Interview

A Proud Tradition of Service

Nicholas Van Deelen, MD, Co-President/CEO and Chief Medical Officer, St. Luke’s

Please share some of the rich history around how St. Luke’s began.

St. Luke’s is a nonprofit health care system based in Duluth, Minnesota. Our two hospitals and more than 40 primary and specialty care clinics serve residents and visitors of northeastern Minnesota, northwestern Wisconsin and the Upper Peninsula of Michigan.

St. Luke’s has provided medical leadership since its founding as Duluth’s first hospital in 1881. It was founded by St. Paul’s Episcopal Church in the upstairs of an old blacksmith shop in response to concerns resulting from a deadly typhoid epidemic (St. Luke’s is now secular). In 1884, St. Luke’s moved to a 38-bed facility, and in 1889, St. Luke’s established the area’s first nursing school. In 1902, St. Luke’s opened a four-story facility with the capability of serving 95 patients.

Even though St. Luke’s has grown into a regional health care system that serves three states, it has retained its renowned patient-centered focus. The high-quality medical staff provides state-of-the-art care in one of the most beautiful settings in the United States.

What have been the biggest developments along the way to becoming the health system St. Luke’s is today?

In the early 2000s, St. Luke’s began changing from a hospital/outpatient facility into a regional health care system. We did this by hiring physicians, most often through practice acquisition of both primary and specialty care clinics. We now employ more than 200 physicians and advance care clinicians.

St. Luke’s leadership in education, starting with opening a nursing school in 1889 (which closed in the mid-1980s) and now serving as a clinical training site for area colleges, medical students, pharmacy students and residents, has been integral to our growth and success.

In partnership with the University of Minnesota Medical School, Duluth Campus, and through a generous trust bequest from Miss Muriel Whiteside, we created the Whiteside Institute for Clinical Research (Whiteside) in 1996. Whiteside focuses on clinical research, especially in the areas of cancer, lung and heart disease. This allows our physicians to partner with medical students on important research that benefits patients in our region and beyond. One example of our success in research is our ongoing involvement in the RECOVER study for COVID-19 (RECOVER). St. Luke’s is one of six organizations nationally participating in this CDC study. In addition to us, Kaiser Permanente, the University of Arizona, the University of Miami, the University of Utah and Baylor, Scott & White are also involved.

St. Luke’s ongoing physical developments are numerous. From opening several new primary care clinic buildings throughout the region to ongoing development of our hospital campus, we are always focusing on thoughtfully, economically and sustainably evolving our facilities to meet the ever-changing health care needs of our patients. Most notably, in 2012, we built a new five-story medical office building (St. Luke’s Building A) that is serving as the hub of our future campus. The building opened with 35,000-square feet dedicated to specialty clinics. In 2015, we built out an entire floor to significantly expand our surgical space, including adding a hybrid operating room. In 2020, we completed the infill of this building, with one floor dedicated to an emergency department tripled in size from the previous one and another floor dedicated to state-of-the-art cardiac cath labs, cardiac rehab and cardiac diagnostics.

We are now beginning a significant expansion of Building A, adding two stories for private inpatient rooms for intensive care and cardiac care patients. This will also allow us to make all-private inpatient rooms throughout our hospital.

We have two wholly owned ambulatory surgery centers (in Duluth, MN and Superior, WI), and this year opened Northern Lakes Surgery Center, an ASC in Moose Lake, MN, which is a partnership with Gateway Family Health Clinic.

We value being good stewards of our resources and our community.

Many people may not realize just how large St. Luke’s has become. Please tell us about the scope and range of services you provide.

St. Luke’s is a regional health care system serving approximately 500,000 residents of northeastern Minnesota, northwestern Wisconsin and the western Upper Peninsula of Michigan. It includes St. Luke’s Hospital in Duluth, Lake View Hospital in Two Harbors, three ambulatory surgery centers and more than 40 primary care and specialty clinics throughout the region. We have more than 200 employed physicians and advance practice clinicians. We are a charter member of Wilderness Health, a regional health care collaborative working to improve patient quality and outcomes. St. Luke’s provides full spectrum adult and pediatric health care. In addition to our high-quality primary care, we have a busy OB-GYN service, a level 2 nursery, a level 2 trauma center, a regional cancer center, a stroke center and a regional heart and vascular center.

What kinds of research projects are being conducted at St. Luke’s?

As mentioned earlier, St. Luke’s is participating in the national RECOVER study. Participation is led by St. Luke’s Infectious Disease Specialist Dr. Harmony Tyner. Her work and findings from the study have been published in the Journal of the American Medical Association. The study focuses on frontline workers who both have and have not been vaccinated. The findings help inform public health guidance nationally.

