “I’d rather cut it on the short side because what we do is too important,” he says.
Sitting at his desk, Sorenson has to stop to choke back his emotions as he recalls his career and life’s work.
“It’s the most important thing I could spend my life on,” he says. “It’s really personal to me. It comes down to individual patients and nurses and physicians who are trying to do this hugely important work, and people depend on us … To have been there with patients — those who worked out and those for whom our knowledge and skills are not sufficient to save them.
"You’re just never done. There’s no room for being arrogant or callous. ... I’ve been fortunate to work with people who are very smart and hard-working and dedicated to this mission of helping people live the healthiest life possible.”
Email: drob@deseretnews.com