The Good Samaritan Who Runs Good Sam Hospital

One hundred years ago, a woman founded what was to become the Hospital of the Good Samaritan in Los Angeles. A hundred years later, it is still being run by a woman.

In 1885, Sister Mary Wood, an Episcopal nun, began serving the sick in a cottage accommodating nine patients. Now, in its centennial year, the hospital has grown into a facility built in 1976 at a cost of $33 million that provides 411 patient beds, employs as many as 1,400 people and has a staff of 500 doctors; its total assets for the fiscal year ending Sept. 1, 1984, were more than $108 million.

Wide Horizons

Responsibility for the hospital’s operation falls on Geneva A. Clymer, its executive director, a trim 60-year-old whose professional life has centered on Good Sam since she took her nurse’s training there. The only time since entering nursing that she has not been on the hospital staff was during 1951-52 when she was earning a bachelor of science degree at UC Berkeley.

Clymer, however, has wide horizons. She serves on the board and/or committees of 15 civic and professional organizations, belongs to several more, teaches at Cal State L.A. (where she earned her master’s degree) and participates in numerous health care conferences and programs.

Yet she finds time for gardening at her home in the Eagle Rock area, where she lives with a black Labrador dog named Brutus. She enjoys reading, art, music and an occasional game of tennis (“something I wish I had more time to do”), visiting with family and friends and, especially, their children. She travels both for business and pleasure.

She sat in the living room of her hillside home on a sunny spring morning, looking out on the pleasant brick patio she herself built. She talked about her family--her mother, brothers, their children and grandchildren--and the things she enjoys: a book she is reading, a painting that her mother did, a sculpture she bought on her first trip to Europe, the golden Sunday mornings that she spends on her patio with a cup of coffee and a newspaper and, above all, her garden.

But Geneva Clymer is never far from her work; it is the paramount part of her life. She juggles her many interests among 12-hour work days that frequently stretch out into the evening hours, plus weekend events.

‘Challenging, Frustrating’

In a quiet conference room outside her office in the sleek new hospital, Clymer talked about her job, which she termed “exciting, challenging, demanding, frustrating.”

“But I am not easily discouraged,” she said. “A lot of my role is just in listening. This is a very tense environment. We are dealing with intense situations--literally life and death.”

She spoke of the rapid changes in the health care industry in recent years.

“Hospitals as an industry are undergoing some of the most radical changes in their 200-year history in the United States,” Clymer said. “There is not a day that I don’t see an article in a publication about the health delivery system. It has undergone a revolution in the past couple of years.

“It has to do with payment. The people paying the health care bills have interspersed themselves in the system. The biggest payer is the federal government, then the state and local governments. Next are the employers who provide medical insurance and who have the primary objective of lowering the cost of the premiums. The insurance companies are in the middle of the payment mechanism.

“They have been successful. We see the occupancy of hospitals as considerably down. It has plunged. This has created a crisis situation in hospitals.

“Newspaper stories on hospitals used to appear in the society pages; now they appear in the financial section.”

Clymer noted the trend of unaffiliated, independent hospitals to join with others, adding:

“This (a hospital) is no longer a service or a community institution. It is big business. We are moving into a corporation scene with emphasis on the bottom line.

‘Came Down Too Hard’

“Probably, the hospital system has brought some of this on itself. Our basic conception has been on service and perhaps we have not been as business-like as we should have been. Formerly, the government paid us what it cost us. Then they came down too hard. We must move back to not forgetting the reasons why we went into (medical care) in the first place.

“Our whole insurance system makes no sense. It is not health insurance; it is really sickness insurance. Our money would be much better spent in keeping people well. But there is not enough glamour in that. We do heart transplants instead.”

Clymer also spoke of Medicare and the health needs of both the elderly--those over 65 account for 60% of hospital patient days--and the young.

“The old are presenting a major crisis as far as health care delivery goes,” she said, “but also in other areas--housing, jobs, the acceptance of their contribution to society.

