Outgoing Concord Hospital CEO has a caretaker's calling
"A lot of people, when they talk about what's happened to Concord Hospital, they talk about what's happened to the hospital as a facility - what do we have today versus the square feet we had when we started," he said. "I don't even know those numbers because those numbers aren't important to me."
Still, he can't resist pointing with pride to the rows of aerial photographs that line the hallway outside his modest office, documenting the growth in the main hospital building and outlying facilities in the years since it first opened in 1956. Much of that growth took place under Green's leadership, which will come to an end in December of next year.
But don't call it a retirement.
"A doctor friend of mine said, 'Mike, I'm not going to congratulate you for retiring because this is not a graduation, it's a matriculation to the next phase of life.' I'm not ready to retire. I'm stepping down from this role because I want more flexibility and time, but I don't expect to retire entirely. I don't know what I'll do, but I'll stay actively engaged in health care."
That's good news for health care in the state, given Green's track record at the hospital serving the capital region during two decades of tumultuous change in the industry.
When he came on board in 1992, the hospital had 222 beds. Today, it has only a few more. But the measure of a hospital is not its physical footprint, or number of beds, he said. In 1992, 70 percent of the hospital revenues came from in-patient services. Next year, only 35 percent will come from in-patient, with 65 percent coming from outpatient services.
That means more health care professionals to serve a largely out-patient population. When Green started, the hospital had about 1,200 employees and six doctors on staff. Today it employs 3,000 health care professionals and 180 doctors. He guided the transformation of a small but respected community hospital into a regional health-care system with a variety of specialities that is widely recognized as a leader in the use of information technology to enhance medical services.
An interest in efficiency
Concord Hospital's reputation as a leader in IT should come as no surprise. That culture existed when he got there, Green said, and his background as an MIT graduate with computer experience in the military only accelerated the trend.
A Concord native and Concord High graduate, Green never wanted to be a doctor and never thought he'd work in a hospital, even though his father was a surgeon at the very hospital he would come to manage later in life.
"I didn't like the sight of blood," he said. "Didn't like the idea of sticking a needle into somebody or any of those things."
A liberal arts major at Dartmouth, he graduated with a teaching certificate in 1974 and worked briefly in the training department at the State Hospital in Concord, where he met consultants from the Whittemore School of Business at UNH. "That was when I decided my interests were much more aligned with running a facility like this with more efficiency," he said. "I saw so much waste, and working with the consultants from the Whittemore School made me think about business school in a very different way. I decided to go into business school with a focus on health care."
In order to finance a growing household and a graduate education, he applied to the Navy and was commissioned as an ensign. "They needed people formally trained in health-care administration," said Green, who had already been accepted into the Sloan School of Management at MIT.
After two years at MIT and three at the National Naval Medical Center in Bethesda, Md., he was discharged from active duty in 1979 and did a brief stint as a consultant with a medical services company. In 1984 he was hired as assistant administrator at Eastern Maine Medical Center in Bangor, Maine; later served as chief financial officer of what was then Nashua Memorial Hospital; and moved from there to become chief operating officer of Lawrence and Memorial Hospital in New London, Ct.
He was in his fourth year at New London when a call came from a recruiter about an opening for the CEO position at Concord Hospital. Even though the search committee wanted someone who was already serving as a hospital CEO at the time, he got the job.
Optimistic about future
Despite the many challenges facing health care, Green is optimistic that the cost curve can be contained and that nonprofit hospitals like Concord can balance their role as a charity with the necessity of operating in the black. But, he added, "We have to be prepared to make tough decisions."
Patients will have to be more realistic about what Medicare and Medicaid can do for them, technology will have to be improved to simplify the exchange of medical records, and hospitals and doctors will have to adapt to new compensation models and new realities.
"You have to deal with it on the consumer side, to get them more engaged," he said, "but you also have to deal with it on the provider side. If there's a hospital in this country that says they cannot continue to function if they take a one percent cut in Medicare, then they shouldn't be in business."
He is a big supporter of reforms designed to compensate hospitals on the basis of quality outcomes rather than number of procedures, and believes Concord Hospital will fare quite well under that model.
A search committee will start its work as the new year begins, hoping to have a replacement in place by the time Green leaves at the end of the year, if not sooner. In the meantime, Green will continue to do everything he can to make sure the momentum he put in place during his tenure continues into the future.
The job he hands his successor will be very different from the one he accepted two decades ago.
"I never thought I'd end up in hospital administration," he said, "and you know, I wouldn't have if the job hadn't changed. I don't mean this in a disparaging way, but my predecessor and his predecessor were more responsible for managing a facility than a creative enterprise - the business aspect, the clinical aspect, the combination of all facets. It's the complexity and constant change that kept me engaged for the past 20 years."
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Dave Solomon may be reached at firstname.lastname@example.org.