Norman LaConte is president and chief executive officer of Proctor Hospital and its related organizations. LaConte joined Proctor in 1965 as controller and has been involved in the growth of the hospital through the years. He is a Fellow in the American College of Health Care Executives, a board member of two insurance companies, and various civic and health care related organizations. He was recently elected to the board of directors of the Illinois Hospital Association.
Although Proctor commands much of his attention and interest, LaConte is also an avid pilot and aircraft enthusiast. He also has a strong interest in classic automobiles and American history. He has a bachelor’s degree from Bradley University and an MBA from the University of Illinois.
Tell us about your background, schools attended, family, etc.
I have lived in the area all of my life. I grew up and attended elementary and high school in Eureka. I have a degree in accounting from Bradley University and an MBA from the University of Illinois. Over the years I have been involved in numerous professional education programs and forums related to health care delivery and management.
I have one daughter, Lisa, who is a lawyer with a local firm and specializes in health care law.
Your background is in finance. How has that knowledge helped guide Proctor Hospital through the years?
My financial education and experience provided a good foundation for my career at Proctor. I became associated with Proctor during my career in public accounting. I was a specialist in health care auditing and accounting and in 1965 was asked by the board of Proctor to become the chief financial officer at a time when they were dealing with a number of critical financial issues.
The Medicare program began in 1965, and it was a real challenge to prepare the hospital to participate in the program. We had to restructure the organization and create new financial systems to meet the requirements of this radical new program. The hospital was also entering a period of substantial growth and expansion which required significant capital refinancing of the organization. I became president and chief executive officer in 1979 and have continued to assume additional responsibilities as we developed our parent corporation, foundation, practice management corporation, and other organizations to provide expanded services to our community.
Tell us about Proctor Health Care, Inc. and its subsidiaries.
Proctor Health Care, Inc. is the parent corporation for all of the Proctor entities including Proctor Hospital, Proctor Health Care Foundation, Belcrest Services, Proctor Health Systems, and Health Plus. Proctor Health Care, Inc. provides support and coordination for all of our related entities. It is governed by a smaller board than the Hospital. I serve on that board and am president and chief executive officer of Proctor Health Care, Inc., in addition to Proctor Hospital.
Originally, Proctor Hospital was the only entity. However, in 1983 we went through a strategic reorganization to position the hospital to meet the changing demands of health care. At that time we formed Proctor Health Care Foundation, which has the mission of providing continuing support for Proctor Hospital through fund raising and other philanthropic activities.
Belcrest Services, Ltd., a for-profit corporation, was created to provide services and manage activities that were not appropriate for the not-for-profit environment; for instance, operation of our Proctor First Care units, Proctor Medical Equipment, physician office buildings, etc.
Proctor Health Systems was created to employ physicians and manage physicians’ practices. Health Plus, also a for-profit corporation, is an Illinois licensed Preferred Provider Organization (PPO) which is the managed care and business development unit for the Proctor organization and Proctor Hospital. Health Plus negotiates and administers contracts with insurance carriers, national PPOs, HMOs, and employers.
Tell us about the beginning of Proctor Hospital. Who were the early leaders of Proctor?
Proctor Hospital was established in 1882 as Cottage Hospital, when a group of physicians realized the need for a community hospital that would practice the newly-developed sterile regimen being taught in European medical colleges. Dr. O. B. Willis, Dr. John Hamilton, and Dr. Thomas McIlvanie acquired a 15-room frame house on Second Street and opened the 50-bed Cottage Hospital of Peoria.
Cottage Hospital offered state-of-the-art hospital services for that time. A new standard for quality care was quickly established. John C. Proctor, a local philanthropist, led the formation of a not-for-profit organization to support the hospital and to build a new brick wing to the frame building in 1893, followed by a new 127-bed stone hospital that opened in 1902. In 1907 Cottage Hospital was renamed John C. Proctor Hospital in his honor.
The hospital operated as John C. Proctor Hospital until 1956, when it was renamed Proctor Community Hospital to reflect its expanding role in the growing community. In 1959 the hospital moved to a new facility at its current location. The facility was expanded to accommodate 305 beds by additions in 1961, 1965, 1967, 1970, and 1990. Proctor Hospital is an Illinois not-for-profit corporation.
