Burrell, Dr James III 1998

Dr. Burrell, Chief Medical Officer at St. Mary’s Hospital and Co-chief Medical Officer at Covenant Center, gives his perspective on the hospital merger and background on Lubbock medicine.

General Interview Information

Interviewee Name: Dr. James Burrell III

Additional Parties Recorded:

Date: October 14 and 26, November 13, and December 23, 1998

Location: Lubbock, Texas

Interviewer: Fred Allison

Length: 5 hours, 30 minutes

Abstract

Tape 1, Side 1: Burrell, James, background, b. St. Louis, Missouri, Moved to Midland, Texas, Graduated Midland High School, 1964, Attended University of Texas Medical Branch (UTMB), Galveston, Texas, Graduated, 1972, To Lubbock, Texas, 1975, Started medical practice with Medical Arts Clinic, Family background, Grandfather, Chemist for Purina Mills, Father, Worked for Purina, Moved to Permian Basin with oil boom, George Bush family, Knew George Bush, Jr., Familiarity, Impression/reputation, Intelligence, Schooled in the East, Early interest in medicine, Grandfather, Influence, Interest in science, Father's advice, Chemistry major at Texas Tech, Views on medical profession, Grandfather's and grandmother's influence, Role of grandfather in society, Old time doctors, Turning point in medicine, 1930, Science, Antibiotics, Technology, Changing view of hospitals, Surgery, Preparation for medical school, Quality of Midland High School, High academics, Influential and wealthy families, Oil money, West Texas oil towns and education, Example of Andrews, Texas, Classes available, College prep, Segregation, Effect on education, Midland, Texas, in oil boom, Migration into Midland, From east and west coasts, Wealth, Oil business, Exploration, Production, George Bush (again), Father, Midland schools (again), Segregation (again), Hispanics, African-Americans, Texas Tech, ca. 1964-1968, Size, Students, Few hippies, Protests, Against outside speakers, Ag students, Vietnam War, Medical school (UTMB), Students, Competitive nature, Effect of draft and Vietnam War , Doctor shortage, West Texas, Burrell, James, first Internist in Lubbock in seven years, Galveston, Texas, and background, Training, Galveston, Texas (again), Poor condition, Environmental Protection Agency's concerns, Sewage, Reputation of UTMB, John Seely Hospital, Burrell, James (again), Choice of specialization, Internal medicine, Reasons for, UTMB (again), Women students, Only seven in class, Galveston's reputation, Harassment, Effect of Vietnam, Subsequent careers, Changes, Daughter, Pre-med at George Washington University, Medical schools in Texas, University of Texas, San Antonio, Texas A&M, Burrell, James (again), UTMB (again), Minorities, Affirmative action, Other students' reaction

Tape 1, Side 2: Burrell, James (continued), UTMB (continued), Minorities (continued), Generally accepted, Women (again), Harassment (again), Troubling, Example: 'Iron Mike', Expectations, Changing philosophy of medical education, No longer 'running the gauntlet', 'Pyramid system', High attrition rate, Now harder to get in medical school, Surgery residencies, Changing expectations of doctors, Values and ethics taught, Social sciences, Female medical students/doctors, Feminine qualities, Burrell, James (again), To Lubbock, Texas, 1975, Quality of Lubbock medicine, Medical Arts Clinic, Dr. R. C. Douglas, founder, Dr. Travis Bridwell, Lubbock medicine, ca. 1975, Compared, Methodist Hospital, In its 'hay day', West Texas Hospital, Declining, Sold to 'For Profit' company, Methodist Hospital (again), Quality, Dr. Robert Salem, Coronary by-pass work, Dr. Don Bricker, Angiography, Dr. Sam King, Dr. Don Bricker, training, Dr. Michael DeBakey, New techniques quick to come to Lubbock, Background of angiography, Europe, Lubbock medical quality (again), Background, West Texas Hospital, Methodist Hospital, Specialization, George Brewer, Significance, Nursing School, Building, Nurses, High quality, Physicians high regard, Character of West Texas people, Impact of Texas Tech Medical School, Nursing schools, Methodist, Texas Tech, South Plains

