Robert M. Heyssel, 72, former president of The Johns Hopkins Hospital and founder and first CEO of the Johns Hopkins Health System, who was widely recognized as the chief architect of the institution's emergence as a diversified, modern health care delivery enterprise, died June 13 at Nanticoke Memorial Hospital, Seaford, Del., of lung cancer.

Robert Heyssel

Heyssel's 20-year tenure at the helm of Hopkins Hospital anchored an extraordinary career in which he guided the world-renowned institution through two turbulent decades of changes in academic medicine, substantially rebuilt and expanded its East Baltimore campus, forged partnerships with corporations and the East Baltimore community and earned national praise as one of the nation's top health-service executives.

"He was that rare physician who understood not only the big picture and practice of modern medicine and the forces that influence it but also dealt firmly with the ups and downs of day-to-day management of a complex institution," said Ronald R. Peterson, a Heyssel protege who is the current president of Hopkins Hospital and Health System.

In his years at Hopkins, Heyssel established a reputation for speaking out and doing something about soaring health care costs, demands for reform, government and industry controls of medical care and care of the aged. In dozens of published papers and prepared speeches, he addressed issues of quality assurance, decentralized management, the disadvantages of for-profit hospitals and the impact of health care competition on research and medical education.

Heyssel led, or served on, nearly every national commission and organization charged with supporting and saving the nation's teaching hospitals, particularly those serving inner cities. Colleagues say his commitment to these causes was at the foundation of his efforts to improve the health and pioneer the redevelopment of the East Baltimore community in which Hopkins Hospital operates.

Heyssel came to Hopkins in 1968 as associate dean of the School of Medicine and director of outpatient services, was named executive vice president and director of Hopkins Hospital in 1972, its president in 1982 and president and CEO of the health system in 1986. Until his retirement in 1992, Heyssel worked closely with East Baltimore residents on affordable housing projects, putting together a coalition of public and private groups that attempted to revitalize the area around Hopkins. He created a community service award in honor of Baltimore's first black mayor, Clarence "Du" Burns, and helped bankroll an innovative Community Health Initiative guided by neighborhood leaders.

Heyssel's strength as a leader in his field owed much to his respect for the teaching and research arms of Hopkins Medicine, and especially to the long, parallel tenure of former School of Medicine dean Richard S. Ross. "A big, imposing man, he also was a man of his word. You always knew where he stood on an issue, and he always did what he believed strongly to be in the best interest of the hospital," Ross said.

When Heyssel retired in July 1992, his legacy was marked by two major phases of physical redevelopment at Hopkins Hospital, including construction of Hopkins' first Oncology Center, the Nelson Patient Tower, the Harvey Teaching Tower, the Meyer Building for Psychiatry and Neurosciences, the Clayton Heart Center, the Maumenee Building of the Wilmer Eye Institute and the Johns Hopkins Outpatient Center, whose main building bears his name.

On the business side, Heyssel kept Hopkins financially solvent as other urban hospitals struggled to stay afloat in the rising tide of efforts to control medical costs. His decentralized approach to administration, giving much budget responsibility and control to clinical department chiefs, was used as a case study at the Harvard Business School for many years.

He made major acquisitions and mergers, and launched both the Johns Hopkins Health System and the Johns Hopkins Health Plan, moving the institution into the world of managed care with a base of corporate clients, government contracts and tens of thousands of members. He created the Johns Hopkins Medical Services Corp. to retain control of the provider side of the enterprise when the plan was sold. Under his leadership, Hopkins acquired the failing Baltimore City Hospitals, expanding it into the centerpiece of the Hopkins Bayview campus, home today to a completely renovated and expanded medical center, a Geriatrics Center, a biotechnology development center, the Hopkins Asthma and Allergy Center and the clinical branches of two NIH institutes.

In the early 1970s, Heyssel was part of a Hopkins group that launched the Columbia Medical Plan and the East Baltimore Medical Plan, two of the earliest health plans in the region. The Columbia Plan was precursor to Howard County General Hospital, now a part of Johns Hopkins Medicine.

He served as chairman of the Association of American Medical Colleges and its Council of Teaching Hospitals and of the Commonwealth Fund Task Force on the Future of Academic Health Centers. In addition, he was a member of the Institute of Medicine of the National Academy of Sciences, a fellow of both the American College of Physicians and the International Society of Hematology and a member of the Association of American Physicians and the Society of Medical Administrators. In Maryland, he served on the Governor's Commission on Black and Minority Health Care and the Baltimore City Commission on Health Care for the Homeless. He also served as professor of medicine at the Hopkins School of Medicine and as a trustee of both the hospital and university.

Born in Jamestown, Mo., in 1928, Heyssel attended the University of Missouri and graduated in 1953 from the St. Louis University School of Medicine, which awarded him an honorary doctor of science degree. He came to Hopkins in 1968 from Vanderbilt University, where he held faculty appointments in hematology and nuclear medicine. His interest in public health has been traced to his years in medical school and as an enlistee in the U.S. Public Health Service, where he eagerly accepted an offer to study the effects of radiation in Nagasaki and Hiroshima with the Atomic Bomb Casualty Commission. During his time with the commission, he investigated the delayed effects of radiation in humans. With his colleagues, he provided the first description of the dose- response relationship of radiation to human leukemia in a nonselected large population. He maintained this interest in health policy with a faculty appointment at what is now Hopkins' Bloomberg School of Public Health.

On the occasion of his retirement, Hopkins officials and trustees lauded him as both "chief architect of a sophisticated ... health care organization that is a national model" and as a "self-described country boy" whose "booming laugh fills the duck-hunting lodge and whose Missouri accent and aphorisms--and love of heated discussion--keep the party going far into the night."

Heyssel is survived by his wife, Maria, five children and nine grandchildren.

Funeral services were June 15 in Seaford, where the Heyssels had moved shortly after his retirement, and a memorial service was held the following day in JHMI's Hurd Hall. Contributions may be made to the Robert M. and Maria Heyssel Fund, The Johns Hopkins Hospital, c/o Fund for Johns Hopkins Medicine, 1620 McElderry St., Baltimore, MD 21205, or to Nanticoke Memorial Hospital, 801 Middleford Road, Seaford, DE 19973.