Today, Proctor Hospital is a fully accredited (JCAHO) medical facility offering state-of-the-art services in emergency care, inpatient and ambulatory surgery, cardiology, cardiac surgery and rehabilitation, pulmonology, neurosurgery, family-centered maternity care, gynecology, pediatrics, addiction treatment and skilled nursing care. Our Addiction Recovery Center has helped more than 30,000 people to manage their addiction and behavior problems and put their lives back together. The recent addition of the Heart of Illinois Wound Care Center reinforces Proctor’s commitment to providing technologically advanced care to meet the needs of our community.
In your long career at Proctor, what has changed the most in our community over the years? How has health care delivery changed over the years? Locally?
The most dramatic change has been the transition from dependence on heavy manufacturing to a more diversified economic base. In the early years, Peoria had an image largely centered around heavy manufacturing and not much else. Today, Peoria has firmly established a reputation as a major regional provider of health care services. The health care industry rivals Caterpillar as our largest employer. We continue to move from an industrial-based economy to a service-based economy, and in many respects health care is leading the way.
The rapid evolution of technology is the most significant factor driving change in health care delivery. The subspecialization of physicians and other health care professionals has also increased dramatically, with physicians now supported by other caregivers such as physician assistants, nurse practitioners, and other specialized health care technicians. The development of new drugs has made many new treatments and procedures available to support a whole new range of services.
What is the greatest challenge facing the health care industry today? The next five years?
The health care industry today faces two major challenges; the first is financial. The Balanced Budget Act of 1997 dramatically cut funding to the Medicare program. This placed the financial health of many hospitals in jeopardy.
Recently, in response to public pressure, our elected officials and leaders in Washington have recognized that the cuts went too far and reinstituted some of the lost funding, but there is still much work to be done. In a related matter, hospitals are struggling to maintain adequate staffing levels. Recruitment and retention of nurses and other health care professionals is a major challenge facing hospitals and the entire health care industry. Together with improved funding, we must find better ways to attract and retain health care professionals by making the health care industry a more attractive profession.
What is unique about Proctor Hospital compared to other area hospitals?
You have given me an opportunity to talk about one of my favorite topics. Proctor is very special. It was the first "real" hospital in Peoria. By that I mean it was the first hospital to practice sterile techniques. While Proctor is not as large as the other hospitals, it has a rich history of innovation and leadership. For instance, Proctor introduced the first intensive care unit; the first respiratory care department; and in the 1950s and 1960s, we had unique cold humidity rooms to treat pediatric illnesses. Many of the non-invasive cardiac procedures that are now taken for granted and practiced everywhere in our community were first introduced at Proctor, in cooperation with our cardiologists. Proctor was the first hospital in the Midwest designed and built with central air conditioning.
Proctor’s Illinois Institute for Addiction Recovery is a nationally and internationally recognized leader in the treatment of alcohol and drug addiction as well as compulsive behavior problems such as gambling, spending, Internet, and sex addiction.
Our program provides clinical services, education, and consultation to patients, employers, governmental units, and other organizations throughout the nation and many foreign countries.
I think our location and campus provide a more accessible, less intimidating atmosphere than the downtown hospitals, and it is the hospital of choice for many residents in the suburbs and smaller communities.
We have always been more focused on patient care and enjoy a good reputation for personalized care as a result. You might be surprised to learn that, in spite of our smaller size, more than 97 percent of the time Proctor can provide the services patients seek at hospitals.
Of course we don’t provide services like transplants and neonatal intensive care, but those specialized services comprise a very small percentage of the total services people seek from hospitals. In virtually any area of comparison, our technology is equal to or superior to our competition, and is provided in a more patient-focused environment.
I understand the Peoria area and its health care providers are uniquely compared with others within the state and region. How so?
When you consider the comprehensive array of medical technology and the availability of specialists in the Peoria health care community, it compares favorably with urban areas much larger than the Peoria area.
It would take more pages of print than probably would be practical in this article to discuss the advantages in detail, but when physicians are being recruited to come to Peoria, they are regularly surprised at the scope of care available in our community.
The three hospitals and the medical school provide a unique attraction to health care professionals and patients. Our challenge is to do a better job of telling our story outside our immediate area, and to compete more effectively with other regions throughout the Midwest. We have the services and capabilities, but we need to be more effective in communicating our strengths.
What are your thoughts about possible collaboration between area hospitals, the U of I College of Medicine and the National Center for Agricultural Utilization Research? What has worked in the past? What has not? Why not?
