HCA Virginia
November 08, 2022

By Gene Marrano, Valley Business FRONT

Tapped to replace New Zealander Lance Jones as the LewisGale Regional Health System market president and LewisGale Medical Center (Salem) chief executive officer earlier this year, Alan Fabian is certainly no stranger to the region nor to the parent company HCA Healthcare, which he joined in 1995. First it was several senior leadership roles at Louisiana hospitals, followed by 9 years at LewisGale Hospital Montgomery as the CEO there. Now that facility and LewisGale Hospital Pulaski, LewisGale Hospital Alleghany, and LewisGale Medical Center are all on his plate, along with outpatient centers like the two Roanoke County standalone ER facilities that have opened in recent years.

A New England native (he attended Western New England University as an undergraduate) Fabian started out on the IT side of the health care business in California before joining HCA in 1995. “I wasn’t always interested in health care – I was always interested in information technology. It just led me into the hospital environment.” In fact, as an outside consultant, Fabian installed and managed IT systems for HCA before he “morphed,” to the patient care side of the business. Fabian still understands the IT lingo, something he says the Information Technology manager at LewisGale appreciates – they can speak the same language. “[Its] something I’ve done all my life. I actually help him think through right to the problem.”

The move to replace Lance Jones (who decided to leave the HCA family to explore other aspects of health care) was a comfortable transition for Alan Fabian, considering he already led one of the hospitals in the LewisGale orbit. He also likes the investments made by HCA in the LewisGale system - $133 million just since the start of the pandemic, says Fabian. “We are investing for the future.” LewisGale has launched a number of technologies including robotic surgical aids that in many cases it claims is a first in the area. “I feel good about where we are … the capital investment in our facilities, and the leadership at each one of the [LewisGale] hospitals.”

Fabian spent 18 years working at hospitals in Louisiana for HCA (New Orleans, Lafayette), earning an MBA from Tulane while in the Big Easy. Shortly after the devastation from Hurricane Ian in southwest Florida, he said it was “something he lived with for 18 years,” in Louisiana, that is, preparing for a worst-case hurricane scenario.

“You do a tremendous amount of work for something that may never show up.” He does call HCA hurricane preparedness “fabulous at assuring you are prepared.” Fabian was confident the 40-plus HCA hospitals in Florida would be ready to serve patients post-Hurricane Ian. System-wide there was even pandemic preparation well before COVID showed up. When it finally hit here, “I felt HCA was behind us and I felt really good about it.”

The mammoth size of HCA Healthcare Inc. – more than 180 hospitals and 2000-plus other centers of care, gives it a scale and scope that reaches across the entire country notes Fabian. Technologies and techniques tried first elsewhere can migrate to clusters like the LewisGale Regional Health System. When the cutting edge becomes mainstream, “they provide better patient care.”

That includes utilizing the four DaVinci Robots in Salem and one in Montgomery County, and multiple orthopedic robots through the system that provide the best outcomes while minimizing patient discomfort. A $16 million expansion at LewisGale Montgomery that got underway before Fabian headed north to Salem and the Roanoke Valley will help that facility keep up with growth in the New River Valley; it includes several, “supersized,” operating rooms as he puts it. It will allow space for new procedures and for “that new technology coming down the line.”

Nursing shortages are nothing new and that was the case pre-pandemic as well, but Fabian says health care systems are now experiencing workforce challenges in what he calls ancillary services – lab technicians, pharmacy techs, in radiology, respiratory therapy. They are and will be “in high demand.” That’s why Fabian says its incumbent to have a good working culture, a great working environment, “so people are willing to stay with our organization. It's been a challenge across all four hospitals.”

LewisGale partners with local colleges that provide nursing and medical technician training, working to make sure their curriculums align with the needs of local health care providers. “If we don’t maintain that and assist [them] in some instances – the growth of these nursing schools – we’re going to be in trouble, in 5 to 10 years.” Keeping that workforce here in the Roanoke and New River Valleys is key. Conversely, Fabian notes that the recruitment of physicians has gone well over the past several years. He remains bullish despite the challenges: “I expect that with the growth in southwest Virginia … we are going to be prepared for that future - and be in a really good position.”