Vermont Medicine Magazine

Sunil “Sunny” Eappen, M.D., M.B.A., has hit the ground running since taking over as the UVM Health Network’s president and CEO on November 28, 2022. He brings to the Health Network decades of experience as a physician, educator and administrator. Dr. Eappen most recently served as chief medical officer of Brigham and Women’s Hospital in Boston, where he also was interim president in 2021. He previously held key leadership positions at Massachusetts Eye and Ear and was an associate professor of anesthesia at Harvard Medical School. In late winter, Dr. Eappen took a few moments to reflect on his career, the state of academic medicine and his vision for the Health Network.

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What led you to this health system, and this region?
SE: I was excited by the opportunity to do something I really believe in, which is the idea that Vermont is espousing: providing medical coverage for everyone in the state, and delivering equitable care that’s high quality while reducing the cost. The opportunity to do that as a model for the whole country was really inspiring and intriguing for me. Having that be centered on the University of Vermont Medical Center, which has a great reputation, added to the appeal. I’d been at UVMMC to lecture a couple of times and traveled throughout Vermont over the last 30 years, and I knew what a beautiful place it is. All of those pieces compelled me to look a little further, and the more I learned about the health system, both in Vermont and Northern New York, the more interested I became.

What have been your major priorities since starting this job?
SE: My biggest priorities initially were to visit all of our sites—each of our Network’s six hospitals, along with our Home Health & Hospice—and really listen to folks to hear their concerns and the challenges we’ve had. The big concern we’re taking on right now is the financial situation that has impacted health care providers all over the country, with the very high cost of temporary workforce and inflationary pressures, while reimbursements haven’t kept pace.

Other issues include the challenges of recruitment, along with challenges in housing and child care, which add an additional burden on recruitment. And for our communities, the issues around patient access have really been front and center. All of these challenges are connected, and they exist not only for our Network, but throughout the state. These feel like the most pressing problems we’re taking on right now, while we also pursue our underlying goal and mission of, how do we provide equitable, high-quality care to everyone, and do it in a way that is value-based, cost-efficient and sustainable for the long run.

You’ve talked about being a “servant leader”— what does that mean to you?
SE: It means I help everyone around me succeed, and that’s how I succeed as a leader. A big part of that is transparency and honesty, and creating a safe place for conversation and sharing ideas. When we do that, we can make decisions that are not about us, but about the people we serve. It should always come down to, what’s the best thing to do for our patients?

Why did you pursue medicine as a career, and how has it led you to where you are today?
SE: My dad is a pediatrician, so the idea of medicine was always in the back of my mind. But I really went into college fighting it. I was a math and computer science major. I made a late decision to take the MCATs and go to medical school, and I’ve never regretted it. I went to the University of Chicago and chose anesthesiology with the idea of being an intensivist in critical care. But I found that I really enjoyed anesthesia, specifically OB anesthesia, and went down that path.

Initially, I thought I was going to be an academic anesthesiologist, and I spent the first three years after I finished residency in a basic science lab. I realized that wasn’t the life for me. And yet, I could still have a very academic career, which involved teaching medical students, training residents and moving into a more administrative role in an academic environment, which involved interacting with and understanding that whole world—while still delivering clinical care. There are many ways to be an academic physician: You can start on one path and end up on another, and still be happy and content and successful.

Can you talk about the importance of academic medicine, and how you see it benefitting patients and providers across the UVM Health Network?
SE: I’m completely committed to, and appreciate the value of, medical student and resident/fellow education. It really enhances the quality of the clinicians we have, and provides a pipeline of residents, and then faculty and clinicians, who want to live here and stay in the community. The opportunity to do research just makes us better and makes us stronger. It makes us more innovative and creative for our patients, so we’re right on the cutting edge. It allows us to have training programs, allows us to recruit and bring really high-quality folks here to take care of our patients. We have an incredible network of opportunity for this to happen, and I don’t think we’ve fully realized the potential of that by utilizing our entire health system, in Vermont and Northern New York.

