Padraic O’ Maille interviews Jimmy Sheehan, Founder and CEO of the Galway Clinic.
From as far back as Jimmy can remember he loved working with his hands. “I was always interested in carpentry. I loved taking things apart and putting them back together again. I always liked the concept of manual skills. There was no career guidance then. I had never seen the inside of a hospital. No one in previous generations of my family had done medicine. But from a young age, surgery, and in particular reconstructive surgery appealed to me and I set my mind on it.”
He is far too humble to admit it but his C.V. underscores a brilliant mind evidenced by a myriad of awards, gold medals and first class honours received as an undergraduate. What his C.V. may not reveal was that each summer he would return to his roots in Kerry and work in the local hospital. There he was to meet and befriend the county surgeon, Colm Galvin. “He was the best surgical technician I ever knew and he influenced me profoundly. He encouraged me and inspired me to specialise in ‘carpentry of the skeleton’ and some day I hoped to be able to bring this back to a community in need”.
After graduating from UCD he went to the UK to the Royal National Orthopaedic Hospital and later to Wrightington Hospital where he was to meet up with the celebrated Sir John Charnley.
“Sir John designed the first artificial hip joint, the Charnley hip prosthesis and it was first inserted in the early sixties. This procedure is now one of the most common procedures in the world and to be involved in this process was both fascinating and exhilarating. Every artificial joint was actually finished in Sir John’s workshop and we did our apprenticeship on lathes and milling machines. I realised I needed much more in-depth exposure to engineering. I returned to university to study bio-engineering and subsequently went on to do a PhD in mechanical engineering over a seven year period.”
Jimmy was appointed consultant at St. Vincent’s Hospital and shortly thereafter set up the joint replacement unit in Cappagh Hospital. His raison d’être for doing medicine was being realised. He was fulfilling those dreams that Colm Galvin and others had kindled in him formerly of improving the health and quality of life of the individuals and community he served. “You’re too young to remember but right up to this time, the early seventies, there was a huge reservoir of untreated people sitting by firesides all over Ireland. ‘Put Granny sitting by the fire’ was the panacea for treating a plethora of terrible afflictions at that time associated with joint problems. In fact, many of the health problems we encountered then are now thankfully almost obsolete”
Jimmy’s contribution at Cappagh was immense and he is justifiably proud of the fact that it is now the second largest joint replacement unit in Ireland and Britain. Then, as now, the early eighties were characterised by massive cutbacks in the health sector. The Health Board in their wisdom decided to ration the supply of artificial joints from ten a week to just one a week.
“Although I was being paid, I was basically redundant. There was a five year waiting list for joint replacements and I was determined to work and not remain idle. I had a choice of either emigrating or doing something myself. And that was the motivation for the Blackrock Clinic”.
Together with Maurice Nelligan, who also had a five year waiting list for cardiac surgery, George Duffy, a nuclear medical consultant and Jimmy’s brother Joe, they figured that they could free up the system by targeting patients with private insurance who amounted to 30% of the population. Although now an outstanding success it was a baptism of fire for Jimmy then who had precious little business experience.
“We bought the site in the early eighties in the height of the recession. You’ve got to understand that interest rates were running at 23% for that period and I had to put my own home on the line to provide collateral. I have an abiding philosophy however that if you provide excellent patient care the marketing will look after itself and it did just that. I still have borrowings on Blackrock twenty six years later and it is my wish, within my lifetime to clear those debts”.
In 2000 a group of people from the west of Ireland approached Jimmy with a view to opening a clinic in Galway. “It was put to me that the west was very much the poor relation in respect to health services. Cancer services were totally inadequate. There was no radiotherapy and there were massive waiting lists in orthopaedics”. I can assure you that I needed to open another business like a hole in the head but it’s always easier to do nothing and I’ve always been motivated by a challenge. I’ve always been interested in design and functionality and I became very excited about developing a state of the art hospital for Galway. I feel strongly that anyone going to hospital shouldn’t have a lesser service than they have at home”.
Be that as it may, Galway City Council had other views, and refused him planning permission. “I was totally dejected but I walked away with a certain feeling of relief. I had given it my best shot, had invested a lot of my own money and my conscience was clear”. Galway might forever have lost the opportunity to house the Galway Clinic but for the vision and initiative of “four councillors (Declan mc Donnell, Michael Leahy, Fintan Coogan and John Mulholland) who landed up to my door in Blackrock one evening and persuaded me that if I resubmitted they’d see to it that it was passed”.
