“That background is so important, I think,” says Dorothy Hill, CEO of Acadia Hospital, a 100-bed psychiatric facility with 700 employees and a massive outpatient program. “Being a nurse gives you a real understanding of the 24/7 nature of a hospital, the nights, the weekends, the coverage issues, and the challenges. There’s a connection there: Having done the work makes me more aware of what the issues are as a CEO.”
While the preponderance of females in the top job at Bangor’s hospitals is unusual, it reflects a national trend. In early 2006, 21.5% of hospital CEOs in the U
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“You have a leg up if you’ve been on the clinical side,” says Deborah Carey Johnson, EMMC’s CEO. “The business of health care is taking care of patients, and if you’ve been involved in that directly, you know what questions to ask, what approaches there are to solving problems. You can be a good executive without clinical expertise, but it really helps.”
Here’s a look at each of the city’s hospital leaders—their unique backgrounds, challenges, and vision.
Deborah Carey Johnson
CEO, Eastern Maine Medical Center, since 2004
Education: Diploma in nursing (RN), Mercy Hospital School of Nursing, Portland, 1974; BS, nursing, University of the State of New York, Albany, N.Y., 1984; master’s in business, Husson College, Bangor, 1987.
Professional History: Deborah Carey Johnson began her career as a critical care nurse at Portland’s Maine Medical Center, before moving to EMMC as a staff nurse in the critical care unit, in 1974. Johnson was the department’s head nurse a year later. In 1981, she started a move toward hospital administration when she became assistant administrator for nursing. In 1993, she was named executive vice president/chief operating officer, under Norman Ledwin. Over the years, as parent company Eastern Maine Healthcare Systems grew, Ledwin stepped into a larger role with the system, and Johnson began to add responsibilities at EMMC. When Ledwin retired, she survived a national search and a rigorous selection process to become CEO in August 2004.
As CEO of Eastern Maine Medical Center, Deborah Carey Johnson steers a Bangor institution, a flagship for all of eastern and northern Maine, and the area’s largest employer. While EMMC is just down the pike from where Johnson grew up, it’s been quite a climb to the top for a Milo girl.
“I sort of grew into it,” she says of the CEO role. “I’ve been here a long time, and I’m very knowledgeable about this organization and its people. It’s not something I aspired to, or a lifelong goal. I just tried to do a very good job at whatever position I was in, and here I am.”
Johnson started as a nurse in the critical care unit, and carries that experience, along with 32 years in various positions, into the boardroom and the CEO’s office.
“I can truly relate to caregivers because I’ve been in their shoes,” Johnson says. “I can discuss clinical issues, quality issues, strategic planning, or problems with them, and I think my background brings credibility to all of my interactions.”
With more than 400 beds and 3,000 employees, and even its large physical plant along the Penobscot, EMMC is a Bangor giant that serves the population of the northern two-thirds of the state, providing almost every possible medical treatment outside of organ transplants and severe burn care. It’s everything from the ER for a child’s bump on the head to a state-of-the-art cancer facility.
It’s the kind of operation, Johnson says, that would never happen today. During the 1970s, she says, talk of a medical school associated with the University of Maine led many high-quality, specialist doctors to the area. The medical school never happened, but the doctors stayed.
“The seeds were planted here, and those people grew their practices, met the growing demand, and offered a full array and depth of services. We’re a sophisticated, tertiary care facility in a rural environment, which is rare, and we’ve been able to recruit very fine physicians as a result. People want to come for the lifestyle, in a safe, family-friendly community. And professionally, we offer everything they could want.”
That includes innovation, in areas like cardiac stent surgery and weight-loss surgery, where hospital physicians have been on the cutting edge in recent years. It also includes a connection to the community’s economic development: EMMC is working to partner with Jackson Labs and others to build a new cancer facility and genetics lab in Brewer, part of Gov. John Baldacci’s plan to make Maine a player in biomedicine.
EMMC is also the area’s Level II trauma center, meaning that it provides 24-hour critical-care trauma services for community hospitals across the entire region. That’s of huge importance, especially as so many community hospitals downsize due to financial pressures in the increasingly difficult world of health care.
“We’re charged with providing quality, 24-hour care for this community,” Johnson says. “We need to meet the area’s primary-care needs, and provide specialty services for the region. We’re the only place for neonatal intensive care, for example.”
It’s a huge mandate, one Johnson is not afraid to personalize. “If I can’t provide it, there’s no one else who can.”
Dorothy Ellen Hill
CEO, Acadia Hospital, since 2001
Education: Diploma in nursing (RN) from Washington Hospital Center School of Nursing, Washington, DC, 1968; certification in psychiatric and mental health nursing, 1983.
