COOS BAY — For Michael van Duren, seeing the grey skies of the southern Oregon coast is a comforting feeling.
The Netherlands native is the new Chief Medical Officer at Bay Area Hospital, having begun as a consultant last year to work on projects in an interim position.
Van Duren entered into the health field through family medicine, but did OBG/YN work for 10 years at a small hospital where there weren’t enough officially trained OBG/YNs.
“So they let a family doctor do deliveries, C-sections,” van Duren said. “I did about 4,000 deliveries and loved every minute of it, but got more interested in the complexity of how organizations worked.”
While most doctors hate meetings, van Duren found them interesting because he could see how people reacted to challenges and how they could be led to work together.
“I was interested in managing the whole machine and went back to business school,” he said.
This happened early in his career, but he found he loved business school where he learned about management, changing people’s behavior and fixing system issues.
“Because when something goes wrong, it’s usually not one person doing a bad thing but the whole system that isn’t working,” he said. “People say, ‘How do you change that?’ I say, ‘Let me try.’”
After business school, he gradually transitioned from full-time clinical to full-time administration. He worked for three different health plans in California for 10 years, which he found interesting but got frustrated that they didn’t directly affect the quality of care.
“I wanted to get closer to care delivery, so I joined a large doctor group of 2,000 doctors in California and started working with them on the efficiency of care delivered,” he said. “And ‘efficiency’ is a good word for ‘cost.’ We looked at whether we are doing too many CTs or MRIs for people who don’t need them.”
As he pointed out, some worry about not getting a scan when they need it and don’t believe a doctor orders too much of anything, but it can happen.
“People walk in with a headache and say they worry it’s a brain tumor,” he said. “A good doctor will listen to you, examine you and tell you that it doesn’t sound like one. If they are in a hurry and more worried about their Yelp scores, they order a scan. It is useful for people to look at that.”
He later worked at Sutter Health in California, which comprises 24 hospitals and 25,000 doctors. He was also there for 10 years and enjoyed working in a large system with plenty of resources.
“The transition from a large system to the beautiful southern Oregon coast was driven by my wife who got a job as the Chief Nursing Officer in Coquille,” he said.
To see her, he took daily flights back and forth before deciding to make the move himself.
“In a way, it is a weird transition to take your career from a high level to something smaller but I’m loving it,” he said. “Instead of talking with administrators all day and justifying my existence, I’m dealing with issues in the Emergency Department and then something in radiology. It makes you feel good about what you’re doing.”
In high school, before his interest in medicine, people would ask what he wanted to do when he grew up. His answer was that he hadn’t decided between a psychologist and a priest.
“I joke with people now that what I do is both,” he laughed. “Every situation has technical aspects, but a lot is helping people listen to each other. I like the role of being a peacekeeper.”
As for what he hopes to implement in the future at BAH, he first pointed out that there is good quality at the hospital that continues to improve. However, in other parts of the country there is more focus on safety that he would like to see at BAH.
“Last year, the joint commission came through and found everything good but nudged us forward to zero harm possibilities,” he said. “Some complications should never happen and people say, ‘Things happen,’ but with an attitude like that you will continue to see problems.”
What BAH is doing to accomplish this is implementing a culture of safety where everyone is working on something and if one sees something amiss, report it.
“People don’t want to tattle, but that’s not what it is,” he said. “We’re measuring every slight deviation from perfect to make sure it doesn’t happen again.”
To the community, van Duren underlined that BAH is a medium-sized hospital that is independent from a corporation, operating in the black financially, and that is not something found in many places.
“This is a rich resource we can be proud of,” he said.