Nuns and priests were CEOs at 770 of 796 Catholic hospitals in the U.S. in 1968. This year, there are only 8 of them leading 636 hospitals. Sister Mary Jean Ryan, who retired as CEO of SSM Healthcare, says, “We’re a dying breed.”
Why has this happened, and why should we care — whether or not we’re Catholic?
The New York Times covered this story on August 22, 2011, titled, Nuns, a ‘Dying Breed,’ Fade from Leadership Roles at Catholic Hospitals. NY Times editors smartly placed this story in the “U.S.” section and not under the “Religion” corner of the paper.
At the crux of this historical transition at religious hospitals is whether the values that drove the heart and soul of these institutions — caring for the needy, the safety net population, and the larger community — will translate when MBAs and MHAs take over leadership of these organizations. The Times wrote, “Although their influence is often described as intangible, the nuns kept their hospitals focused on serving the needy and brought a spiritual reassurance that healing would prevail over profit, authorities on Catholic health care say.”
This is not a marginal issue in American health care: in 2009, 1 in 6 hospital admissions was in a Catholic hospital.
Health Populi’s Hot Points: With the U.S. economy in decline or stasis in most of the nation, and health benefits for covered workers lucky enough to be covered by a health plan, moving more financial burden onto employees, more health citizens in the U.S. have been moving into safety-net, under-insured, or un-insured status. As such, more people seek care in emergency rooms and outpatient care in the community, and more have a difficult time paying for health care (my blog posts have featured this issue over the past 4 years; search on the topics of safety net, Medicaid, self-rationing, and medical home in Health Populi‘s search box).
The wild card in the disappearing-nuns-from-healthcare scenario is how non-clergy will make decisions at the helm of Catholic health care. Will the so-called “healing presence of God” yield to the bottom-line and shuttered services that skew to the poor and under-served?
I can tell you that my work with Catholic health providers, including two of the nation’s largest Catholic systems and several local individual hospitals in the U.S. over the past twenty years, have shown me the power of nuns at the helm of health care. Many of these women have had MBAs themselves and other advanced degrees, and have had a knack at meshing business discipline with innovation in managing the bottom line while keeping the mission at the center: caring for people, whether insured or not, across socioeconomic strata.
The decline in the supply of nuns and priests in the U.S. is impacting a portfolio of human services: education, too, has been negatively impacted, witnessed by the growing number of Catholic schools shutting down throughout the country.
There’s a new school of thought among some business leaders that MBA students should have a broad liberal arts — and some say fine arts — education before entering business school. This is one way to strengthen left-right brain — and hopefully, heart and soul — in business people who will take on leadership positions in health.
Jane Sarasohn-Kahn is a health economist and management consultant that serves clients at the intersection of health and technology. 
I felt so sad with this post, with the nuns disappearing from the health care department part. I may not be that of a religious person but I think we need more nuns on the health care scene. I remember when I was young and got hospitalized, I have seen nuns roaming around every room and ward giving prayers to every patient in need of spiritual push and faith in God. It sometimes help us. Sadly, tides have changed in the health care department.
Thanks, Jane, for this fine post.
Wow. Where do I start? I AM Catholic, but that’s not the point. Then again, having gone to parochial school from 1st through 12th grade, and graduating from a Jesuit University may grant me a few immunities as I make some candid observations.
To start with … “Them Nuns is tough!” Seriously. Any MBA, MHA, or MPH is going to understand basic business strategy, reimbursement issues, and cost containment. But the Sisters have the business savvy AND something that trumps their layperson counterparts … a “calling”. Trust me. No stone will be left unturned as they attempt to meet their goal.
In addition to my Catholic upbringing, I worked as a Nursing Home Administrator for about 8 years. During that time I was involved with the Sisters of St. Joseph of Orange at “St. Joseph’s Hospital” (Orange, CA), and “St. Mary’s Hospital” (Apple Valley, CA). Then there was “St. Bernadine’s Hospital” (San Bernardino, CA), though the specific order of Nuns escapes me at the moment. In each case I can attest to the level of expectation of care that was present. Their business acumen, combined with a sincere “mission” is something that I respect to this day.
Many “business types” can, and do make a better living outside of healthcare. Then there are those of us who chose healthcare as a profession, because we see value in it. But the Nuns, with their “calling”, chose something that demands so much more, and they’ve delivered.
As their ranks regress, so does a special blend of business and compassion in the field that we serve.
And on that last point, your notion of integrating liberal and fine arts into the traditional schooling of our next generation of healthcare executives may well be a positive step in helping to mold the “mission” of finding a way to care for ALL those in need. After all, healthcare, though a business, is about caring for our society.