Finding a new leader to replace the outgoing MedWest-Haywood President Mike Poore could take months and will be handled by Carolinas HealthCare Network rather than the local hospital board.

Carolinas HealthCare System, a Charlotte-based network of 34 hospitals that MedWest-Haywood joined two years ago, will conduct the search and vet applicants. The MedWest-Haywood board will make the final pick from among two or three finalists.

Finding a replacement who can navigate the complicated structure of MedWest may take time, according to John Young, the vice president for Carolinas HealthCare’s western region.

MedWest-Haywood is one of three hospitals under the MedWest banner, along with MedWest-Harris in Jackson County and MedWest-Swain.

Until recently, Poore had served as the CEO of all three hospitals plus the overarching MedWest partnership — in effect four organizations.

“He has taken on multiple roles in a complicated situation,” said Dr. Benny Sharpton, a member of the Haywood hospital board.

Poore had to balance the wishes of three medical communities, answer to the individual hospital boards plus the joint MedWest board — all the while reporting to his primary boss of Carolina’s HealthCare.

“This is not the place for a new CEO,” Young said.

Earlier this year, however, Poore was reassigned. He was stripped of his CEO status over all of MedWest and pulled back to his former role as president of MedWest-Haywood only.

Meanwhile, MedWest-Harris and Swain were given their own president in Steve Heatherly, who had been in Harris management for 15 years.

The management shuffle was aimed at placating dissention among some Jackson County doctors who felt Harris was not getting the attention it needed from Poore under the new MedWest venture. Harris has been faring worse financially than MedWest-Haywood and had seen a growing loss of patients to Mission, while Haywood’s market share has inched back up.

Failure to fix concerns raised by the Jackson medical community could potentially threaten the MedWest joint venture. When the joint venture was launched, an escape clause was built into the contract at the three-year mark, which comes up next year.

Young said dissolving it would be bad for both hospitals.

“The real issue from my perspective is simply we are better together,” Young said. “When you put the hospitals together, you have enough market share and enough demographics to be able to compete for primary and secondary care with Mission way better than any hospital could by itself.”

The hope is that MedWest-Harris and MedWest-Swain would get more attention under their own CEO than they could have gotten from Poore as CEO of the entire system.

How long the hospitals will remain under separate leadership isn’t clear. Ultimately, there needs to be a CEO over the entire MedWest venture, Young said. Having a president for each hospital plus a top CEO results in a “pretty hefty salary load,” Young said. So ideally, the president of either Haywood or Harris would serve in a dual role as CEO over the whole entity.

But, it is unclear when a return to joint leadership may occur. And, that complicates the hiring of a replacement for Poore.

“This is not the best moment for us to be looking for someone because we have this bifurcated approach,” Young admitted.

Young said there is no easy way to get through this “awkward moment.”

Given the complexities, an interim president will most likely be appointed while a permanent one is found. If the interim leader proves their mettle, they could be asked to stay, however.

“So we need as robust a search for an interim leader as a permanent one,” Young said.

For now, Young will serve in a transitional capacity while a search is conducted for an interim president.

“This organization has had enough change,” said Young.

The president of MedWest-Haywood hospital suddenly stepped down this week after three-and-a-half years on the job.

Mike Poore’s tenure at the helm of MedWest-Haywood was marked by an aggressive strategy to restore a crisis of community confidence, rebuild plummeting finances and compete head-to-head with the much-larger neighboring Mission Hospital in Asheville.

The news that Poore was resigning came as a surprise to the medical community and hospital’s board of directors, who met for two-hours Monday to digest the news.

Dr. Benny Sharpton, a long-time surgeon in Haywood County, said the medical community is going to be disappointed at the loss.

“The medical staff was not only comfortable but optimistic with his leadership,” Sharpton said. “He opened up lines of communication that had been broken it he past. He had an open door policy. Not all CEO’s have good rapport with their medical staff.”

Poore will be best known for rescuing the hospital after a tumultuous period when it failed federal inspections and was forced to essentially shut its doors for four months in 2008. The previous CEO, David Rice, who had become a lightning rod of controversy even prior to that crisis, stepped down and Poore stepped in — not only filling a leadership void but also putting the hospital on a path to recovery.

