WANTED: Turnaround artist/hero needed to save Georgia's largest public hospital. Must stem huge

financial losses, replace rickety equipment, survive

(ENLARGE)

Michael Butler

(ENLARGE)

Michael Young

(ENLARGE)

Gregory Burfitt

(ENLARGE)

James Burkhart

Grady headlines: Ex-Grady CEOs dueling in court  Teens volunteer, learn ropes at Grady hospital  Grady works to secure $26.5 million from Fulton  Grady's dialysis clinic may close  Grady's decision to close 3 clinics raises anger  • Photos: Grady's new board • Photos: Demonstrators take to the street • Slideshow: Inside Grady's Trauma Center Topics: Metro Atlanta hospitals Grady hospital Back to Health news

nasty politics, and end years of scandal.

The CEO job at Atlanta's Grady Memorial Hospital would appear to fall somewhere between unattractive and impossible, given the organization's recent troubles.

Yet industry experts said the slate of finalists announced last week is impressive. The winner will become the sixth leader of the Grady Health System in the past three years.

"I thought that, under the circumstances, it's a good group,'' said Larry Tyler, president of Tyler & Company, a health care executive search firm.

More controversy erupted last week after The Atlanta Journal-Constitution reported that current CEO Pamela Stephenson had secured a two-year, $600,000-a-year contract to lead the ailing Atlanta hospital. The deal was struck even as the hospital was moving under management of a new private non-profit corporation. Stephenson is also chairman of the Fulton-DeKalb Hospital Authority, the board that hired her. The board of the new corporation had made it clear it would hire its own CEO.

The strength of that new board—made up of corporate, academic and medical leaders—may have helped attract a deeper pool of applicants, said Tyler, whose firm is not involved in the Grady search.

The new head of Grady will face daunting challenges. The hospital's finance chief has projected a deficit of $18 million to $43 million this year. On the plus side, the switch to a private, nonprofit government brought the promise of millions in capital funding, primarily from the Woodruff Foundation.

All the candidates for the CEO job have dealt with some of the same problems that plague Grady. All appear to have experience in a hospital turnaround, said Peggy Cella, an Atlanta consultant with Noblis, a consulting firm.

"These guys have been around a long time,'' said Cella, who said she does not know them personally. "They appear to be ready to take on a different challenge.''

Here's a look at each candidate:

MICHAEL BUTLER

A couple of times a month, Michael Butler works a shift in a Louisiana emergency room.

Not unusual for a surgeon, but it's striking for a man who's in charge of that hospital in Houma and six others in the state.

"I didn't want to lose my clinical skills," said Butler, interim CEO of the LSU Health Care Services Division, which runs the state's charity hospital system.

The ER shifts also keep him in touch with the needs of medical staff and patients, Butler said.

Butler, 52, has focused on improving medical care, first as the system's chief medical officer, and, for the past year, as the acting CEO.

Colleague and friend Dr. Tom Nolan said Butler has boosted care of patients suffering from diabetes, congestive heart failure, hypertension and asthma, among other chronic ailments. Hospital admissions for asthma, for example, have dropped, while diabetes and prostate cancer screenings have increased.

"He has walked the walk and talked the talk" in turning around one of the most challenging hospital systems in the U.S., said Nolan, chairman of obstetrics and gynecology at LSU Health Sciences Center School of Medicine at New Orleans. "He's gregarious and very open. A lot of people here think if he goes to Grady, it will be a tremendous loss."

Butler helped coordinate communications and recovery for the charity hospitals during hurricanes Katrina and Rita. Now as chief of those hospitals, he faces the annual funding tug-of-war with state legislators. He's also the only doctor among the four finalists for the Grady CEO job.

If hired, Butler said his game plan would start with improving Grady's medical care. That, he said, would lead to more revenue.

"Grady looks like the LSU hospitals 10 years ago," he said. At least half of the LSU hospitals' patients have no health insurance, a figure similar to Grady's.

"Grady has all the appropriate pieces in place to be on a path to greatness in medical care."

Personnel file

• Age: 52

• Birthplace: Baton Rouge, La.

• Current Position: Interim CEO, LSU Health Care Services Division.

• Education: Bachelor's degree, Amherst College; medical degree, Tulane University; master's in health administration, Tulane.

• Experience: Chief medical officer, LSU Health Care Services Division, 1999-2007; CEO, South Louisiana Medical Associates, and medical director, Leonard J. Chabert Medical Center, 1997-2001.

• Family: Married; two children.

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MICHAEL YOUNG

Michael Young said he operates with a basic formula: "You grow volume; you control expenses."

Young took the helm of the 550-bed Erie County Medical Center in western New York in 2005, just after the hospital ended 2004 with a $28.4 million loss. Last year, the medical center reported a $17 million operating profit — its second consecutive year in the black.

Bruce Boissonnault, president of the Niagara Health Quality Coalition, gives the credit to Young, whom he calls a "straight shooter."

"The hospital's reputation and its financial situation did a 180 after he came," Boissonnault said.

