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During his career at UNC, Brian Goldstein, MD, MBA, has

During his career at UNC, Brian Goldstein, MD, MBA, has served as a resident and chief resident in the Department of Medicine; since 2000, as a faculty member in the Department of Medicine and as a practicing General Internist; as UNC Hospitals’ Chief of Staff; and then as UNC Hospitals’ Executive Vice President and Chief Operating Officer. As he prepares to leave for a new appointment as Chief Health System Officer at the University of Washington, we sat down with Dr. Goldstein to reflect on his career at UNC.

Brian P. Goldstein, MD, MBA, Executive VP and COO, UNC HospitalsReflections on UNC

You’ve had three distinct roles at UNC Medical Center from your time as a resident and chief resident in the Department of Medicine through today. Reflect on your time at UNC.

I’m a Tar Heel bred. I came to Chapel Hill to be a resident in internal medicine in 1989. I was here three years as resident and one more year as chief resident in the Department of Medicine. That’s where I got my first taste of the wonderful patient-care culture that we have and the collegiality that exists among our physicians and nurses and staff.

Then I left between 1993 and 2000, and during that time I gained some key early experiences practicing medicine, managing groups of physicians and working for a physician-owned HMO. My wife and I always had in mind trying to come back to North Carolina. When I started my career there weren’t many physicians who had said, “I want to combine medicine and management explicitly.” So, there weren’t a lot of role models, and it wasn’t exactly clear what path I should take to achieve my goals, and it wasn’t clear whether a specific job would be available at UNC – or anywhere else for that matter – for someone with my specific skills and interests.

So, like a lot of people in their careers, it was just my good fortune that we’d come back to North Carolina in the late 1990s, and in May of 2000, Dr. Andrew Greganti, who was the interim chair of the Department of Medicine, hired me as a clinician and as a manager to help with the business affairs of the Department of Medicine. He thought, “Let’s give this a try and see if Brian can add value practicing part-time but also supporting the business affairs of the department.” I was blessed to be able to come back to the faculty at UNC to do the things that I wanted to do and trained to do. Immediately thereafter Dr. Marschall Runge arrived, and fortunately he fully supported me in the role.

Then in 2002 I was selected out of an internal search to become the Chief of Staff of UNC Hospitals and the Executive Associate Dean for Clinical Affairs of UNC School of Medicine. In that role, now called the Chief Medical Officer, I really functioned as a bridge between the physicians and the hospital, and increasingly through that decade I worked on quality and safety matters as well as helped the physicians be more effective in the hospital.

Then in 2010 I was selected again out of an internal search to become the Chief Operating Officer for UNC Hospitals. To boil it down, I would say this place is filled with dedicated, compassionate, smart people. You can’t really possibly ask for anything more. So, I think my main job in my most recent role has been to empower smart, passionate, dedicated people, support them, nudge them as necessary, but mainly stay out of their way and let them do their excellent work. Part of the role is knowing what’s going on at the top level of the organization so that I can make sure that the folks who are involved in operations have the information and resources they need to do their job.

There’s tremendous pride in UNC Health Care and the university, and I just think that adds to the energy that we bring to helping the people of North Carolina and beyond. The vast majority of people are in the health-care profession because they want to serve. You combine that with a desire to be good stewards of state resources and to add to the success of this health-care system and university, and that makes it special.

Memories, People, Milestones

What memories, people, milestones stick out to you when you reflect on your career at UNC Medical Center?

Honestly, it’s really hard to pick out individual memories, people, or milestones. I feel that I would leave people out. But I will say that I’m eternally grateful to Dr. Andrew Greganti and Dr. Marschall Runge for giving me the chance to start to show what I could do, I’m grateful to Eric Munson and Dr. Jeff Houpt, who entrusted me as Chief of Staff, and I’m grateful to Gary Park and Bill Roper, who gave me the chance to be the Chief Operating Officer.

I’m very proud that we won a Quest for Quality Award from the American Hospital Association in 2012. That was a national award, and basically all hospitals across the country are eligible for it, and we landed second place for the entire country. I saw that award as a reflection of the progress we had made in improving quality and safety. This hospital, I believe, has always delivered high-quality and safe care – it’s just that we’re increasingly counted on to demonstrate that with data. That award was a reflection of the fact that we got better at demonstrating – and frankly at improving in – areas we needed to improve.

On behalf of many people, not just me, I’m proud of the Hillsborough Campus – the office building, and then more recently the opening of the inpatient facility. In my opinion, it has been very successful overall, and that success is a reflection of literally hundreds of people who have dedicated themselves to that effort. It’s the first time we’ve ever done anything like that — opened up a brand new campus. It’s a big part of our future.

I’m also proud about the future opening of the surgical tower. We desperately need to replace those original operating rooms and support spaces, and I will be thrilled on the day that someone cuts the ribbon to open that new facility.

Public Mission

What appeals to you about both UNC and University of Washington?

The missions are very similar, and I’m still learning about the University of Washington, but much of what I’ve seen of the culture there is similar. It’s a very successful, research-intense, public academic medical center that also excels in primary care. And there’s a lot of pride in the university, just as there is here. When I look back at when I first understood the importance of the public mission to me, I’d have to go back to residency at UNC. I don’t think I appreciated the distinctions between different medical institutions when I was in medical school. But as my career has evolved I’ve been so fortunate to work in public academic medical centers.

Missing North Carolina

What will you miss about North Carolina?

Too many things to list. So, I will simply say that I could not imagine working with a better group of people than those I was fortunate to work with here at UNC. This work we do is rewarding, but it’s also intense. So, you have to really be enjoying the people you’re working with all day long, and I’ve been very blessed to work with wonderful people here.

But I won’t miss mosquitoes. I’m looking forward to exploring a different kind of outdoors in the upper northwest. My wife and I are going to try to be intentional about taking advantage of our time there to explore the waterways and the mountains and the national parks. It’s something that’s always interested me. We’ve done a fair job of taking advantage of those things in North Carolina, but I want to do even better in the northwest.

Future Challenges

What future challenges do you see for UNC Health Care?

One challenge is how we continue to bring the latest and the greatest advances to the bedside and to outpatient practices in a way that’s also affordable and mindful of the overall costs to our society. That, to me, is the challenge, because we will continue to be able to do more for people, and we should, but it’s figuring out what’s the right pace of introducing new technology to maximize the benefit to society. That’s a key challenge not just here, but everywhere. I’ll say again that we have smart, passionate, and dedicated people – it’s a matter of finding, over time, consensus on how to, in a financially responsible way, keep bringing the latest and greatest advances to people.

My experience with patients here is that they are kind, very appreciative, and generally filled with common sense and realism about what health care can and can’t do. And again, it’s been a true privilege and a blessing to be one of many folks that serve these people. And we owe it to them to continue to try to make this thing we call a system better, and we are – we’re working on it.

The future is so hard to predict, but what I think will happen is we will continue to expand the population we serve, and that this campus plus Hillsborough will be the place we serve the most complex patients that get care in our system.