Following the sudden resignation of Duke Hospital CEO Mike Israel, the University has pegged current chief medical officer Dr. William Fulkerson to take over, administrators announced Thursday.
Fulkerson, professor of pulmonary medicine, will take office in a few weeks, just before long-time CEO Israel leaves to become chief operating officer of the North Shore-Long Island Jewish Health System in New York.
Hospital administrators said they had targeted Fulkerson as a possible successor beforehand, said William Donelan, executive vice president of the Duke University Health System.
"In organizations like this, the organization is always thinking of succession issues," he said. "Bill is someone we had identified as a developing leader."
Fulkerson said he will focus almost exclusively on Duke Hospital. Although Durham Regional Hospital CEO Richard Liekweg and Raleigh Community Hospital CEO James Knight now report to Israel, they will report to Donelan in the future.
Fulkerson and Israel will work together on the health system's $850 million to $950 million budget for next year throughout May and June.
"I think the main priorities are going to be dealing with the big problems we [as a research hospital] face--trying to control our costs of care, which are rapidly increasing, and contracting reimbursement," Fulkerson said.
Israel said hospitals are being asked to provide more services, but are getting paid less. In addition to the usually tight budget scenario, Israel said the hospital may face between $20 million and $22 million in Medicaid cuts because of North Carolina's budget crisis. The federal government is also reducing reimbursement for outpatients, he added.
"The environment is such that you sort of get caught between a rock and a hard place," Israel said. "I don't think there's a hospital in the United States producing the margins it needs to reinvest within itself. While Duke is doing very well compared to other entities like us out there, they're still not producing the dollars needed to reinvest."
Fulkerson said other long-term concerns for the hospital include addressing the national nursing shortage, finding more operating room and patient bed space and collaborating with Durham Regional on services.
His background has been in clinical care and research, in contrast to the management-oriented Israel. Fulkerson became CMO of Duke Hospital in April 2000 and served as executive medical director of the Private Diagnostic Clinic.
He came to Duke as an assistant professor in 1983. He has served as vice chair of the Department of Medicine and as chief of the department's pulmonary and critical care division. His research includes work on adult respiratory distress syndrome.
"He has vast clinical experience, administrative experience, business knowledge and has been helping to drive quality and efficiency in the hospital for three years," said Dr. Gary Stiles, vice president and chief medical officer of the health system. "He has the respect of the physicians, the nurses and the administration."
Fulkerson said he will continue seeing patients part-time even after he takes over as CEO.
Israel, who will remain at Duke until June, announced his move in a letter to the hospital's management team Thursday. Israel came to Duke Hospital as chief operating officer in 1993 and was promoted to CEO in 1996.
"In Mike Israel, we have recruited a chief operating officer with extensive hands-on experience in the inner workings of a large health system, who understands what it's going to take to achieve our vision of becoming a national health care leader," North-Shore-LIJ CEO Michael Dowling said in a statement.
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