After nine years at the helm as president and CEO of Houston Methodist, the Texas Hospital Association’s chair-elect, Marc Boom, M.D., FACHE has weathered many storms, both literally and figuratively. As he reflects on the past year’s events, he acknowledges the long historical precedent set by those in the health care profession who have weathered similar storms.
“If you look back centuries, you see that throughout history, doctors, nurses and other health care providers have rallied amid pandemics, wars and natural disasters and did what they needed to do to care for those in their communities.”
Houston Methodist is part of that rich history.
The Houston Methodist Hospital was founded over 100 years ago in 1919, at the height of the Spanish influenza pandemic. Since then, Houston Methodist has grown to a 2,300+ bed hospital network. Its flagship, Houston Methodist Hospital, is consistently ranked among the country’s best by U.S. News & World Report. In addition to providing exemplary clinical and spiritual care, Houston Methodist is affiliated with several academic institutions that train the next generation of health care providers and researchers.
Dr. Boom can’t pinpoint what catalyzed his decision to pursue a career in medicine. He initially thought he’d practice veterinary medicine, but after some time spent in a veterinary practice, he realized he would like to work with patients who he could actually talk to.
“I was drawn to internal medicine because of the intellectual challenge that it provides and the longitudinal nature of the practice. You have to know a little bit about everything, and you also really get to know your patients.”
Dr. Boom with his wife, Julie Boom, M.D.
Dr. Boom's children (left to right), Kathryn, John and Janie.
Dr. Boom, who is board-certified in internal and geriatric medicine, still maintains a small primary care practice that allows him to solve those diagnostic puzzles while maintaining long-standing relationships with patients. Some of whom have been under his care for his entire tenure at Houston Methodist.
Practicing Team Medicine
Medicine, like most disciplines, thrives with a multifaceted team approach, and most teams need a captain – a role that felt natural to Dr. Boom, who often found himself mediating conflict in high-stress situations throughout his residency.
“I was trained at Mass General, and it was the perfect fit for me because it had a team-based philosophy,” says Dr. Boom. “We teach the team-based approach to medicine today, but when I was in medical school, medicine was more of an individualized thing.”
A variety of factors catalyzed the transition to an administrative role from a clinical one. Dr. Boom has an apparent propensity for building long-term relationships with his colleagues and patients, coupled with, perhaps, a familial predisposition for change.
“I always joke that this must be in my DNA. My grandfather left the farm in Belgium to build a cabinet-making business. My father was an engineer and then transitioned to a managerial role in chemical plant construction, and my brother, who is an attorney, moved to the managerial side too.”
During his residency, it wasn’t very common for physicians to hold positions as senior leadership members within a health care system. After Dr. Boom recognized his aptitude for leading his peers in medicine, he realized he would like to supplement his clinical practice with an administrative role. Right after residency, Dr. Boom decided to pursue an MBA at Wharton School of Business at the University of Pennsylvania to gain management skills to accompany his technical, clinical training.
After concurrently completing his MBA from Wharton and fellowships in general and geriatric medicine, Dr. Boom moved back to Houston with his family to run a joint venture between Baylor College of Medicine and Houston Methodist.
Navigating the Storm
In June 2001, Tropical Storm Allison became the first tropical storm of the new millennia and of Dr. Boom’s tenure at Houston Methodist. The storm, which left 40 feet of water in the main hospital’s basement, limited the hospital to a few dozen patients for weeks. Since then, he has helped guide the system on how to better navigate unforeseen natural disasters and rebuild and restore hope and healing for the patients and staff who have been impacted.
Over the past 20 years, Houston Methodist has experienced Tropical Storm Allison, Hurricane Rita, Hurricane Ike, Hurricane Harvey, and now the COVID-19 pandemic.
While Dr. Boom and his team have learned a lot about emergency preparedness over the years, nothing could have prepared them for the impact that an indefinite pandemic would have on the health care system and its frontline providers.
“With natural disasters, there is a short period of very acute distress, then the community rallies together, links arms and you get through it,” says Dr. Boom. “About a week later, hospital operations go back to normal, and we focus on how to support our employees who have been impacted by these disasters.”
The pandemic's effects were also complicated by political polarization and the reluctance of some to heed medical advice given by experts such as wearing a mask and social distancing. Unlike the natural disasters where everyone in the community linked arms in solidarity, the pandemic necessitated prolonged isolation, which was not conducive to understanding the virus's complex nature.
In the early months of the pandemic, Dr. Boom realized that a comfortability with vulnerability would be essential in navigating Houston Methodist’s staff, and the patients who depended upon them through the pandemic.
“Showing your vulnerability as a leader is critically important. You have to be transparent in the face of so much uncertainty because you will make mistakes along the way that you later regret, but it was the best decision you could make with the information and facts available at the time.”
The importance that Dr. Boom placed on honesty and transparency was internalized by many in the organization – even, sometimes, at his expense.