This is one of the important ways we can improve our credibility and visibility as a regional provider of medical care. Research is an important component of any regional medical center, and it is imperative the area hospitals and the College of Medicine work in close collaboration with all available resources. I believe we learned some things from our past efforts that can hopefully help us avoid problems in our future endeavors. Certainly it takes more than just funding to make these efforts work.
There has to be a clear vision of our collaborative mission and commitment to achieve our goals. Unfortunately, turf issues tend to be raised very early in many of these discussions. We need to find a way to get past that. We need to provide incentives for all to actively participate in the process.
I believe Dean Rager and the College of Medicine can provide valuable leadership in keeping those barriers from impeding our progress. Community and business leadership can also play an important role in encouraging a constructive and effective collaboration between all of the involved parties.
What are the positives of the proposed patient’s bill of rights? The negatives? How could it be practically implemented in today’s health care delivery system?
Many features of the proposed patient’s bill of rights are long overdue and very important.
HMOs, insurers, employers, and providers have all tended to treat patient information with less confidentiality than it deserves. Patients have not been given access to information they need to make decisions and judgments about their care and their health. We need this legislation, but not in the form many bureaucrats would like. On the negative side, there are practical limits to restrictions placed on the transfer of information as hospitals and physicians share information in regard to a patient’s care. In the rush to protect patients’ rights we need to also ensure the patient’s right to get the care they need is not impeded.
The patient’s bill of rights, HIPAA, and other Medicare regulations need to be considered together as we develop standards for national and local health care information systems.
Whatever we do is going to be costly and take a great deal of time to implement properly. There is a need to maintain a very delicate balance between the information employers and insurers need to authorize and validate care and the rights of patients and their families to a certain degree of privacy and control over access to their health care information. If the ultimate system does not respect the unique needs of the parties requiring access to the information, we could create a real information bottleneck that could have an unintended negative effect on the patients we are trying to protect.
How have HMOs and/or preferred provider agreements worked in the Peoria market to date? What are the downfalls of these programs?
Competition among the hospitals for preferred provider agreements and provider contracts have had both positive and negative impacts on our community. On the positive side, we have technology and specialists providing services that may not have been available had competition not been so keen.
Providers worked diligently to position themselves to be acceptable candidates for contractual arrangements and have competed on the basis of price, quality, and service. Competition generally improves quality and holds prices down.
On the negative side, competition creates duplication that may not be necessary if there were more cooperation. An unwillingness to cooperate among providers creates excess capacity and requires additional capital investment by all providers.
Duplication of services can also aggravate competition for staffing and the shortage of health care professionals. When a large insurer or employer extracts a deep discount from a provider or providers it is many times necessary to offset that loss or discount by higher prices to other customers, commonly known as cost shifting. The biggest cost shift occurs as a result of government programs.
What, if any, misconceptions are in the community regarding Proctor Hospital?
We are fortunate that in Peoria we have three fine hospitals providing care not only to the immediate community but also to an ever-increasing regional community. While Proctor is the smallest of the three, Proctor is a large hospital. That might sound like a bold statement when comparing Proctor against the other two hospitals. However, if you look at hospitals in other communities and compare their capabilities to those at Proctor, you have to conclude Proctor is indeed a very comprehensive, major provider.
Another misperception regards the availability of specialists. Virtually all specialists in Peoria are members of our medical staff and have privileges to practice at Proctor. On any given day you will see many of them on the surgery schedule, responding to consultation or providing treatment to patients. Nearly 500 physicians are members of our medical staff.
What, if anything, would you change about health care delivery as it pertains to hospitals?
I’d change the regulatory environment in which we are forced to operate. The mountains of paper work, confusing regulations, and the bureaucratic administration of health care—both in the government and private sector—cause hospitals to devote valuable resources to management of this environment when those resources could better be used providing patient care.
How does Proctor recruit physicians? Nurses? Specialists?
Our strategy for recruiting physicians has changed over the years. We believe what works best to recruit and attract physicians is to provide superior care and personalized attention to the patients they bring to our hospital.
Insurance considerations aside, physicians want to go where they know their patients will be well treated. We also work very hard to make sure the needs of our physicians are recognized and addressed. We spend a lot of time talking to our physicians about how we can meet their expectations.
Recruitment of nurses is a different matter. The demand for nurses obviously exceeds the supply at this time, and while nurses are interested in pay, they really are focused on the quality of their working conditions and their ability to provide quality patient care. Nobody wants to work every weekend or holiday, and we work very hard to make sure our nurses and other employees are scheduled as fairly as possible.
