Temple University's board of trustees on Friday said that it had appointed four new members to the board of the Temple University Health System as part of a restructuring announced Wednesday.

"These new appointments align with the new direction that the health system is embarking on," said Kevin Feeley, a spokesperson for the Temple University board. The new direction could include the sale of Fox Chase Cancer Center and Jeanes Hospital, and will likely reshape the health system's clinical and research programs.

The goals are "the preservation of the medical school and its ability to continue to serve as a top training ground for health-care professionals, but also embracing Temple's unique status as a health system with a social conscience," Feeley said.

With its main hospital in North Philadelphia, Temple has for decades been forced into the role of a safety net for poor neighborhoods. That means it must contend with unavoidable financial strain from patients who are uninsured or rely on Medicaid for health insurance.

Without special aid from the state that is negotiated every year, Temple would face steep annual losses. Even with a substantial transfer from the state this year, it's uncertain if the system will eke out a budgeted $5 million profit on revenue of more than $1.6 billion, health system officials said on a conference call with municipal bond analysts Friday.

Under chief executive Larry Kaiser since 2011, Temple has pushed into better-paying, highly specialized care that could attract more patients with commercial health insurance in a bid to balance out the Medicaid deficits. Temple's board may have decided that strategy was not going to work in the long term.

Another part of Kaiser's strategy was the pursuit of merger opportunities, but that has not happened.

"We are sort of being surrounded by consolidation in this marketplace, and I think it is an appropriate time that we really need to take a look at our core operations and see how we can best reposition ourselves to continue to serve this population," Kaiser told analysts.

The appointees to the health-system board include Joseph W. Marshall III as chairman. Marshall is vice chairman of the Stevens & Lee law firm, a longtime member of Temple University's board, and a former chief executive of Temple's health system. Marshall, who holds undergraduate and law degrees form Temple, led the system when it eliminated 500 positions in early 2007 in a bid to halt losses.

Other appointees, all already on the university board, are Stephen G. Charles, Bret S. Perkins, and Christopher McNichol, the only one who is not a Temple graduate.

Charles is retired and has become a big donor to Temple, most recently donating $10 million toward the university's new library, which will be named for him.

Perkins is vice president of external and government affairs at Comcast Corp. Early in his career he worked in health care.

McNichol is a Philadelphia-based executive with Citigroup Global Markets Inc.

Lon Greenberg and Jane Scaccetti are leaving the health-system board, which now has 17 members.

Temple also said it had named Stuart McLean of Alvarez & Marsal as chief restructuring officer. He will lead a review of all health-system operations and explore the sale of Fox Chase and Jeanes.