“Within a relatively short period of time, we had regained the market share we had lost. That is not a small feat,” said Dr. David Markoff, an ophthalmologist in Haywood County. “I have enjoyed working with Mike. I am sorry to see him leaving.”

Poore’s family man persona and regular presence at civic and social functions not only built rapport for the hospital but made him generally well-liked around town as well.

“Mr. Poore is one of the finest men I have ever known,” said Dr. Charles Thomas, an oncologist in Haywood County and a hospital board member. “He has done us a wonderful job. We accepted his resignation with deep regret and lots and lots and lots of thanks and platitudes.”

While Poore’s departure seems amicable, many in the medical community are left asking “why now?”

Poore, 47, does not have another job lined up. Depending on where he goes next, his family may stay in Haywood a while before joining him to avoid being uprooted. His son, a football player for Tuscola High School, will be a senior year next year, while his daughter will be a sophomore. His wife is involved in various community civic groups.

Poore is receiving a severance package but the terms aren’t public for now.

Poore said he will look for another hospital CEO position.

“I am a hospital administrator. That is my animal,” Poore said.

Turn-around man

There wasn’t any detectable tension between Poore and the Haywood medical community or hospital board.

But, Poore technically had another boss as well. He answered to Carolinas HealthCare System, a network of 34 hospitals based in Charlotte that MedWest joined two years ago.

Carolinas didn’t have a problem with his performance either, according to John Young, the vice president for Carolinas HealthCare’s western region who Poore reported to.

“This moment is Mike’s choice. This is not because of anything,” Young said. “It is just a certain period of time when it is time for somebody else to come in.”

By all accounts, Poore was dealt a difficult hand when he took the job.

“We will always remember his great leadership in getting Haywood Regional Medical Center back up and running,” said Fred Alexander, the chairman of the full MedWest board of directors.

With no patients to speak of, the hospital’s cash reserves had plunged so low that it had less than a month of operating revenue left when it reopened its doors. Patients who had turned elsewhere for medical care during the closure had to be lured back. And, the historically robust medical community in Haywood County, which had rallied around the hospital, needed reassurance they still had a future in Haywood County.

“He has worked so hard in the past several years to bring this entity, our hospital, upright again,” said Jean Burton, chair of the MedWest-Haywood board and a Cooperative Service agent in family and consumer sciences. “We were so knocked down a few years ago, and Mike worked tirelessly around the clock and has really stuck to the priorities he set.”

With the crisis in the rearview mirror, Poore led the hospital into a new partnership with neighboring hospitals in Jackson and Swain counties. The three hospitals formed a joint venture under the new MedWest banner. At the same time, MedWest joined the Carolinas HealthCare Network.

“I came to the hospital at a time of transition. We have gone through that transition during the last three-and-a-half years. It is just time for me to move on to other things,” Poore said.

Poore’s tenure isn’t uncharacteristically short for a hospital CEO. While the average time at one hospital for a CEO in North Carolina is longer, nationally it is 3.8 years, Poore said. Poore’s time at Haywood was just under that.

“It is not unusual for that turnover, but especially in a circumstance where you have a transition of bringing two organizations together to form MedWest,” Poore said.

There are always rivalries, even if friendly ones, between neighboring hospitals, Poore said. Bringing together two medical communities to act and think like a single entity can be difficult and challenging, he said.

As is sometimes the case in corporate mergers or turn-arounds, the person to affect change does not stay on as the long-term leader, Young said.

“Mike was the man to move the ball,” Young said of Poore’s role during the past three years.

Poore’s total compensation package was $444,000 a year.

Bumps in the road

Poore’s tenure wasn’t without snags, however. His honeymoon period began to fade in recent months, as the financial recovery initially witnessed under Poore began to backslide.

Despite a workforce reduction of 52 employees last year, MedWest has embarked on another round of cuts — 120 positions will be eliminated by July 1.

“It is what we need to do to right-size our organization with the reality of the revenue coming in today,” Poore said. Poore said MedWest is operating under austerity measures until the tide turns.

The layoffs amount to about 5 percent of the 2,100 employees across MedWest, including all three hospitals plus the 16 doctor practices now owned by MedWest.

