Dr. Benjamin Chu has spent much of his life working to improve the U.S. health care system, first in his hometown of New York and since 2005 as regional president of Kaiser Permanente Southern California. There, Chu directs health plan and hospital operations for 11 hospitals and 130 medical offices from Bakersfield to San Diego, serving more than 3.2 million members. He is a primary care internist by training and has an intimate knowledge of both ends of the stethoscope. As a toddler in the 1950s, he contracted rheumatic fever, which left him with a heart valve problem that wasn’t repaired until he was in his early 30s. His parents, Chinese immigrants with little formal education, wanted more for their child and he didn’t disappoint: He was valedictorian of his high school, earned a bachelor’s degree in psychology from Yale and went to medical school at New York University. Chu had spent most of his career in public or academic hospitals, gaining a reputation for pushing for more efficient, patient-centered and higher-quality care, including through the use of digital technology. He eventually became president of New York City Health and Hospitals Corp., the largest public hospital system in the country. That attracted Kaiser Permanente’s attention, which recruited him. He and his second wife, artist Donna Moylan-Chu, live in an award-winning arts and crafts cottage that they bought and renovated after moving to California.

Question: What motivated you to become a doctor?

Answer: When I was about 2 and a half or 3 years old I developed rheumatic fever, which left me with a heart condition. This was in 1955 and the way they treated people for heart conditions back then was a lot of bed rest. I started school a year later than other kids, and was restricted in my physical activity and spent a lot of time at the doctors. Can you imagine being a 3-year-old and having to stay in a hospital bed at the New York Infirmary for three months? But the pediatricians and pediatric cardiac specialists who saved my life were real role models for me.

Q: You were the youngest of three children, correct? Did that and your condition cause you to be coddled a lot?

A: Yes, but I’d always sneak out. In those days the kids all climbed over the schoolyard fence and played basketball. My mother would never overtly let me do that, so I’d sneak out. My condition really never ended up stopping me. I think it gave me a lot more drive to succeed.

Q: Were doctors eventually able to repair your heart?

A: My heart valve problem, which lead to an enlarged heart, was repaired when I was 33. Had to talk my cardiologist into it, though. I had done a lot of research, and I knew that if they didn’t do it soon the damage would be permanent.

Q: You’ve been participating in the cycling portion of local triathlons for a few years now. So you must be fine.

A: Well, I can compete in the cycling leg of a triathlon, which I’ve done a few times. Not the entire triathlon though cycling is enough.

Q: Despite your late start in school, you went on to become valedictorian. How did that happen?

A: Well, my parents were Chinese immigrants and very supportive of me doing well in school.

Q: Tell us about your parents.

A: Both my mother, who is still alive at 92, and my father worked all their lives, but we never really had a lot of money. We lived in a tenement in New York’s Chinatown. My father came over in 1930 when he was 13 to help in his father’s laundry in Spanish Harlem. My grandfather sent money home, but couldn’t bring his wife and children over back then because of immigration rules. It must have been hard for my father coming to a new country as a kid during the Depression. After my father died, I was digging through some stuff and found some switchblades and notices from truant officers. He was a radio man during World War II but didn’t take advantage of the G.I. Bill, so he probably had the equivalent of a sixth- or seventh-grade education. After the war he ran a hand laundry, a dry cleaner and a restaurant at various times.

Q: Did spending a lot of time in hospitals as a kid make you decide to become a doctor?

A: One of my pediatricians gave me a real stethoscope when I was 3 years old and it was always assumed that I would become a doctor .But I really didn’t make the decision for myself until after my second year of medical school.

Q: Really?

A: You know how you get into a track and you haven’t really thought about it that much? I was still uncertain whether I wanted the rigorous discipline of going into medicine. I liked the science, but it really wasn’t something that galvanized the imagination for me. It really wasn’t until my third year, the clinical year, that I realized that it was exactly the right thing for me. It was the patient contact that swayed me.

Q: How long were you a clinician before you got into administration?

A: Actually almost as soon as I finished my chief residency in 1982, even though I’ve always practiced, at least part time, until seven years ago when I took over as president of New York City Health and Hospitals Corp.

Q: How did you end up as an administrator so early in your career?

A: I was always interested in cardiology, naturally, but I ended up not going for a cardiac fellowship. It was the tug of the patients at Kings County Hospital in Brooklyn, where I was a resident, that lured me into my first administrative job. One of the things I could not stand was that the system was so fragmented. I just felt that there had to be a better way. I talked my chairman of medicine into allowing myself and another doctor to take over the adult medical clinic. I was absolutely convinced we could do a better job. So I practiced about a third of my time, was an administrator another third, and taught the rest of the time. It was pretty much that way throughout most of my career.

Q: Was whipping that first clinic into shape harder than you thought it

would be?

A: It actually was easier. I learned that there’s such a void in the health care system that when you bring some focus to it there’s a lot you can accomplish. In the first few weeks I made a point to do every job in that clinic. I gained tremendous insights into how the system worked, or didn’t work. That was the key to putting together a more coherent program. It also earned me a lot of credibility among the staff.

Q: How long did you stay at that job?