When you think about the partnership between the UVM Health Network and the University of Vermont, including the Larner College of Medicine and the College of Nursing and Health Sciences, how do you see those continuing to evolve?
SE: I think the partnership and the relationship between the Network and these organizations is just going to become closer and even more important. There’s an incredible need right now, in this region and across the whole country, for physicians, nurses and many other providers and support staff. We’re working hard, within our health system, on innovative ways to recruit and retain the workforce we need to serve our patients. This goes beyond competitive wages and bonus packages, to things like developing education and training programs; expanding remote and hybrid work where we can; and investing in housing initiatives for our employees. But we’re not going to solve the workforce issue on our own. We’re so fortunate, as a health care system, to have close ties to academic institutions, and I know Deans Rick Page and Noma Anderson, and all the faculty at both colleges, share our commitment to training the next generation of talented, committed health care providers.

You’ve said it’s important to take care of the ‘whole community.’ How can health care providers make progress on persistent social problems, and how does academic medicine fit in?
SE: The traditional concept of being a physician or clinician is taking care of the illnesses that are in front of you and ending it there. And we’ve realized that, in order to keep our patients healthy, we have to have a much more holistic view of what their lives are like. So things like food insecurity and homelessness, or racial inequity in the way we deliver care, or poverty in the way it impacts access, all of those factors play such an incredible role in the health of that particular patient and the population we’re dealing with. It means we need to understand the support structures that exist in our communities; what role we can play directly, to help patients access that support; and how we can act as real advocates in our community to our legislators and regulators, talking about the importance of those social determinants of health.

We’re being asked, more and more, to think about the population at large and the impact we’re going to have on our communities. So education in public health, as part of medical education, is critically important. As we move to population health and value-based care, as we are in Vermont, there’s such a great opportunity for our students and residents to take advantage of that education that’s happening here. We’re ahead of the curve.

What’s your vision for the future of the UVM Health Network, and what needs to happen next?
SE: I hope patient access becomes a non-existing issue that we would be looking back on. That means people get the care they need, when they need it and where they need it—the most appropriate place—and we’ve figured that out, across our Network and across Vermont. That includes a strong, statewide system of inpatient and outpatient mental health care, and our Network can play a leading, coordinating role in that. And it means we would have a National Cancer Institute-designated program that offers the very best comprehensive cancer care.

I want to see the idea of digital health become more of a reality, so we actually have a virtual hospital, or virtual care platform. So that might mean you’ll go to our website, and it’s there. If you need to schedule an appointment with your doctor, you’ll do it online. If you need to do virtual consultation with your primary care doctor or specialist, it will be there—you’ll be able to do it easily. Also, I believe we need to make hospital at home, where you recover or get care in your home instead of coming to the hospital, a normal part of the spectrum of care that we deliver and our patients expect.

We need our measures of the quality of care and inequity to become really clear and transparent, so we have a very tangible measure of how good our quality is, and can identify where we have challenges in the equity space, in terms of access to and delivery of care. And then we can see tangible results in the improvement of quality and elimination of the inequity that we know exists.

Internally for our Network, our goal is that our patients are getting state-of-the-art care in the best facilities possible, in an environment that maximizes their healing. That, to me, means private rooms for our inpatients. There isn’t overcrowding in our emergency rooms. We have the right technology, whether it’s in the operating room, endoscopy centers or in our radiology suites.

Another goal is for our workforce to be content in their employment and in the work they’re doing. We don’t have a shortage, because people love to work here—that’s the dream of where we would be. Part of it is the environment we create, where you can be your true self in your place of work. It’s inclusive, so you know you’re going to be welcome, and your ideas are going to be welcome. It doesn’t mean we reach consensus on everything, but that everyone feels heard and respected.

We’ve got so many challenges right now, but we’re going to get beyond this. It’s absolutely necessary that we pursue our long-term vision, because it’s the right thing to do for our patients and communities. All of these things are essential to being a provider of great health care, now and for the long run. And that’s what we want to be.