In the midst of the financial troubles, MedWest-Haywood has seemingly been on a building and spending spree during the past year — from the very necessary replacement of a broken down generator to the very optional construction of a new surgery center.

In the end, MedWest-Haywood saw its cash-on-hand dip so low it had to turn to Carolinas HealthCare for an emergency $10 million line of credit. It was the first time Carolinas has ever loaned money to any of the 34 hospitals in its network.

While Poore defended the loan as no big deal, as Haywood has no other debt on its books, getting bailed of a cash-flow crunch by Carolinas clearly wasn’t ideal.

The loan was precipitated by a series of unexpected costs. Namely, MedWest-Haywood spent more than $10 million to replace a broken generator, upgrade its electronic medical records system and pay out judgments in two lawsuits dating to the previous administration.

Like Poore, Young characterized MedWest-Haywood as a victim of circumstances. Nonetheless, it revealed just how critical the financial status had become.

Build and they will come

While some costs indeed couldn’t be helped, Poore also oversaw an expansion campaign far more voluntary in nature.

A hospice center, a new surgery center and a new urgent care center are in various stages of construction, costing MedWest-Haywood a total of $2.35 million. The amount put up by the hospital is a fraction of the total cost — the lion’s share was paid for by the non-profit hospital foundation and a private group of physician investors.

MedWest also has new MRIs, a new diagnostic lab and new heart catheterization services.

“The hospital is very well positioned to serve patient needs and to grow and to prosper,” said Dr. Charles Thomas, an oncologist in Haywood County and former chief of staff of the hospital.

Young agreed.

“Mike started us down a track. A lot is already in place,” Young said.

The attention Poore gave to MedWest-Haywood didn’t sit well with some doctors in Jackson County, who felt their hospital was being slighted in favor of making Haywood the flagship of the MedWest system, another bump in the road for Poore in recent months. Disatisfaction among the Jackson medical community led to Poore being replaced as CEO of MedWest-Harris and relegated to being over MedWest-Haywood only.

Perhaps the most expensive piece of Poore’s expansion campaign was buying out several Haywood doctors’ practices. The exact cost of the private transactions are not known, but up-front costs aside, the newly bought doctor’s practices will continue to be a drain on the bottom line for another year or two before turning the corner. The hospital has to foot the bill for salaries, equipment, and overhead before the billing for patients begins to pay off.

While costly and perhaps outside the hospital’s realistic budget, it had to be done, according to Dr. Benny Sharpton, a long-time surgeon.

Mission Hospital in Asheville was courting the same physician practices, and Haywood had to make a competing offer. So Poore acted swiftly despite perhaps not having the money to do so.

“It was done in an extremely short period of time primarily due to outside threats from Mission hospital trying to siphon the loyalty of our doctors off,” Sharpton said. “He took that on in a difficult time. It needed to be done. It had to be done.”

While Poore has taken criticism from some for overspending or failing to enact austerity measures sooner, others disagree. When faced with embattled finances and dwindling market share, MedWest-Haywood had a choice. It could retrench and scale back. Or it could move forward with guns blazing.

Rather than resigning Haywood to being a rural second-fiddle hospital in Mission’s shadow, Poore chose to push Haywood onto a bigger stage.

“He has already laid the foundation,” said Cliff Stovall, a MedWest-Haywood board member. “The person that does all the spade work doesn’t always get to enjoy all the glory.”

The track set in motion by Poore will hopefully continue by the leadership team still in place, said Stovall.

“As much as I hate to see Mike ago, we are glad to have the people he put in place,” said Stovall, a retired army colonel who now works in tax preparation.

Poore assembled a nearly all-new management team for the hospital after he was hired, bringing on board more than a dozen vice presidents and department heads within his first two years.

Poore gives credit to the entire team for the advances that have been made.

“I am so proud of the accomplishments the team has made,” Poore said. “I feel like I am leaving this in good hands on a go-forward basis.”

As Mike Poore waited for an elevator between floors at Haywood Regional Medical Center Monday morning, he gazed out the sixth floor window to see cars circling the packed parking lot hunting in vain for a space.

“That’s a good problem to have,” said Poore, the hospital’s new CEO.