And so it was. Jimmy’s intention was to run it as a charity but was totally unsuccessful in securing “as much as a euro” from the local community. In the meantime, he had commenced building on the assumption that funds would be forthcoming. When they didn’t, the banks were decisive in calling in his loan, and then, in his early sixties, he was left staring head-on at a twelve million euro debt.
“It was a very ropey time. Everything was on the line. I immersed myself in surgery in an effort to meet the interest repayments but for my poor wife Rosemary, it was a most uncomfortable six months”.
And then, out of the blue, Larry Goodman heard about it and was prepared to broker a deal that enabled the site to re-open and building resume. The results have been outstanding. Now employing 500 people, the services are state-of-the-art boasting radiotherapy, open heart surgery, PET/CT imaging, eye laser therapy and robotic prostate surgery.
The Accident and Emergency Department is now open seven days a week and you are guaranteed to be seen within an hour. Waiting lists for orthopaedic work which once ran to ten years in North Galway are now down to a matter of weeks.
Its success is twofold and should become the blueprint for every organisation in this country. Total focus on patient care and a unique management style.
Jimmy is passionate about patient care. “The only reason we exist is patient care. Medicine is all about human relationships backed up by scientific fact. I regret to say that in medicine we’ve got somewhat oblivious to the needs of the patient and forgotten that the only reason we are there is for them. Patients are great detectives and what they will remember most from a hospital experience is someone with understanding and compassion and who will listen to them. I speak for myself when I say that as a profession we have erred in failing to listen with empathy. We speak jargon. We can be dictatorial and don’t always give patients the time and respect they deserve. Patients often say to me ‘I was with the Doctor and he was very nice to me’. Very often what that means is ‘he wasn’t rude’. People have come to expect low standards from our professionals. Our ethos should be to care. Sickness is a journey and we are terribly privileged in health care to go on that journey with people because we too will someday go on this journey”.
Jimmy retired from surgery in 2003 and says “the day I stopped operating was the day my life became one long holiday. The commitment you give as a surgeon means you never wake up in the morning without anxiety. Business on the other hand is a pure pleasure. We treated twenty thousand people in the Galway Clinic last year and I cannot describe in words to you the satisfaction you get when you see people being cared for”.
He became CEO by default three years ago and his management style is equally hands on. “I have no office in that I believe I should be on the shop floor. I have a superb group of seven executives with whom I meet for ninety minutes each week. It’s an inclusive, interactive meeting focused clearly on problem solving, continuous improvement and innovation. We begin by discussing in detail any complaints received, how we can constructively resolve them and most importantly what we can learn from them”.
“I believe an effective CEO should be almost invisible and should achieve results through the effective motivation of others. I encourage innovation at every level and our staff has contributed hugely to our development and success. We have a “Daft” button on our intranet where staff are encouraged (and rewarded with €50) to come up with ways of improving things in the Clinic. For example we have recently changed the explanation rules for using the lift to make them much more understandable. I had been looking at them for five years and didn’t notice how difficult they were to read. We reduced water charges by e80,000 on foot of a suggestion from a staff member that we sink our own well. Someone else suggested that we install our own electrical generator and this is now saving us e200,000 per annum”.
His philosophy on life is simple. “Our role is to do the best we can for as long as we can. I think this concept of people wanting to retire is wrong. If people want to retire they’re obviously unhappy with what they do”.
Mike Shaughnessy arrives to take the photograph. We debate where. Jimmy’s wish is that it be taken in front of the quotation from St. Paul in the main foyer which says.
“Sickness brings patience. Patience brings perseverance. Perseverance brings hope”.
It reinforces his philosophy. While modern medicine owes much to convivial surroundings and state-of-the-art equipment operated by competent technicians, it is still first and foremost about caring for the patient in their journey through sickness. To paraphrase himself, by times he was a Mr. and a Dr. and a Mr. He was at all times however, a carpenter. He brought things to life with his mind and his hands. The Galway Clinic, and the thousands of people who have been cared for there, is a tribute to his patience and perseverance and has provided great hope.