Perspectives on Healthcare - Spring 2011

March 1, 2011 Rod Hochman, MD

Whenever I talk to people about Swedish, they are often surprised to learn we’re a nonprofit organization. Many people, even those who’ve lived here all their lives, just assume Swedish is a for-profit healthcare system. But the truth is Swedish was founded as a nonprofit institution 101 years ago, and we have remained true to those roots ever since.

The Puget Sound region is fortunate that most of the hospitals in our local area are either private nonprofits like Swedish, state or county hospitals like Harborview or public- district hospitals like Evergreen. The for-profits have not yet made significant inroads into our local community.

That’s not the case in other parts of the country. Of the 5,000 hospitals in the United States, about 18 percent, or 889 hospitals, are for-profit. And that number is growing. Most of these investor-owned hospitals are located in the South and Rocky Mountain region. Here in Washington, only six of the state’s 95 hospitals are for-profit.

The issue of nonprofit vs. for-profit is one I am very passionate about. I’m a big proponent for nonprofit health care and believe it plays a vital role in the fabric of society. That’s why I decided to focus this issue of Perspectives on what nonprofit health-care providers do for the community. I also wanted to use this as an opportunity to talk specifically about Swedish’s nonprofit mission and share some of the innovative new ways we are working to address the community’s health needs.

For-Profit vs. Nonprofit

What’s the difference between for-profit and nonprofit hospitals? One of the main differences is that for-profits are accountable to shareholders. Nonprofits are accountable to the community.

As a nonprofit, Swedish is not governed by investors. Our Board of Trustees is made up of volunteers from the community who work to make sure we’re: 1) meeting the health-care needs of the region; 2) delivering high-quality health care; and 3) managing our resources responsibly. Our board members take their role of preserving Swedish as a community asset very seriously and are focused on ensuring that Swedish is available as a resource for those in need for many years to come. In other words, they see to it that Swedish serves the interest of the public, not that of private investors. And it is worth noting that many members of our Board have made their own significant philanthropic investment in Swedish and thus our community’s health.

Nonprofit hospitals are tax-exempt organizations. We maintain this status by providing a number of services that benefit the community – charity care for the uninsured being one of the most vital. Tax-exempt hospitals in Washington state fill this critical need by providing a combined total of nearly $280 million in charity care per year. Washington hospitals also provide an additional $514 million in other services that benefit the community, including Medicaid subsidies, health-education programs, health-screening programs, support groups, medical education and clinical research.

Not being a public-district or government-owned hospital, Swedish does not raise revenue through tax levies. Instead we rely on the generous support of our community to help us invest in the health of our region. That support helps us to actively do our part to meet community needs and continuously look for ways to do even more.

In 2010, Swedish provided $112 million in services for the community, including:

  • $25 million in charity care
  • $67 million in Medicaid subsides
  • $20 million in health education, screenings, clinical research and other community benefits

Innovative Ways Swedish Is Serving the Community

Like other hospitals, Swedish provides many traditional community-outreach services. For instance, for years we’ve operated an active mobile mammography program that brings needed breast-cancer screenings to rural and underserved areas. This program travels to remote destinations, such as Native-American reservations, as well as busy worksites to serve women who might not otherwise have access – or time – to have this important screening done. This important service is greatly supported by individual donors, as well as corporate sponsors like PACCAR.

Another traditional community service we offer is WIC (Women, Infants and Children), a federal nutrition program for low-income mothers and babies. While other local hospitals have closed their WIC programs due to budget cuts, Swedish remains committed to making this service available to moms who can’t afford proper nutrition during pregnancy and after childbirth.

In addition to traditional programs like the ones mentioned above, the team at Swedish is also thinking outside the box to address some of the community’s toughest health issues. Here’s an overview of some of the creative approaches and partnerships we’re piloting.

  • Global to Local – With Seattle being the world headquarters for many leading global-health organizations, we have joined forces with these experts and other organizations to see if we can use global-health techniques to improve the health of impoverished communities in our own backyard. Through a unique partnership with the Washington Global Health Alliance, Public Health – Seattle & King County and Health Point Community Health Center, we are working together to improve the health of residents of the SeaTac-Tukwila area.
  • Free Specialty-Care Clinic – Lack of access to specialty care for the uninsured is an issue the community has struggled with for years. To address this important need, we’ve doubled the size of our Community Specialty Clinic on our First Hill campus. We also partner with King County Access to identify people in need of specialty care and empower them to play an active role in the recovery process, such as following discharge instructions, keeping follow-up appointments and taking medications as prescribed. The clinic also depends on the expertise of physicians, physical therapists and other clinical staff who volunteer their time to serve these patients. Without their volunteer commitment, this clinic would not be possible.
  • Dental Residency and Health Justice Program – We are also working to meet the ancillary needs of our patients. Access to dental health, for instance, is a major issue in our community. Many of our patients are unable to move forward with needed surgeries because they have infections in their mouth that must be taken care of before undergoing an operation. Through a partnership with Seattle Special Care Dentistry, dental residents are now able to help our patients get the dental work they need.

    In addition to health issues, low-income patients in community clinics often face a number of social justice and legal issues. Through a partnership with Seattle University Law School, we are able to connect patients in need with law students and faculty who can provide pro bono services to help them understand their rights and navigate the legal system.
  • Northwest African American Museum – Educating the community about health issues is an important part of our nonprofit mission. One way we’re doing this is through a partnership with the Northwest African American Museum. Together, we are working to educate the local African-American community about five diseases that disproportionately affect this community: breast cancer, diabetes, heart disease and premature and low-birth weight babies.

    In collaboration with our team and with support from other sponsors, the museum has developed a compelling interactive exhibit, “Checking Our Pulse,” that helps drive home the need to prevent and/or manage these conditions. It also includes a history of African-American physicians and health-care professionals in Seattle, including Swedish’s chief medical officer John Vassall, M.D., and Swedish breast- cancer surgeon Pat Dawson, M.D. By sharing this history, we hope to inspire local African-American youths to pursue careers in medicine and health care.

Pulling Together as a Community

When I describe these community health initiatives, many people are surprised to learn how involved Swedish is in the local safety net and how much outreach we are doing to serve low-income and at-risk populations. These same people are also the first to ask how they can get involved in our work and help make a difference.

Many of the programs I mentioned in this letter are made possible by the generosity of individuals who relate to what we’re doing, connect with our nonprofit mission and make their own generous gift. These programs are just some of the critical priorities included in our current $100M Campaign for Swedish. Our charity-care program, as an example, is something that is near and dear to the heart of many of our donors and is supported each year by Celebrate Swedish, our annual gala.

If anything in this issue of Perspectives resonates with you and inspires you to action in any way, I encourage you to learn more and get involved. Please feel free to contact either of these members of my team for more information about our community health programs.


  • Dan Dixon, vice president of External Affairs,
  • Don Theophilus, executive director, Swedish Medical Center Foundation and vice president of Development,

On behalf of everyone at Swedish, thank you for supporting our nonprofit mission. Knowing that all of you are behind us motivates us to continue our efforts to serve the community.


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