It’s a far cry from a year ago, when the parking lot was nearly deserted. Haywood Regional had lost its Medicare status after failing a federal inspection. An exodus of private insurance companies followed, and daily patient counts plummeted to single digits.

The hospital dried up for more than three months while rebuilding its inner workings. The progress of the past year is astounding, but there remains a long road ahead. The community is pinning hopes on Poore to get it there.

Poore won’t shoulder the entire burden of rebuilding the hospital. But he could make or break the efforts. In the people he hires, the tone he sets with doctors, the course he steers in merger talks, the financial advice he gives the board, Poore holds more sway over whether the hospital succeeds than any single person.

Doctors in particular are relying on Poore’s ability to turn things around. So far like what they see.

“I think Mr. Poore has been a breath of fresh air. He is forthright and accessible and seems to be knowledgeable,” said Dr. Steven Wall, a long-time physician in the county with Haywood Pediatrics.

The sentiment seems unanimous. When asked to reflect on the hospital’s progress over the past year, Poore’s arrival appears high on most doctors’ list.

“I have high hopes for HRMC and the new leadership we have in Mike Poore and the team he is building,” said Dr. Shannon Hunter, an ENT.

Poore and his near sweep of top managers ushers in a new era for Haywood Regional. His style is vastly different from his predecessor, David Rice. Rice was commanding and authoritative, while Poore is cooperative and congenial.

The medical community harbored distrust toward Rice, but see Poore as someone who will look out for their interests.

“I think we’re still in the honeymoon stage, but I believe this administration seems to be a lot more transparent,” said Munoz. “I have heard staff say they can discuss problems and issues much more openly than the prior administration.”

Pam Kearney, a hospital board member, agreed that it’s premature to pass definitive judgment on whether Poore will succeed, since he’s just four months into the job so far. But like Munoz, Kearney believes Poore is promising.

“He seems to get along well with the hospital staff and medical staff. The comments we’ve gotten have been very encouraging, and his interaction with board members is transparent and open,” Kearney said.

Poore, 44, left a job at the helm of a five-hospital system in the greater Atlanta area to come here. He stood out in interviews, according to Dr. Henry Nathan, a hospital board member who helped hire him.

“He seemed to be very committed to wanting to do this. He was excited about the prospect of having this job,” Nathan said. Nathan said it was obvious in the interview that he knew how to run a hospital.

Poore says he was attracted to the job for the challenge and desire to make a difference.

Assembling the best

One of Poore’s greatest strengths lies in the people he’s hired. The hospital has replaced nearly a dozen department heads, vice presidents and manager types in the past year — the majority since Poore came on board. There’s a new chief finance officer and chief operating officer. New department heads are found through the hospital from human resources to nursing to the emergency room. Some jobs, like quality oversight, are still being filled.

Before Poore arrived, the hospital was run largely by Compass, a consulting group hired to rescue the otherwise sinking ship. Compass initially worked in tandem with administrators left over from Rice’s era.

When Poore’s arrived, he began building a permanent team.

“He has brought with him an excellent group of upper and middle managers,” said Dr. Richard Lang, a radiologist. “A lot of the folks he has brought with him he has known in other places. I think they look on this as a challenge and they are doing a great job.”

Poore called on people he knew from the industry for key spots in the cabinet, assembling a team with higher qualifications and experience than HRMC has seen before.

“We came because Mike asked us to,” said chief operating officer Teresa Reynolds. “We have a lot of respect for Mike. He has good business and leadership skills. He has pleasant personality. He is an easy person to get along with.”

Dr. Henry Nathan, a gastroenterologist, said Poore’s ability to attract top talent has been an asset.

“One thing that he brings to the table is his connections and knowledge of so many talented people. He can say, ‘boy, I’d like to get so and so to come work here with us,’” Nathan said.

Poore is quick to credit the longtime employees for helping to pull the hospital through.

“There are a lot of people who were here through the storm,” Poore said. “There are really conscientious smart people who take care of patients every day, and they’ve been here throughout.”

For the big picture of steering a hospital, Poore said the influx of fresh ideas from across the country that are manifesting in his new team certainly don’t hurt.

