An Adventurous New COO Takes the Reins at UHealth
Thomas Allan McGrath, M.B.A., sits in his office sporting a necktie with a jaunty DNA double helix. It spirals down from the knot at his throat, gradually unwinding as the tie widens, until it splits into two separate strands near the bottom. It’s a fashion statement, to be sure, but it’s also thematically appropriate for the new Chief Operating Officer of UHealth.
On the molecular level, the double-helix structure serves to protect the nucleotides inside that make us who we are, and it only splits when that information is being passed on. In McGrath’s case, the parallel spirals represent the dual tracks of his career — the adventurous philosophy major who did stints as a cowboy, a bicycle courier and a follower of the Grateful Dead, and the analytical M.B.A. who has empowered teams at prior healthcare institutions to improve their performance and build the bottom line. Now he is in Miami, hoping to unravel that experiential DNA in ways that will propel UHealth to the next stage in its growth.
McGrath comes to UHealth from Stanford University’s Department of Medicine, where he spent four years as Director of Finance and Administration. The department is Stanford’s largest, with 14 divisions, a $250 million annual budget, 300 faculty and 600 staff members. His accomplishments included achieving clinical operating margins of 26 percent, compared to a school-wide average of 16 percent, and doubling the size of invested reserves.
His prior healthcare leadership experience included 15 years in a variety of roles at the University of Chicago, culminating in the position of Vice President at Comer Children’s Hospital. There he guided the operations of 1,200 team members, using financial and operational restructuring to turn a $2 million loss into a $6 million surplus within 18 months.
“I’m a believer in the power of transparency and promoting an environment of candor,” said McGrath. “The more data we share, the more we know about ourselves — both our strengths and our opportunities for improvement. Here in Miami, we’re currently operating on razor-thin margins. In order to continue our reinvestment in the tripartite missions of research, teaching and patient care, we need to create systems of accountability and incentives so we can regularly and predictably earn margins in the 3 percent to 5 percent range.
“We also need to focus on patient access, the patient experience and patient outcomes,” he said. “Simply put, we need patients to be seen quickly, love their experience and leave with outstanding results.”
That kind of thinking was nowhere on McGrath’s radar screen when the native of Joliet, Ill. (“City of Champions,” he reminded us), headed downstate to the University of Illinois at Urbana-Champaign after spending a summer doing construction work for his uncles. Halfway through his undergraduate studies, he enrolled in an accelerated dual-degree program that would enable him to earn a B.A. in philosophy and an M.B.A. in finance in five years.
“I knew I couldn’t earn a living with a philosophy degree,” said McGrath. “My advisor told me that with an M.B.A. in finance I could work anywhere — for a bank, a corporation, a non-profit or the government.”
McGrath initially took the government route, but the job he pursued was a position as a ranger with the U.S. Forest Service in Juneau, Alaska. He spent six months there working with a scientist from the University of Illinois on research studies, such as whether birds or bears were better seed-dispersal agents (the bears won).
“Frankly, I wanted to put off deciding what to do with my life for as long as possible,” he said.
McGrath left Alaska to join a friend who was following the Grateful Dead tour around America. The duo traveled with the band from campus to campus and city to city. They also managed to turn career-avoidance into a profitable business, selling beer and ponchos to the mobile community of thirsty and legendarily loyal Deadheads, who showed up rain or shine. It made McGrath an entrepreneur, and it was his first opportunity to put his business education to work.
“The Dead tour was the last free market in America,” he said. “You were responsible for procuring your goods, pricing your goods, selling your goods, and deciding when to raise or cut your prices. That gave me nine months of really raw business experience.”
By the time the tour reached Montana, however, McGrath’s van was also dead. That’s when his next adventure presented itself. A local cattle ranch was hiring, and McGrath had been riding horses since he was a small child. He quit the tour and signed on to be a cowboy.
“We worked in a very remote area where we only received mail twice a week,” he said. “Most modern ranching is done in pickup trucks and four-wheelers, but there were days when I spent 12 hours in the saddle rounding up cattle the old-fashioned way.”
Nine months later, McGrath left Montana for Chicago, trading his horse for a two-wheeler to explore another dream job — bicycle courier. He likened the experience to being a professional athlete.
“I loved the job,” he said. “The faster I rode, the more I got paid, and it was less dangerous than you might think. I never got broadsided by a car, but I got squeezed between a bus and a bridge a couple of times.”
It did, however, keep him outside in the Windy City’s weather. One cold, rainy day, a friend told him about an opportunity at the University of Chicago.
“I thought it might be nice to work indoors again and spend the next six months being a university guy,” said McGrath. He didn’t know then that his series of short-term adventures was finally about to end, and that he would spend a decade and a half at the university.
McGrath began as a grant administrator for five divisions in the Department of Medicine, which was followed by roles as Division Manager in the Division of Hematology/Oncology ($13 million budget, 30 faculty, 200 staff), Chief Operating Officer of Weiss Memorial Hospital (a 236-bed community hospital that was sold), Executive Administrator of the Department of Medicine ($130million budget, 200 faculty, 250 trainees, 900 staff) and finally Vice President of Comer Children’s Hospital.
But there was still an item McGrath had not crossed off his bucket list — building a “green” house. He left the university, bought an aging two-story home on Chicago’s North Honore Street and launched Elemental Building, a development company devoted to environmentally friendly construction. Two years later, having done much of the demolition and construction work himself, McGrath owned the first certified LEED Platinum single-family home for sale in the city. The project won awards and was featured as a tour site by the U.S. Green Building Council.
“In the process, though, I learned that I missed the excitement of working at a big academic medical center,” said McGrath. “The University of Chicago asked me to come back, and I also had an offer from Virginia Commonwealth University. Then I got the call from Stanford. It was an opportunity to go back to my old role — department administrator — in a new place.”
Once there, McGrath made many changes. He created efficiencies by decentralizing decision making and centralizing processing, using LEAN principles to simplify both functions. He negotiated new support agreements with Stanford hospitals and clinics in key programs, such as cancer, primary care, cardiology and gastroenterology. And he reshaped senior leadership, helping to recruit a new chair, seven division chiefs, six vice chairs, and nine new managers of division-based and core function units.
Four years later, the winds of change have once again carried him to a new place — this time Miami — and he is enjoying the fresh start. He and his partner, Valerie Jenkins, a biotech marketer, are fans of mid-century modern architecture, and they have bought a Russell Pancoast-designed house in the Bayside neighborhood of Miami’s Upper East Side, where they will live with their 10-month-old son, Oliver. Unfortunately, Bailey, McGrath’s Western Pleasure quarter horse, has to remain behind in the drier climate of Palo Alto.
McGrath explained what attracted him to UHealth:
“When you are going through a multi-day interview process, you can get pretty worn out,” he said, “but here, as the days went longer and I had meeting after meeting, I continued to get more energized. There was such commitment and energy in the people I met that I couldn’t help but be infected by it. I feel like this is the kind of a place where I could do my best work.”
The philosopher-explorer in him then offered another take:
“We are all going to die someday, and all that matters is what we do between now and then. Many of my experiences early on were great adventures, but so is the opportunity at UHealth to create the next great American health system. It’s one that we will all be able to look back on and say, ‘We were there when.’”