Dr. Sunil “Sunny” Eappen spent his first weeks on the job as the UVM Health Network’s new leader criss-crossing Lake Champlain from Vermont to New York and back, touring all six hospitals under the network’s umbrella. He expects to make the trip frequently, having made a commitment to visit each hospital on “a very, very regular basis,” Eappen told VTDigger last month.
The visits will not be as hands-on as what he did during his 14 years as a hospital administrator in Boston. An obstetric anesthesiologist, Eappen scheduled himself each month for one work day and one day on call in the busy maternity center at Brigham and Women’s Hospital. But the purpose is the same: to get a direct and immediate sense of what a regular day is like for staff and patients.
“It let me really feel what it was like to continue working,” said Eappen, 56, who started his new role as president and CEO on Nov. 28. Whether it was during the pandemic or during the implementation of a new electronic medical record system, “when people were complaining, I could really understand.”
Wanting to meet and listen closely to as many people as he can is a core component of who Sunny Eappen is, according to longtime colleague and recent supervisor Ron Wells, the chief operating officer of Mass General Brigham, Brigham and Women’s Hospital’s parent organization. He thinks that impulse is part of what makes Eappen so effective.
“He’s a great listener. He’s a quick adapter. He’s ready to take feedback and change course when he needs to do that,” said Wells. “He is one of the most ego-free leaders I have ever worked with in academic medicine.”
As chair of the emergency medicine department, Wells collaborated with Eappen on streamlining and codifying how anaesthesiologists participated in emergency rooms, which saved precious minutes getting a trauma patient into surgery. In 2018, after moving into an executive role, Wells recruited Eappen back to Brigham to serve as chief medical officer — a position he’d held at the Massachusetts Eye and Ear Infirmary.
Making the shift from the smaller specialty hospital was “a giant step,” Wells said, perhaps an even bigger one than moving from Brigham to leading UVM Health. But Eappen took it in stride, according to Wells. “You would have sworn that Sunny had been in that role for five years if you met him three weeks into it,” he said.
In fact, in its scale, Brigham is slightly larger than UVM Health network. The former had expenses of $4.5 billion in 2021, around 21,000 employees and 1,000 licensed inpatient beds, while UVM Health’s expenses were just under $2.4 billion, with 15,000 total employees and 620 licensed inpatient beds. The Boston hospital trains physicians through an affiliation with Harvard Medical School, similar to the relationship between UVM Health and the University of Vermont’s Larner College of Medicine.
Eappen’s accomplishments at Brigham over the last four years — 10 months of which he served as interim president — included a complete reorganization of pharmacy operations, making them more patient friendly and efficient, Wells said. Eappen also confronted some “very challenging professionalism issues” with empathy and an even hand.
“He was really good at that because he always put the patient first,” said Wells. “He always cared about the providers, too, and cared greatly about them, but the patients were the trump card.”
Eappen says his model of service to the patient is his father, a Chicago-area pediatrician in a solo practice who rarely went a night without waking up to respond to a family with a sick child. Eappen’s compassion and calm demeanor were informed by a very public tragedy that years ago rocked his young family.
In 1997, his eight-month-old son, Matthew, died from injuries consistent with being violently shaken. Later that year, a jury convicted a British au pair, hired to care for the infant and his older brother, of second-degree murder in his death, though a judge reduced the charge and sentence. The trial garnered international media attention at the time, drawing talk radio commentary and hate mail, mostly directed at his wife, Debbie, an ophthalmologist, Eappen said.
The loss changed them both and shaped their approach to work and family, Eappen said. It put all other concerns into perspective and rearranged their priorities. The couple both changed their medical practice schedule to part time in order to share the care for their three other children, all now adults.
They also founded the Matty Eappen Foundation, named for their late son. The all-volunteer organization, in which his wife is still very active, is dedicated to educating the public and medical professionals about abusive head trauma, also called shaken baby syndrome, and supporting victims and their families.
Eappen still feels the impact of the balance that they both worked to achieve. “I don’t really get too stressed out by things that are going on,” he said. “I think it’s brought a certain sense of peace and calmness to me and the people around me, and a positivity that I am happy about.”
Those qualities will be an asset as Eappen tackles the financial and workforce challenges facing UVM Health and other hospitals around the state.
The health network ended its fiscal year with a $90 million operating loss, largely attributed to having to pay high rates for traveling clinical staff because of an inability to find enough local workers. Most critical for Eappen, the hospital’s operating margin is now so low — and has been for so long — that it is getting difficult to invest in the buildings and people needed to deliver high-quality care to patients.
One result: A report from the Vermont Agency of Human Services found that getting in to see a medical specialist at UVM Medical Center for most people took almost three months or more, the longest wait time in the state.
Eappen says that he sees at least two key areas where effort can yield improvements. First, the system needs more workers, so it must do what it can to make UVM Health a place where clinicians and others that support them want to work. That means more projects like one recently announced to construct 120 new apartment units and a child care center in South Burlington.
Joining the group of part-time doctors at Brigham in the late 1990s exposed him to the issues concerning working parents, particularly mothers.
“At the time, it was me and 28 women,” Eappen said. “The challenges that they had really shaped the way that I think about diversity and equity in the workplace.”
Drawing long-term employees is also about promoting a mission-driven culture, he said. “When you are cleaning a room or serving food, you are not just doing that. You are actually helping families and helping individual patients get better,” Eappen said. “When you are working in a back office, you are not just doing (information technology). You’re making it easier for patients to see the information they need to see.”
Second, clinicians like doctors and nurse practitioners can be supported more broadly by community health staff, pharmacists and social workers in providing care, so they can focus on what they have been trained to do.
“Patients can connect to the entire health care system, or (a wider variety of staff in) an office that they go to, as opposed to feeling like it’s just me and the doctor,” he said.
That more expansive view of care is deeply rooted in the UVM Health staff he has interacted with during his bi-state visits, Eappen said. That they already see their jobs as supporting health in entire communities and not just reacting to individuals visiting the hospital or doctor’s office is what most interested him in taking the job.
“The idea that we provide care to everyone, that we’re committed to doing that, and the quality of care is the same regardless of where you live, what color you are, that is the dream,” Eappen said. “It’s a really different enterprise when you start thinking like that, that all of the whole community is ours and that we’ve got to commit to taking care of them.”
Mike Fisher, the state’s health care advocate who works for Vermont Legal Aid, welcomes Eappen to a very difficult job. No doubt his greatest challenge will be addressing the real needs of the state’s largest health system without making care even more expensive and inaccessible for Vermonters, Fisher said.
Vermont hospitals often look to the regulatory Green Mountain Care Board for permission to raise commercial insurance rates as a primary source of new income. An annual health insurance survey showed in 2021 that although only 3% of Vermonters are uninsured, around 40% of those who do have insurance are considered underinsured, meaning the cost of the premium, deductible and copayments amount to more than 10% of household income.
“They may really need a rate increase from their perspective, and that rate increase will price more Vermonters out of the ability to get the care they need,” Fisher said. “That’s tough for somebody who really wants to do both.”
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