The day often starts with surfing. Norman E. Vinn, DO, awakes to a house that’s quiet—but not for long. The incoming AOA president makes his way to the kitchen of his modern San Clemente, Calif., home, purchased in part for its proximity to one of the best stretches of California coastline for surfing. He prepares coffee and an English muffin as his two dogs prance at his feet.
Dr. Vinn’s wife, Marsha, comes downstairs next, followed by his daughter Lily, who is visiting from college in Mississippi. They congregate in the garage. This is California, so surfboards line the ceiling and jockey with bicycles for space against the walls.
Marsha and Lily get their bikes and depart for a morning ride, and Dr. Vinn chooses a blue custom-made surfboard with “DO” emblazoned on it. He heads back through the house, past walls adorned with accoutrements of family, medicine and surfing—art from surfing trips in Fiji, family portraits, a plaque from a recent commencement speech, a physician figurine from Italy propped up against a windowsill. He climbs the stairs to the rooftop, where he assesses the surf conditions. The flapping of the American flag at a nearby Carl’s Jr. hamburger eatery tells Dr. Vinn that the wind is blowing from the south, which will make for choppier waves, but he’s going to head out anyway. He tries to surf as much as he can when he’s home.
The short walk to the beach is sprinkled with pastel beachside homes, cypress trees and sky-scraping palms. San Clemente’s beach is expansive and void of people save for a handful of fellow surfers. In the water, Dr. Vinn talks with Gonzo, another local surfer. He takes in the glassy green hue of this slice of the Pacific Ocean as he waits for a good wave. When it comes, he climbs atop his board to catch it as it crests and ride it toward the shore.
Dr. Vinn’s passion for surfing began years ago, when he was a teenager. Back then, he had no idea he would one day lead a successful company and a national medical association.
“I didn’t go into osteopathic medicine to be a leader,” he says. “I say in my graduation speeches that I was kind of an unlikely leader.”
The young Dr. Vinn wasn’t always set on medicine as a career, either. In his undergraduate years, Dr. Vinn got an English degree at Tulane University in New Orleans and considered careers in film, media and literature before settling on medicine. Later, his diverse background would be an asset to his developing career.
“Norm was always a renaissance guy,” says Paul Womble, who attended college with Dr. Vinn at Tulane. “He had interests in a lot of things. He loved words, and he loved art.”
Several other friends, including former fraternity brother Wendel Stout, also noted Dr. Vinn’s talent with words.
“Norm has a tremendous ability for plays on words and puns,” Stout says. “He was so good at it, instead of calling something a pun, we would call it a Vinn-ism. Our fraternity actually created an official poet laureate position for him. Norm was the first poet laureate of the Alpha Omicron chapter of Sigma Chi.”
The literary world’s loss was medicine’s gain when Dr. Vinn, inspired by his role model and father, J. Edward Vinn, DO, decided to go to medical school. The move was also motivated by his search for a career path that was more service-oriented, Dr. Vinn says.
But when he took on his first leadership role as a medical student, Dr. Vinn made use of his skills in words and film. At the Philadelphia College of Osteopathic Medicine, he wrote and directed a skit performed by the freshman class in the school’s Christmas show. The following year, he produced the entire show. Highlights included an osteopathic manipulative treatment parody set to the tune of “Dem Bones,” a parody of Woody Allen’s Everything You Always Wanted To Know About Sex, But Were Afraid To Ask, and monologues poking fun at the professors.
“I thought of it as a creative outlet from the tedium of basic science courses,” Dr. Vinn says. “It was a chance to do what I like to do—write parody songs and corny jokes.”
After some (fortunately) positive reviews of the show, Dr. Vinn’s fellow students nominated him for student council. Student council was his first introduction to organized leadership. And while it wasn’t an initial goal, leading came easily to Dr. Vinn.
“Norm always came to the table with ideas, but he also wanted to hear what everybody else had to say,” says AOA Editor-in-Chief Gilbert E. D’Alonzo Jr., DO, who attended medical school with Dr. Vinn. “He was very quick to pick up good information, valuable input, and he would incorporate it. But most importantly, he would always make everybody involved in the effort feel like they were part of it.”
