Born to a career IBM research physicist and a teacher, Harold (Hal) Paz, M.D., M.S., has always been fascinated by the interface between research and teaching. Paz fed this passion with a career in academic medicine and management where he pioneered new roads in health care delivery. As Aetna’s new executive vice president and chief medical officer, his expertise in pursuing and balancing multiple interests to create new value will help Aetna transform health care.
“Collaboration with hospitals, health systems, doctors, employers, patients and employees is absolutely critical to improving the system and giving patients affordable access to care,” Paz says. “Successful collaboration depends on a vision that inspires people to participate and a successful strategic plan that helps people to achieve the vision.”
A non-traditional, distinguished road
Paz’s academic and medical training prepared him not only to treat patients, but also to lead health care systems. While serving as chief medical resident at Northwestern University Medical Center, he found that he enjoyed medical administration and teaching. He didn’t see then that this was the start of a unique career path.
“When I was the chief medical resident at Northwestern, the chief of medicine predicted that one day I would be a hospital president. I was intrigued, but at that time believed I would pursue only a research career in academic medicine,” Paz says.
Not until he completed a fellowship in pulmonary and critical care medicine and a post-doctoral fellowship in environmental health science at Johns Hopkins did Paz begin to entertain the prediction shared with him during his days at Northwestern.
In 1988, Paz joined the faculty and served as the director of medical intensive care units at Hahnemann University in Philadelphia. During his six years there, he was the first physician to be selected for a program designed to train future administrative leaders with clinical degrees. He was promoted to associate dean for graduate medical education and was the associate hospital medical director responsible for medical affairs and quality management. Through these positions he honed his leadership abilities and recognized the value of connections between medicine and other disciplines.
In 1994, Paz joined the Robert Wood Johnson Medical School (RWJMS) and University Medical Group in Brunswick, New Jersey, as the associate dean for clinical affairs. He was promptly promoted to CEO for the medical group. A year later, Paz was appointed dean and chief executive of the medical school. At 40 years old and only seven years out of his fellowship, Paz was perhaps the youngest medical school dean in the nation.
Paz says his primary challenge was creating an effective multi-specialty practice that had an operating relationship with the hospital. He knew that following the crowd, however, would not build the best platform for growth and improvement.
“Rather than purchasing primary care physician practices, which was very much in vogue in the mid-1990’s, we partnered with them, and initiated a hospital network strategy that included 34 hospital affiliates and 11 major ambulatory care sites with full-time faculty members practicing as far away as 70 miles from the main campus,” Paz says.
The reorganized departmental faculty practice became the largest multispecialty group practice in the state, with more than 500 full-time physicians and 200 clinical programs. This multi-specialty clinic supported patient care as well as research and education. Paz was instrumental in establishing a series of institutes to help advance centers of excellence. Paz’s insights into the challenges faced by patients and doctors led him to design a flexible curriculum that encouraged students to participate in joint degree programs in the basic sciences, public health, business administration, medical informatics, bioethics, and jurisprudence.
Taking on new challenges
Paz’s distinctive leadership was instrumental when he became chief executive officer of the Penn State Hershey Medical Center and Health System, senior vice president for Health Affairs for Penn State University and dean of its College of Medicine.
“In 2006, the medical center faced a number of critical challenges including faculty morale, vacant leadership positions, and a challenged operating margin,” Paz says. “I quickly launched a new strategic plan that resulted in a period of unprecedented growth, but most importantly we began to build a new model of health care delivery supported by connectivity and collaboration.”
The resulting health system is now a growing network of 18 affiliated hospitals across central Pennsylvania. Similarly the Penn State Hershey Medical Group was established and now has more than 1,100 clinicians at 64 ambulatory care centers, imaging and surgery facilities across Pennsylvania. The system is supported by investments in infrastructure including a fully integrated electronic health record system, telemedicine technology and a growing medical transport system. A number of post-acute care initiatives, 14 Level 3 NCQA-certified patient centered medical homes and Centers for Medicare & Medicaid Services bundled payment programs helped the health system transition to population health management. Paz also led Penn State Hershey’s involvement in new models of regionally based health care delivery. The results, published in the Journal of Academic Medicine, included cost reduction, improved patient access and satisfaction and experience managing a large capitated population of lives.
Looking ahead to Aetna
Joining a health care benefits company after several distinguished decades in academic medicine and management may seem like an unexpected detour. For Paz, the move is part of the unique course that he has forged by following his passions and leading positive change.
“My philosophy has always been to focus on the future of health care practice, not the past,” Paz says. “Clearly, health plans, doctors, hospitals and others can leverage collective strengths to improve health outcomes and costs. Continued investment in relationships and new delivery models can begin to break through many of today’s barriers in health care,” Paz says. “We are beginning to see improvements, and I look forward to helping Aetna create a health care system rooted in value and build a healthier world.”