Professional History: Hill began her career as head nurse, inpatient female psychiatry, at St. Elizabeth’s Hospital in Washington, DC, before moving to Maine in 1971. She worked at the Veterans Hospital in Togus, as well as a nursing home in Augusta, until 1984, when she moved to the Jackson Brook Institute in South Portland, now called Spring Harbor Hospital. Hill began the move up the administrative ladder soon afterward, from clinical nursing supervisor through several jobs, eventually becoming director of nursing at Jackson Brook in 1985. In July 1991, she moved to the Bangor area, and worked at EMMC while planning for the 1992 opening of Acadia Hospital. Before the facility was built, she was director of nursing, in charge of establishing the nursing department and setting policies and procedures, and even helped design the facility. Hill was named vice president of patient care services in 1991, interim CEO in July 2001, and took the Acadia helm in November of that year.
Seven hundred people are enrolled in the methadone clinic at Acadia Hospital, the most allowed under the facility’s license. In a perfect world, Acadia could take many more, Dorothy Hill says. That’s true across the board, and not just for narcotics: Licensed for 100 beds, the hospital could fill more.
“Our struggle,” she says, “is to meet demand. We’re always full. It’s difficult to meet that demand, and to financially support our operations. The state is in a crisis itself, and they owe us all money, and we have such a large Medicaid population, a whole other group that’s uninsured. It’s a big problem.”
Like its sister company EMMC, Acadia Hospital serves a large geographic area, from Waterville to the northern reaches of the state, and even accepts patients from Portland when southern Maine facilities are full.
Hill—who grew up in New Jersey but spent many summers in Maine, owing to the fact her parents were from Milo and Brewer—championed the movement at Acadia to ensure that people who call the hospital for help are seen as an outpatient by the next day—a goal that became a reality when Acadia opened its door, and remains a reality, despite the overwhelming numbers.
“If you wait, the person may not come back,” Hill explains. “When people have an emergency, when they call us, they need help now. We get them in for treatment or detox right away. It cuts down on the people who wait a few days and say, ‘Maybe it wasn’t as bad as I thought.’”
In part because she’s a nurse, Hill is extremely proud of Acadia’s status as the world’s first psychiatric hospital to be named a “Magnet” hospital by the American Nurses Credentialing Center. The product of an extensive evaluation process, the award recognizes Acadia’s commitment to provide the best patient care and professional nursing practice.
Hill, a mother of four with four grandchildren, all living in Maine, called the award “validating,” and used the same term to describe her feelings on being named American Psychiatric Nurse of the Year for 2003. Mostly, she says, she’s proud of her nursing staff, both for choosing psychiatric nursing and for excelling at it. It’s a job, she says, that one either loves or hates. Why does she love it?
“You’re treating the whole person, and seeing them reconnect with meaning in their lives. Those are the paybacks, and for all of the stories that are depressing, there are so many success stories. That’s what’s so satisfying.”
Sister Mary Norberta Malinowski
CEO, St. Joseph Healthcare, since 1982
Education: Diploma in nursing (RN) from St. Elizabeth Hospital School of Nursing, Brighton, Mass., 1957; BS in science, Our Lady of the Elms College, Chicopee, Mass., 1966; MS, public health, Tufts University, Medford, Mass., 1972; MS, management (concentration in health administration), Sloan School of Management, Massachusetts Institute of Technology, Cambridge, Mass., 1980.
Professional History: She was certified as one of the first-ever pediatric nurse practitioners at Massachusetts General Hospital, Boston, in 1969 and held a variety of nursing and teaching positions, including a faculty job at Harvard Medical School and Boston College Graduate School of Nursing. Sister Mary Norberta was appointed associate executive director of St. Joseph Hospital in 1980.
It was, Sister Mary Norberta thought, a strange request. At the end of a routine procedure on her first day as a nurse at St. Joseph Hospital in 1959, a colleague asked her to call the fire department.
“I thought they were being funny, taking advantage of the new kid on the block,” Sister Norberta recalls. “Next thing I know, another nun called them, and two burly firemen came up the back stairs to move the patient from the second to the first floor.
“Turns out, there was no elevator,” she says with a hearty laugh. “That’s how they did it.”
So began a long career in Bangor for the nun from South Boston, who will celebrate her 25th anniversary as St. Joseph CEO in 2007. The story is illustrative in a few ways: It shows how far St. Joseph has come, from a 36-bed facility in an old Bangor mansion to a 112-bed, full-service community hospital with outreach programs in several area towns. It shows how far Sister Norberta has come, to head of an 800-employee company with an operating budget of nearly $60 million—and an arsenal of elevators.
The St. Joseph story is also one of survival against the odds, a small hospital that thrives less than a mile from a regional giant, Eastern Maine Medical Center, a place that once sought to take over the smaller hospital.
Sister Norberta doesn’t like to talk about it, but it was big news in the 1990s, with all sorts of verbal volleys from Norman Ledwin, then CEO of EMMC, and Sister Norberta. Rumors flew that Ledwin offered her a guaranteed salary: “He couldn’t afford me,” she told the Bangor Daily News (as a nun, she has taken a vow of poverty).