Becoming a leader
Following medical school and his internship, Dr. Vinn moved to Southern California “to surf, raise a family and start a practice,” he says. Once again, he didn’t seek out leadership roles, but where he went, opportunities seemed to find him.
In 1978, Dr. Vinn ran into some friends from the Osteopathic Physicians and Surgeons of California (OPSC), who suggested that he get involved. Dr. Vinn discovered he enjoyed advocacy, and later he worked on state legislation to prevent discrimination against DOs in California’s medical systems.
The same year he joined OPSC, another physician at Dr. Vinn’s hospital asked him to chair a preferred provider organization steering committee.
“It forced me to learn about the socioeconomic changes that were occurring in the industry,” Dr. Vinn says. “And the doctors needed to be better organized.”
Dr. Vinn learned more about managed care, independent physician associations (IPAs) and group practices. He saw where the field of medicine was heading. In 1988, he attended his first AOA House of Delegates’ meeting.
“As I heard the deliberations, I was very aware of what was going on in California in the managed care arena,” he says. “I realized the AOA and its membership really was behind the curve in understanding these massive forces pushing healthcare in different directions.”
Dr. Vinn, under the guidance of Howard M. Levine, DO, lobbied the AOA to create a Managed Care Task Force. Over time, it evolved into what eventually became the AOA Bureau on Socioeconomic Affairs.
Back in California, he took on increasing responsibility at work, leading large IPA networks and continuing to follow trends in medicine.
“Norm could do two things at once,” says former colleague Arthur C. Ungerleider, DO. “He could handle a lot of patients very well—they liked him very much—and he also excelled at administration.”
Dr. Ungerleider worked with Dr. Vinn in the ’90s at Naples Medical Group, an IPA which Dr. Vinn helped develop. Dr. Vinn then oversaw the group’s merger with another IPA, Mullikin Independent Physician Association, and became the new group’s chief medical officer.
Dr. Vinn looks at health care through a different lens, says colleague Steven Rudy, MD. Dr. Rudy’s company, Monarch HealthCare, has a longstanding contract with Dr. Vinn’s house call group, House Call Doctors Medical Group.
“Norm spent a lot of time looking at the macro aspect of health care and the changes that are going on not only locally with his business, but on a much bigger level,” Dr. Rudy says. “Most physicians spend all their time with their heads down getting from the morning to the evening. Norm does that and does it well, but he’s also been able to poke his head up and look around and see the changes that are coming and the importance of physicians continuing to take a prominent position when it comes to implementing them.”
After earning an MBA and rising through the ranks in the health care administration field, Dr. Vinn became interested in consumer-driven health care. Via a chance meeting between a friend and a future colleague, he joined a venture-funded house call company in San Diego in 1999.
“I felt house calls could be a great asset in the managed care industry, which is always concerned with outcome,” he says. “They are a way to avoid a lot of unnecessary hospitalizations and futile care when people can be treated effectively and compassionately and in a high-quality manner in the comfort of their own home.”
Dr. Vinn quickly fell in love with the house call model and the way it gave physicians the chance to see patients in their homes and spend more time with them.
“From an osteopathic perspective, house call clinicians get a true opportunity to view the whole patient—their environment, their nutrition, their safety and their caregivers,” he says. “There are many factors affecting their care that physicians would not see in an office setting.”
In 2002, Dr. Vinn decided to start his own house call company. Fittingly, he ran it out of a house. After four years and much persistence, House Call Doctors Medical Group landed its first contract with a Medicare Advantage IPA. Another contract followed shortly after, then another. Today, 60% of the group’s business comes from Medicare Advantage payers. In 2004, Dr. Vinn moved the fledgling company out of his home and into an office. House Call Doctors Medical Group has grown steadily since then and now has 50 staff members and 30 physicians and midlevel practitioners.
