Dr. Sunil “Sunny” Eappen spent his first few weeks on the job as the new leader of the UVM Health Network, crossing from Vermont to New York and back to Lake Champlain, visiting all six of the network’s hospitals. Eappen told VTDigger last month that he expects to travel frequently, promising to visit each hospital “very, very regularly.”
The visits will not be as hands-on as he has been during his 14 years as a hospital administrator in Boston. As an obstetric anesthetist, Eappen schedules one day a month to work and one day to be on call in the busy obstetrics center at Brigham and Women’s Hospital. But the purpose is the same: a direct and immediate insight into what the day-to-day life of staff and patients is like.
“It gave me a real sense of what it’s like to keep working,” said Epen, 56, who began his new role as president and chief executive on Nov. 28. Whether it’s during a pandemic or implementing a new electronic medical record system, “I really understand when people are complaining.”
Longtime Sunny Eappen colleague and recent supervisor Ron Wells, chief operating officer of Mass General Brigham, parent company of Brigham and Women’s Hospital, says the desire to meet as many people as possible and listen carefully is a core part of Sunny Eappen. He credits impulsiveness with part of what makes Eappen so effective.
“He’s a great listener. He’s a quick adaptor. He’s ready to take feedback and change course when needed,” Wells said. “He was one of the most selfless leaders I have ever worked with in academic medicine.”
As Chief of Emergency Medicine, Wells worked with Eappen to simplify and standardize the way anesthesiologists are involved in the emergency department, saving valuable time in trauma patients undergoing surgery. In 2018, after taking on an executive role, Wells brought Eappen back to Brigham as chief medical officer — a role he had held at Massachusetts Eye and Ear.
Switching from a smaller specialty hospital is a “big step,” Wells said, perhaps bigger than switching from Brigham to leading UVM Health. But according to Wells, Eappen took it in stride. “If you saw Sunny after three weeks, you’d swear he’d been there for five years,” he said.
In fact, in terms of size, Brigham is slightly larger than the UVM Health network. The former will spend $4.5 billion in 2021 with about 21,000 employees and 1,000 licensed inpatient beds, while UVM Health will spend just under $2.4 billion with 15,000 employees and 620 licensed inpatient beds. Boston Hospital trains doctors through its affiliation with Harvard Medical School, similar to the relationship UVM Health has with the University of Vermont’s Lanner School of Medicine.
Wells said Eappen’s achievements at Brigham over the past four years — 10 of which he served as interim president — include a complete reorganization of the pharmacy business to make them more patient-friendly and efficient. Eappen also confronts some “very challenging professional issues” with empathy and fairness.
“He’s really good at that because he always puts the patient first,” Wells said. “He’s always cared about the providers too, cared deeply about them, but the patients are the trump card.”
Eappen said his role model for serving patients is his father, a Chicago-area pediatrician in solo practice who rarely does not wake up at night to respond to families with sick children. Eappen’s compassion and calm demeanor stem from a very public tragedy that rocked his young family many years ago.
In 1997, his eight-month-old son, Matthew, died from injuries caused by the violent shaking. Later that year, a jury found a British au pair hired to care for a baby and his older brother guilty of second-degree murder, but a judge reduced the charge and sentence. Eappen said the trial attracted international media attention at the time, sparking talk radio comments and hate mail, primarily targeting his wife, Debbie, an ophthalmologist.
Eappen said the loss changed both of them and shaped the way they approached work and family. It takes all other issues into account and reprioritizes them. The couple have both shifted their medical practice schedules to part-time in order to share care of their three other children, all of whom are now adults.
They also created the Matty Eappen Foundation, named after their late son. The all-volunteer organization, which his wife is still very active in, works to educate the public and medical professionals about abusive head trauma, also known as shaken baby syndrome, and to support victims and their families.
Eappen is still feeling the effects of the balance they worked together to achieve. “I don’t really get stressed out about what’s going on,” he said. “I think it brings a certain sense of peace and calm to me and the people around me, and a positive mood that I’m happy about.”
These qualities will be assets to Eappen in addressing the financial and workforce challenges facing UVM Health and other hospitals across the state.
The health network ended its fiscal year with an operating loss of $90 million, largely attributable to high costs for traveling clinical staff as it couldn’t find enough local workers. Crucially for Eappen, the hospital’s operating margins are now so low — and have long been — that it has become increasingly difficult to invest in the buildings and personnel needed to provide high-quality care to patients.
One result: A report from the Vermont Department of Human Services found that most people take nearly three months or more to see a medical specialist at UVM Medical Center, the longest wait in the state.
Eappen said he sees at least two key areas where efforts can improve. First, the system needs more staff, so it has to do everything in its power to make UVM Health a place where clinicians and others who support them want to work. That means more projects, such as the recently announced construction of 120 new apartments and a childcare center in South Burlington.
Joining Brigham’s part-time physician group in the late 1990s introduced him to issues of working parents, especially mothers.
“It was just me and 28 women,” Epen said. “The challenges they faced really shaped how I think about diversity and equity in the workplace.”
Attracting long-term employees is also about promoting a mission-driven culture, he said. “When you clean a house or serve food, you’re not just doing that. You’re actually helping families, helping individual patients get better,” Eappen said. “When you’re working in the background, you’re not just doing (information technology). You’re making it easier for patients to see the information they need to see.”
Second, community health workers, pharmacists and social workers can more broadly support clinicians such as physicians and nurse practitioners in delivering care so they can focus on the work for which they were trained.
“Patients can be connected to the entire healthcare system, or (broader staff) the office they go to, rather than feeling like it’s just me and the doctor,” he said.
Eappen said this broader view of care was deeply ingrained in the UVM Health staff he interacted with during his bilateral visits. They’ve seen their work as supporting the health of the community as a whole, not just responding to individuals visiting a hospital or doctor’s office, which is what interests him most about taking the job.
“Our idea of providing care for everyone, and we’re committed to it, that the quality of care is the same no matter where you live or what color you are, is the dream,” Eappen said. “It’s a really different business when you start thinking about it like that, the whole community is ours and we have to commit to looking after them.”
Mike Fisher, a state health care advocate who works for Vermont Legal Aid, welcomed Epen’s hard work. Fisher said his biggest challenge will undoubtedly be addressing the real needs of the state’s largest health system without making healthcare more expensive and inaccessible for Vermonters.
Vermont hospitals often seek permission from the regulator, the Green Mountain Board of Nursing, to raise commercial insurance rates as a major source of new revenue. An annual health insurance survey for 2021 shows that while only 3% of Vermonters are uninsured, about 40% of those who are insured are considered underinsured, meaning that the cost of premiums, deductibles and copays accounts for 10% or more of household income.
“From their perspective, they probably really need to raise rates, and that rate hike will deprive more Vermonters of the ability to get the care they need,” Fisher said. “It’s hard for someone who really wants to do both.”
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