The Hand that Guided Hopkins


After two decades at the helm of Johns Hopkins Hospital, Dr. Robert M. Heyssel retires Wednesday as president of the institution he has guided with a sure hand, compassion and unwavering commitment to the community it serves.

He will be succeeded by James A. Block of the University Hospitals in Cleveland. His many accomplishments include helping develop a community hospital-based ambulatory care system that has become a model for the nation.

Dr. Heyssel came to Hopkins from Vanderbilt in 1968 and gained the title of president in 1982. His tenure coincided with an era of explosive growth in health care costs. During the 1970s, poor people saw doctors and received hospital treatment at about the same rate as those who could pay for it.

But the '80s brought galloping inflation that threatened to make the poor unintended victims of an industry-wide revolution. "Revolutions are very messy," Dr. Heyssel said in 1985, when the Reagan administration imposed new cost controls on Medicare and Medicaid, the federal health care insurance programs for senior citizens and the poor. "In this one, the poor are the ones that are going to fall through the cracks, and everyone needs to understand this."

Yet the hospital never backed off its commitment to the needy. Dr. Heyssel was a leader in efforts to restructure the institution to survive in the new environment of cost containment, managed care delivery systems, reduced lengths of stay and competition for market share. The growth of the Hopkins HMO, its acquisition of several community hospitals and revamping of the medical school were all part of his vision.

For all his efforts to preserve Hopkins' financial integrity, Dr. Heyssel never lost sight of the overriding importance of good people as the cornerstone of quality care. "In an institution like this people who are good and who you want to attract tend to congregate together," he observed during the hospital's centennial celebration in 1989. "If you understand that, you behave in certain ways. It isn't difficult to attract a high caliber of people."

Largely for that reason, the Hopkins hospital today remains one of the premier institutions of its kind in the world.

And for the future? Dr. Heyssel's prognosis is both hopeful and pragmatic: "The epidemics today are AIDS, heart disease, cancer, substance abuse, behavioral problems and problems of functions of the brain -- schizophrenia, manic depressive diseases, Alzheimer's Disease -- and the problems of the aging of our population. Tough problems all, but [they are] the 21st century problems in human disease. Their solution lies in our old ingredients of success: the best people in modern facilities focusing on care and compassion for patients and dissatisfaction with what is. That is what we are about, will be about, in the next century."

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