UCSF Benioff Children’s Hospital: A Tale of Great Leadership in Three Acts

By  |  June 17, 2010 | 

This is an amazing tale of leadership – by my hospital CEO, our former chancellor, and, most importantly, a remarkable philanthropist. I’ll start with the latter, veer off to describe the former two, and then return, on this special day, to the philanthropist.

The first time I met Marc Benioff – in 2007 – he was not a happy guy. A adult relative of his was hospitalized at UCSF, night had fallen, and Benioff – the billionaire founder of cloud computing pioneer Salesforce.com – was growing concerned about the slow pace of the workup and the seeming absence of Gray Beards there to supervise the trainees. I received a call from our dean, David Kessler, asking if I could help. I came into the hospital, spent some time discussing the case with Marc and his relative, and things went well.

Over the next couple of days in the hospital, Marc asked me about my job, and I described the idea of a hospitalist. He immediately got it. “We have to do the same thing in my business,” he told me. Like every complex organization, Salesforce – a company with 4,000 employees and over $1 billion in yearly revenue – has many workers with deep and highly specialized knowledge, but needs generalists to serve as connectors and coordinators. Marc is a very smart and innovative guy, and it was fascinating to see my own work through his eyes. We had some spirited and interesting discussions, but when his relative left the hospital, I figured that that was the last I’d see of him.

I was wrong.

A few months later, Marc invited me to join him for breakfast, and we picked up the discussion where we left off. About halfway through the meal, he posed a question.

“Do you have an endowed chair,” he asked, me in mid-bite. I told him I didn’t.

“Would you like one?”

After I was done choking on my French toast, I said, “sure.”

And that’s how I came to receive the nation’s first endowed chair in hospital medicine: the Marc and Lynne Benioff Endowed Chair.

This was not an aberration – Marc and his wife Lynne have now endowed four faculty chairs at UCSF. Not only have they given generously of their money, but they have also helped energize a much broader group of Bay Area philanthropists to support the university. Credit for this has to be shared with our development office and our senior leadership – particularly our hospital CEO, Mark Laret.

UCSF isn’t like some (particularly private) institutions, for which fundraising is part of the organizational DNA. I’ve always felt that, as a state institution, we were a bit sheepish about diving deeply into the philanthropic world – with its images of marble floors and private mega-suites built to attract Saudi princes. We’re a pretty egalitarian place and the thought of aggressive philanthropy made us a bit antsy.

Mark Laret became CEO at UCSF Medical Center a decade ago, when the institution was at low ebb – losing boatloads of money and coming out of a painful divorce with Stanford Hospital. Laret felt that we needed to find donors to support our key missions (particularly with state support plummeting, a trend that has only gotten worse), and that there was a way to pursue philanthropy without selling our collective souls. And I think we’ve managed to pull it off – I’ve come to realize that soliciting philanthropy is fundamentally about telling your story and inspiring people – rich and not-so-rich – to share in your vision for the future. It’s a narrow sweet spot, but I think we’ve hit it pretty well.

Now a word about UCSF Mission Bay, since it represents an equally impressive example of leadership. UCSF has always been disadvantaged by being landlocked: in the late 1980s, we struck an agreement with our neighbors on our main Parnassus Heights campus to not build another inch. In the early 90s, as UCSF’s research enterprise mushroomed, it was clear we needed more space. Our Chancellor at the time, Joe Martin, began looking for a new campus. He eventually settled on Mission Bay, a sunny but seedy warehouse district in the shadows of the Bay Bridge, a neighborhood targeted for urban redevelopment by then-Mayor Willie Brown (the anchor tenant was the SF Giants ballpark).

But there was a big monkey wrench in the early plans for a second campus: Newt Gingrich, brandishing his “Contract with America”, had just taken over Congress, threatening to cut public funding for everything, including medical research. Academic medical centers began rethinking their growth plans; many switched into retrenchment mode. In this environment, did building a new billion-dollar campus make sense?

Joe Martin held a faculty town hall, where these questions dominated the discussion. “I know this doesn’t seem like good timing,” I remember him saying. “But I think that it’s never a good idea to bet against the American public’s support of medical progress and innovation. We need to do this.”

And so the plan moved forward. Gingrich left Congress, NIH funding doubled, and Mission Bay is now a thriving research campus. Had we not built it, UCSF would have been in a world of hurt.