- Charm, S.E., Paz, H.L., Kurland, G.S. Reduced plasma viscosity among joggers compared with non‑joggers. Biorheology 1979;16:185.
- Paz, H.L. Textbook of Critical Care (Book review). Annals of Internal Medicine 1989; 110:580.
- Cunningham, L.W., Grobman, M., Paz, H.L., et al., Cholecystopleural fistula with cholithiasis presenting as a right pleural effusion. Chest 1990;97:751‑752.
- Henry, B.L., Paz, H.L., Blumberg, E.A. Seafood and abdominal pain: a red herring? Hospital Practice 1990;25:120‑121.
- Paz, H.L., Wood, C.A. Pneumonia in the patient with chronic obstructive pulmonary disease: diagnosis and antibiotic treatment. Postgraduate Medicine 1991;90:77‑86.
- Paz, H.L., Crilley, P., Patchefsky, A., Schiffman, R.A., Brodsky, I. Bronchiolitis obliterans following autologous bone marrow transplantation. Chest 1992;101:775‑778.
- Paz, H.L., Little, B..J., Ball, W.C., Winkelstein, J.A. Primary pulmonary botryomycosis: a manifestation of chronic granulomatous disease. Chest 1992;101:1160‑1162.
- Johns, C.J., Paz, H.L., Kasper, E.K., Baughman, K. Myocardial sarcoidosis: course and management. Sarcoidosis 1992;9:31-236.
- Paz, H.L. Chronic Obstructive Pulmonary Disease (Book review). Postgraduate Medicine 1992;91:53.
- Paz, H.L., Crilley, P., Topolsky, D.L., Coll, W.X., Patchefsky, A., Brodsky, I. Bronchiolitis obliterans after bone marrow transplantation: the effect of preconditioning. Respiration 1993;60(2):109-114.
- Paz, H.L., Weinar, M., Crilley, P., Brodsky, I. Outcome of patients requiring medical ICU admission following bone marrow transplantation. Chest 1993;104(2):527-531.
- Paz, H.L, Cowen, J.S., Hansen-Flaschen, J. Cost controversies in chronic obstructive pulmonary disease: “A Patient With Respiratory Failure.” Hospital Physician 1993;29(12):16-26.
- Paz, H.L., McCormick, D.J., Kutalek, S.P., Patchefsky, A. The automated implantable cardiac defibrillator: prophylaxis in cardiac sarcoidosis. Chest 1994;106:1603-1607.
- Sherman, M.S., Paz, H.L. Respiratory failure in patients with amyotrophic lateral sclerosis. Respiration 1994;61:61-67.
- Fisher, C.J., Dhainaut, J.A., Opal, S.M., et. al. and the Phase III rhiL-1ra Sepsis Syndrome Study Group. Recombinant human interleukin-1 receptor antagonist in the treatment of patients with sepsis syndrome. JAMA 1994;271:1836-1843.
- Ravry, M.E., Paz, H.L. The impact of HIV testing on blood utilization in the intensive care unit in patients with gastrointestinal bleeding. Intensive Care Medicine 1995;21:933-936.
- Paz, H.L., Livingston, J. Using a benchmarking system to improve patient care and assist in technology assessment. Physician Executive: Journal of Management 1996;22(3):10-12.
- Paz, H.L., Weinar, M., Sherman, M.S. Motility agents for the placement of weighted and unweighted feeding tubes in critically ill patients. Intensive Care Medicine 1996;22:301-304.
- Knaus, W.A., Harrell, F.E., LaBrecque, J.F., Wagner, D.P., Pribble, J. P., Draper, E.A., Fisher, C.J., Soll, L., and the rhIL-1ra Phase III Sepsis Syndrome Study Group. Use of predicted risk of mortality to evaluate the efficacy of anticytokine therapy in sepsis. Critical Care Medicine 1996;24:46-56.
- Antonio, A., Baughman, R., Kalpalatha, et al, and the Exosurf Acute Respiratory Distress Syndrome Study Group. Aerosolized surfactantin adults with sepsis-induced acute respiratory distress syndrome. The New England Journal of Medicine 1996;334(22):1417-1421.
- Paz, H.L., Paradis, J., Zatz, S. A fellowship in quality management. Quality Management in Healthcare 1996;5(1):68-73.
- Garland, A., Paz, H.L. The clinical outcome of the bone marrow transplant recipients requiring intensive care. Seminars in Pulmonary and Critical Care Medicine 1996;17(5):359-363.