Tape 2, Side 1: Lubbock tornado, 1970, Douglas, Dr. R. C. role in emergency care, Director of Emergency Services, Efforts, "heroic", Methodist Hospital, ca. 1975, Recruiting specialists, Types, Significance to Lubbock, Facilities "best", George Brewer's role, Marion Key, board member, Burrell, James (again), Hospitals practiced at, Shifted practice to Methodist Hospital, 1978, Sale of West Texas Hospital, Doctor/shareholders sold to Chanco, American Medical International (AMI), New building, Former West Texas doctors, New hospital not successful, Poor facilities, Foreign doctors, Canadian national health care, Competition, Dunn, Dr. Sam, passed away, Partnership of Dr. O. W. English and Dr. Euell Hunt, Longevity, Retirement, Medical Arts Clinic, West Texas Hospital doctors, Moss, Basil, Montgomery, Larry, Douglas, R. C., Bridwell, Travis, Smith, Dick, West Texas Hospital sale (again), Reasons, Capital shortage, Technology, Disappointment with AMI, Had been premier hospital in 1930-40s, Methodist Hospital (again), Relationship with Methodist Church, Brewer, George (again), Move to 19th Street, Earlier location, City growth, Texas Tech University, Book, St. Mary Hospital, background, Formed from Plains Clinic, Drs. Sam Arnett and Olan Key, Offered clinic to Catholic Church, Sisters of St. Joseph of Orange hospitals, Several in California, Agricultural area, Focus on indigent health care, Hispanics, Growth, Late 1960s acquired land, Dr. Joe Arrington's good deal, American State Bank, Opened new facility, 1970, Community focus, Medical staff, Relationship with Texas Tech Medical Staff, Teaching hospital, West Texas Hospital, Pressure to grow, Sister Maureen, CEO, Retirement, Book, Indigent care (again), Medical students, Sisters' mission, Methodist Hospital overflowing, Younger doctors split patient load

Tape 2, Side 2: St. Mary Hospital (continued), Pressure to grow (continued), Administration change, Reduction in Medicare/Medicaid payments, Insurance, Need for professionals with financial orientation, Professional administrators, Robert O'Leary became CEO of St. Joseph Health, System, Changes implemented, Centralization, Benefits, Jake Henry, CEO and Jim Houser, Chief Operating Officer, first professional administrators, Vision, Competition with Methodist Hospital, Recruiting physicians, Hospital competition (again), Relationship between George Brewer and Sister Maureen, Bond Sales, Building expansion, OB unit, Cardiac Care Unit, Catheter labs, Physician survey, Private rooms needed, Improved radiology and pathology units, Drs. Tom Madison and Jim Balch, pathologists, Dr. Philip Duvall, radiologist, Significance, Attractive to younger doctors, Relationship with Texas Tech Medical School, Methodist Hospital and George Brewer, Resisted being teaching hospital, St. Mary given time to expand, 'Veiled threats' to doctors, Relationship with Cardiology Associates, Sam Arrington and Jake Henry, More business to St. Mary's, Became legitimized, Physicians in good bargaining position, Duplicity in technology, Financially detrimental, Concerns of federal government, St. Joseph Health System, Financial position, Top bond rating, Advantages, Compared to Methodist Hospital, Methodist Hospital (again), William Poteet takes over as CEO, late 1980s, George Brewer retirement, Description and personal details, Jake Henry, and Jim Houser to St. Joseph in California, Graduate School, Trinity University, Trimble, Charley, class president and classmate, Background, Charley Trimble, CEO, St. Mary, His and Jake Henry's philosophy of management, Financial focus, Jake Henry (background), Physician awareness, St. Joseph Health System, administrators, Characteristics, Strategic planning, Statuto, Rich, Background, Methodist Hospital (again), Compared to St. Mary Hospital, Poteet and Brewer compared, Burrell, James (again), Conflict with Brewer, Dr. David Close, Oncologist, Resigned as Chief of Staff, Offered Chief of Staff position at St. Mary, Medical director, Responsibilities, Recruiting physicians

