On a rare morning when he had time to have a leisurely breakfast, Robert S. Juhasz, DO, the AOA’s 2014-15 president, sat at the base of his expansive yard with his wife, Donna, enjoying homemade blueberry muffins and freshly pressed grape juice.
Dr. Juhasz and his wife call nearly four acres in Concord Township, Ohio, home. Sitting on what was once an old country road, the verdant space serves as a respite from suburban Cleveland’s highways, traffic lights and noise. Once a home for grazing horses, the pasture on the south side of the property now hosts casual football games and family portrait sessions. Alongside the pasture, grapevines and blueberry bushes proliferate.
Inside the house, Dr. Juhasz’s passion for the outdoors is also evident. Prizes from hunting exploits, including a mounted deer he stuffed himself, adorn the walls, along with an antique bamboo fly-fishing rod—the very rod that introduced him to the sport.
Dr. Juhasz says fly-fishing and hunting appeal to him because they offer him the chance to continually learn new things and hone his skills.
“Fly-fishing has so many different facets to it,” says Dr. Juhasz, whose AOA presidency begins this month. “You have to learn about entomology. You have to learn how to cast. You have to learn how the water changes and where the fish usually are. You’re studying an art and then improving on it.”
Next door, in his home office, it’s clear that Dr. Juhasz has taken the same approach to his career as an osteopathic physician. As president of the Cleveland Clinic’s South Pointe Hospital in nearby Warrensville Heights, he keeps a poster with the names and faces of current residents beside his desk. On his bookshelf are titles such as “How Doctors Think” by Jerome Groopman, MD, and “Critical: What We Can Do About the Health-Care Crisis” by former Sen. Tom Daschle.
This constant drive for improvement has served Dr. Juhasz, and his community, well. A northeast Ohio native, he became president of South Pointe Hospital last year, the same institution where he began his medical career as a dishwasher back in 1971, when it was called Brentwood Hospital.
“The hospital was a great place to start,” he says. “I would ride a bus here from school. I worked in the kitchen and later became an orderly and echocardiography tech. One of the best jobs I ever had was being an orderly, because it gave you the opportunity to meet patients’ basic needs, which they always appreciated.”
Between his high school days and last year, when he became president of South Pointe, Dr. Juhasz completed his residency there, served as an internal medicine residency program director for another area hospital, was in private practice for 12 years, and then joined the Cleveland Clinic, one of the most prestigious hospital systems in the country, in 1998. Afterward, he became the medical director of a Cleveland Clinic community health center.
In 2011, he also helped rejuvenate South Pointe by offering its space as an on-site extension campus of the Ohio University Heritage College of Osteopathic Medicine (OU-HCOM) at Athens, an idea that will come to fruition next year when the school opens its doors to its inaugural class.
Two serendipitous meetings spawned Dr. Juhasz’s idea. As an AOA Board member, he met with David Bronson, MD, the president of Cleveland Clinic Regional Hospitals, to discuss osteopathic medical education in northeast Ohio. While talking about South Pointe’s residency program, Dr. Bronson noted that one of the hospital’s buildings could be put to better use.
The next day, Dr. Juhasz met with Jack Brose, DO, then the dean of OU-HCOM, who said he was interested in developing an extension campus in Cleveland but needed a building to house the school.
“I said, ‘That’s interesting, because I spoke to Dr. Bronson yesterday and he has a building that he needs to do something with, and you have a need,’ ” Dr. Juhasz says. “Maybe the two of you should talk.”
Dr. Brose and Dr. Bronson met for dinner shortly after, where they hatched a plan.
“The way I look at it, I made the reservations for the dinner, then Dr. Brose and Dr. Bronson took off with the concept,” Dr. Juhasz says.
Dr. Juhasz is a humble leader, says Brian Monter, South Pointe’s chief operating officer, and he doesn’t take as much credit for the development of OU-HCOM’s Cleveland Extension Campus as he should.
“He was able to connect the dots in changes in medical education—looking at northeastern Ohio, the space capacity at South Pointe, [the hospital’s] strong osteopathic background—and put all those pieces together and get the right people talking,” he says. “And the result of those conversations is we’re getting a medical school next year.”