At the time of its conception, the plan was for Mission Bay to be exclusively a research campus; we didn’t appear to need more clinical space. In fact, when I first arrived at UCSF Medical Center from San Francisco General Hospital in 1995, the former ran about half-empty; some days I felt like asking the last patient who left to remember to turn out the lights. My medical service ran a census of 35-40 patients – puny.

Today, our service runs a census of about 70 patients at UCSF Medical Center, with 20 more on our non-teaching service at Mt. Zion Hospital. And the hospital has gone from 50-60% filled in the 90s to 90-100% filled today. By about 2002, it was clear that we needed new clinical space. It seemed logical to build it – a Women’s Hospital, a Children’s Hospital, and a Cancer Hospital – on a parcel of land adjacent to the research campus in Mission Bay.

The estimated total cost: a cool billion-and-a-half.

Which brings us to today – in an act of astonishing generosity, Marc and Lynne Benioff announced a gift of $100 million to our Children’s Hospital, now to be known as UCSF Benioff Children’s Hospital (they describe their rationale in today’s Wall Street Journal blog). While remarkable, this gift is simply an extension of Marc’s long-standing devotion to philanthropy. Inspired by Colin Powell, from the early days of Salesforce Marc committed to donating 1% of the equity, 1% of the profits, and 1% of his and his employee’s time to philanthropy. As he described in a recent Forbes profile,

… it starts with the first day of work. The first day you show up at Salesforce, you spend the morning learning about the products, the technology and the organizational structure. In the afternoon you go out and do community service.

I’ve seen this attitude play out in many ways over the past few years, and it is very real. And very impressive.

It has been great fun watching the threads of this story weave together over more than a decade, beginning with Joe Martin’s decision to build a new campus in Mission Bay, Mark Laret’s choice to pursue philanthropy as a core strategy for UCSF Medical Center, and finally, today’s gift by Marc and Lynne Benioff.

There’s one more thread I’ll share with you. My girlfriend, Katie Hafner, has covered technology for Newsweek and the New York Times for over a decade. She showed me her 1996 Newsweek piece (“The Wealth and Avarice of the Cyberrich”), chronicling how, at the time, few Silicon Valley bazillionaires were giving back to their communities. The story is sad, even a bit maddening, but Katie leavens it with examples of a few hopeful seeds that were just being planted.

Those seeds have sure grown! Today, we see people like Bill and Melinda Gates as living examples of how much that attitude has changed – for the betterment of mankind.

And so too, on this great day, are Marc and Lynne Benioff.


  1. Bob Wachter June 17, 2010 at 3:27 pm - Reply

    And here’s the official UCSF announcement, from our Chancellor Sue Desmond-Hellman (who also played a central role in this gift) and Mark Laret.

  2. untilyou219 June 19, 2010 at 11:50 am - Reply

    ok thanks

  3. Julie Dong June 19, 2010 at 8:29 pm - Reply

    This is such a great inspiring story. Thanks for providing the background information behind the donation to our hospital.
    — Julie D. Pediatric Pharmacist

  4. kellylo9009 June 23, 2010 at 3:25 pm - Reply


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About the Author: Bob Wachter

Robert M. Wachter, MD is Professor and Interim Chairman of the Department of Medicine at the University of California, San Francisco, where he holds the Lynne and Marc Benioff Endowed Chair in Hospital Medicine. He is also Chief of the Division of Hospital Medicine. He has published 250 articles and 6 books in the fields of quality, safety, and health policy. He coined the term hospitalist” in a 1996 New England Journal of Medicine article and is past-president of the Society of Hospital Medicine. He is generally considered the academic leader of the hospitalist movement, the fastest growing specialty in the history of modern medicine. He is also a national leader in the fields of patient safety and healthcare quality. He is editor of AHRQ WebM&M, a case-based patient safety journal on the Web, and AHRQ Patient Safety Network, the leading federal patient safety portal. Together, the sites receive nearly one million unique visits each year. He received one of the 2004 John M. Eisenberg Awards, the nation’s top honor in patient safety and quality. He has been selected as one of the 50 most influential physician-executives in the U.S. by Modern Healthcare magazine for the past eight years, the only academic physician to achieve this distinction; in 2015 he was #1 on the list. He is a former chair of the American Board of Internal Medicine, and has served on the healthcare advisory boards of several companies, including Google. His 2015 book, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age, was a New York Times science bestseller.


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