“I actually saw several comments on the videos we were putting out that remarked on how tired I looked,” Dr. Boom says jokingly. “I reflected on that, and I am glad that people could see that, even as a leader, I get tired and stressed because we were all tired at that point and I think that vulnerability helped me connect with people.”
The Sacred And
Houston Methodist is driven by its values of integrity, compassion, accountability, respect and excellence, which are all signified by the acronym “I CARE,” to shape and improve patient and employee experiences.
Amid the pandemic, Dr. Boom and his team leaned heavily on the I CARE values. They also recognized the need to develop another guiding principle called “The Sacred And,” to reinforce the importance of caring for COVID-19 patients and patients with illnesses unrelated to COVID-19 and caring for those who provide the care.
“Our sacred responsibility as physicians, nurses, clinicians or other hospital employees is to fulfill the care of COVID-19 patients and to fulfill the care of patients who do not have COVID-19 and still depend on us,” says Dr. Boom. “And the third part of the Sacred And is that we care for each other and the 26,000 employees in our institution.”
During the pandemic, many patients deferred routine, or even acute care for fear of being exposed to the virus in a medical facility. Patients’ hesitation to seek care amid a pandemic meant that health care providers had to work hard to ensure that they take every precaution to guarantee the safety of patients and personnel.
To counteract this rising trend of deferring care, Dr. Boom and other health care leaders throughout Texas reinforced the importance of returning to the doctor for care, including routine visits and screenings. Shortly after Houston Methodist started externalizing the messaging that reinforced Texas hospitals were safe, he received a letter from a patient that will remain memorable to him.
“I got a letter from a patient who said they saw [our] public messages about the importance of not delaying routine care, and it made her feel safe enough to get a mammogram that she was supposed to have a month prior,” recalls Dr. Boom. “She was diagnosed with breast cancer, but it was caught early enough so she would hopefully have an easier treatment and prognosis.”
The impactful anecdote illustrates the importance and relevance of “The Sacred And” as hospitals across Texas balance caring for COVID-19 patients with caring for the patients in their communities who need routine care. Dr. Boom remains “incredibly proud” of his team’s hard work to ensure safe care for all patients who seek treatment at Houston Methodist.
In 2021, Dr. Boom will begin his appointment as Board Chair for the Texas Hospital Association. In this role, he will play a critical role in helping amplify the voices of THA’s 450 member hospitals and health care systems as the state enters its 87th legislative session. He looks forward to addressing key issues that have been underscored by COVID-19 and working alongside fellow health care leaders at THA with whom he built a strong professional camaraderie during the pandemic.
“Having open lines of communication with other leaders was invaluable during this time,” says Dr. Boom. “THA’s advocacy and the ability to communicate the needs of the hospitals to state leaders was exceedingly helpful.”
Dr. Boom is glad he won’t have to talk about the Medicaid Fiscal Accountability Rule (MFAR) during the upcoming legislative session. The rule was recently withdrawn by CMS in September after health care provider groups like THA advocated that the rule would have unintended consequences, particularly for rural hospitals. While MFAR isn’t a pressing concern now, there is a lot of work to be done to protect Texas hospitals and patients.
“I am very excited to have Dr. Boom take the reins at THA,” says Ted Shaw, THA president and CEO. “This year he has been a key leader in the state and in the city of Houston’s response to manage the COVID-19 crisis. As we enter this legislative session, Dr. Boom will lead our hospitals continuing response to the pandemic and to address the critical funding for health care both in Austin and Washington.”
For Dr. Boom, the events of the past year are at the forefront of his mind when considering the priorities for the next year. Specifically, health care equity for underserved minority populations in Texas and expanded health care coverage for those who lost their jobs and health insurance during the pandemic.
“Access to care has been a major issue during COVID-19, and there have definitely been populations with hindered access to health care who have suffered more during COVID-19 and we urgently need to solve that societally."
Another priority that Dr. Boom wants to address is pandemic preparedness. As an advisory board member for the Texas Medical Center (TMC), Dr. Boom witnessed first-hand the difference that proactive preparedness makes in mitigating future disasters. In the late 1970s, TMC experienced major flooding, which happened again in 2001 when Tropical Storm Allison brought forth 31 inches of rain. After Allison, it was determined that future storm preparedness was imperative.
“A lot of time and effort was put into flood mitigation practices, so when the Category 4 [Hurricane] Harvey made landfall with 51 inches of rain, the Texas Medical Center did not flood,” recalls Dr. Boom. “I know we can apply analogous lessons to pandemic preparedness, and the time to do that is before COVID-19 even ends.”
While changes in the health care industry are usually made with legislation, we’ll continue to depend on the 400,000 health care professionals across Texas to meet these changes with the same compassion and dedication that they have exemplified throughout the pandemic. Dr. Boom’s unique position to serve patients as a physician and a health care executive gives him a unique perspective of the profound impact that everyone within the health care profession can make on the lives of those who seek care.
“I really truly believe that health care is a calling, and I mean that broadly. That calling applies to doctors, nurses, administrators and everyone in between,” says Dr. Boom.
“When I see people living out the I CARE values, it gives me the boost I need to keep going.”