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The promotion came quickly for Beth Goldstein Raucher ’76. Hired by Lutheran Medical Center (LMC) in Brooklyn in July as vice president for medical quality, she was promoted to medical director in September.
She is responsible for assuring high quality of care and safety for the patients; education of the medical students, interns and residents; and making sure that the physicians on staff maintain their credentials to practice medicine in their specialty and participate in continuing medical education.
“Being medical director is not a desk job!” says Raucher, a biology graduate. “Of course, I do not do any of this by myself, and work side by side with outstanding senior administrators and nurses.”
The medical center discharges 22,000 patients annually, a 22 percent jump in the past five years. In the same period, the center has become one of the first New York State designated stroke centers, received approval to perform cardiac catheterization, created a bariatric (obesity treatment) surgery program that is fully accredited by the American College of Surgeons and named a Bariatric Center of Excellence by the American Society for Bariatric Surgery, significantly expanded the radiation cancer program, and overseen growth in a trauma center that has become one of the busiest in the state.
Before joining LMC, Raucher worked at Beth Israel Medical Center for 20 years. During her time there, she became medical director for clinical informatics and chief of quality improvement. The move to LMC has shifted the way Raucher operates in the profession. Previously, she was able to work in administration and still see hospitalized patients in her specialty, infectious diseases.
“That arrangement was ideal during the first half of my career,” she says. “In my new role I do not currently have time to provide hands-on care to patients. However, I hope this will change in the future when I am more familiar with Lutheran and gain experience as a medical director.”
Raucher’s position does allow her to interact with the student and resident teaching program, attend clinical conferences, and give lectures. She also spends time on the patient units interacting with doctors, nurses, patients, and their families “to see how we are doing with respect to quality of care and patient satisfaction.”
Raucher—who is board certified in internal medicine and infectious disease—earned a medical degree from Mount Sinai School of Medicine, New York City and a master’s in health care management from Harvard School of Public Health. She is an elected fellow of the American College of Physicians, Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America.
Throughout her distinguished career, she has had to adjust to changes in the healthcare profession. According to Raucher, medical school and her residency did not prepare her (or any physician who trained when she did) for the changes that occurred in the 1990s in regard to managed care and oversight by insurers and the government.
“Admittedly, there was a significant amount of waste in the healthcare system and managed care was supposed to streamline the process for patients and make the system more efficient for healthcare providers,” she says. “Unfortunately, early efforts by HMOs frustrated both patients and doctors alike.”
Patients, Raucher explains, could not get to see their family doctor and doctors had to schedule patients every 10 minutes in order to meet performance benchmarks set by HMOs. The paperwork burden alone drove many of the most experienced senior physicians right into retirement.
“As a physician on a hospital staff, I was not affected to the same degree as doctors in private practice,” she notes. “The paperwork was there, but for the most part, the hospital billing department did the work for me. However, I was limited to certain tests I could order and when I had to discharge a patient from the hospital. A non-physician frequently made the decision and I never got used to that.”
Not all of the interventions of managed care were bad, however. Raucher says that several years ago, insurance companies and the government as the largest insurer of all (Medicare and Medicaid) began to set quality benchmarks for hospitals/doctors to meet in order to be paid their full reimbursement. Once doctors realized that the concept of “pay for performance” (P4P) was not going away, some enlightened physicians joined the committees and task forces to help set the agendas, she says, adding that today, this concept is taking hold and both hospitals and physicians are being held accountable for the quality of care they provide.
“As the chief quality officer for the hospital, I have no problem with this as long as the practices that are expected of us are based on the best medical evidence and are achievable,” Raucher says.
Times have also changed for those entering the medical profession.
“Lafayette students entering the medical profession now will be far more prepared and will learn about this side of medicine during their training,” Raucher notes. “I am sure that there will be a continued evolution of P4P and other ways to raise the bar of medical quality and cost containment; however, I do not believe that there will be the revolution that I experienced since my training.”
Raucher lives in Englewood Cliffs, N.J., a small town located just north of the George Washington Bridge, with her husband, Harold ’74. Her parents still live in town and her sister moved back with her family shortly after she did in 1986.
Their ties to Lafayette remain strong with daughter Leslie ’10.
“[We’re still very close to] our very dear friends Bob [Jones Professor of History] and Sandi Weiner who we met during our years at Lafayette,” Raucher says. “Bob was best man at our wedding and I am sure was very instrumental in Leslie’s decision to attend Lafayette this year. His exuberance about Lafayette and Hillel [Society] is contagious!”
Raucher is excited for Leslie because she knows how rich and valuable the Lafayette experience is.
“Lafayette provided me with a strong academic environment that was competitive but not cut throat,” she explains. “I learned college survival skills such as time management, passing organic chemistry, and getting along with roommates. Judaism became an important part of my life because of the time I spent at Hillel participating in activities with wonderful people.”
Raucher says that because of its small size and teaching mission, Lafayette’s professors were available to help and lend support to students during office hours and at many other times. And she found opportunities available to Lafayette students that would not have existed if there were graduate students on campus.
“I received a stipend as a biology teaching assistant and was able to do research as an undergraduate,” Raucher says. “I know that this is common today; however, it was a special feature of Lafayette in the 1970s. I didn’t know that I liked to teach until I had the experience at Lafayette and continue to enjoy it today.”
Raucher’s work with biology professor Robert Chase, her honors thesis adviser, had a profound impact on her while at Lafayette and throughout her career.
“I was not particularly interested in studying the influence of environmental crowding on the growth of guppies; however, I had come to know Dr. Chase as a biology major and found him to be an outstanding teacher and caring human being,” she recalls. “I had the sense that he could teach me a lot about my chosen field, how to do research, and help keep me sane in the competitive pre-med environment. So his research interest became my interest, and I was not disappointed.”
In fact, Raucher adds, Dr. Chase is her role model for how she mentors doctors in training to this day.