Byline: Jane Erikson
Nov. 6--The son of a World War II fighter pilot, Norm Botsford learned to fly planes when he was 9 years old.It was improbable, risky, exhilarating -- much like the feats Botsford performs today as president and CEO of University Physicians Healthcare.
From his resurrection of Kino Hospital to his decision earlier this year to take University Physicians Healthcare into Maricopa County, Botsford, 55, has proved his skeptics wrong time and again. Like the boy flying his father's Cessna, he's doing things others doubted he could.
While many of the UA doctors opposed University Physicians' takeover of Kino last year, Kathy Reed, the University of Arizona's chief of maternal and fetal medicine, has been a strong supporter of Botsford's goals.
'Norm is a visionary who has the courage to guide an organization to the next level -- in fact several next levels,' Reed said in an e-mail. 'He has this amazing ability to see farther and persuade, negotiate, nudge, encourage, and inspire a naturally resistant group of well-intentioned physicians and staff into unfamiliar territory.' Another thing she likes about Botsford: He can conduct an e-mail exchange in the style of haiku, a Japanese poem written in 17 syllables.
And despite being diagnosed with a heart arrhythmia in May -- a problem that put him in University Medical Center for a night but is now controlled by medication -- Botsford is optimistic about the future.
'Life is rich and full of possibilities,' he said.
The possibility on Botsford's mind last week was a proposed $60 million expansion of psychiatric services at the former Kino Community Hospital, now known formally as University Physicians Healthcare Hospital at Kino Campus and informally as UPH.
To pay for $48 million of the construction, the county will need to sell bonds. Botsford's job on Thursday was to convince a three-member subcommittee of the Pima County Board of Supervisors it was a good idea.
On Wednesday Botsford was sweating the presentation.
He wants to add a separate 80-bed psychiatric hospital and a UA Institute for Psychiatry and Clinical Neurological Sciences on the hospital campus. The new psychiatric hospital would include its own emergency department to reduce the crowding and chaos in UPH's emergency room -- and in other ERs around the city.
When he appeared before the subcommittee, Botsford's tension eased. He came across as relaxed and upbeat.
He told the subcommittee treating the mentally ill in the UPH emergency room creates 'an incredibly difficult environment for us to try to calm someone who is in the middle of a psychiatric episode, and at the same time try to take care of grandma with a heart attack and junior with a broken leg.' He has a good effect on people in such situations, said attorney Larry Hecker, who chairs the bond advisory committee.
'The word I would use is calming,' Hecker said, 'like we're working together toward a common goal. He's very straightforward and factual, as opposed to trying to embellish or exaggerate. I trust what he says is accurate.' After a friendly exchange of questions, the three-member subcommittee voted 3-0 to recommend the expansion to the full committee. Eventually, if the bonds are to be issued, the supervisors and county voters will be asked to approve.
Botsford grew up in Racine, Wis., where he not only flew planes, but developed a passion for swimming, camping and fishing in northern waters. He spent a lot of time at the YMCA, became a lifeguard and was on his high school's swim team.
'It was a nice way to grow up,' he recalled.
It is perhaps no accident that Botsford ended up a health-care wonk. After World War II, his father took over his grandfather's accounting firm and was on a hospital board for his entire adult career. His mother was an orthopedic-surgery nurse at the same hospital.
Botsford earned a bachelor's degree in history and a master's degree in finance from the University of Wisconsin. Then he went on to work in hospital administration for 15 years, most of them at the University of Wisconsin Hospital and Clinics.
He arrived in Tucson in 1991, joining University Physicians Inc. as associate director of ambulatory care services. At the time the group had about 300 doctors. Botsford was promoted to chief executive the next year.
Tucson then was becoming a proving ground for managed care -- a health-care trend that slashed patients' costs but also their doctors' pay. Managed care would later bear the blame for the demise of some of the city's most revered health-care institutions: Tucson Clinic, Thomas-Davis Clinic, Group Health Medical Associates and Tucson General Hospital.
University Physicians survived, but with some speed bumps along the way -- notably, the group's temporary loss of its Arizona Health Care Cost Containment System contract in 1994.
Botsford's best-known maneuver emerged from a health-care crisis.
Kino Hospital was all but shut down in May 2003. Years of administrative and financial turmoil -- including four different hospital administrators over eight years -- led to an exodus of nurses and doctors. Kino was little more than an emergency room and some clinics, and it stopped admitting patients.
Botsford first suggested University Physicians take over management of the hospital in 2002. County Administrator Chuck Huckelberry supported his idea, but some supervisors and citizens were skeptical.
'I was not one of the skeptics,' said Sharon Bronson, who chairs the Board of Supervisors. 'I was thrilled because I thought we would be able to restore Kino to a full-service hospital that would attract more patients. It was certainly a risky proposition, but I was ready to take that risk. Today it certainly it seems to be working better than even I expected.' And it is working for University Physicians. Its roll of doctors has grown to 350 and revenues are growing. In 1995, University Physicians took in $55 million; in the 12 months ending June 30, it had revenues of $200 million, with about $90 million of that coming from UPH clinics and inpatient services.
The former Kino Hospital is operating at a loss, but less than before, Botsford said.
'We'll probably lose $20 million this year. Last year it was $25 million. The last year the county had it, the loss ran into the $30 million-plus range,' he said.
Attorney Hecker said after the subcommittee meeting that he's impressed with Botsford's work at Kino.
'He's been able to turn a very large ship around and it's heading in the right direction.' Asked to predict the future, Botsford replied by e-mail: 'Professionally, I have 10 years to make the vision of the Kino campus a reality. Having the opportunity to work with a great team of professionals makes me certain we will get it done.'
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