Richard Liekweg has a picture of a basketball hoop hanging on his office wall.
"You'll always miss 100% of the shots you don't take," it reads.
Liekweg, 40, has not shied away from tough shots during his career. While some of his colleagues describe his career moves as ones nobody else would have the courage to make, he describes them as welcome challenges.
His current position as chief executive officer of the financially troubled Durham (N.C.) Regional Hospital, a community hospital within the Duke University Health System, is no exception.
During the first year Duke leased Durham Regional, fiscal 1998, the hospital suffered a $13 million loss. That was before Duke's external auditors discovered Durham Regional had been using a flawed formula to calculate income from managed-care contracts. All of a sudden, a hospital that had looked like a promising addition to the system was projecting a $22 million loss for the 1999-2000 fiscal year. Add in the tensions inherent in a marriage between a community hospital and a large academic medical center, which was what Liekweg stepped into in late 1999 when he became Durham Regional's chief operating officer.
"I like to look at my career path as being in the right place at the right time," he says.
After becoming CEO in June 2000, Liekweg closed an outpatient senior center this past January and closed a chemical-dependency program this summer. He has also taken 300 positions out of the hospital's payroll, with fewer than five individuals actually being laid off in the process, he says.
In its most recent fiscal year, Durham Regional posted an operating loss of $7.5 million, an improvement from a $17 million operating loss last year. And the hospital has budgeted for a smaller $3.7 million net loss at the end of the current fiscal year ending June 30, 2002. Liekweg concedes that it has been a slow, sometimes painful process.
Liekweg has been with the Duke system since 1987, when he graduated with a dual master's degree in business administration and health services administration from the University of Michigan and was offered an administrative fellowship at Duke University Hospital, the system's flagship academic hospital in Durham.
Since then, he has held such positions as assistant administrator of Duke University Hospital, administrative director of the pediatrics department and associate chief operating officer of the hospital. In 1999, 18 months after Duke began leasing Durham Regional, Duke officials asked Liekweg to become its COO, with an understanding that he would be a contender for the CEO slot the next year.
Charles Blackmon, Durham Regional's board chairman and a board member for six years, says Liekweg has had to make tough choices, such as closing a popular but money-losing fitness center.
Before shuttering the facility, Liekweg tried to negotiate with numerous buyers to find an alternative solution.
"It went well beyond the call of duty," Blackmon says.
Michael Israel, vice president and chief of hospitals and clinical facilities, and CEO of Duke University Hospital, says Liekweg has the business acumen and communication skills to become the CEO of a large system.
William Donelan, executive vice president of Duke University Health System, picked Liekweg to become an administrative fellow at Duke 14 years ago.
"Part of my job at that time was developing human talent," Donelan says. "I thought this guy was worth continuing to make some special investments in."
Donelan encouraged Liekweg to take the position in Duke's pediatrics department.
Liekweg looks back fondly on that period, during which he increased the department's professional revenue 75% over three years and helped begin the campaign to build Duke Children's Health Center.
"It helped me truly begin to understand the physician's perspective," he says.
Liekweg, who has a 20-month-old daughter and whose wife, Stacey, is a former hospital administrator from rival UNC Hospitals, says he has learned, both from his job and from being the youngest of six children, never to take himself too seriously.
He enjoys running and playing golf "to keep my head clear," he says.
His mediocre golf game is evidence of the amount of time he spends on the job, Blackmon says.
"I've been pushing him lately to take some more time to work on that."