- Sherman, M.S., Kosinski, R., Paz, H.L., Campbell, D. Measuring cardiac output in critically ill patients: disagreement between thermodilution-, calculated-, expired gas-, and oxygen consumption-based methods. Cardiology 1997;88:19-25.
- Opal, S.M., Fisher, C.J., Dhainaut, J.F.A., et al and the Interleukin-1 Receptor Antagonist Sepsis Investigator Group. Confirmatory interleukin-1 receptor antagonist trial in severe sepsis: A phase III. randomized double-blind, placebo-controlled, multicenter trial. Critical Care Medicine 1997;25:1115-1123.
- American Thoracic Society, ATS Bioethics Tasks Force. Fair allocation of Intensive Care Unit Resources, American Journal of Respiratory and Critical Care Medicine, 1997;156:1282-1301.
- Arons, M.M., Bernard, G.R., Carmichael, L.C., Dupont, W.D., Edens, T.R., Higgins, S.B., Morris, P.E., Paz, H.L., Russell, J.A., Steinberg, K.P., Swindell, B.B., Wheeler, A.P., Wright, P.E. A trial of antioxidants n-acetylcysteine and procysteine in the acute respiratory distress syndrome. Chest 1997; 112:164-177.
- Garland, A., Paz, H.L. Improving Quality of Care in the ICU. Chapter 4. In: Hall, J, Schmidt, G., Wood, L. (eds), Principles of Critical Care. 2nd Edition, McGraw Hill, New York, 1997.
- Paz, H.L., Garland, A., Weinar, M., Neighbour, M.E., Walker, K.E., Crilley, P., Brodsky, I. Effect of clinical outcomes data on intensive care unit utilization by bone marrow transplant patients, Critical Care Medicine 1998;22:66-70.
- Gilbert, T.T., Halurkuride, V., Wagner, M., Paz, H.L., Garland, A. Use of bispectral electroencephalogram monitoring to assess neurologic status in unsedated, critically ill patients. Critical Care Medicine 2001; 29, 1996-2000.
- Dombrovskiy, V., Sunderram, J., Martin, A.A., Paz, H.L. Facing the challenge: Decreasing case fatality rates in severe sepsis despite increasing hospitalization. Critical Care Medicine 2005; 33, 2555-2562.
- Rice, T.W., Wheeler, A.P., Morris, P.E., Paz, H.L., Russel, J.A., Bernard, G. R., Safety and efficacy of anti-tumor necrosis factor alpha, ovine fab (CytoTAb®) in severe sepsis. Critical Care Medicine 2006; 34, 2272-2281.
- Dombrovskiy, V., Sunderram, J., Martin, A.A., Paz, H.L. Utilization of drotrecogin alfa (activated) for treatment of severe sepsis at acute care hospitals. American Journal Health-Systems Pharmacy. 2006; 63, 1151-1156.
- Paz, H.L., Martin, A.A., Sepsis in an aging population (Editorial). Critical Care Medicine 2006; 34, 234-235.
- Dombrovskiy, V., Sunderram, J., Martin, A.A., Paz, H.L. Occurrence and outcomes of sepsis: Influence of race. Critical Care Medicine 2007; 35, 763-768.
- Dombrovskiy, V., Sunderram, J., Martin, A.A., Paz, H.L. Rapid increase in hospitalization and mortality rates for severe sepsis in the United States: A trend analysis from 1993 to 2003. Critical Care Medicine 2007; 35, 1244-1250.
- Paz, H.L., Weaver, D., Willits, B., Young, S., Human Resources and Personnel Management. In: Inui, T., Frankel, R. (eds), Enhancing the Professional Culture and Accountability of Academic Health Science Centers. Radcliffe Press, Oxford, England, 2012.
- Marshall, J., Weaver, D., Splaine, K., Hefner, D., Kirch, D., Paz, H. L. Employee Health Benefit Redesign: Results of a Five Year Experience at Penn State University. Academic Medicine 2013; 88(3):328-334.
- Hwang, W., Chang, J., LaClair, M., Paz, H.L. Effects of Integrated Delivery System on Cost and Quality. American Journal of Managed Care 2013; 19:e175-e184.
- Hwang, W., Derek, J., LaClair, M., and Paz, H.L. Hospital Patient Safety Grades May Misrepresent Hospital Performance, Journal of Hospital Medicine, 2014;9:111–115.
- Hwang, W., Derk, J., LaClair, M., Paz, H.L. In response to “It’s Safety, Not the Score, that Needs Improvement.” Journal of Hospital Medicine, 2014;9(4):275.
- Dillon, P.W., Paz, H.L. Reframing Surgical Care: A New Academic Health Center Responsibility (In press: JAMA Surgery).
This list includes only peer-reviewed papers. Abstracts, chapters, commentaries, etc. are not listed.