Robert Wesley Steele

A hospital goes up in Springdale, and the man responsible says it’s not complicated.

As Arkansas Children’s Hospital’s chief strategist, Dr. Rob Steele is the one responsible for the hospital’s plans to build its first second hospital in Springdale and, just as importantly, execute a build-out — at Jonesboro, Monticello, Texarkana — toward the other three corners of the state and all the catfish-andcover-crop stops in between.

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“We need to serve children in a way that, when they need services, they want to come here.”

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“One of the things I wanted when I got here [was] … someone who lived for strategy. That’s not a trait found in every executive. Some folks have trouble saying, ‘I disagree.’” — Marcy Doderer, president and CEO of Arkansas Children’s Hospital

Date and place of birth: June 12, 1967, New Orleans.

Family: wife Renee; sons Ryan, 22, Mitchell, 20, Christopher and Austin, 8; and daughter Dora Jean, 12.

What’s always in my refrigerator? Milk. We have gallons of milk. Seriously. If you go into [the refrigerator] right now you’ll find no fewer than six gallons of milk.

Fantasy dinner party guests: Wynton Marsalis, Paul Prudhomme and Zach Galifianakis.

An obsolete item I won’t part with: a handkerchief. I keep one in my pocket.

When I drink, it’s a well-mixed martini.

My favorite color: Green.

Favorite designer: Tom Ford.

Favorite item of clothing? My cowboy boots.

Where I hang out with my kids: Altitude Trampoline Park.

I love watching Seinfeld’s Comedians in Cars Getting Coffee.

Most memorable concert? Prince. Best concert ever.

I can’t stand wasting time.

The best decision I ever made was choosing happiness over money.

My worst physical pain: I completely separated my AC joint of my shoulder while skiing.

My favorite part of the body: What kind of publication is this? You really want an answer? The iris.

A phrase that sums me up: Enthusiastically intent.

Steele became a pediatrician about the time George Clooney, as Dr. Doug Ross on ER, made that the sexiest thing a man can do. Steele’s handsome face and cheery voice presage a gentle bedside manner. After an invitation to be immodest (otherwise he is not), he says he’s good bedside. He knows it. “We actually measure that through patient satisfaction scores, and I always have the highest ones.”

Hospitals are big business. From latex gloves to IV solution — Children’s Hospital will spend hundreds of thousands of dollars this year on drip — almost everything’s a hefty line item. The new magnetic resonance imaging (MRI) machine will come in at $5 million. Recent purchases of Angel One helicopters were about $12 million each.

Today, health care spending in this country amounts to 18 percent of gross domestic product, as high as it has ever been, and “there are economists who say 20 percent is implosion — there’ll be too much in one industry. Employers are crying foul,” he says.

Upon this game scape Steele steps with the intention of expanding services and rewarding all players — patient, doctor and provider — when patients get well and use services less.

“We need to serve children in a way that, when they need services, they want to come here,” he says.

It’s called market share, and Steele wants it.

He also says, “We’re no different from any business; we’re going to earn their business,” and by they, he means “not just the children and families but employers, payers, the state through Medicaid. So, we will always prove our value.”

Value is a tricky thing to prove in the children’s hospital business model. A general hospital delivers babies, comforts the dying, sets broken bones and pumps poisoned stomachs. A children’s hospital does all of that, of course, but for just the first two decades of a life. Steele says the demographic threshold for a children’s hospital is 500,000. That is, for this model to work, the patient service area must have at least a half million kids.

Arkansas has a bit more than 700,000.

About 100,000 are in Pulaski County alone. Quite a bit more live in Washington and Benton counties combined. Meanwhile, the Delta county of Desha has just four young people for every square mile.

“What we want is to find out, how can we get outside Little Rock in a way that makes sense from a business perspective, that can be sustainable,” he says, because building a hospital isn’t complicated — “it’s hard work, but it’s not complicated” — whereas “figuring out what the children in Desha County need, and how to get them to it” is nuanced.