Despite its growing size, the staff of House Call Medical Doctors Group maintain close relationships with one another, a result of Dr. Vinn’s leadership, says Blake A. Wylie, DO, who is a physician with the group.
“Dr. Vinn cares about his practice, his patients and the people who work for him like they are members of his own family,” says Dr. Wylie, an occasional surfing partner of Dr. Vinn’s.
Attending house calls with Dr. Vinn is always an adventure, Dr. Wylie says, as they often stop in unexpected places for great food at the end of the day.
“We went to a Cuban restaurant one time when we were in one the harder areas of Los Angeles,” he says. “This place was fantastic. It’s neat that he knows the intricacies of these areas.”
These days, Dr. Vinn has fewer patients as he devotes more time to leading the company. But he spends a lot of time with those he still sees such as the Medreas, who live in a sun-drenched home on the southern edge of the Los Angeles suburbs.
On a recent visit, Dr. Vinn approached the house with his “black bag”—a beat-up Swiss Army bag on wheels that looks like it’s accompanied him on house calls for years—and his stethoscope. He and Sharon Medrea greeted each other like old friends. Dr. Vinn treats Sharon’s mother, Thelma. Thelma uses a wheelchair, and it would be difficult for Sharon to take her to a doctor’s office.
Seated at the kitchen table, Dr. Vinn took his time discussing Thelma’s condition with Sharon. They talked medication, eating, sleeping, skin, muscles, physical therapy and more. Dr. Vinn also asked Sharon how she was holding up as a caregiver and listened to her concerns.
The three have an easy, comfortable rapport that reflects the years they’ve been working together. Jokes were peppered in between talk of vitamins and blood pressure.
“That’s a pretty color for a shirt, Dr. Vinn,” Thelma said, complimenting Dr. Vinn’s turquoise button-down.
“I had to go bright for you,” he replied with a smile.
The year ahead
Dr. Vinn’s dedication to homebound patients has been recognized by the California medical community. In 2011, he won the Orange County Senior Care Humanitarian Award. Two years earlier, the American College of Osteopathic Family Physicians of California named him Physician of the Year. And previously, he was recognized for his work as a leader in transforming health care delivery in California, winning the Osteopathic Physicians and Surgeons of California’s Physician of the Year award in 1991 and its Lifetime Achievement Award in 2009.
When Dr. Vinn’s friends and colleagues talk about why he’s a good choice to lead the AOA in 2013, they too note his knowledge of patient care and the business of health care. In addition to these skills, Dr. Vinn’s wordsmithing skills will be an asset, says friend Pat Quinlan.
“When Norm was with the Mullikin group, he ran around the country and spoke about managed care and the direction that health care was taking,” says Quinlan, who is a retired medical equipment account manager. “He’s always been very interested in that aspect of medicine, and that’s why he’s a good fit to be the president. He looks at the direction his profession is going, and he’s able to articulate that to the group very well. He’s an excellent speaker.”
The coming year will bring great changes to both osteopathic medicine and the national health care environment. The AOA supports continued discussions with the Accreditation Council for Graduate Medical Education and the American Association of Colleges of Osteopathic Medicine on forming a single, unified graduate medical education accreditation system, Dr. Vinn says. And with the Affordable Care Act, physicians may see droves of new patients as millions of uninsured Americans enter the health care system.
The AOA is going to need at its helm a leader with in-depth knowledge of the profession as well as strong financial and business acumen, Dr. D’Alonzo says.
“Probably more than anyone I can think of, Norm understands the financial aspects of medicine,” Dr. D’Alonzo says. “He understands what being a DO is all about. He knows the uniqueness of our profession. He can put this all together and drive this profession over the next year in a very positive direction.”
Dr. Wylie agrees that the next twelve months will be a challenging year for the profession, but that Dr. Vinn is well-equipped to take the reins.
“He’s coming in at a very hard time,” says Dr. Wylie, “not only with the changes in the American medical system, but also the changes in the osteopathic world. Dr. Vinn’s leadership skills are going to take us through this transition year. There will be a lot of changes, but I’m sure his vision will take us in the right direction.”