Charting new directions.

James Barber, new president of Center of Health Resources, plans to broaden constituency of advocacy group solely for hospitals

It was not difficult to guess it was James D. Barber's first day as president of the Center of Health Resources, the primary trade association for Southern California hospitals.

He had looked down at his desk to find his business cards and nearly as quickly looked back up.

"I don't have any yet," Barber admitted to a visitor who had asked for one.

Barber also hadn't yet gotten a chance to hang up the pictures of boats -- sailing is a particular passion of his -- that would line his office. They leaned against the walls at floor level of his corner office, which is dominated by built-in wood cabinets and bookcases.

Barber's office also offers a dramatic view of traffic zooming along the Harbor Freeway, which seems somewhat analogous to the way his career is zooming along as he negotiates a tricky lane change.

Barber is navigating the 500-employee trade, lobbying, management consulting and medical equipment refurbishment entity for 250 of the region's hospitals through some fairly radical changes, shifting it from an advocate solely for hospitals to one for medical groups and integrated health systems as well.

Yet the Center of Health Resources, of which the Hospital Council of Southern California is a subsidiary, is not exactly emblematic of change -- at least not in the leadership department.

Including Barber, COHR has had only four presidents in its 71-year history. But it has grown dramatically since the early 1960s, from just three employees to about 500 today, and has become a powerful rallying force in shaping regional health care policy.

Barber, who served as the council's executive vice president for five years prior to assuming the top post, has spent his entire career in health care and hospital administration. At 40, he has already compiled a lengthy track record, including three years as administrator of Daniel Freeman Hospital in Inglewood before joining COHR. Prior to that, Barber served for three years as an executive vice president at Queen of the Valley Hospital in West Covina, and for four years as assistant administrator at Community Memorial Hospital in Ventura.

Although he just turned 40, Barber intends to serve a tenure as long as those of his predecessors and see his vision become a reality.

Health care has always been a part of Barber's life. His father, Donald Barber, practiced dentistry in Glendale for nearly 50 years before retiring in the early 1980s. His brother, Donald Barber Jr., is a USC medical school graduate who now practices medicine in Glendale.

When Barber began to ponder career options in the 1970s, while finishing up his college education, health care seemed to be the logical choice.

"It was a field at the time that was growing, and it seemed that people were looking for more creativity in management and the administration of hospitals and health systems," he said. "The people I met in the field were educated, articulate and intelligent -- folks who had a service orientation about them I thought was appealing at the time. It combined a lot of good things: community service as well as straight business aspects that fit with my personality and outlook on life."

Rather than enter the field as a hands-on patient care provider, Barber opted for management because "managing an operation was more appealing than the clinical side of medicine or dentistry, and my aptitude was more on the administrative side of things."

In his new job, Barber's energies are focused toward long-term strategic management. There are no pressing financial problems at COHR: annual dues from its member facilities total about $4 million a year.

A for-profit subsidiary, COHR Inc., of which Barber is chairman, has about a $2 million annual operating profit on revenues of about $25 million. The for-profit subsidiary's business comes primarily from refurbishing and maintaining hospital equipment. It also purchases equipment for hospitals and provides management consulting services.

"We're at the top of our game right now in terms of membership, solid dues revenue streams, and in terms of the diversified group of business services we provide," Barber says.

Yet he is working 10- to 12-hour days, practically abandoning his chances for sailing, skiing and mountain biking, to reshape COHR for the future.

"So the point is: Why change if we're doing well and have a lot of support?" he asked. "This is what we see: The future of health care delivery and financing is going to be integrated, (hospitals and doctors) are going to align much more, and there will be much more of a seamless delivery system."

Integrated systems, often touted for their efficiencies and elimination of duplications, fall into line with Barber's fiscally conservative management style. A 1992 article he wrote for Hospitals magazine may best sum up his vision. In the article, he criticized what he sees as rampant consumerism in health care: "Americans seem to be enthralled with the expensive and bored with the economical," he wrote.

As for the council itself, its board of directors voted a couple of weeks before Barber assumed his post on Aug. 1 for an organizational makeover, which has become Barber's task to draft into a business plan. The council's 250 members began voting on the plan last month. While votes from the region's hospitals are still coming in, the tally to date has been overwhelmingly in favor of reorganizing.

"It's going to be an ongoing job, difficult to implement, and will take a long time, a matter of years," Barber said.

The key change will be in the composition of the council. Instead of representing just hospitals, it is going to begin accepting medical groups as members. Barber is proposing that these medical groups, comprised of several doctors practicing as one business entity, be put into a "physician organization section" of the council.

The council's board of directors has also decided to begin allowing integrated health systems into the council. These systems are a combinations of hospitals and medical groups.

As for Barber's tenure, he sees two key issues which must be addressed by the council: managed care integration -- including the antitrust implications of ever-larger health care systems being formed -- and health care reform on both federal or state levels.

"I guess the best way to describe my duties is that I'm a futurist," Barber said.

Snapshot

James D. Barber

Native of: Glendale Resident of: La Canada Age: 40 Education: B.A. in psychology, University of Southern California, 1976; Master's of Public Health, University of California at Los Angeles, 1979 Spouse: Andrea