Perhaps not surprisingly, when he’s away from work, he likes people who are fun and direct and transparent, like his kids and especially his wife. Renee Steele is an outspoken promoter of her husband, whom she has given the mildly teasing and moderately humiliating moniker “The Rubster Fresh.”

“We don’t need to get into that,” Steele says, on a long exhale.

“You see I have no filter?” she says.

In 2009, living in Springfield, Mo., Renee — who considers herself a “developer” of connections, of opportunities — failed to get her husband into the July issue of 417 Magazine’s Top Doctors feature, perhaps because he was in the previous month’s feature, “Meet 417-Land’s Hottest Husbands.”

“We need to serve children in a way that, when they need services, they want to come here.”

“Yeah, he was a hot husband,” she says.

“You don’t have the time to …” Steele says with a wave.

“Really?” she says, disbelieving. “He’s not even serious.”

Steele’s short profile in the magazine is nerd-hot. He likes the trumpet and ballroom dancing. He mentions the Scout II he restored and boasts he can still do a standing backflip — after all, he was a university cheerleader. He hates child abuse and that’s why he’s involved in the local Child Advocacy Center and on the board of the Parenting Life Skills Center. When the magazine asks, “What makes you a Hot Husband?” he talks about how hot his wife is — “She is quick-witted, laughs at my stupid jokes and flirts with me till my toes curl.”

If she picked him, under the transitive property of equality, he himself must rank.

A FAR-FLUNG FOOTBALL

His earliest memory in life is being pushed in a child’s swing on the island of Oahu, Hawaii.

The family bounced around for Lt. Col. Russell Steele’s military medical career, eventually landing in Little Rock, where the doctor was chairman of pediatric infectious disease and immunology at Children’s.

Rob Steele was a standout gymnast at Little Rock Central High School. In 1982, he won a state championship. Another member of Central’s Class of 1985, Marcy Doderer, is now his boss.

“One of the things I wanted when I got here [was] … someone who lived for strategy,” she says. Yes, their parents were friends and all attended the same church, but Steele was by then a doctor and hospital president, and he has since proved to be the kind of executive team member who sets a Socratic tone of questions and challenges, points and counterpoints.

“That’s not a trait found in every executive. Some folks have trouble saying, ‘I disagree.’”

Steele’s brother is less than two years his junior. That provided lots of opportunity for aggressive negotiation and adolescent trials. When they moved to Little Rock, to a native parcel at the end of River Ridge Road, the boys spent time that summer competing to unearth by hand the largest buried boulder from the yard. When Rob matriculated at the University of Texas, Chris Steele visited, and the two took a football to the 50-yard line of Texas Memorial Stadium, where Rob threw a perfect spiral that landed right at the end zone.

Chris chucked it well into the end zone, and today, if asked by a newspaper writer for a profile about his big brother, this is the one Chris wants told.

“He was not afraid to flip, to tumble … he could dazzle off the diving board, but when we went toe-to-toe” in a sport like basketball or football, “I made sure I beat him in that,” he says.

At UT, Rob Steele was only an “OK” gymnast. This, and the size and culture of the campus didn’t suit him, and by 1987 he was a North Carolina Tar Heel and a cheerleader.

He was admitted to the medical school at Vanderbilt University in Nashville, Tenn., where, for the first time, he wasn’t clearly at the head of every class. For one thing, “they’re totally brilliant people,” but also, many of them had taken medical school courses as undergraduates. “OK, one, I didn’t even know you could do that, and two, why would you? … You’re going to do that the rest of your life! I took drama; that was awesome.”

Gross anatomy was tough, “which is funny because fixing a car is a lot like anatomy,” but then, no. The corpses are old. They’ve had -ectomies. Things have torn, shifted. The pressure mounts. Get one C and you must repeat. Get two, and a student repeats the year. “I’ve got a defective cadaver!” he might’ve yelled.

He didn’t.

He persevered, eventually earning his degree and landing a pedigree residency at Cincinnati Children’s Hospital. He believes he was the first graduate ever to have been handed his diploma onstage by a family member — his father, the lieutenant colonel.