Poore has also enlisted the help of a recruiter that specializes in health care fields. That helped land one of the most important posts: the chief finance officer. Gene Winters, the CFO, is a dynamic numbers guy who relishes in saving struggling hospitals. He talks about fixing hospitals like most talk about a trip to the grocery store. Winters was attracted to the challenge of pulling HRMC up, but more importantly wanted a good community in which to raise his new son.

“It is a place where I could be challenged and also be a hero, to be honest,” said Winters, who has a connecting door to Poore’s office.

Where to start

Poore’s first day on the job in October was likely overwhelming. Cash reserves were dwindling, patient confidence was still shaky, doctors were sizing up his every move as they decided whether to stay put or jump ship, and staff were walking on egg shells in constant fear of surprise inspectors.

“One of the things I had to do was accelerate my learning. I had to learn as much as I could as quickly as I could,” Poore said. “I set up a learning plan to educate myself from people internally and externally about the hospital about all the information in the hospital.”

Poore ultimately held face-to-face interviews with 120 people in the medical community, the hospital ranks and the community at large. He asked them for their thoughts, ideas and perceptions on what the hospital needed to do. He asked them what landmines to avoid, what needed changing and how he should go about it.

That first move was savvy. It bought Poore face time with people he needed on his side: the hospital board, doctors, key staff, county commissioners and VIPs in the community.

“He was pretty smart. A lot of people come in and make changes, but the first thing he did was interview everyone he could find to find out what we knew and what we thought,” said Cliff Stovall, a hospital board member.

For most doctors, the interview was their first encounter with Poore. When Poore showed up at their office with lunch in hand, it immediately showed a marked difference from the former administration. Past CEO Rice rarely sought opinions from the medical community. In fact, some doctors feel Rice actively discouraged their input and squelched their ideas.

Trust was lacking under the old administration. But Poore’s ability to listen sent a message to doctors and staff that they could trust him.

“He met with just about every physician face to face and asked us what could he do better, how could he help improve things in the hospital,” Lang said. “I was very impressed that he was such a good communicator.”

The interviews those first few weeks set the stage for future interactions. Doctors felt valued and saw that Poore’s door was always open and he would respond to the their concerns. For example, when radiologists brought up an issue in the medical staff meeting two weeks ago, Poore took it seriously.

“He was in the radiology department the very next day when he had more time to spend on it,” Lang said.

The attitude extends not just to doctors but to the rank and file as well. Morale among nurses and staff has improved under Poore compared to Rice, according to Dr. Al Mina, a surgeon.

Mina still remembers the stinging assessment of Rice’s regime by consultants brought in to help rebuild the hospital a year ago. In a lengthy report, the Compass Group characterized Rice’s regime as a “lone ranger” dictatorship that propagated “a culture of fear.”

“In retrospect, unfortunately, I think that was an accurate assessment,” Mina said. “I don’t think Mike runs his ship in a culture of fear. He is open to suggestions, as is his team.”

The approach is one of Poore’s talents as a manager.

“I give people the tools they need to do their job,” Poore said. “I knock down barriers they aren’t able to knock down and then get out of the way and let them do their job.”

Poore said hospital staff are finally getting the opportunity to shine.

“Whereas in the past they felt like they didn’t have the support of administration,” Poore said. “They tried it once and nobody listened to them. What I am seeing now is people are stepping up and saying ‘I have an idea of how we can improve this.’”

When Poore makes rounds in the hospital, he asks employees what’s working, what’s not, and if they need anything. A believer in positive reinforcement, he also asks if there is anyone he should recognize.

When employees address him as Mr. Poore, he implores them to use his first name.

“He’s Mike to the people in the hospital, and that’s hard for them to get used to,” said Cliff Stovall, a hospital board member.

Empowering the rank and file could well be Poore’s biggest legacy.

“I think one of the main things is that we had to change the culture, and he’s gone about that in a great way by being able to communicate and listen,” said Mark Clasby, another hospital board member.

County Commissioner Kevin Ensley, who was the subject of one of Poore’s 120 interviews, feels like Poore is someone he can call with a concern. Before when Ensley heard complaints, he didn’t know what to do with them, he said.

“I just didn’t think by going to David Rice anything would get done,” Ensley said. “I think now if you complained about a certain situation things would get done.”