Boissonnault's non-profit organization produces an annual New York State Hospital Report Card. Young is a member of its board, but his hospital—like every other— has faced criticism, Boissonnault said.

Young is not defensive, he said. "He uses the data to fix the problems."

Erie County legislator Thomas Mazur, chairman of the Health and Human Services committee, echoes Boissonnault's praise. "He's top notch," Mazur said. "He knows hospitals."

Young is a "driven man" with a "strong personality" that some people might see as a drawback, Mazur said. But, he said, those traits help Young get things done.

Under Young's leadership, Erie County Medical Center, a public facility, recently completed long-running negotiations for a merger with the private Kaleida Health.

Young said he believes he could turn Grady around. Success would bring more success, he predicted.

"This is America," he said. "People like success. Organizations like success. Once you start being successful, people rally around an organization and make it work."

Personnel file

• Age: 52

• Birthplace: York, Pa.

• Current Position: President and CEO, Erie County Medical Center Corp.

• Education: Bachelor's degree, University of Pittsburgh; master's in health administration, University of Pittsburgh.

• Experience: President and CEO of Lancaster General Hospital and Health System, 1986-2004; vice president of operations and professional affairs, Shadyside Hospital, Pittsburgh, 1979-1986

• Family: Married; two children

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GREGORY BURFITT

Gregory Burfitt has lived in Atlanta before, as head of operations in the South for Tenet HealthSystem, which operates Atlanta Medical Center and South Fulton Medical Center.

He came to appreciate Grady Health System's importance in those days.

"Its survival is paramount," he said. "Ensuring it's viable in the short and long term is absolutely critical."

During his years at Tenet, Burfitt was know as a hard worker who "is not one to put up with excuses or road blocks," said Chris Hummer, administrator of Carolinas Medical Center — Pineville, in North Carolina. Hummer served as CEO of South Fulton Medical Center under Burfitt at Tenet.

But, Hummer said, Burfitt was "not a dictator. He's very effective at building consensus."

Should Burfitt become Grady's new CEO, Hummer predicted, "he will understand the issues, take a stance, stand by it, and not let the mission of the organization get sunk by people's trivial self-interests."

After his Tenet tenure, Burfitt took a position with Inova Health System, then two years later was named CEO of Centura Health system in Englewood, Colo., the state's largest health-care system with 12 hospitals and various other services.

He left Centura abruptly in December. The health system's board released a statement saying it had "terminated its contract" with Burfitt "due to differences in management philosophy."

Burfitt said he left over a difference of opinion about the future of the company.

Personnel file

• Age: 59

• Birthplace: Warren, Ohio.

• Current Position: Health care consultant; CEO of Centura Health in Colorado until December 2007

• Education: Bachelor's degree, Youngstown State University; master's in business and hospital administration, University of Florida

• Experience: Chief operating officer, Inova Health System, Falls Church, Va., 2004-2005; senior vice president, operations, Southern States Region, Tenet HealthSystem, 1999-2004; chief executive officer, Brookwood Medical Center, Birmingham, Ala., 1986-1999

• Family: Married; two children.

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JAMES BURKHART

James Burkhart sees similarities between Shands Jacksonville medical center, where he is CEO, and Grady Health System.

Both are Level 1 trauma centers and safety net hospitals for the indigent. And both are affiliated with well known medical schools — Shands with the University of Florida and Grady with Emory University and Morehouse schools of medicine.

But there's one major difference: Although Shands Jacksonville was preparing for bankruptcy several years ago, it has reduced its debt, invested in capital improvements, and begun operating in the black. Some of the change came because of an infusion of money from city and state governments, and the University of Florida.

Last year, Moody's Investors Service boosted the hospital's bond rating. The investment firm cited among its strengths its "strong governance, management and fiscal oversight," according to the Jacksonville Business Journal.

Burkhart first went to work at Shands in 2000 as a consultant with a consulting firm hired to salvage the hospital's dismal financial situation. He took over as interim chief executive officer in 2002 and was officially named to the position in 2003.

Should Burkhart be named to head Grady, there would be another similarity. Otis Story, who preceded Burkhart at Shands Jacksonville, was Grady's CEO from May 2007 until January.

At Grady, Burkhart said, he would look at operating costs, revenues, managed care contracts and the debt structure.

"It's going to take a combination of a lot of different things to get it to operate in the black," he said. "No one person can do this. It will take a large number of people to make it successful."

For his part, he said, "I don't shy away from tough jobs."

Personnel file

• Age: 54

• Birthplace: Knoxville, Tenn.

• Current Position: President and administrator, Shands Jacksonville Medical Center

• Experience: President and principal, Endeavor Health Group, Ft. Lauderdale, Fla., 2002-03; Principal V4 Consulting, Indianapolis, 2000-02; President, Fort Sanders Park West and Regional Medical Centers, Knoxville, Tenn., 1988-2000 after being vice president, 1984-88

• Education: Bachelor's degree, University of Tennessee; master's of hospital and health care administration, University of Alabama at Birmingham.

• Family: Married; three children.

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