The extension campus will provide northeast Ohio with a much-needed injection of primary care physicians, says Jeffrey A. Stanley, DO, and it may have saved South Pointe.
“The relationship between Ohio University and South Pointe really cemented the identity of this hospital in the community,” says Dr. Stanley, a vascular surgeon at South Pointe. “Everybody knows now that South Pointe Hospital is going to be an osteopathic training center. The Cleveland Clinic and the university have invested time and money in this venture. Bob’s leadership, particularly with the primary care aspect, is going to be huge in helping the hospital move forward.”
Staff at South Pointe paint a picture of Dr. Juhasz as a humble, team-oriented leader with a sense of humor. John Bruyere, South Pointe’s vice president of operations, was impressed that Dr. Juhasz, upon entering the role, quickly showed his colleagues that he didn’t take himself too seriously.
“During our first meeting with Dr. Juhasz, everyone was a little nervous: ‘Here’s the new hospital president,’ ” Bruyere says. “At some point in the meeting he stands up and starts to unbutton his shirt, and he pulls his shirt open, and he has a Superman shirt on underneath. It was funny to say the least.”
After that first meeting, Sheila Miller, MSN, South Pointe’s head of nursing, had a chance to observe Dr. Juhasz’s approach to problem solving.
“Even when Dr. Juhasz has a good idea in his mind of what needs to happen, he’s always willing to listen to and consider other perspectives,” she says. “He has a way of engaging people in conversation around issues to help form their opinions. We see that locally, when he works with patients or physicians or caregiver staff. And this skill will serve him well in his efforts with the AOA. I have an image of him interacting with lawmakers in a way that is respectful, well-informed and collaborative.”
Champion of education
Dr. Juhasz will also bring multifaceted expertise in medical education to his role with the AOA. Before joining the Cleveland Clinic in 1998, he directed an AOA-accredited internal medicine residency for 12 years at what is now University Hospitals Richmond Medical Center in Richmond Heights, Ohio. After joining the Cleveland Clinic, he served as associate medical director and medical director of the Cleveland Clinic Willoughby Hills (Ohio) Family Health Center.
The Cleveland Clinic system houses AOA-accredited residency programs as well as those overseen by the Accreditation Council for Graduate Medical Education. Since joining the Cleveland Clinic, Dr. Juhasz has served as a preceptor for DOs and MDs in the system’s ACGME-accredited programs. Residents in Cleveland Clinic facilities typically spend time in community hospitals and health centers, as well as academic medical centers, which allows them to develop different competencies crucial to the art of practicing medicine, Dr. Juhasz says.
“If you’re in an academic medical center, you’re 10 specialties deep, you’re ordering consults with a lot of people, and you have patients who are critically ill,” he says.
“In community settings, you don’t have all of those resources, so you have to be resourceful. You have to know what you can and can’t take care of in a community setting. You have to learn to communicate very well with specialists and consultants as well as primary care physicians.”
In his career, Dr. Juhasz has also prioritized mentorship and worked to help residents maintain their osteopathic distinctiveness—even in an MD-heavy environment such as the Cleveland Clinic.
“Last fall at OMED, we met with students,” he says. “They said, ‘When we go out on our third- and fourth-year rotations, if we don’t see osteopathic physicians practicing osteopathically, we feel like we’ve been shortchanged.’ That was really impactful for me.
“We need to demonstrate the type of care we provide. We are hands-on physicians. Oftentimes we greet people with a handshake or a hug. When we examine patients, we often put our hands on them appropriately to make sure we’re using our palpatory skills as part of the diagnosis. And we use OMT in patient care. It’s important as we’re teaching to make sure that we’re modeling these tenets. If students and residents don’t see that happening, they’re probably not going to do it.”
