THE “VISION” THING

This is a more personal bit of musing than I would normally be comfortable in putting in this space. If that might make you as uncomfortable as it does me, you probably should stop here.

Yet as I sit on the beach and look back on my career for lessons that might help others, I cannot help but think that sometimes serendipity plays an important role. Serendipity can have a powerful effect on one’s career.

I have always believed that a manager of whatever rank needs to be able to articulate a view of where they want to be in the future both for themselves personally and for their organization. Call it the “vision” thing.

For me the vision thing began when I accepted my first and as it turned out my only CEO position. Serendipity played a role in that I was fortunate to have as my first board chair a remarkable man who too had the “vision” thing and who encouraged me to develop my own view of the future.

That man, B. Gale Wilson, passed away recently after a very long life. I was asked by my former organization—NorthBay Healthcare—- to put some thoughts to paper about Mr. Wilson and my experience with him. Consider the following a case study of the vision thing and serendipity with a special thanks to NorthBay for their help with editing my thoughts.

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I remember like it was yesterday, the August evening in 1981 when, after spending an entire day in Fairfield being interviewed as a CEO candidate by board members, physician leaders and selected managers, I received a phone call from Gale Wilson at my then-home in Union City.

He asked me to come to his office the next day to “discuss some things.” I had not yet really processed in my mind whether I was still interested in the position. Coming from a much larger health care organization in Berkeley, I pondered if Intercommunity Hospital (ICH) would be the right move professionally.

In his office the next day, Gale talked to me about his vision for Fairfield and the need for Fairfield and Solano County to have a local health care organization it could be proud of. He wanted to see someone develop that vision for the future. Any doubts I had about that CEO position vanished. When he made me the offer, I accepted. So began a nine-year relationship with him as the board chair to whom I reported.

I collaborated with many other talented people, some of whom were already at ICH and some of whom I recruited to join the organization to explore the possibilities for ICH. Together we developed a plan some board members thought was far too ambitious for little ICH and Solano County.  

At the penultimate board meeting before approving or negating the plan and committing the necessary resources, Gale told reluctant board members that I had been recruited to bring change to health care in the county and he emphasized the board needed to live up to that commitment. His comments carried the day. 

That was real leadership. Other board members respected his opinion and judgment.

As board chair, Gale gave me great latitude in the way I did things. He said as city manager of Fairfield his wish was to have the freedom I had to make things happen. He understood, though, that public entities had different constraints than private organizations.

In that first year we made many changes operationally which made some people unhappy. We upgraded rehabilitation services, ended an exploitative contract with an outside firm managing our pharmacy and brought in a new group of well-trained, young emergency service physicians. When I expressed to Gale my concern about the opposition I was getting, his response was, “The dogs may bark but the caravan moves on,” his way of saying he and the board of directors had my back.

Another problem needing to be addressed in that first year was how to meet the health care needs of Vacaville. A few years earlier, a developer had come to town with big promises to build a hospital. When he failed to do that, he left a bitter community. I sensed that bitterness early in my tenure when Gale took me to Vacaville to meet community leaders, all of whom — despite the fact that ICH’s board had Vacaville residents on it — could not believe the hospital in Fairfield could or would do something meaningful in Vacaville. Gale knew I must understand the depth of bitterness in Vacaville about the lack of health care services. He saw Vacaville as a growing community that deserved more services in their community, so he asked me to devote some attention to the issue.

This was interesting to me because many people felt that Gale was only concerned about making Fairfield better and he did not care for any other city. That was an unfair and incorrect judgment to make. Gale wanted all communities in Solano County to progress.

After this visit, my team quickly developed and implemented a strategy that would include opening an urgent care center in Vacaville. Before it began seeing patients, we held an open house on a Saturday. There was a throng of interested Vacaville residents waiting to see this new service from ICH. It was then I truly realized that Gale sagely understood the desires of Vacaville.

From that modest beginning, we started thinking “big” about Vacaville. Gale encouraged me to think big. With his help in opening some doors within county government, we were relieved of an onerous prior bond issuance which would have made it very difficult to finance any major project in Vacaville. 

With that accomplished, we began to conceive something all the consultants and experts said was a folly — building a hospital in Vacaville. Since it was a “big” idea, Gale was an enthusiastic supporter from the beginning. He helped us develop community support from elected officials in both Vacaville and Fairfield. Without Gale Wilson, then-Vacaville Mayor Bill Carroll and then-City Manager Walt Graham, there is no way NorthBay VacaValley Hospital would have happened.

A side story: Gale wanted us to include, if possible, a large water feature to distinguish the setting of a Vacaville hospital. Our budget was extremely tight, but Gale was stubborn. I finally convinced him we could not afford the water feature. He always seemed sad about that.  

Gale also was instrumental in establishing the neonatal intensive care unit in ICH. When I explained that critically ill newborns were being separated at birth from their mothers and sent to hospitals in San Francisco and Napa, he was very upset. He was a strong advocate of the idea that those babies should stay with their mothers in ICH. We had to overcome much opposition from the other hospitals that questioned whether upstart ICH could operate a quality NICU.

One day I explained to Gale the difficulty in attracting a neonatologist to direct our NICU. What I did not know was that Gale was a friend of a neonatologist who attended his church and who was stationed at David Grant Medical Center. This highly qualified physician would be leaving the Air Force in a year’s time. Once Gale got him interested in ICH’s NICU development, we were able to recruit him as medical director. To this day, the NICU is consistently highly rated for the quality of its care.

Soon we recognized ICH had grown beyond being just a hospital. With the opening of the hospital in Vacaville, we needed to consider reorganization. Gale was very interested, but as usual, it met with some resistance from some quarters. He helped guide a yearlong process with the board, resulting in a holding company being formed to oversee operation of three subsidiary organizations. Again, without his support and leadership, this never would have been possible.

During the nine years I was blessed with Gale as board chair, we completely modernized the operations of ICH, opened a second hospital, started the process of bringing specialized hospital services to Solano County, improved the financial underpinnings of the organization, built two medical office buildings, started a hospice program and completed a corporate reorganization. That is what happens when you have leadership at the board level.

I well remember the day I learned Gale would be leaving his city manager position, and therefore his board membership, to become a missionary for his church. One day when I was between planes at the Dallas-Fort Worth Airport, I heard: “Mr. Gary Passama, you have a message at the red courtesy phone.”

At first I didn’t believe they were saying my name. But then it repeated. With trepidation I found a courtesy phone. Somehow, Gale had tracked me down and wanted to let me know that later that day it would be announced he would be leaving his position with the city. He did not want me to be surprised.

Gale was a visionary leader in many venues. When I suggested to the city that the new street in front of NorthBay Medical Center be named for Gale, it became a fitting tribute. Today it stands as a memorial to a man who wanted his community to be outstanding in every possible way.