Early on July 11, a tall, gray-haired stranger strolled into Grady Memorial Hospital.

He lingered in the lobby studying the stream of patients and family members. He walked the halls observing people at work. He looked into their faces.

Don Heupel/STR (ENLARGE)

Michael Young becomes Grady Health System's sixth leader in 3 years this coming September.

By the time he left Grady that hot summer day, Michael Young was captivated by the stalwart but beleaguered old safety net for the poor.

Young, 52, a hospital CEO since his early 30s, was in Atlanta to interview for the top job at Grady. He wanted to avoid the kind of spit-shined reception orchestrated for a potential boss. He needed an authentic sense of the historic hospital.

Young had heard all about Grady's struggles — the red ink that could reach $43 million this year; the long-neglected equipment; the frayed political ties.

"I saw employees focused on the patient," Young said. "I saw them smiling. I saw them interacting with families. There's a lot of professionalism there, a lot of pride.

"There's great hope," he said, "for Grady."

The hope — and high expectations — are focused on Young, who returns in September as Grady Health System's sixth leader in three years. He arrives with a three-year contract, an annual salary of $615,000 and a potential bonus of up to 50 percent.

In announcing the appointment Monday, Pete Correll, head of Grady's new private, nonprofit corporation, cited Young's "exemplary record" at the two hospitals he has led. Correll said Young stood out among the CEO candidates.

"This man is a pro," Correll said. "He'll do a good job."

Young understands Grady's place in the community, not only as a major source of indigent care but as an urban teaching hospital with centers for trauma, burns and other serious medical problems.

Young's present hospital, Erie County Medical Center (ECMC) in Buffalo, has all of those. Under his leadership, it conquered some of the challenges Grady faces.

"Grady is exactly the equivalent to ECMC ... on steroids," Young told reporters at a news conference in Buffalo when his departure was announced.

In three years as its CEO, Young navigated the 550-bed ECMC through a changeover in its governance, from a county hospital to one with an independent board.

He turned a $28.4 million loss in 2004 into a $17 million operating profit last year. He updated the hospital's facilities and equipment, from replacing obsolete beds to enlivening the lobby, which now looks like a welcoming mini-mall.

Young "cleaned the place up, gave people a sense of ownership, improved efficiency ... and made patients feel comfortable to be here," said Dr. Lawrence Bone, chairman of orthopedics at the medical school of the State University of New York at Buffalo, which furnishes most of ECMC's physicians.

Now Young will try for similar success in a hospital system twice as big.

"Grady's a challenge," Young acknowledged. "I'm not sure it can be done. But if anybody can do it, it's probably me."

'He knows his job'

Young speaks with an assurance that sometimes is misinterpreted.

"He can come across as arrogant," said the Rev. Michael Badger, a Buffalo pastor and member of ECMC's board. "He isn't. He knows his job."

Badger helped organize a June rally to support ECMC in the midst of a contentious state-forced shotgun wedding with Kaleida Health System. Young and his board fought hard — even suing the state of New York — to ensure that ECMC survived intact.

A settlement allowed ECMC to retain its identity but brought it under a common board with Kaleida. A Kaleida executive was named head of the new system. Young continued as CEO of ECMC.

Personal challenges

Young has gained a reputation as a fierce worker who takes a challenge head-on, whether it's a hospital in dire straits or the family curse of alcoholism. He's also known for frankness.

Five years ago, as CEO of Lancaster General Hospital in Pennsylvania, he returned from 90 days at the Betty Ford Center to make public his treatment for alcohol dependency.

Young had spent 18 years at Lancaster General, 16 as CEO. Under his leadership the hospital opened two new hospitals — one for women and children, the other for orthopedic patients — and an outpatient facility that allowed patients to complete multiple tests and receive results in one visit.

When he returned from treatment, the hospital board expressed support and the local newspaper praised his "personal courage and public leadership" in confronting his addiction.

He said, however, that he was treated differently after coming out of Betty Ford.

"I got questions I didn't get before," he said. "I had to remind people I went away for alcoholism, not stupidity. It was uneasy for everybody."

He quit his job and took a few months off before he was hired by ECMC.

He still attends weekly Alcoholics Anonymous meetings. Confronting alcoholism helped him understand prejudice, he said.

"What I learned is people don't treat alcoholics the same," he said. "Maybe that's a good thing that came out of Betty Ford. Until I went there I didn't think there was discrimination. I thought everybody got graded on their track record. ... It sounds hokey, but I'm not sure I could have done this job without that."

Path to administration

Young grew up in York, Pa., the third of four children of a math teacher and a secretary who later sold insurance. He delivered newspapers, cut neighbors' lawns, swam competitively and dreamed of being a dentist.

Blindness in his left eye from a genetic disease called amblyopia disqualified him from dental school — "probably a good thing for the patients I might have hurt," he said.

With a bachelor's degree in biology from the University of Pittsburgh, he was selling pharmaceuticals to hospitals when he decided to return to Pitt for a master's in health administration. He wrote his thesis on the nursing shortage, advocating treating nurses with respect as a way to retain them.

The thesis served him well. As an administrative intern at Shadyside Hospital in Pittsburgh, he was escorting an accreditation committee around the hospital when he met Karen Gallagher, a nurse. He later asked her to check his blood pressure, then invited her to lunch at Wendy's. (He later became a vegetarian.)

They married on Sept. 25, 1982. The Youngs have two sons, Jonathan, 24, an Air Force officer, and Christopher, 22, who builds engines in Philadelphia.

Karen Young said she is happy about the move to Atlanta and the challenges that await. She understands her husband's passion for helping those who can't afford medical care as well as his practical sense of responsibility to the taxpayer.

"He's very much a person of balance," Karen Young said.

Pursuing growth, not cuts

The board of ECMC was looking for that kind of balance after firing its CEO in 2004. Financial planner Jody Lomeo, chairman of the board, headed the search for a new leader.

Within five minutes of meeting Young — who has become a close friend and golf buddy — Lomeo said he knew he had found his man.

Young "knows every aspect of everything that's going on in that hospital," Lomeo said. "If you ask him what kind of IV pumps they're using on the fourth floor, he'll tell you. If you ask him what's going on in medical billing, he can tell you. He will build a culture based on accountability and results."

Young believes in improving the bottom line by growing programs, Lomeo said, "not by slash and burn."

Young himself said he remade ECMC by recruiting good leaders, collecting debts, increasing productivity, and making patients accountable for keeping their appointments. He set standards and trained employees to meet them, he said. As the hospital's finances improved, Young added more staff.

"I don't think layoffs are a solution," he said. "That scares everybody to death. I prefer to work on the growth side."

Young said he'll assess the Atlanta medical market and the skills of Grady's doctors to determine what services could become magnets for paying patients.

"Every community is different," he said. "At Grady, I'll have to make the right calls. I don't know what they are yet."

He does know how he'll measure success.

"When important people in Atlanta think Grady is good enough for them to go to," he said, "then you'll know we've been successful."