Because the Cleveland Clinic was an early adopter of electronic health records, Dr. Juhasz was able to work with cutting-edge EHRs before many physicians did. And in 2005, he spoke with President George W. Bush about them. In 2004, Bush had laid out a plan for all physicians to convert to EHRs in coming years, and he wanted to hear how state-of-the-art EHRs were working. The Cleveland Clinic had a new online patient portal, a revolutionary step for the time, and Dr. Juhasz, on a panel with other physicians, spoke about the benefits patients reaped when they had online access to their test results and health information. He also brought a patient along. In another example of his humility, he credits her comments during vetting with helping him land the meeting.
“To this day, I’m certain the reason I met with the president is that my patient did a great job in speaking about her experience,” he says.
Nine years later, physicians at the Cleveland Clinic continue to dedicate themselves to improving their use of EHRs as practice tools, Dr. Juhasz notes. The clinic’s latest model, which has been dubbed “Turbo Practice,” involves a medical assistant seeing a patient first and typing the preliminary history into the note. Next, the physician enters, and the medical assistant serves as a scribe to document the encounter. After the visit, the physician files orders and reviews the note to make sure everything’s correct while the medical assistant has begun a new visit with the next patient.
With current technology, Dr. Juhasz says he tries to involve patients with EHRs as much as possible. He turns the screen toward patients and uses the information to teach them about their health, and then he’ll print a summary of his documentation for patients. He sees EHRs becoming less burdensome over time.
“I can envision a day when you walk in a room and you don’t type,” he says. “There would be four cameras or four high-end mics that would record your interactions with the patient. You’d speak to the patient about what you thought was going on with them and also what you think the appropriate treatment was. Then you’d be done.”
The AOA president and the year ahead
Dr. Juhasz harbors lofty goals for both osteopathic medical education in northeast Ohio and the future of EHRs. His visions for his year as AOA president are no different. He plans to focus on the transition to a single graduate medical education accreditation system, facilitate osteopathic medical research and bolster the benefits of AOA membership for DOs and students.
Research on osteopathic medicine will give DOs crucial information to communicate their distinctiveness to their patients and communities, he says.
“I’d like to see more outcome studies on osteopathic manipulative treatment, especially as it relates to common problems such as upper respiratory infections, low back pain or chest congestion,” he says. “We should be highlighting opportunities to treat patients without medication.”
But more research is just one added benefit Dr. Juhasz sees the AOA offering its members. He and other AOA leadership plan to review and update member services to ensure that DOs and students are getting what they want and need, he says.
“It’s important for us to create affinity for the AOA,” he says. “We want people to really feel like they love being members of the AOA. We want them to think of the AOA as having their back and really championing their needs for them while providing the necessary services.”
In the coming years, the transition to a single GME accreditation system will be one of the greatest challenges the AOA faces. But Dr. Juhasz is well-primed to handle this task for the next 12 months, notes AOA Trustee William S. Mayo, DO.
“As we are moving forward with unified GME, Dr. Juhasz is uniquely qualified to take the reins because he has been with the Cleveland Clinic for years as a faculty member in a system that has both allopathic and osteopathic teaching,” says Dr. Mayo, an ophthalmologist in Oxford, Miss. “He was involved in patient care every day, and he runs a hospital now. He understands medicine across a broad spectrum.”
Dr. Stanley cites Dr, Juhasz’s stamina for advocacy and enthusiasm for the osteopathic medical profession as key assets he’ll bring to the role of AOA president.
“Dealing with politics is hard because you put a lot of work in and sometimes make very little change,” he says. “It really discouraged me, but it never discouraged Bob. He realizes that political change is sometimes a slow process, but that it’s important to move that process forward.”
History suggests Dr. Juhasz will be applying his advocacy prowess to osteopathic medical education and helping DOs in practice.
“Bob has invested his whole professional career in furthering the goals of the osteopathic medical profession,” says Leonard H. Calabrese, DO, the chair of osteopathic research and education and the vice chair of rheumatic and immunologic diseases at the Cleveland Clinic. “At every step, in every venue, and certainly in our part of the country, Bob is there carrying the banner of osteopathic medicine, whether he’s talking to osteopathic medical schools or representing the profession at meetings or in other educational venues. He has no boundaries in terms of his generosity.”