John Kastanis, President & C.E.O of Temple University Hospital
Interviewed by Paul Kotrotsios
Founder & Publisher of the Hellenic News of America
Mr. John Kastanis was welcomed to Philadelphia by Paul Kotrotsios, publisher of the Hellenic News of America on October 6, 2012. Mr. Kastanis has served in several different leadership positions at many different healthcare institutions. They include: Southampton Hospital; Hospital for Joint Diseases in New York City, and the New Rochelle Hospital Medical Center. He is a Fellow of the American College of Health Care Executives (FACHE). Mr. Kastanis was selected as the permanent President and CEO at Temple University Hospital in August 2012. Located in Philadelphia, PA, Temple University Hospital is an internationally renowned academic medical institution. Not only does it train future doctors, but is also involved in academic research.
HNA: Please describe your role as a healthcare professional and as a leader in one of the main healthcare institutions in the region, Temple University?
JK: As you know, I am President and CEO right now of Temple University Hospital. With that title comes a lot of responsibilities. It is not just the day to day leadership of the organization guiding all the management teams and advisory groups we have but the various professionals starting with some very high ranking physicians, nurses, allied health professionals. That all falls under me. On a day-to-day basis, this office is ultimately responsible for the observations of the enterprise. Just as important as that aspect is, the fact that this industry, as most of you know, is under a lot of change. Whether it’s the Obama administration or anyone in Washington that’s in the leadership role, healthcare now has become a primary focus and a major topic of discussions and issues. Any hospital right now, particularly in an academic medical center this size and scope such as Temple, we really have to remain focused on strategies.
This is an industry where we have a lot of changes/phenomena, medical research and discoveries and new technologies that are coming forward. We have to stay abreast. We try to plan financially and operationally for the type of care we want to render to our patients. We are always focused on the best and highest quality care possible. We do it in the most cost effective manner possible. We are always aware that the industry is always changing, regulatory wise, politically, socially, but more so technologically. We have a lot of advances in medicine that have now changed our whole aspect of rendering medicine. We are seeing less patients needing to be admitted into a hospital based on new technologies. We see that we have more need to provide intensive care on an ambulatory basis. That shift alone has really been redirecting the industry more. The need for an acute care bed will diminish over time. We are going to have more of a need for much sicker patients who need to be admitted. When you are running an academic medical center like Temple, tertiary and quaternary care, which is the highest and most intense level of care, will remain as a major component of an academic medical center. But we have to balance it all. When you look at the trends in terms of trying to effect cost effective care, improving the patient experience and focusing on population health, these are the big trends we will stay focused on regardless of who is in office.
We have to remain focused on the mission of an academic medical center, which is training our future physicians and in this particular location of Philadelphia. We have a high concentration of low-income patients. Many are on Medicaid. Given their low-income status, we are able to get them some type of coverage, either through Medicaid or subsidization from the State of Pennsylvania. The immediate mission, serving the immediate communities surrounding this medical center, will remain a major part of our mission.
We remain focused on our mission as an academic medical institution, which is to provide high quality care, training future physicians and also really being part of research. Day-to-day we treat a lot of patients here. We have researchers in a lot of different specialties, such as Cardiovascular, Pulmonary, Thoracics, Orthopedics. We provide different specialties, in terms of direct patient care. There is also a research component as well. There is a big responsibility that comes with running Temple University Hospital on a day-to-day basis. There are things we have to juggle day in and day out. In essence that is what I am doing here in my leadership role.
HNA: What is the most important factor in the healthcare process?
JK: As a provider, whether you are running an academic medical center, a nursing home or if you are a healthcare agency, the No. 1 objective is to provide high quality safe care. Patient care is paramount. On a day-to-day basis that is what we worry about more than anything else: how are we rending care, the safe way, in a high quality way. Given the economics of our industry, it has to be cost effective as well.
HNA: Tell us about your background since you appeal to the Greek American Population all over the United States and to the younger generation as well. What kind of educational background have you had that has prepared you for your current role?
JK: It didn’t come easy for me, I wasn’t sure when I got out of college what I wanted to do. I thought I was going to go into law. I have an undergraduate degree in political science and thought I was going to get into government. Fortunately, I got involved in New York with another Greek American, a friend of mine, who was a social worker and he was running a drug and alcohol rehab program in upstate New York. He and I wrote a grant at the time, in the mid 70’s, because we were noticing a high recidivism rate of people who were getting behind the wheel and getting arrested for drunk driving and winding up being the same offender in the same category.
We wrote a grant to the New York State Department of Motor Vehicles. Through the local persecutors office, we were audited for several years. We ran a program that had the local District Attorney’s office refer first time offenders for drunk driving to our program. Our program had a curriculum, where we not only taught the basic elements of alcoholism, social drinking and its negative impact on our driving skills. We taught about the traffic system and the overall disease itself: alcoholism. We had screens in the curriculum to identify those who were real alcoholics or just social drinkers. They made the mistake of getting behind the wheel while drinking under the influence. Long story short, the program was audited. The New York State Legislature mandated this program be offered to all first time offenders in New York State. It is still in effect today. Those years you were not offered a conditional drivers license to drive back and forth to work or to school. They offer that now.
