Carol McCarthy became the AHA's first female president in 1986, a job she held until resigning in 1991. While the AHA board thought McCarthy's hard-nosed style could turn the organization around financially, others criticized it for driving off key staff members.
During her tenure, the AHA approved a national healthcare reform strategy and Humana rejoined the AHA after leaving in 1985 over representation issues. But state and local hospital association leaders reportedly questioned McCarthy's ability to lead the industry on major healthcare issues.
Before coming to the AHA, McCarthy, 57, served as president of the Massachusetts Hospital Association. Since leaving the AHA, she has practiced health law at the Baltimore-based law firm of Ober, Kaler, Grimes & Shriver.
Why did you want the AHA top job?
I was approached and asked. When you have spent as many years as I had spent working in the healthcare industry . . . and someone asks you whether you have an interest in providing leadership at the national level, it's something you look on as an honor and a tremendous opportunity.
What were your major accomplishments at the AHA?
One of the major changes we made was to make the local groups (regional policy boards) an integral part of the policy development process. The second was that it was the beginning of the AHA's development of a healthcare reform package. . . . It looked at reforming the healthcare system, not just how you paid for it. The third: It was a difficult time to be sure that the AHA was again being not only responsive but cost-effective. We went through a number of downsizings, and that's always a difficult thing to do.
Regrets, oh I don't think so. It was a wonderful opportunity to be in a national position, to have people indicate that kind of confidence in you. . . . It was a tremendous honor to be the first woman chief executive officer of a national trade association as well, particularly in a field that very often had a glass ceiling for women at that time. To me, it was a wonderful experience, an exciting time and a very demanding time. . . . I must say I had far less of a home life than I would have liked and am enjoying that very much now.
Anything you would have done differently?
I believe you make the best decisions you can with the information you have at the time the decisions are made. I have never been one to do Monday-morning quarterbacking.
What role does the AHA play in today's healthcare industry?
I think it's the same role. I think it's just becoming increasingly difficult. The most important role for the AHA is to be sure there really is a voice for healthcare facilities and organizations in Washington and to do that job very well to be sure that issues and concerns are brought before the lawmakers. . . . It's extremely difficult now.
When I first started, we used to try to make the world a little bit better for everybody. . . . Maybe they were more favorable to some than others, but at least everybody gained a little. Now, we moved to the position where it's all a trade-off. We began to work with a shrinking dollar and the inability to address everyone's concerns.
How will the AHA's role have to change in the future?
I believe advocacy will always be its primary role. . . . If you're trying to see and work with the great diversity in the system and forge ahead and do something good, I don't know an organization better able than the American Hospital Association to help provide the focus that embraces the large and the small, the East and the West.
Where does the AHA have the greatest impact?
I think that maybe its greatest impact is in effecting change and that it effects change in two ways: It does it in the legislative and regulatory arena, and it does it with its members. . . . The AHA has been extremely successful in providing tools to its members to help them change and help them adjust to a different environment. Effecting change is what it's all about.
Where do you see the AHA in 10 or 20 years?
I guess I see them in much the same role. I would suggest they will be far more focused on the issues of integrated delivery systems as the number of freestanding facilities becomes fewer and fewer, and that will lead them into increasing challenges in the representation area. I believe there will be even more issues for them to identify and even a greater challenge for them to focus the resources that they have to be most effective for their members and most effective in advancing sound health policy for this country.