Today, Sister Norberta doesn’t want to dredge up old wounds. The two hospitals collaborate on more and more initiatives these days, she says, and each has its role in the region. EMMC is the large, tertiary-care facility, and one that does an excellent job, she says.
“We don’t see ourselves as a competitor to them,” she says. “We give people a choice by providing quality, what you’d call bread-and-butter, services. We’re blessed in this community to have that choice.”
When her religious order, the Felician Sisters, first asked her about moving into hospital administration (she was teaching in Boston), she said she needed more training, even though she already had an impressive educational resume. She went to MIT’s world-famous Sloan School of Management, and earned a master’s with a concentration in health care, and returned to St. Joseph in 1980 as associate executive director.
Two years later, when she became CEO, a few physicians had concerns. Was she qualified? Sister Nor-berta told them that if she didn’t have the ability to do the job, she wouldn’t last long. And, she started building relationships.
“I learned then to involve the medical staff in planning,” she says. “We started a capital planning group among the doctors. They sit down and take each other on in a collegial way, and we’re all able to work things out, to spread our limited resources as wisely as we can to cover all the demands.”
One of those demands, in her mind, is continual improvement. Over the years, she’s led several expansions at the hospital, the largest a move to 80% private rooms in the mid-1990s. In her time at the helm, St. Joseph became the first hospital in the state to allow fathers into delivery rooms and has established and subsidized family practices in many small towns. With her support, St. Joseph established the Maine Center for Osteoporosis research and education, an internationally recognized facility, headed by Dr. Clifford Rosen.
She’s used the knowledge she’s acquired over the years to help other hospitals all over the state, especially in central and northern Maine. In 1995, she helped establish the Maine Health Alliance, a group of 10 (now eight) small and midsized hospitals from Lincoln to Fort Kent. They banded together to work through issues and challenges—from financial difficulties to improving patient care in a changing environment—while remaining independent.
According to Jim Cassidy, CEO of St. Mary’s Regional Medical Center in Lewiston, not every hospital has been able to hold on to its independence. “A lot of hospital leaders said, ‘Look, this is just overwhelming. It’s time to merge.’ They decided that they just couldn’t survive. But that’s not Sister Norberta.”
Mary Louise McEwen
CEO, Dorothea Dix Psychiatric Center, since 2001
Education: BS, nursing, cum laude, Salem State College, Salem, Mass., 1982; MBA, University of Maine, Orono, 1987.
Professional History: McEwen became a registered nurse in 1982, and received certification in psychiatric nursing in 1989 and in nursing administration in 1990. She spent the early part of her career in the military, first as an Air Force nurse in California, and then with the Maine Air National Guard in Bangor. In 1987, McEwen joined then-Bangor Mental Health Institute, becoming director of patient care services in 1993. Named interim superintendent in 2001, she took the job permanently in 2002. She also serves as commander, Mission Support Flight, for the Maine Air National Guard. She’s spent 21 years in the Guard, after three years on active duty.
Mary Louise McEwen isn’t just one of the area’s top healthcare executives. She’s also one of the highest-ranking female members of the Maine National Guard, a lieutenant colonel, one of two female flight commanders in Maine, who works on recruiting and heads up mission support operations. Finally, she’s run 25 marathons and two ultra-marathons, as a member of both the state and national National Guard marathon teams.
McEwen, an RN with certifications in psychiatric nursing and administration, is a leader in just about everything she does. “She’s something else,” says Major Deborah Kelley, Maine Air National Guard’s wing executive staff officer. “She’s amazing. Her work at Dorothea Dix is obviously impressive, plus she excels in the marathon world, and she’s excelled out here.”
“The military has been wonderful for me, and really dovetailed my professional career,” McEwen says. “I get to do leadership seminars all over the country, and it’s really helped me at the hospital.”
At Dorothea Dix (Bangor Mental Health Institute until August 2005), McEwen oversees the entire 64-bed operation. Funded by the state, Dorothea Dix accepts the patients who have overstayed their welcome at other facilities for one reason or another, from lack of insurance to being too difficult a patient for others to handle.
“The biggest challenge is making decisions on resources,” McEwen says. “We have limited funds, because the state is always limited with its budget. So we have to work to distribute what we have, especially in areas like technology and recruiting.”
One of the biggest challenges faced by all of Bangor’s hospitals is recruiting, and the issue is especially acute at Dorothea Dix, because of the setting and the pay scale. While Maine is a great place to live, a state psychiatric hospital isn’t the happiest place to work, McEwen says, because so many people either don’t get out or end up coming back. Finding doctors can be difficult.
“Nurses, too,” McEwen says. “Nurses don’t go to nursing school saying, ‘I want to be a psych nurse.’ But it can be a very rewarding career.” Asked where she hopes to take the hospital in five years, or 10, McEwen answers honestly and simply: “We’re hoping to stay the same size, and continue to provide a valuable service. People look at state hospitals and say, ‘Do we really need them?’ We do. We’re the safety net.”
