Q.When Hawaii Medical Center took over the former St. Francis hospitals they were losing money. What's the status of the debt?

A. We assumed the debt of St. Francis Medical Center-Liliha and -West when we took over both hospitals. I cannot give a specific deadline or timetable for paying down that debt. Our lenders are aware that a financial turnaround for both hospitals is going to take time. We are already seeing some positive indicators that we are making progress. The overall activity at HMC West has increased. Our ER is very busy. The number of surgeries performed at West has doubled. This tells us more patients are choosing to come to HMC West. More physicians are choosing to send their patients to HMC West.

Q. How was Hawaii Medical Center selected to take over St. Francis?

A. Compassionate and quality healthcare in Hawai'i was a mission begun by the Sisters of St. Francis from the day they arrived in Kalaupapa, Moloka'i, to help Father Damien and the residents with Hansen's disease. They could have chosen other potential buyers to take over St. Francis Medical Center-Liliha and -West. By choosing HMC to take over, the Sisters have entrusted us with their legacy. Therefore, we physicians at HMC have a responsibility to make both hospitals successful. We are determined to do just that.

Q. When the hospitals switched hands there were some labor issues. Have those been resolved?

A. We're still in discussion with the unions in regards to that issue. I myself have not been involved with those negotiations so I couldn't give you a time frame (for when those issues will be resolved).

Q. The new ownership said it would do $32 million in improvements. Is that still the goal?

A. Yes. We're still looking to improve the physical plant and also improve our equipment. We expect to have a new MRI and new CT scan by the end of the year and having our IT coordinated with our scanning capabilities.

Q. How did you go from being a medical doctor to an administrator?

A. When I finished my residency at Dartmouth in New Hampshire and I came back in an administrative position with the University of Hawai'i as a chief medical resident, that was the beginning. After doing a year as a chief resident I joined St. Francis as a hospitalist, so I've been associated with St. Francis since I was a medical student and coming back as chief resident. When the prospect first came up of buying the hospital, I looked into it and I did become one of the investors ... Because of my involvement with the former St. Francis Medical Center, Dr. Danelo Canete, HMC CEO, appointed me the chief medical officer at HMC West.

Q. Were there issues that came up during the transition that surprised you?

A. As a practicing physician, I didn't know everything there was to know about the administrative side of the hospital. Certainly I didn't know of some of the problems that the hospital was facing, so now as an administrator my eyes were open and as an owner we have to fix it. But I think as a physician and an administrator, I'm able to bring my role as a clinician into the role as an administrator in solving some of these problems. Some of the problems that needed to be addressed were in terms of efficiency. For example, some of our physicians were saying they weren't getting their X-ray reports on time, so we needed to see how we could become more efficient in turning over some of those reports and that needed to have a coordination between our computer systems people, our IT people, our radiologists, the way we schedule appointments. It was a multi-factorial. The main thing was to regain a physician confidence in the hospital and the way we do things. That was the first objective.

Q. Does it help that you've been a physician at St. Francis for a while?

A. It helps in that we can talk to our fellow physicians one on one. It helps in that we've increased the confidence of our staff members that they know that we physicians are communicating with one another on that level and we're trying to fix things on that level. The staff knows that as a practicing physician they see us in the hospital, we're on the floors every day taking care of our patients, and they know that they can come up to us at any time and tell us, "Dr. Ley, we noticed this going on — can you look into it?" At the same time we've encouraged our nonphysician administrators, such as our director of nursing, to be visible as well so our floor workers can approach them and tell them about problems, rather than for it to wait going through the usual hierarchy.

Q. Where would you like to be in five years?

A. We expect that with this physician ownership that we can turn the hospitals around. It would be for the benefit of the O'ahu population to have both hospitals. In five years I'd like to be giving an interview to CNN about how a bunch of doctors in Hawai'i turned around two failing hospitals. Physician hospitals on the Mainland are primarily specialty hospitals, specializing in orthopedic surgery or cardio-vascular surgery, so it is rare to have physician-owned general practice hospitals. With the history of St. Francis and both hospitals having had financial challenges, going into this we've had to start off on a negative balance. But it's been about seven months and we're already starting to see some positive things turn around.

Reach Curtis Lum at culum@honoluluadvertiser.com.