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Barbara Cook
The President of Johns Hopkins Community Physicians reflects on the organization and some of the experiences that shaped her.



In 2000, when Barbara Cook joined Johns Hopkins Community Physicians as vice president for medical affairs, she faced an internal primary care system urgently in need of transformation. Since then, the engaging, high-energy physician has helped develop the organization into a system serving more than 100,000 patients in 18 locations throughout the state. She will retire from the post of president of JHCP in January.

As a doctor with the National Health Service Corps in the 1980s, you served as director of the outpatient clinic at a small hospital in Welch, W. Va. What did you learn from that job?

You couldn’t have practiced in a more challenging place. I worked with two other women right out of residency in a place called Miners Number One Hospital. We were determined to practice the kind of medicine we learned in our residencies in a place that had never had it.

For instance, we were required to deliver babies, but there was no operating room. The closest OR for an obstetrical emergency was an hour away, over three mountains. After our second obstetrical emergency, we marched into the state department of health and demanded proper resources. So they shut it down for six months, until we had a 24/7 operating room and a surgeon.

We took on the powers that be to provide quality care to those patients. It showed me early on what people committed to doing the right thing could accomplish if they stuck together.

During the past eight years, you have helped transform JHCP by consolidating practices, reallocating resources and setting productivity standards for clinicians. What’s the current state of the organization?

It’s in a good place. We now have the electronic medical record to help make health care delivery more efficient and safe. No matter where you are, you can plug into the system to find out what’s going on with a patient. Patient satisfaction is increasing. We’re also in good shape financially: We’re exceeding budget for the fourth year in a row.

Looking ahead, what is the biggest challenge JHCP faces?

Job number one is going to be dealing with the shortage of primary care physicians. First, their compensation must increase. Primary care physicians do a remarkable job listening to a patient’s story, coming up with a differential diagnosis and getting that patient proper care. Yet that’s not what is highly compensated in our society. Procedure-oriented medicine still rules the day in terms of reimbursement.

What do you consider one of your finest accomplishments as president?

Watching individuals make a difference in their jobs and expand their spheres of influence. Although all practices have to follow certain Hopkins systems and policies, we have given each one a certain amount of autonomy. The practice in Frederick, for instance, has fostered an environment where the entire staff knows it is respected and valued. The patient and employee satisfaction scores at that practice are now close to 100 percent.

Has the role of president changed your perspective as a physician?

Doctors love to believe that a situation is black and white: “You’ve got chest pains and shortness of breath going up stairs?  You’ve got angina.” We like to make those diagnoses. In management, it’s all gray. And you have to figure out just where in that gray you’re going to land and take a stand.

As president of JHCP, you have continued to see patients. Can you compare the two roles?

As a doctor, I’m concerned with diagnosing and treating patients and working with them to maintain their health. When I’m seeing them, I don’t worry about money, I don’tworry about insurance. I just take care of those patients in the best way I can.
 As president of an organization, I have to worry about the bottom line and also general morale. I worry about how to inspire people, to encourage them to give their best and to believe in the mission as passionately as I do.   

— Linell Smith



Johns Hopkins Medicine

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