Tape 3, Side 1: St. Mary Hospital (again), Upgrading physical plant, OB unit, Neonatal intensive care unit, First in Lubbock, except Tech Medical School, One room care, Purpose, Additional business, Cutting edge, Cardiac care unit (again), Attracted cardiology patients, State of the art, Cardiac Associates (again), Joe Arrington, Disagreement with Brewer, Chairman of the Board St. Mary, Influence on Dr. Bricker's group, Influence on Lubbock, Radiology Associates, Legitimized St. Mary, Physician-friendly administration, Henry's and Houser's compared to Brewer's, Partnership, Growth (again), Orthopedics, Medical Arts Clinic, Shift to St. Mary Hospital, Patients who preferred St. Mary, Role of Sisters in hospital, Declining, Fewer numbers, Increasing prominence in Lubbock, Methodist Hospital predominance in region, Henry and Houser transfer (again), Success at employee and physician relations, Methodist Hospital predominance, Cardiac care, West Texas Hospital, South Park Hospital, Physician relations, Premier physical plant, Regional influence (again), Physician referrals, Impact of St. Mary influence on specialists, Loss of business, George Brewer's physician relations (again), Appropriate when no competition, Adversarial, Doctors desire for more space, High tech equipment, Competition with St. Mary, Management philosophy differences, Henry, Houser and Brewer

Tape 3, Side 2: Methodist Hospital predominance (continued), St. Mary challenge (continued), Interaction with Texas Tech Medical School, Younger doctors, Physician dining room, Physician loyalty, Aging doctors, Few clinics, Brewer's and Poteet's views, Impact on patient volume, Physician groups, Recruiting new doctors, Doctor recruiting, Changes, 1970-1998, Large cities attractive, Attractiveness of Lubbock, Managed care, Effect on doctor population, Reduced doctor income, Shortage of doctors, West Texas, Texas Tech Medical School, Residences substandard early, Hospitals, University Medical Center (UMC), Methodist Hospital opposition, Medicare/Medicaid, Method of reimbursement, Reagan tax cuts, Diagnosis Related groups (DRGs), Effect on hospitals, Poteet, William (again), Views on physicians, Compared with Brewer's, Compared with Jake Henry, Trinity University graduate (M.A.), Classmates: Trimble, Houser, Henry, Hospital Administration program, Demand, Duties, requirements, St. Mary Hospital, growth, Poteet, William (again), El Paso, Texas hospital, Physician loyalty (again)

Tape 4, Side 1: Poteet, William, leadership of Methodist Hospital, Hospital assumed his personality, Expansion of physical plant, St. Mary Hospital got overflow, Changes from Brewer's administration, Handling money, Large scale building program, Increasing debt, Massiveness, Risks, Aimed at market share increase, Cuts in Medicare payment, 'Bunker Hunt' mentality, Driving out St. Mary Hospital, St. Mary Hospital, growth strategy, Experts consulted, Bob Go, Price-war, Integrated delivery system, Methodist Hospital's plan, Ignore St. Mary Hospital, Become premier hospital in region, High tech, Focus on specialties, Geographic coverage, Cardiac Associates Group, Contract with Methodist Hospital, Dr. Bob Wey, Expansion, Technology, National acclaim, Drop in St. Mary's admissions, 1992, Clinton Health Care plan, Alliance system, St. Mary Hospital's plan in reaction, Strategy effective to compete with Methodist Hospital, Based on primary care physicians, St. Joseph Health System, Past experience in competing, Managed care, Three-legged stool concept, Methodist Hospital building program (again), Funding, Bond sales, High interest rate, Poor bond rating, Little opposition from hospital board, Poteet, William; Schilder, Paul; Wey, Dr. Paul, leadership

Tape 4, Side 2: Methodist Hospital building program (continued), Poteet, William, leadership (again), Personality traits, Gains support of hospital board, Hospital profitability, Managed care, effect on hospitals, Explanation, Discounting, Preferred Provider Organization (PPOs), Operation and effect on hospitals, Bidding war, Negative effect on St. Mary, 'Scary', Managed care, Control, Managed care, history and background, Kaiser Permanente, States where started, Late in coming to country's midsection, Reasons, St. Mary Medical Group, Organizational set-up, Doctors' salaries and benefits, Advantages, Stability, Run doctors' business, Success, Early operations, Burrell, Dr. James, role, Physician recruitment, Challenges, Doctors' loyalty to Methodist Hospital, Gains made against Methodist Hospital, Impact, Patient choice, Number of doctors recruited, Family health care centers, Rural communities, Clinics, Supported by Sisters of St. Joseph, Medicare patients, Indigent care, Mission of Catholic Church, Doctor's attitudes, Screening doctors

