Viston Taylor has battled cancer since 1990. At age 73, Taylor had his annual CT scan in June, and it showed a possible reoccurrence of lung cancer. On July 18, he went to Memorial Hospital for a bronchoscopy and biopsy.
He "died" on the table.
"While I was asleep, my heart just stopped," Taylor recalls. "I was in CCU for four days and I still don't know about the lung cancer; can't do that test because it might kill me."
The affable Taylor, winner of the Champions of Healthcare Administrator award, sits in his office at the headquarters of Alexian Brothers PACE and laughs about his first encounter with his oncologist, Dr. Darrell Johnson, after the eventful day.
"He says, 'So, you're a champion of healthcare,'" said Taylor, who has battled cancer previously in 1990, 1996 and 2015. "I said, 'Yeah, I survived the healthcare system.'"
Joking about the state of healthcare in America fits the man who'd rather talk poetry in 2019 than the last 46 years spent becoming a nationally recognized authority on senior healthcare.
Taylor has never been anything but a healthcare administrator. Organizations dedicated to senior healthcare were not in existence when he got out of the army in 1972. As a result, he became the first director of the Southeast Tennessee Area Agency on Aging and Disability at age 26.
He started the gerontology program – Senior HealthLink — at the Erlanger Health System in the late 1980s and was the executive director of Hospice of Chattanooga for eight years. Taylor was the first non-physician member of the Medical Foundation of Hamilton County and is a fellow in the American College of Healthcare Executives.
Taylor was appointed as a delegate to White House Conference by President Bill Clinton in 1995 and taught policy at the University of Tennessee for 15 years. He came to what he calls his "last stop" at PACE in 1999, which he describes as "the best interdisciplinary care model" he has seen.
"And, I have seen a few," Taylor says.
Growing up in Marion County
Taylor's story starts in South Pittsburg, Tennessee. His father was a physician who attended McCallie School and Vanderbilt University on his way to establishing a primary care practice in Marion County.
The younger Taylor accompanied his father on house calls before Medicare and Medicaid began in 1965. He saw his father get paid in all kinds of currency including "poke salad," sides of beef and squirrels.
"People used to bring him a whole mess of squirrels," says Taylor, his ever-present bowtie bouncing as he laughs.
Taylor looks back over more than four decades of executive leadership in healthcare, including work to start 10 different initiatives and service on 41 different organizations or boards. But he also likes to remember his time as a child in the Sequatchie Valley.
"I can remember my father making house calls all over Marion County and the Sequatchie Valley helping people, which wasn't the safest thing back then," said Taylor. "One time, a guy held a gun on him until he took a bullet out of him. That's what I grew up with. That's where, I guess, I learned about taking care of people."
THE 'REAL DEAL'
Dr. Edward Baker Jr. knows Taylor well, really well. He's married to Taylor's sister, Pam, and lives in the South Pittsburg house where Taylor grew up. Baker is the son of former 3rd District Congressman LeMar Baker, who died in 2003.
"Viston takes a deep, deep personal interest in people, literally everybody he meets regardless of status or position. It comes so naturally to him," Baker said. "It is not forced; it is the real deal."
Taylor graduated from McCallie in 1964 and did his undergraduate work at Vanderbilt. While there, he joined the ROTC in order to get into graduate school at the University of Tennessee in Knoxville. He got his master's degree in administration and a commission as a 1st lieutenant in the U.S. Army.
"I got into grad school so I could go to Knoxville and ended up in Vietnam," said Taylor, who described his time in military intelligence in somber tones as an effort in "fighting a losing battle."
Taylor, who lives on Lookout Mountain, learned healthcare administration from the top down since there wasn't a place he could learn while working his way up when he returned from Vietnam. Taylor's career moves to Erlanger and Hospice of Chattanooga were a natural progression as his reputation here and around the country grew during the 1990s.
He was approached in 1998 about moving to PACE. He studied the PACE model, which started in 1972 in San Francisco, and saw what he had been looking for since he returned from Vietnam.
"When you put a social worker, a nurse, a physician, a nurse practitioner, a registered dietician, a recreational therapist, an occupational therapist, a physical therapist, a representative of the driver that is providing your transportation, the CNA doing your home care and they are all sitting at the table every morning talking about your health, that is the most intensive interdisciplinary care that has ever been done in this country and it works."
PACE is funded by Medicare and Medicaid, and the basic requirement is that a patient be "nursing home qualified," said Taylor. It's part Ascension Health, the largest Catholic health system in the world and the largest non-profit health system in the United States. Ascension purchased Alexian Brothers in January 2012.
Winner: Viston Taylor
Accomplishments: The veteran health care administrator has headed the Southeast Tennessee Area Agency on Aging and Disability, Senior HealthLink, Hospice of Chattanooga and Alexian Brothers’ PACE program. He was the first non-physician member of the Medical Foundation of Hamilton County and is a fellow in the American College of Healthcare Executives.
The program is a one-stop shop for low-income, nursing-home level citizens who would rather stay at their house than a nursing home. The dining room/activity room is full the day Taylor returns to work as patients eat, interact with others and rest when needed. Four seniors take part in physical therapy just off the main room.
"It's primary care, daycare and home care coordinated care with everything included and no out-of-pocket costs for the rest of their lives," said Taylor, who said PACE has some private-pay patients. "It's what every person deserves."
PACE's census is 287 and its capacity 325. Taylor said the program wants to grow but restrictions to TennCare rules by the General Assembly made it more difficult to qualify. Taylor said he estimates there are 1,500 "really frail, really complex, really poor" citizens in Hamilton County that would benefit from the PACE program. He called the state's current program to treat the same population, Choices, "just a band aid created to lower costs."
"Hey, we're a red state, and they don't like Medicaid. That's just the way it is," said Taylor. "Other states are not nearly as strict; one need, one call and you're in. Is there another reason why there is not another PACE program in Tennessee or Georgia?"
Taylor is resolute that healthcare is a right and a single-payor system the best vehicle. It is a view filtered not through the lens of politics but through a lifetime living the system, including as a cancer patient.
He said with equal conviction that the insurance and pharmaceutical industries are primary reasons the United States does not have a healthcare delivery system model for all citizens. Taylor believes there is plenty of room for both industries to make money and his model is straightforward.
"Who's the intermediary for Medicare? BlueCross (BlueShield)," said Taylor. "That's the hybrid model. However much you expand the role of government is not relevant because BlueCross will continue to be the intermediary and provide supplemental policies. It's about control."
Taylor discounts the decades-old argument about government waste as nothing more than a red herring.
"The healthcare industry is huge, I mean just huge, and there is a lot of waste," said Taylor, "but it's not Medicare. Those dollars are helping people. It's prescriptions, its hospitals, its insurance companies just about everything but Medicare. There are too many people with fingers in the pie, and they don't want to take their fingers out."
Taylor said the core issues in healthcare remain the same – smoking, alcohol, obesity – as they were in 1973 and that 50 percent of the causes of preventable death and disease are behavioral. He believes that only 10 percent are the result of access to healthcare, "the thing we are all hollering about," he said.
Taylor is more a healthcare statesman than practitioner now, an evolution centered on his time dealing with his own health versus the health of others. Believing he has seen the best model of primary care possible puts his professional career at rest. His focus is on his wife, Rose, his three children and 10 grandchildren.
"I don't know where healthcare is going, and I don't spend time wondering anymore," said Taylor. "After my close calls, I just started thinking about poetry, music and my grandkids. Those are the things I love spending time with."