We also strive to provide competitive benefits and pay—and most recently have added a nurse recruiter who specializes in recruiting and retaining our nurses. Specialist physicians are attracted to a hospital as a result of referrals by primary care physicians. Specialists generally require specific technology, instrumentation, and skill sets from employees to provide their specialty care. Communication with specialists is important to ensure we meet their needs and are responsive to changes in their specialty. Much of the technology in our hospital is driven by the needs of specialists, and we are diligent in tracking the evolution of technology in the various fields.
What future plans do you envision for Proctor Hospital?
Since moving to its present location in 1959, Proctor has never stopped growing. We have had a series of major expansions over the years. The hospital has never really been static; it’s a dynamic organization, changing to meet the needs of our community and evolving with changes in health care delivery. With the addition of the former Belcrest subdivision between the hospital and Knoxville Avenue, we now have more than 50 acres of campus available to us. In our planning considerations we try to maintain the campus-like feel of our site and avoid the institutional stigma of larger hospitals.
Currently, we are planning a major expansion of the hospital campus to provide additional medical office buildings on the 13-acre site of the former Belcrest subdivision. We have a lot of interest from physician groups and are trying to plan for the best use of that site, while maintaining visibility of the hospital from Knoxville Avenue. We constructed a new entrance drive with traffic signals to provide much safer access to the Hospital and campus. We have recently completed a major strategic planning process and will be considering a number of opportunities for the future. These are exciting and challenging times for Proctor.
What significant changes or breakthroughs in health care and medicine do you foresee in the next decade?
The media and health care publications regularly report on new products and procedures for diagnosing and treating disease. I believe we are on the verge of major breakthroughs in disease intervention and cure through the genome project. These emerging technologies will radically change the way hospitals and physicians provide their services, and could make obsolete many of the techniques that have been the hallmark of hospital care for so many years. Genetic therapy, stem cell research, cloning, and "smart drugs" all hold great promise for the near future of health care and medicine. Proctor is committed and prepared to be a part of the exciting future.
Will the central Illinois health care industry be able to meet the challenges of aging baby boomers?
That’s a good question, and one in which I have been engaged in considerable discussion and debate. Anyone who has followed the path of the baby boomers through our economy and society has witnessed the significant impact of their presence. Schools, housing, consumer demand, the stock market, have all been impacted by the baby boomer phenomenon. Now it is health care’s turn. What I call the leading edge of the baby boomers, people born in 1946 and later, are beginning to use health care services at an increasing rate. For at least the next 20 years, the health care industry should expect a steadily increasing demand for services as baby boomers age and begin to access the health care system in increasing numbers.
You frequently hear people offering the observation that we have too many hospital beds in this country. I believe in a few short years that perceived surplus will turn to a shortage, and in spite of new technology and reduced incidence of hospital care, American and central Illinois hospitals will be pressed to meet the peak needs of aging baby boomers. Perhaps the new technologies will supplant some of this demand by providing alternatives for treatment and more effective preventive care.
What frustrates you the most concerning health care in America?
I continue to be perplexed by the dialogue about how much health care is enough. Constant references to the percent of GNP spent on health care in this country versus other countries may not be relevant in a society such as ours that has an obsession with health care. Health care has become a consumer commodity evidenced by massive advertising of prescription drugs, the evolution of alternative treatments and the continuing disconnection of the consumer from the traditional physician/patient relationship.
Consumers and patients have an almost endless source of health care information available to them through the Internet and media.
Health care is no longer something you think about only when you are sick. We talk and think about it daily. As a result, health care is no longer a fringe benefit provided by a few employers. It is considered an essential part of almost every employment and in many cases will become the deciding factor when an employee has a choice between several job opportunities.
At a time when employers are trying to reduce health care costs, they are under increasing pressure to provide more health care benefits. With stiff competition for skilled workers, a good health care plan is essential to attract quality employees. With the increasing awareness and demand by consumers and employees and the willingness of employers to provide these plans, a natural result is that you are going to have higher and higher utilization.
Placing the blame on the health care system for this increased utilization is incorrect. In the 1950s and 1960s, consumers focused on automobiles, homes, and other durable goods as desirable expenditures. Today, health care is competing for those consumer dollars. As a society we need to rethink the importance we place on health care benefits and decide whose responsibility it shall be to fund those benefits. Perhaps the time has passed when employers should have the responsibility for funding the majority of the cost. IBI