Role of the Hospital

“Hospitals are designed for acute infectious diseases, not for the elderly who have chronic problems . . . . The role of hospitals in the care of the aged is ironic in that payment under Medicare is . . . directed to the acute illness phase. But the need is on long-term care.

“I think our emphasis should be on the young--prenatal care, to work with young women in making them realize how important it is while they’re pregnant to eat well, to stay away from drugs. We also need early treatment and emphasis on nutrition--but we have cut out our nutrition programs.”

The increasing role of insurance, both governmental and private, in health care also has resulted in major shifts in hospital care, Clymer said, citing Good Samaritan’s plans to study services in obstetrics and emergency care.

“We closed the obstetrics ward 10 years-plus ago, but we are currently in a feasibility study to reopen it,” she said. “Part of this payment mechanism that is driving the medical system now is responsible for considerable reopenings of OB departments.

A Certain Volume Assured

“The law now allows insurance companies to give an option in which the insurance company selects certain doctors and hospitals and assures them a certain volume of patients at a discount rate. They (insurance companies) want to be able to go to the larger employers who are looking for full-service hospitals.”

Clymer said that while Good Samaritan has had “an ambulatory care department that could take care of you if you could walk in,” it is now in the process of opening an emergency department.

In addition to the operation of the hospital itself, Clymer is concerned with the needs of the community surrounding it and of its personnel. For the older people who live near the hospital, it provides a subsidized meal program and maintains an affiliation with Angelus Plaza, a Bunker Hill housing complex for low-income senior citizens.

“We have a contract with Angelus Plaza to provide a physician, nurse practitioner and other personnel at a health office on the site,” she said. “We also have a transportation program to bring them here (to the hospital) for tests if necessary, and we accept whatever Medicare provides as payment in full. The program is not self-sufficient; we are blessed with support from the community.”

Two programs for hospital personnel are near and dear to Clymer’s heart, especially “the thing I had personal involvement in,” a child care center.

“I recognized early on the problem nurses had with child care,” said Clymer, who was the hospital’s director of nursing for 14 years before becoming executive director. “I was able to get a child care center that the hospital operates, an ideal center. It has about 75 children. Any employee is eligible to enter a child--men, too. The children get care and well-balanced meals designed by a dietitian and made in the hospital kitchen.

“We also have a fitness center for employees--and it is not an executive fitness center. These things--child care, fitness--are not all that costly, and if they make the employees happier and healthier it’s worth it.”

Another community involvement is a hotel next to the hospital that the Weingart Foundation donated to Good Sam. It houses some employees and provides a place at a modest rate for patients requiring tertiary care who have to come from a distance. In addition, some residents, mostly elderly, who lived in the hotel before it was given to the hospital, remain.

Viewed as a Role Model

Clymer also works with hospital administration students who come to Good Sam on six-month paid internships. She concedes that the women students view her as a role model “but I am quite frank in saying it is not an easy field for women, especially if they want to add the duties of wife and mother and homemaker.”

Divorced and childless, Clymer maintains close ties with family and friends and happily shows off the photos of their youngsters. She clearly cherishes her modest, cheerful home, its hilltop view and the garden she keeps meticulously. A result of her work, a Pink Perfection camellia so perfect it appeared to be fake, stood atop her dining table the other day.

Her home, taking Brutus on his morning walks, the quietude of the neighborhood, her garden clearly are part of what helps Geneva Clymer cope with the problems of running a complex medical/financial institution.

“I love the out-of-doors,” she said. “Did you see that old beat-up camper in the driveway? I love to get in it and go up the coastline, stop somewhere and fix lunch. I take friends along, and Brutus loves it, of course. It is a good change for me.

“I do all of my own yardwork. I enjoy gardening; I see something completed. Sometimes at work I am dealing with projects and complaints and I feel nothing is resolved. That is not so with my garden.”