Tape 5, Side 1: Merger - St. Mary and Methodist Hospitals, Early discussions, Joint venture on HMO, Methodist Hospital and First Care, Meetings, St. Mary and Blue Cross, Unsuccessful, Anti-trust, Aims, Clinton Health Care plan (again), Alliances, Columbia Health Care, Interest in Lubbock market, Background, Exposure in Texas, Rejected by UMC's Board, Administrators had approved, Interest in Methodist Hospital, Typical acquisition, Methodist Board rejected, St. Mary's attempts to lease UMC, Rejected by UMC administrators, Study of health care in Lubbock, Glut of hospitals, Physician staffs of St. Mary and Methodist overlapped, Physicians disapproved of intense competition, Wasteful and costly, Polarizing effects, Hospitals sought loyalty, St. Mary Medical Group hiring physicians, Lease of UMC (again), Technicalities, Taxes, Columbia Health Care, Methodist Board's rejection of offer, Reasons, Predatory nature, Concern for citizens, Money offered to Methodist, Coverage of West Texas (again), Not yet in West Texas, Legal problems, Spin-offs, Money offered tempting, Methodist Board, Best interest of Lubbock, Methodist Hospital and Internal Revenue Service, Tax exempt status, Early discussion between Alan White and Charley Trimble, Opening of Arrington Cancer Center, Alan White concerns, Plains National Bank, Approached Trimble, First true merger talks, Informal

Tape 5, Side 2: Merger, St. Mary and Methodist Hospitals (continued), Discussions in California with St. Joseph's administrators, Challenges, 'Trust and anti-trust', Anti-trust considerations, Federal Trade Commission (FTC) relaxing rules, Proving competition, Larger geographic area, Analysis, Hart-Scott-Rodino filing, Merger approved, Summer, 1997, Physician views, Trust issue, Poteet and other Methodist Hospital administrators resigned, Houser, Jim became temporary CEO of Methodist, Hospital, Effectiveness, Key relationships, Charley Trimble and Alan White, Drs. James Burrell and Robert Salem, Merge medical groups, Details, Salem's reputation, Friendliness, Salem, Dr. Robert, key role with Methodist Church, Father, Joe Salem, Church's approval of merger, Sisters of St. Joseph approval, Unusual aspects of merger, Church differences on sterilization, Abortion, Tubal ligations, Compromise reached, St. Joseph Health System, reason for merger, Improve health care in area, Efficiency, Alan White and Charley Trimble insisted on 50/50 deal, Assumption throughout, Sisters of St. Joseph liberality, Example of Sister Mary Catherine Small

Tape 6, Side 1: Merger, St. Mary and Methodist Hospitals (continued), Sisters, socially liberal (continued), Sister Mary Catherine Small (continued), Bioethics, Explanation, Financial aspects, 50/50 control (again), Assumption of Methodist Hospital debt, Bond sales, Value of Methodist's physical plant, Net benefit to St. Joseph Health System, Equal control (again), Complimentary aspects of hospitals, More in the future, Plans for eliminating duplication, Reaming hospitals, Christian health care concept, Role in providing health care, Pastoral care program, Ecumenical, Few problems with theology, Medical groups merger, Becoming Covenant Medical Group, Role of Drs. Burrell and Salem, Effect in rural communities, Physician recruiting, Cooperation, Shift to Covenant, Employee loyalty to hospital, New culture, Consolidation of services, Personal concerns, No firings, Attrition, Barnett, Chris, Consolidation ongoing, Regional outreach, Trend toward mergers nationwide, Henry, Jake, Clinton Health Care plan happening, Role of Catholic Church

Tape 6, Side 2: Trend toward mergers nationwide (continued), Catholic Church (continued), Historical background, Sisters of St. Joseph, Christian health care, Similarity of Methodist and Catholic views, Integration of cultures, Ecumenicalism, Profits in health care, Patients' fears, Preference for non-profit hospital

Range Dates: 1930s-1999

Bulk Dates: 1994-1999

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