Becoming a Modern Hospital Financial Leader: Q&A With Methodist Dallas Medical Center VP of Finance Sarah Choi

For the past 15 years, Sarah Choi has worked at Methodist Dallas Medical Center, the 515-bed flagship hospital of Dallas-based Methodist Health System and currently serves as vice president of finance, or the hospital's CFO. But Ms. Choi has taken a more unique route to get where she is today.

Ms. Choi was born and raised in Hong Kong for the first 19 years of her life. Hong Kong at that time was still a British colony, eventually becoming a special region of China in 1997. She decided to move to the United States, pursuing a college education at the University of Texas at Austin. Ms. Choi admits it was a "little bit of a culture shock" when she first arrived to the United States, but her sister, aunt and other nearby relatives in the States made the transition easier.

Ms. Choi, 39, landed her first position at Methodist Dallas upon graduation — initially as a staff accountant and then as a financial analyst before reaching her current position — and she hasn't looked back since. Today, she oversees the finances of the hospital, which has more than 2,800 employees and provided more than $125 million in uncompensated care in fiscal year 2011. Ms. Choi is also part of a progressive, all-female senior executive team.

Here, Ms. Choi explains what her current role at Methodist Dallas is like, why she makes patient rounding a priority and why hospital finance leaders must break out of their stereotypes.

Sarah Choi is the vice president of finance at Methodist Dallas Medical Center.Question: Who has influenced your career choice to enter the healthcare and finance fields?

Sarah Choi:
My dad has been my biggest influence. He's a business entrepreneur, and he taught me finance and reinforced the importance of managing finances from an early age. He is officially retired now from his business, but he says he is never really off work. My brother has been handling the business in Hong Kong, but my dad is still actively involved.

Q: How would you describe the current fiscal position of Methodist Dallas?

SC:
From a financial perspective, the whole Methodist Health System has a really strong balance sheet and operating liquidity. Our operating margin, cash on hand, expense per discharges are all strong — we do really well on all these measures. Methodist is also rated "AA-" by S&P, and this is a great representation of our fiscal position. We have a lot of competitors in Dallas-Fort Worth, but we are still able to maintain a positive margin.

Q: What is a typical day like right now for Sarah Choi as the top finance executive of Methodist Dallas Medical Center?

SC:
We are going through the budget season right now. I do a lot of work analyzing our reports and looking at financial growth. We spend two months on the budget to look at our current performance and how we should approach it for next year. I work closely in collaboration with our CNO, COO and president.

Q: I understand that you visit patients regularly. How often? What do you hope to get out of those patient visits? And do you believe patient interaction helps break a CFO stereotype that finance execs are reclusive?

SC:
My goal is to round on patients once a week and also participate in community outreach. This outreach has given me the opportunity to listen to patients who can help us identify strengths to build on and identify areas where we can improve. We do provide great patient care here, and I'm proud of it. I want our patients to always feel comfortable.

When I do rounding, it helps me to experience what is going on with our staff so I have a better understanding of employees' perspectives, especially the nurses who care for our patients each day. There are many capital requests, and making the right decisions on what's really important and impact the quality takes priority. Talking to frontline staff helps me understand the critical issues and identify the priorities.

Rounding helps my personal growth. Like you said, finance is stereotypically crunching numbers, but I need to get out of the Excel spreadsheet and visit the floors. Rounding connects me to patient care and helps me understand the human side of healthcare.

Q: As you said, you're also involved with community outreach. You've participated in a breast cancer awareness video and other hospital-based campaigns. Outside of finances, what issues are most important to you in healthcare?

SC:
That breast cancer awareness video was fun and helped promote our breast cancer program. Our hospital is very active in the community supporting a variety of health causes, including the March of Dimes, Health Walk, transplant awareness, American Cancer Society, as well as community events like Earth Day. I try and participate in these programs because it shows our community that we are committed.

When I'm out in the community, it again helps me to better understand what we should be doing for our patients. It allows me to connect to others. It is important to maintain a viable financial position for the hospital, but it is important that we serve the community.

Q: What do hospital CFOs need to do today to be "modern"?

SC:
CFOs need to think and plan strategically. There are many changes with healthcare reform and value-based purchasing, so they need to be able to stay current with all issues impacting the way we provide care. [CFOs] also need to focus on developing good relationships with physicians. Physicians are the main player in healthcare, and we want to make sure we understand their needs. The last thing: Finance and operations don't always work well together, but you need to work with them and collaborate with operations. A really strong, working relationship with them is important for the team. I'm pleased to be working with a collaborative team at Methodist Dallas.

Q: What looming issues in healthcare give you the most cause for concern? What issues give you hope?

SC:
The issues here are the same as in other hospitals: increased operating costs but lower reimbursement. They don't equate, in our financial perspective, and the reimbursement reduction not only affects hospitals but also physicians. Now physicians are exploring more formal relationships with hospitals, which open up more opportunities and challenges.

Physicians, by nature, are entrepreneurs, so it can be really challenging. We need to collaborate and focus on how we can improve quality, patient care and patient experience — and lower costs. We are working on this through our ACO and clinical integration.

More Articles on Hospital CFO Issues:

Establishing a Firm Financial Footing: Q&A With Swedish Health Services CFO Dan Harris
Creating Regional Health Networks: Q&A With LifePoint Hospitals CFO Jeff Sherman
The Rigors of Today's Healthcare Finances: Q&A With Hendrick Health System CFO Stephen Kimmel

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