Lindsay Graham joined Columbia University Medical Center as senior vice president/chief operating officer of CUMC and chief executive officer of ColumbiaDoctors, CUMC’s faculty practice organization, on Sept. 5. Graham, who has nearly 30 years of experience in finance and administration at Brown University and the University of Michigan, succeeds Mark McDougle, who retired on June 30.
Graham works closely with Lee Goldman, MD, dean of the Faculties of Health Sciences and Medicine and chief executive of Columbia University Medical Center, to provide leadership and guidance for medical center operations, including facilities, information technology, human resources, communications, and government and community affairs.
Graham also oversees operations at ColumbiaDoctors, and works closely with members of the FPO executive committee, president George A. “Jack” Cioffi, MD, and vice president John A. Chabot, MD, FACS, and the FPO’s Board of Governance and its various committees.
Graham spent the past seven years at Brown University, most recently as vice president for finance and chief financial officer. Previously, he served as the executive dean for administration and finance at Brown University’s Warren Alpert Medical School. Before joining Brown University, he served as chief administrative officer of the Department of Internal Medicine for the University of Michigan Health System. A certified public accountant, Graham earned a bachelor’s degree in accounting from the University of Detroit. Nearly two months into his tenure at Columbia, we posed five questions to Graham:
Q: What are your early impressions of the faculty practice thus far, as well as our relationship with NYP?
I’ve been very impressed with the quality of the faculty here and the emphasis on clinical quality and academic strength which I think is really what sets us apart. I am also impressed by the quality of the staff – we have a collection of really bright, energetic individuals doing their best to support the schools and physicians. One thing I would hope to achieve during my tenure here is to continue our evolution toward a more cohesive, collaborative, team oriented administrative organization.
In contrast with certain of my prior experiences, I’ve also been impressed by the level and depth of collaboration with NYP. It’s clearly a long and very deep, complex relationship. Examples such as our joint ventures in radiology, ambulatory surgery, and the like, are indicators of a fundamentally strong and mutually supporting partnership. This may not always seem so obvious in the day-to-day, but from the recent outsider’s vantage point, this is a very strong relationship.
Q: As the “new guy,” you bring a fresh perspective to your role at Columbia. What are some of the recurrent, overarching themes you’re hearing in your encounters with faculty, staff, and administrators here?
Competition here in New York is intense — some of our competitors seem to be putting up a new practice every 15 minutes. We have and must execute an appropriately aggressive strategy for growth and expansion over time, and we must continue to out-compete on quality. It is very clear however that we must improve on the experience of our patients in our system. Both our patients and the marketplace require that we do so. Some of our competitors are quite good at this and the rest of the field is moving so we have our work cut out for us in this regard. Operating in an efficient, highly integrated manner is the healthcare currency of our day. To compete effectively we’ll have to place an acute focus on the patient experience which will require improved processes and doing business in a more consistent, integrated, patient-friendly manner.
A revelatory experience during my days at the University of Michigan was the power of the application of Toyota lean manufacturing concepts to the healthcare setting. Through this systematic process, they were able to fix many patient handoff disconnections, flow issues, and associated processes that were so frustrating for patients, families, and providers alike. In the current day, these kinds of frustrations can send patients quickly to seek other providers just out of convenience. This kind of change can also be a bit painful at times and requires a deep institutional commitment, but like anything else worth doing, it’s an investment and it’ll have a return.
Physician satisfaction is incredibly important. We have to work hard to make clinical operations as efficient as possible to enhance the physician experience. That means providing the necessary infrastructure, people, and processes so that the providers’ time is maximized and focused on taking care of the patient. Obstacles to providing these necessary elements are a major dissatisfier for our doctors. We are all working to fix this, and again, a large part of the solution comes back to working in a more collaborative, organized, and teamlike fashion.
Q: How did you wind up in the field of healthcare, and what are you passionate about?
Being an accountant in a corporate for-profit setting did not appeal to me — I needed to be connected to something that had a broader, more meaningful mission. I had an opportunity to audit at the University of Michigan and quickly found that healthcare fulfilled that need. It was everything I hoped it would be and I quickly branched out into more operational domains and found that I enjoyed working with physicians. There’s a lot I like about being on the cutting edge of academic and research advances.
Change is a constant in healthcare and academic medicine, and oddly, that’s one of the reason it’s very rewarding to be here. I appreciate that I’m working with physicians who probably don’t like change, but they embrace it, and figure out how to maximize it to continue to deliver the best healthcare to patients. In some cases they bend the change — the drive to quality, for example, in the 1990s. Macro forces in the industry set the stage for the need for EMRs, the need to connect transitions of care, and getting patients into the right setting of care. It was physicians who drove the change at the level of the patient to achieve the needed outcomes.
Q: What about in your off-hours?
My wife, my kids, and our two cats are the true passions in my life. I’m also an avid fan of music — I enjoy all forms, in particular opera and classical music. I’m in heaven here in New York being only a couple of subways stops from the Lincoln Center! I am also an amateur musician, and I play the trumpet. I’ve been a lifelong avid reader of history — I started off my college studies as a history and philosophy major, and these subjects have remained a passion of sorts.
Q: And now, the ultimate New York question — please share your sporting allegiances.
I am a long-suffering Detroit Lions fan as well as an avid fan of the Detroit Tigers and Red Wings. But I am also a diehard Boston Celtics fan and I’ve already taken some ribbing here about that.