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After 20 years of growth and change, Michael Green to step down as Concord Hospital chief

Mike Green, CEO of Concord Hospital, photographed Wednesday, Jan. 26, 2011.
(John Tully/ Monitor Staff)

Mike Green, CEO of Concord Hospital, photographed Wednesday, Jan. 26, 2011. (John Tully/ Monitor Staff)

Thirty years ago, Michael Green graduated from Dartmouth College with a liberal arts degree and not much sense of what he wanted to do, except that an aversion to blood made surgery, his father’s profession, off limits.

Next December, Green will step down after two decades as CEO at Concord Hospital, 20 years of shepherding the organization through constant change and exponential growth.

Speaking in the cramped, decidedly un-luxurious conversation space in his office yesterday, Green said he is most proud of the developments under the Concord Hospital roof, not the buildings themselves.

“We obviously have been able to grow dramatically, or I wouldn’t still be here. The only reason I am still here after 20 years is because every year was exciting in terms of the opportunities to do things differently, to become more sophisticated, to add services to meet the needs of the patients we’re serving,” he said. But “a hospital is just walls and bricks and beds. You need the doctors and the physicians’ assistants and the nurse practitioners to provide the care that make it matter.”

While Green, 63, has led Concord Hospital, revenue has more than tripled, and the number of staff members and the size of the hospital campus have steadily expanded.

One of the major projects the hospital undertook during his tenure was the capital campaign and construction of the Payson Center for Cancer Care. The hospital’s first application for permission from the state Health Services Planning and Review Board to provide oncology was denied, but a second application was approved.

The center opened in 2003, including a sun-filled rotunda crowned by offices for head administrators. Green’s office was to be the one in the middle of a group facing west, with views of open fields and mountains on the horizon.

Instead, Green decided he’d keep the office he has had since shortly after he started work at the hospital. The set of three chairs arranged for informal conversation barely fit between the door and the window. The view from his desk is the exterior brick wall of another part of the hospital, and a series of mechanical units on the roof of a connecting wing

He chose his office when he realized, shortly after starting work, that few employees ventured past the fire doors of the administrative hallway, and fewer still walked to the CEO’s office at the very end of the hallway.

He wanted to be available for his staff, and he hopes his successor, to be chosen by a committee over the next year, will be, too – to a point.

“I’d like them to be accessible. Maybe not as accessible as I’ve been, but accessible,” he said. “I’ll be really candid, I would probably encourage my successor not to take this office.”

“He literally leaves his door open for anyone to stop by,” said Thomas Akey, who has been a doctor at the hospital and member of the board of trustees for about six years, after several years running an independent practice in Concord. “I’ll stop by and pop my head in. He’s had patients stop by and pop their heads in; he’s had janitors stop by and pop their heads in. He chose not to be off in the corner.”

Staying on the main hallway and not in the sunny window-walled office was a choice to put his philosophy of leadership into action, Green said. It’s a philosophy that draws on his past experiences both positive and negative, from varsity hockey games at Concord High School in the 1960s, to his time in the military and the hospitals where he worked before returning to Concord in 1992.

In an earlier job, Green remembers his supervisor relaying a comment from the organization’s CEO: “He had said to him, ‘How does Mike Green possibly get anything done when he walks around smiling the way he does?’ That was really indicative to me that it wasn’t a great fit for me there. There’s nothing contradictory between smiling, being nice to people, and expecting high levels of performance,” he said.

“We set very high expectations for the end results, but we also set very high expectations for how we get to the end results. You are to get to the end results without compromising integrity. You get to the end results by respecting people, . . . by engaging people and educating people and letting them do their jobs, not by bullying people.

“I remember my coaches at a very early age telling me, my teammates wouldn’t play any better because I was yelling at them. It sunk in for me.”

In the past 20 years, in addition to the Payson Center, the hospital has added The Orthopaedic Institute at Concord Hospital, the Family Health Center and family practice residency program, a new emergency department, Granite Ledges assisted living facility, and expanded the Pillsbury Medical Office Building.

Hospital revenue has grown from about $100 million to almost $450 million, Akey said.

Under Green’s leadership, the hospital has also created partnerships with dozens of physicians and specialists to bring their private practices under the hospital medical group umbrella. “We never felt like we needed to own everything. We wanted to make sure it’s all available,” he said.

But Green’s tenure began at a time when the hospital faced severe shortfalls in revenue and survival, not expansion, was the task at hand.

Just one year after he became CEO, he led the administration through layoffs of 10 percent of the hospital staff.

Technological advances made many formerly in-patient surgeries into out-patient procedures, and health management organizations were pressuring hospitals to shorten recovery times for patients who did stay at the hospital. The 225-bed facility was seeing fewer than 170 patients at a time.

Black Thursday – June 10, 1993, the day the hospital laid off more than 100 people – “was the most difficult thing I’ve ever had to do in my career and something I have worked really hard to avoid ever having to do again,” Green said.

“The morale was okay but not great the next year, but we were in the black the next year. We were in the black the year after that. . . . As we started to make other investments in our future, people started feeling better and better about the organization and their role within the organization.”

Akey, whose practice was separate from the hospital then, said the way Green led the administration through the layoffs set the tone for the staff and the rest of Green’s tenure.

“He was very honest and very across-the-board about it; he let go one of his senior vice presidents,” Akey said. “People were very fearful initially, but I think they responded to the honesty of the administration following through on what they said.”

Since then, Green has been “a visionary leader,” Akey said, a word repeated by other board members.

Green “understands health care and hospitals are in the midst of an extraordinary shift,” said trustee William Chapman. “I think he’s doing what needs to be done so that Concord Hospital will continue to be a very important provider of care . . . and I think that’s why Concord Hospital has been able to weather the storms of the last several years.”

Green doesn’t know – or won’t say – what’s next for him, except maybe some more golf with his wife and sleeping in just a little bit later after years of 7 a.m. meetings with physicians.

“I’m not ready to be a greeter at Walmart yet, but I’d like to do something less intense,” he said. “This is a great job. I love my job. But if you really care about what you’re doing, this role is 24 hours a day that you’re thinking about it.”

Between the meetings and the paperwork and the people stopping by his office to talk, Green makes time to speak at every new employee orientation. He speaks about the hospital’s official mission, to meet the health needs of individuals from the region without regard to their ability to pay. He speaks about the hospital’s vision, and official values: stewardship, leadership, quality, integrity, and caring.

“I tell them if they embrace our mission, our vision and our values, they’ll thrive here,” he said. “If they think they’re just words on a piece of paper, this is not necessarily where they should be. That fit is very important to us here.”

(Sarah Palermo can be reached at 369-3322 or spalermo@cmonitor.com or on Twitter @SPalermoNews.)

*This article previously referred to Concord Orthopaedics as part of Concord Hospital. It has been corrected to The Orthopaedic Institute at Concord Hospital.

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