On a cold January day in 1942, Merrill Gappmayer came into the world at Utah Valley Regional Medical Center, a Provo hospital that since has become part of Intermountain Health Care, a Salt Lake City-based system.
Years later, Gappmayer was instrumental in the birth of nearby Orem (Utah) Community Hospital. For the past 19 years, he has served as a trustee of both hospitals, each of which boasts an impressive view of the mountains along the Wasatch Front.
Not many people get so involved in the governance of the health facility where they were born and, as Gappmayer said, most likely will die.
However, Gappmayer would be just as apt to serve his community "if he were born in Abu Dhabi," according to Larry Dursteler, who since 1988 has worked closely with Gappmayer as chief executive officer of IHC Hospitals of Utah County, which includes Utah Valley Regional, Orem Community and American Fork (Utah) Hospital.
For the service he has given to his hometown of Orem-and on regional and national levels-Gappmayer is the recipient of MODERN HEALTHCARE's Trustee of the Year award for hospitals and healthcare systems with more than 200 beds or annual revenues of more than $25 million. The 53-year-old Gappmayer is president of Vista Enterprises, a building and development firm in Orem.
"I think that everything he has done, he has done with determination, sincerity, intelligence and a strong willingness to strengthen his local, regional and statewide environment," said Scott Parker, president and chief executive officer of IHC.
Parker started working for the secular not-for-profit system when it started up in 1975. IHC was formed when the Mormon Church donated its 15 hospitals to the community.
The system, which posted 1994 earnings of $63.2 million on revenues of about $1.1 billion, operates 23 hospitals in Idaho, Utah and Wyoming.
CON debate. .
As it has worked out, the two facilities have been complementary. Orem Community started out primarily as an obstetrical facility and currently is shifting its focus to ambulatory care. Meanwhile, 395-bed Utah Valley Regional has served as a major referral center for the southern part of the state.
The smaller facility usually breaks even or reports a loss, as do several of IHC's hospitals in rural communities. It posted an $860,000 loss on revenues of $6.8 million in 1994. Utah Valley Regional has been extremely profitable, reporting earnings of $12.8 million on revenues of $142.6 million in 1994, according to HCIA, a Baltimore-based healthcare information company.
Although the two hospitals have shared a governing board since 1984, the system has not merged the assets of the two facilities because of their different purposes. "We keep the two separate to measure performance," Gappmayer said.
IHC asked Gappmayer, who had served on the Orem board since the facility was built, to chair the merged board.
Fourteen of the boards' two-dozen total members were chosen for the new board, based on such factors as geography and experience. The board now has 16 members, and Gappmayer has served as chairman for 11 years.
For the past six years, he also has served on the IHC board and has helped spearhead the system's drive to build more clinics and outpatient facilities.
"The system needs support of the local boards," Gappmayer said. "I think we're decentralizing. We're finding the board's connection to the community is stronger
On top of his experience in Utah, Gappmayer chaired the American Hospital Association's National Congress of Hospital Trustees in 1994. In that capacity, he campaigned for the increased involvement of the thousands of volunteer community leaders who serve on hospital governing boards.
He also served from 1989 to 1994 on the board of directors of the Utah Hospital Association, which awarded him its Distinguished Service to Healthcare award in 1994.
Put to the test. Gappmayer's ability to face a tough situation often has been put to the test, perhaps most notably three years ago when the Orem Community/Utah Valley Regional board revoked the privileges of a physician in its obstetrical department.
To gather information so the board could weigh its decision, Gappmayer put together an independent hearing board consisting of a nationally known healthcare attorney, a nonlocal physician from the same specialty, a nurse and a lay representative.
Gappmayer said he walked the thin line between protecting the rights of the physician and those of the community. "The board has the interests of the whole community as its responsibility," he said.
The conclusion of the fair hearing process that Gappmayer developed has been tested as the dispute has moved into the courts. Although a district court dismissed the physician's case, litigation is still pending. The physician has appealed the decision to the state Supreme Court.
When problems arise in the credentialing process, or in any other realm relating to physicians, Gappmayer does not pretend to understand all the intricacies, said Clark Bishop, M.D., who serves as medical director at both hospitals. Instead, he is more likely to guide the medical staff to a fair resolution.
Bishop noted Gappmayer's evenhanded style in dealing with a medical executive committee vote to deny Caesarean-section privileges to family practitioners. "Rather than overruling that and being heavy-handed, he sent it back to the (committee) and asked, `Why don't you reconsider this?' " Bishop said.
After Gappmayer requested justification for denying certain privileges, the committee established cross-departmental guidelines for all surgical procedures.
"He tries very hard to be an advocate for this hospital, for the medical staff, and for the quality of care," Bishop said.
Within the IHC board, Gappmayer serves on the community relations committee, which looks at healthcare resources for the underserved.
The committee recently set up a $20 million IHC endowment that will be used to maintain five community-based clinics the system does not own. The health centers provide care to indigent residents along the Wasatch Front, which reaches from Ogden to Provo.
Close to home. Although his experiences have run the gamut from the local to the national levels, Gappmayer has remained close to his hometown of Orem. He lives in Mapleton, which is about 20 miles away. He and his wife, Marie, have eight children, ranging in age from 13 to 27, and four grandchildren.
He also has served on the Utah National Parks Council of the Boy Scouts of America and has held leadership positions within the Mormon Church. In 1993, the Provo/Orem Chamber of Commerce recognized his civic efforts by giving him its Outstanding Citizen award.
Those who have worked with him over the years tout Gappmayer's understated leadership style. IHC's Dursteler quotes the Chinese philosopher Lao-Tzu in describing his colleague: "The best leader is one who people hardly know exists. But after little talk, when much is accomplished, then all the people stand back and say, `We did it ourselves.' That's Merrill."