For Raymond Moreno, MD, his new role represents a full-circle moment.
“The office that I’m sitting in right now is directly above the place where I did my first shift 20 years ago as an ER doc,” he told Becker’s during a recent conversation.
Dr. Moreno has served as chief executive of Providence St. Vincent Medical Center in Portland and Providence Oregon’s west service area since Jan. 27. He is the first physician to lead St. Vincent, though he is not new to the organization.
As a first-generation Cuban American, Dr. Moreno’s first encounters with the healthcare system were serving as an interpreter for his parents, mostly his mother, at medical appointments.
“Spanish is my first language, and those are some of my very first interactions with the healthcare system,” he said. “I grew up in Newark, N.J., in a Spanish-speaking household, went to college and did a lot of things, like a lot of first-generation college folks. School was hard. I worked quite a bit, and one of those jobs I did was working on an ambulance [as an emergency medical technician], and once I started taking care of patients, that was the thing for me.”
Dr. Moreno eventually attended medical school at Brown University in Providence, R.I. Given his EMT experience, that led him to become an emergency medicine physician. He did his training at the University of Cincinnati and then moved to Oregon for a faculty job at Portland-based Oregon Health and Science University.
“I did that for several years and was very happy [at OHSU]. But as I was working there, people would talk about Providence, and they’d talk about St. Vincent, and they’d talk about it in glowing terms,” he said. “The residents would do rotations here, and they’d come back bragging about what a fantastic place it was to work. And then I got a phone call, and the phone call was to join the group of emergency physicians here [at St. Vincent]. That was 20 years ago, and it’s the best professional position of my life.”
During his 20-year tenure, Dr. Moreno previously served as chief medical officer at St. Vincent. He also has held roles as the emergency department’s medical director and within the Oregon Emergency Physician group as its president.
He began his new role as St. Vincent nears completion of its expanded emergency department. In the role, he leads St. Vincent and oversees Providence Oregon’s North Coast ministries, including Providence Seaside Hospital.
Dr. Moreno said he is particularly excited by the ability to affect multiple patients and an entire community, compared to taking care of one patient at a time as he did earlier in his career.
“When you look at clinicians who moved into leadership roles, a lot of it is informed by, ‘I’m doing my work every day and I’m willing to raise my hand and try to work on making some of the processes and some of the situations better,'” he said. “That’s how it starts. And then you get encouraged, and then you keep raising your hand, working on problems. So now this ability to work on issues that are personally very meaningful to me at scale, in a place that I’m really proud to have been affiliated with, essentially my professional home for 20 years, is this very unique opportunity and privilege for me right now.”
Like many healthcare leaders, he is focused on areas including capacity, access, workforce and finance. Ultimately, he said he wants to create an environment where healthcare professionals feel valued, good about being at work, and have the support they need to provide high-quality care.
“When you look at St. Vincent, we are both a tertiary and quaternary place to provide care. We do heart transplants here, but we’re also the community hospital for the west side of Portland,” Dr. Moreno said. “We are the busiest emergency department, for example, here in the Portland metro area.”
He said this ultimately means “you can serve whoever comes in with what they need, and you can really double down on things that you’ve developed extra expertise on, and continue to push the envelope with that care.”
He acknowledged the challenges in today’s healthcare environment to sustain such care due to rising costs and expenses that are outpacing revenue. Despite those and other workforce challenges, including a 46-day strike at Providence Oregon facilities that ended in February, he is optimistic.
“This has been my professional home, so I have a lot of relationships in this building, and I care about this place, as do the people who work here,” Dr. Moreno said. “They care about the place, and they care about the patients. We’re aligning and working together with that. But to not acknowledge that [a strike is] difficult is disingenuous. It really is. But despite that, I feel hopeful. People don’t raise their hands for these jobs unless they have some fundamental hope that they can contribute and continue to make things better. At least, I hope they feel that way, because otherwise, it’s a pretty hard job to not have that optimism or that hope for what’s next.”