I really started to learn a lot about the basic elements about our healthcare system during the program. The program evolved where it was state wide, and a lot of other states have mimicked the program, but during the course of being a counselor, I winded up taking over my friend’s job. I became the county coordinator for all addiction services and got into more of a management role. I was watching the whole spectrum of care. We use to have patients/clients from their alcoholism that go into delirium tremors. We would take them to a local emergency department.
Therefore, I learned a lot about the healthcare system. Given my management experience, I decided to go back to get my M.B.A. in health administration. So, I took time out, went to school full -time and it was the best thing I did. I moved back to New York City. I got my M.B.A. and relevant experience through a couple of administrative residencies. I was assigned to a couple of top CEO positions in New York City.
HNA: The goals and objectives for the upcoming year?
JK: They are pretty formidable. This is really a first class academic medical center. It has gone through some rough spots. Our major goal is to make sure that this is a major destination point for tertiary and quaternary care in the Delaware Valley and Mid-Atlantic region. We have new physician leaders. They have been recruiting a lot of top specialist in all our service lines. We reactivated our heart and lung transplant program, only this past January. The Medicare program has recertified our lung transplant program. We are about to get out heart transplant program recertified. There is just a lot of high-level type of patient care that we are trying to rebuild here. We are very excited about some of the new physician leaders and specialists. There is a whole new spirit of rejuvenation going on here at Temple University Hospital.
HNA: Can you describe some of the challenges you encounter in your role?
JK: There are quite a few. When you have an emergency department as a large as ours, processing over 80,000 patients from low-income neighborhoods and 18,000 pediatric visits as well throughout the year, we need to have a tremendous resource here. Our trauma team is one of the best rated in the area. We have a lot of volume that can be very challenging, given some of the level of violence in North Philadelphia. Right now every hospital is in the same boat trying to provide high value with the highest level of quality care at a cost efficient level.
Every third party payer right now starting with the government payers, starting with Medicare and Medicaid, are making that a mandate and government programs are stipulating new reimbursement methodologies. They are now demanding higher value. They are monitoring all of the outcomes, monitoring the cost of care, and starting to discount our reimbursement more and more based on those elements. If we do not provide or if they do not have a sense that we are providing high value for the payments they are giving us, they are now inherent penalties that are going to be built in the reimbursement system.. This is quite a challenge on any given day.
HNA: Has your Hellenic identity help guide you in any way?
JK: I would think so. As a fellow Greek American, I think you all can appreciate the fact that our heritage is such that we are spiritual and religious. From that I have drawn a lot in terms of my sense of right and wrong, my sense of family, work ethic, which in our culture is very high, especially for our Greeks that have migrated to other countries. Particularly the United States, where we have been very hard working people. With some of our conservative bent on things, we have been big contributors in the local communities that we have settled in. That work ethic runs strong in most Greek Americans.
HNA: how do you see the future of Hellenism?
JK: You can’t help but to think about what is happening in the homeland, its rather depressing to see Greece going through this economic strive. From it you read some of the daily coverage. You see its Greek vs. Greek lately that is pretty discouraging. Most visitors that go to Greece are comment on how friendly Greeks are and how hospitable. Yet it’s ironic to see our culture kind of turning on its self. The desperation is coming through. I am very concerned about that. But those of us that have done well and that have left and are looking to see what’s going on back in the homeland, its incumbent for a lot of us to be supportive. Not only financially, but in other ways as well.
In terms of the future of Hellenism, it goes strong in this country. When you look at all the different church groups, Greek American community groups that exist. I think we still have a strong ethnic base first as Americans. Those of us that are here have embraced that privilege of being in this country. Those of us that have been born here take great pride in being Americans, tied to Hellenism. The Greek ethnic background will continue to be a source of pride.
HNA: Do you have any advice for our fellow young Hellenes that are heading in the correct direction with the Hermes Young Professionals Initiative?
JK: I would say stay true to your interests, as discouraging your interests might be. If you are trying to be a doctor or a lawyer or getting an MBA and going into Wall Street, if it is still discouraging and trying to make inroads in your respective interests or areas of professional pursuits, I just say stick with it. Even if there are digressions where you can’t get into a school you want to get into or you can’t get the job you want, you just continue to be stubborn about it. Digressions I found are really good, there is always a reason why you can’t get to what you want at that moment in time. If you think you need to get there, getting side tracked and doing different things, but staying focused on who you want to be and what your true interests are, it will come over time.
Photo 1: Paul Kotrotsios, Publisher of the Hellenic News of America & John Kastanis, President & CEO of Temple University Hospital
Photo 2: Mr. Walter, Mr. Kotrotsios, Ms. A. Kotrotsios, Mr. Kastanis & Ms. S. Kotrotsios
Photo Credit: Yiannys Degermentzidis