Richard Rodriguez and the business of caring: Richard Rodriguez, FHFMA, brings experience with finance and operations, along with Texas-bred wisdom, to his HFMA chairmanship

Healthcare Financial Management, June, 2005

"Within its borders I have seen just about as many kinds of country, contour, climate, and conformation as there are in the world saving only the Arctic, and a good north wind can even bring the icy breath down."--John Steinbeck, Travels with Charley

The open spaces of Texas are legendary. The stark horizon and broad sky show a person the grandeur of nature ... and at times the vulnerability of people. For HFMA's new Chairman, Richard Rodriguez, health care is intertwined with the landscape and the people of Texas.

The Roads of Texas

Rodriguez didn't begin his professional life with health care in mind. After graduating from St. Mary's University in San Antonio with an undergraduate degree in accounting, he wanted to go into the oil and gas business.

Rodriguez recalls. "By the mid 1970s the oil and gas industry was the place to work, and I was looking for a job."

However, he saw a posting for an auditor position with Blue Cross and Blue Shield of Texas and decided to investigate. At the interview, he was told, "We have an opening in Lubbock. But no one seems to want to go to Lubbock."

To which Rodriguez replied, "I'll go; I need a job." So Rodriguez went to Lubbock and worked as a Medicare auditor for hospitals and home health agencies. "We were on the road all the time," Rodriguez says, "from Lubbock up to the Texas-Oklahoma border, east to Wichita Falls, south to Abilene, and west to El Paso. We stayed in touch using CB radios. That was my introduction to health care."

Eventually, Rodriguez tired of the road. So when Rodriguez's friend Ferd Gaenzel, who had left Blue Cross' San Antonio office for University Health System, called to ask whether Rodriguez was "ready to come back home," he answered, "You bet."

Rodriguez was offered a job as reimbursement manager for University Health System in San Antonio. And he's been there ever since. "I'm an anomaly," Rodriguez says. "I've been there 25 years. I was reimbursement manager, budget director, treasury manager, and controller. I was even CFO. But always with the same employer."

A New Opportunity

Although Rodriguez's career in finance at University Health System had been as varied as might seem possible, several years ago, University Health System's CEO approached Rodriguez with an unexpected opportunity: moving from finance to operations. Knowing the sound of opportunity knocking, Rodrigaez said, "Yes."

He became assistant administrator of University Health System, responsible for "a hodgepodge of areas," including support services such as plant engineering, food service, and housekeeping, as well as clinical areas, including inpatient and outpatient dialysis units, vascular lab, and endoscopy. He is also involved with San Antonio AirLife, a joint venture between Baptist Health System and University Health System, which is one of the first civilian rotor-wing air ambulance services to provide emergency services to south Texas.

The Business of Caring

Rodriguez's work in operations has brought with it a new appreciation for the relationship between business and caring. "You get to know the inner workings of a hospital you don't see on the finance side," he says, "including what goes into keeping a hospital clean, keeping it at the right temperature, and keeping patients fed." He works closely with physicians and nurses. And he is better acquainted with the face of the patient.

"On the finance side, I always seemed to be dealing with financial statements, spreadsheets, and budgets; I never seemed to see the human side of health care. Now I see the face of the patient. I've been in situations where a patient is telling me he can't afford to buy his medications. And the dialysis patients are going through cycles of emotion as part of that disease process. You get close to some of those patients."

This experience has convinced Rodriguez of the need for those in healthcare finance to have a better appreciation of how care is provided and for those who provide care to become better acquainted with health care as a business.

"You can't escape the fact that health care is a business, and we have to manage it as a business. But we also have to understand who we serve. Patients are much more than just customers. And we have to understand what they are facing and take care of them."

Rodriguez's passion for building bridges between business and caring may have been fueled by his move into hospital operations, but it has been with him for many years--in fact, long before he was a healthcare professional.

"San Antonio has a lot of poverty in some of its neighborhoods. And when I was in college, one of my fraternity brothers was from one of those neighborhoods. He and his family had been very economically deprived. Once, this friend of mine told me a story. It's a long story, but the basic facts are simple. My friend's brother had been sick, very sick. But his family was too poor to send him to a doctor. And my friend's brother died. If he had been able to afford health care, he could still be alive. That story has stayed with me. That situation was just not right."