For 10 years he practiced pediatrics at what was St. John’s in Springfield, then he volunteered to sit on a board, then chair a board that brokered contracts between the hospital and health providers like Aetna. It was perhaps the middle of Mercy Springfield Community’s transition into a managed care model, and the beginning of Steele’s second act as a full-time hospital administrator.

In winter 2013, he became the first physician ever picked to be a president within the 122-year-old system.

In 2014, he was wooed away by Arkansas Children’s Hospital — and the promise of statewide care of children.

SCOUT II

The Steeles’ attached three-car garage in the Maisons neighborhood in west Little Rock includes a couple of modern family wagons and a 1979 International Scout II dripping 10-weight motor oil from its valve covers. These covers and other exterior engine parts are painted “International red.” The clutch pad is bigger than modern-day brake pedals. The seats and arm rests are stitched with the I-over-H (International Harvester) logo. He swears — swears — he can get 12 mpg on the highway.

“He hypermiles,” Renee says.

“I’m [coasting] in neutral a lot,” he agrees.

Steele restored this nearly 3-ton tank a few years ago, and really, the only thing car and driver have in common is steel. But then, he spells his with an E at the end.

Steele is interested in children in a way much different from most people, even most doctors. He’s interested in demographic density of children across the state. For instance, in Northwest Arkansas, there are, broadly, 78 children for every square mile. In Jonesboro, the density is 37, and in Texarkana, 17.

So in Northwest Arkansas, the population as well as market-share competition encourage construction of a hospital (which is not the trend across the country).

In 2018, Children’s Hospital Northwest in Springdale will begin admitting pint-size patients. It’ll be small, 24 beds — that’s a tenth the size of the Little Rock hospital, and still $160 million. “Acuity” won’t be as high — Children’s Hospital is a Level 1 trauma center — but all the subspecialties will be available, such as pediatric cardiology, pulmonology, endocrinology, rheumatology. (The list exceeds 20.)

Elsewhere in the state the answer is decentralized care. About 1 in 9 families in south Arkansas and the Delta don’t have cars. “If you don’t have a car, how are you going to get to Little Rock? Heck, how are you going to get to your own doctor?”

That’s a tough one for Steele, tougher even than

How do we get a doctor to you?

How to export the brain trust that is Children’s Hospital all the way out to the state line and beyond? One answer is telemedicine — doctor visits and consultations that take place remotely via video conferencing. Another is encouraging specialists such as cardiologists and orthopedists to hold clinic hours once a week or month at clinics and small hospitals in the hinterlands.

“What we would love,” says Allan Nichols, chief executive officer of Mainline Community Medical Center in Dermott and eight other small southern Arkansas towns, “is to get specialists down to the area or … replicate their technology and do some of the things they can do in Little Rock.”

Because transportation is the biggest issue for many of the families served by Mainline, and more than half of the state’s kids don’t live in Pulaski, Washington or Benton counties. “Dr. Steele gives us tremendous hope,” he says, because he seems to take it personally, and these kids, “they need it to be personal.”

Steele said it’s a moral obligation. For one thing, Arkansas Children’s Hospital is a nonprofit, and its mission is to serve the health needs of Arkansas children. “Notfor-profit hospitals are a resource for the community, by definition.”

For another thing, the health of children is a marker for the health of an entire state, and in the most recent Annie E. Casey Foundation Kids Count report, Arkansas was 44th nationally. That, he says, “gets me up in the morning,” and the answer isn’t better cardiology but better education and broad access to care.

For that reason and others, Steele is reticent when asked if his long-term plans include a return to pediatrics. Yes, he’s board-certified in Arkansas. He might begin practicing by way of the telemedicine he hopes to bring to small clinics along the state line.

“I’m positioned to do it, but do I ever see myself going back, 100 percent back, to practice? No, I don’t.” He says it’s intoxicating for him to move from bettering one life at a time to bettering thousands at a time. “It’s just … it’s different.”

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