A: After three years I was promoted to the chief of ambulatory care. Kings County had the largest ambulatory care department in the country at that time over 800,000 patient visits a year so I spent a lot of time putting some order to that.

Q: What was the hardest job you ever had?

A: About three or four years into being the chief of ambulatory care at Kings, I decided to take on the adult emergency room. It was the height of the crack epidemic in New York in the late ’80s and HIV was rampant. We professionalized the ER and put in place enough of the academic backbone to offer a residency training program in emergency medicine. That took a lot of training and capital expense. After two years that was probably the job that nearly burnt me out.

Q: How did you avoid burn out?

A: I decided I needed to learn the larger context in order to change the system. I won a Robert Woods Johnson health policy fellowship to work as a legislative assistant for Sen. Bill Bradley of New Jersey in 1989. That just completely changed my life. It gave me a broad enough insight to understand the huge systemic problems with health care in the United States.

Q: What was it like working for Bill Bradley?

A: You have to understand, I grew up in New York, was an avid Knickerbockers fan and “Dollar Bill” Bradley was my hero. And he actually turned out to be more than a great basketball player. He had been a Rhodes scholar and had a great mind. I learned about politics watching Bill Bradley. For example, he was a big supporter of Medicaid and supported Medicaid getting the best price for drugs, but he also had to balance that against the fact that there were a lot of big drug companies in New Jersey, too. So we danced a lot. I learned a lot about how to dance and still stay true to my values.

Q: How did you eventually become head of the public hospital system in

New York?

A: In 2001, the year Michael Bloomberg was elected mayor, I actually supported his opponent, Mark Green, and helped draft his health policy position papers. But Mayor Bloomberg’s people did an interesting thing they invited me to interview for the position to run the New York public hospital system, the job I would have gone into had Mark Green won. I had a lot of ideas on how to make the public hospital system more patient-centered and drive for quality and better outcomes. When I got ill as a child I was treated at public hospitals.

Q: What was one change you implemented?

A: One thing that always drove me crazy about the public hospitals was it would take you weeks to get an appointment and then hours to see someone. The average visit took three hours. You might have to take an entire day off work to go to the doctor. It was a very large cultural change, but we managed to get it down to a one hour average in two years.

Q: What do you think of the current health care reform proposals being debated in Washington that would require everyone to have insurance and employers to contribute in some way?

A: Health care in the U.S. is a $2.5 trillion industry and health care inflation is growing four times faster than the consumer price index and workers’ wages. Kaiser has been very supportive of health reform. Getting something that all of America can agree with is not going to be easy, but I personally am very optimistic in spite of the economy, and perhaps even because of it. (But) the hardest part is going to be cutting costs.

Q: What was your first big initiative when you came to Kaiser?

A: Implementing electronic medical records and digital radiology. They were just getting into EMR when I got here and hadn’t even started on radiology. After we got both of those features in the New York public hospitals, the flow of information was much more free flowing and facile. It let us do so much preventative work. So that was a big priority for me when I came here.

Q: Kaiser was criticized for taking so long to implement the records system. What happened?

A: This is a huge system you’re dealing with here. Across all of Kaiser, we have 150,000 employees across eight regions who had to learn how to use the computer, to document cases on the computer, to get comfortable with work-flow changes.

Q: Getting back to your personal life, you live in an interesting arts and crafts house in Pasadena that you and your wife began renovating after you moved here. What was that experience like?

A: It was a fixer-upper in a historic district, so we had to be careful about what we did. We converted the garage into an art studio for Donna and actually were able to get permission to make an addition in the back so we could have a proper kitchen. The fireplace in the living room had been bricked in but after my wife and the gardener uncovered everything we discovered this amazing fireplace made of river rocks. But there wasn’t enough left to hold up in a quake so we built it up, and at the same time embedded bits and pieces of our life in it. We have old rice bowls, and fine china and pieces of memorabilia in it. It’s unique.

Q: You also have a lovely rose and vegetable garden out back where it used to be all concrete. Did either of you garden much before you moved here?

A: No, not at all. Not a lot of greenery on the lower east side of New York. The gardener who helped my wife with the house while I was working helped us set it up after Donna planned it out. Now I do the vegetables and Donna does the flowers. I unfortunately was the one who decided to put in bamboo back by the studio. I thought, how exotic, how Asian. Well it took over the place. I have to keep cutting it back.

Dr. Benjamin Chu

Title: President

Organization: Kaiser Permanente Southern California

Born: 1952; New York

Education: B.A., psychology, Yale University, 1974; M.D., New York University, 1978; M.S., public health, Columbia University, 1989

Career Turning Point: Becoming a Robert Wood Johnson Policy Fellow and working as a health policy legislative assistant for former New Jersey Sen. Bill Bradley

Most Influential People: Bradley; New York Mayor Mike Bloomberg; Saul Farber, former dean of the New York University School of Medicine

Personal: Lives in eclectic Arts and Crafts cottage in Pasadena with second wife Donna Moylan-Chu; has two children from a previous marriage and one stepson

Hobbies: Recreational cycling; visiting art museums with wife, who is an artist; practicing the Chinese cooking he learned from his mother; working in his vegetable garden