Taking the fall

Ironically, the hospital’s first chief of staff under Poore is one of the few remaining fans of Rice. The chief of staff is chosen by doctors from among their own ranks to serve as a liaison between them and the hospital and generally represent the doctors’ interests. It’s a duty few envy, given the time it takes away from the doctor’s own practice.

This year, the position went to Charles Thomas, a cancer doctor, who is one of the few who will stand up in support of Rice to this day.

“I do not think Mr. Rice was a bad person,” Thomas said. “I think Mr. Rice was an honorable man who made some errors. It had terrible consequences but he is and was a fine person.”

Thomas remembers the dire straights the hospital was in when Rice arrived in the early 1990s. Rice was the hero then who brought it back into solvency, investing in equipment and recruiting doctors heavily.

“The hospital was almost bankrupt,” Thomas said. “Mr. Rice came here and did an awful lot of wonderful things. There was huge progress.”

Thomas credits Rice with growing the number of doctors in the community, modernizing the hospital and expanding the medical care it offered. Patients and revenue followed. Rice had built a war chest of $19 million in cash reserves the day he left. Rice was saving it to build a surgery wing — including a floor of offices for himself and the administration.

But that money is nearly all gone now, spent to keep the hospital afloat during the year since the crisis.

“I grimly joked we should be grateful to him that the money they saved up got us through,” Thomas said.

Rice’s drive to build ultimately led to his downfall. His energies initially were dedicated to building a quality hospital. But as he amassed more and more power for himself, he pushed aside the interests of doctors, nurses and even patients to make way for his own agenda, according to his critics.

While Thomas is quick to defend Rice, he has also embraced Poore. The two can be spotted regularly over breakfast in the hospital cafeteria.

“He is a good fellow to meet even at 7 a.m.,” Thomas said. “He is bright, energetic, well-educated has a good depth of experience and has a commitment to our hospital.”

Dr. Richard Lang, another doctor who sympathized with or at least understood Rice’s point of view, called Poore an “extremely bright spot” in the hospital’s past year.

A better relationship

A pivotal moment for the hospital’s future is whether new doctors come here, and that could largely depend on whether they like Poore. Dr. Steven Wall with Haywood Pediatrics said Poore proved helpful in recruiting a new pediatrician recently. Poore spoke to prospective doctors enthusiastically and ultimately helped land one, Wall said.

The relationship between doctors and a hospital can be tumultuous or indifferent, cooperative or combative, one of admiration or mutual dislike. Under Rice, it was strained at best. Many doctors lived in fear of retaliation for speaking out.

Rice couldn’t exactly fire a doctor — they aren’t employees of the hospital. But doctors rely on the hospital for space and equipment to perform surgeries, deliver babies, run tests, take MRI’s and generally care for their patients beyond office visits.

Should a hospital pull a doctor’s privileges to practice there, it would effectively run them out of the community. Many doctors feared Rice might ruin their reputations in this manner if they expressed concern over the direction he was steering the hospital.

Rice once appointed a committee of doctors to recommend the best software to implement electronic medical records hospital-wide. When he didn’t like the top picks, he disbanded the committee, appointed a new one stacked with his own people and chose the system he wanted all along.

Doctors who were upset by Rice’s policies were barred from going over his head to the hospital board. Rice conveyed the attitude that everyone was dispensable and didn’t seem to care if doctors or nurses walked, chalking them up to a poor fit with the hospital anyway.

The broken relationship between the hospital and administration needed fixing, Poore said.

“There was no basic level of trust in the organization,” Poore said. “I told the medical staff I’m not asking you to trust me. I’m asking you to let me earn your trust.”

Poore also found the lack of communication troubling. The organizational structure was permeated with what he calls “silos.”

“There were silos where the executive teams did not communicate,” Poore said. “They felt these are my departments and I take care of them and these are your departments and you take care of them.”

While Rice controlled the flow of information, Poore encourages it.

“We are constantly receiving emails from him with information about what’s going on with affiliation, with inspections, with specific guidelines. There is much more communication,” said Dr. Munoz, the pathologist. The emails from Poore average twice a week, but Munoz can’t remember ever getting one from Rice.

Poore keeps staff informed by holding what he calls town hall meetings three times a year. It’s not an uncommon practice — West Care’s CEO Mark Leonard holds them with each shift every quarter. But Rice rarely took the podium in front of employees for a state of the hospital report.

