Although Duke Hospital CEO Mike Israel will leave in June, his legacy will remain--in his eight-and-a-half years, Israel has watched the Duke University Health System rise to national prominence and overseen two major restructurings in the face of growing budgetary pressures.
"Duke today is a much more active participant in the community it lives in," said Israel, who has taken a position as chief operating officer for North Shore-Long Island Jewish Health System, the nation's third-largest non-profit health system. "It's a totally different environment than it was back then, and I think the people who have benefited are the people in central North Carolina who get the services."
Israel came to Duke in October 1993 after serving as executive vice president of St. Luke's Episcopal Hospital in Houston. He set about to restructure the hospital's management, and though the process angered some employees and targeted 850 full-time positions for elimination, the hospital managed to avoid massive layoffs.
"Mike led the hospital--there was no health system then--through a very complex and difficult set of decision makings," said William Donelan, executive vice president of the health system. "The hospital adjusted programs, resized itself, adjusted staffing programs and implemented a set of performance standards--that's really continuing to serve us today."
Administrators said Israel also played a pivotal role in the creation of the health system in the late 1990s. Dr. Gary Stiles, the system's vice president and chief medical officer, credited Israel with the health system's successful mergers with Durham Regional and Raleigh Community hospitals.
"He really has led [Duke] to the creation of the health system, in terms of integrating the different hospitals into one coordinated system, not three separate hospitals," Stiles said. "That takes a lot of vision."
Four years of discussion culminated in 1997 as Durham Regional, which was floundering at the time, and Lincoln Health Center merged with Duke Hospital. In the plan, Duke rented Durham Regional from the county for 34 years in exchange for control of its $146.7 million in assets, shouldering its $39 million debt. Although Durham Regional employees were tentative about the deal, administrators say the merged system has worked much better.
"Nine years ago, we were competing against each other," Israel said. "Today, we're working together and trying to figure out how to utilize finite resources to deliver the most health care possible to residents."
The Medical Center beat out four competitors who also put in bids for Durham Regional, and in 1998 the union became a formalized reality. Since then, Duke has shut down the Senior Health Center in Northgate Mall and the Oakleigh Substance Abuse Treatment Center.
"In that period since 1998, he's had to work through a series of very difficult reorganization and re-establishment of systems and operations practices at Durham Regional Hospital and provided guidance," Donelan said.
In 1998, the Medical Center also bought Raleigh Community from Columbia/HCA's Atlantic Group.
"He was almost like a kid in a candy shop," Stiles said. "He had accomplished what he had always wanted, in having a facility in Raleigh. He was like a kid getting a new toy to add to his collection."
Dave Ingram contributed to this story.
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