Another recent research project focuses on the positive effects of early low-dose chest CT screening on rural patients. St. Luke’s Radiation Oncologist and Whiteside Medical Director Dr. Nils Arvold has partnered with Maddy Hinojos, a student a student at the University of Minnesota Medical School, Duluth Campus, and others. They are researching the outcomes of lung cancer patients living in rural areas who get an early diagnosis due to a low-dose CT scan. Lung cancer is the biggest cancer killer in the U.S.; Drs. Arvold and Hinojos discovered that by screening eligible patients with a low-dose chest CT for lung cancer, the historical association between living rurally and having worse lung cancer outcomes disappeared.

We also have a number of other Phase II, III, and IV clinical trials happening.

What are some of the biggest challenges you face?

The challenges St. Luke’s faces are not unlike those being faced by other health systems. We are experiencing extremely high labor and supply costs and low reimbursement rates from governmental payors. This is putting a lot of financial strain on systems.

Having enough staff with the appropriate skills is also a current challenge. We are finding ways to encourage young adults to choose careers in health care. There are thousands of nursing positions left unfilled across the state because people aren’t entering the field like they used to. St. Luke’s is addressing that through the way it recruits and celebrates employees while working closely with our excellent educational partners.

The pandemic also led to people delaying care, and we’ve seen people coming in when they are at a point where they are diagnosed and treated for more serious heart conditions and advanced stages of cancer. We continue to remind patients of the importance of regular visits with a primary care provider and that early care and prevention will improve their health in the long run.

What kinds of changes are you seeing in your patient population?

Our patients are accessing care differently than before. Consequently, St. Luke’s is constantly evaluating the options we provide to make sure that we are available. Whether a patient needs highly specialized care accessed through our state-of-the-art emergency department, an annual appointment with their primary care provider or a virtual visit for a minor condition, St. Luke’s staff are ready to serve, and the options for scheduling are more robust than ever. Additionally, in response to our patients delaying care, the St. Luke’s Primary Care clinics are proactively reaching out to them with a special focus on their wellness. The clinics are scheduling appointments to assist with the management of chronic illnesses like diabetes and asthma and making sure all the preventative measures that were delayed during the worst years of the pandemic are caught up to date.

Please tell us about the St. Luke’s Foundation and some of the work being done there. 

St. Luke’s Foundation has a mission of advancing patient care, research and community health. The Foundation provides grants to those in the community that support the community health needs assessment’s priority areas of food access, mental and social well-being, substance use and housing.

Through funds raised annually, St. Luke’s Foundation has also provided support for many important projects at St. Luke’s. That includes a new level 2 nursery, a new emergency department, a new physical therapy space for patient rehabilitation and new cardiac catheterization labs.

St. Luke’s Foundation supports cancer patients with gas cards, grocery cards, lodging and more. They help fund palliative, personal, emotional and spiritual care for patients in hospice. They do so much and show such incredible support for those in need.

What are some of the most surprising things that people might not know about St. Luke’s?

It often surprises people when they learn St. Luke’s was the first hospital in the community, founded in 1881. We’re proud of our heritage and our tradition of serving our patients. Since we began as a hospital, some are surprised at the depth and breadth of our services. We offer extensive primary and specialty care, at a very high quality.

People may also be surprised to learn about St. Luke’s sustainability efforts. We value being good stewards of our resources and our community. It’s important both to the health of our organization and communities we serve. Therefore, we’ve strived to have a more environmentally friendly impact. We group these sustainability initiatives into three categories, environmental, social and economic. Examples of environmental sustainability are: composting food waste and using compostable products in our cafeteria, redistributing surplus food to those in need, sourcing local food and ingredients when possible and paperless invoicing. Examples of social sustainability include: heating water for laundry with reclaimed steam, collaborations with the Duluth Transit Authority to improve access to public transportation and consulting with Minnesota Power regarding solar energy. Economic sustainability initiatives include: environmentally preferred purchasing practices, collecting single use devices to be reprocessed for future use or for materials to be recycled and redistributing equipment and supplies to countries in need.

Moving forward, what are the short- and long-term plans for the future of St. Luke’s?

St. Luke’s is excited about the future and the role we play in our region. We will continue to provide the highest quality care available, utilizing the latest technology, delivered in a highly personal way. We are redeveloping our Duluth campus to promote efficiency and comfort, as well as improve access for our patients and our staff. We are working with our Wilderness partners throughout the region to identify ways that we can further support our patients. We look forward to further investing through our role in medical, pharmacy, nursing and allied health education. Long term, St. Luke’s will continue to live our longstanding mission: the patient is above all else.

Nicholas Van Deelen, MD, Co-President/CEO and Chief Medical Officer, St. Luke’s.