Poore has been willing to take his show on the road as well. In the aftermath of the crisis, Haywood County commissioners demanded that hospital leaders to make regular progress reports at their meetings, a practice Poore continued after taking the helm.

“We haven’t even asked him a couple times and he’s just showed up,” said County Commissioner Chairman Kirk Kirkpatrick. “I am impressed with his willingness to come before the board of commissioners and explain exactly what is going on with the hospital in a matter of fact and truthful way.”

Surgery center

Poore has already proved willing to cooperate with doctors on a major front: a new surgery center. The hospital has long needed a makeover of its surgery wing.

For years, several doctors tried to make the case for a joint venture with the hospital and physicians. They would share construction costs and run it together as business partners. But Rice preferred to go it alone, with the hospital building and running it all on its own.

“There was a huge wall,” said Dr. Chris Catterson, an orthopedist. “We got shot down very quickly. That’s not the case now.”

Unlike Rice, Poore is open to the idea of a joint venture, and not just because the hospital no longer has money to go it alone.

“It is important to me to make sure we have physicians involved,” Poore said.

The hospital and interested doctors are splitting the cost of a feasibility study. It will determine whether there’s enough demand in Haywood County for a surgery center, and if so, what model would work.

Who’s Poore?

Poore set out in college to become an orthopedic surgeon. He had been a heavily-recruited football player in high school but tore up his knee. A series of surgeries landed him in the care of doctors and nurses and the halls of hospitals during an impressionable time, driving him to combine his new-found admiration of health care with his love for sports.

But in college at Auburn, the dreaded organic chemistry course frustrated his plans to become a doctor.

“It kicked my tail,” Poore said. “I started looking around for another career, but I really liked health care.”

Perusing course catalogs, he signed up for classes in health administration instead. What sealed the track was a summer internship at the university hospital. Poore found he loved walking through the doors of a hospital each morning.

“It’s the people in the hospital. There is a different culture there. They go into the health field because they want to help other people. It’s that culture that I love,” Poore said.

Poore made the dean’s list for the next three semesters.

“I was so on fire after that,” Poore said. “I knew that was what I wanted to do.”

Poore got his first job as a hospital administrator at the age of 22. It was several years later before Poore refined his definition of a hospital administrator, though, when his kids were little and asked him what he did at work.

“I told them my job was to take care of the people who take care of people,” Poore said.

Poore’s bible when it comes to hospital leadership is called Hardwiring Excellence by Quint Studer. Poore buys copies in bulk, passing them out to each hospital board member and his management team. The book lays out five pillars of a hospital that must be keep in sight at all times.

During his first month at HRMC, he shared the five pillars with the entire staff during a series of town hall meetings. Poore’s talk on the five pillars has also become a requisite part of orientation for every new hire.

Poore likes the community so far. His three children attend local schools. His wife, Penny, has a seat on the hospital foundation board.

Poore was well-liked at the hospital he left. His going away gift from his old employees occupies prime real estate on his desk along with a photo of Poore driving his antique Corvette in a hometown parade with a bouquet of balloons.

During his first weeks on the job, Poore was talking to a doctor back home about the challenge he faced here convincing the medical community to trust him.

“He said ‘I’ll come up there, I’ll tell them,’” Poore recounted.

People have been impressed not just by Poore’s attitude, but his skills as well. He has been invaluable in talks with larger hospital systems about a possible merger with HRMC.

HRMC was well into talks with other hospitals when Poore was hired. Poore’s first brush with the affiliation team was during such a talk with a prospective partner.

“I can remember sitting across from him and thinking ‘This guy knows what he is talking about,’” said County Commissioner Chairman Kirk Kirkpatrick, a lead player on the affiliation team. “He immediately added a lot to our committee.”

Poore, with the help of his CFO Gene Winters, has made big strides on the financial side as well. HRMC is not only breaking even, but making a few cents. It’s an area everyone is watching.

“You also have to be impressed with the bottom line,” Lang said. “Nothing has overtly changed except the management, and yet we have stemmed the flow of losses every month and are showing a small profit. It won’t be enough to keep us going for 10 years, but it is real progress.”

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