Harold Ray, M.D., is a lover of M&M candies, an amateur astronomer and a wine connoisseur. And, oh yes: The senior vice president and chief medical officer of sprawling Denver-based Catholic Health Initiatives is the winner of the 2003 Physician Executive Award for Lifetime Achievement, sponsored by the American College of Physician Executives and Modern Physician.
Ray, 70, practiced as an OB/GYN for 30 years in Sacramento, Calif., and delivered an estimated 7,500 babies while building an executive career in medical group practice, hospitals, consulting and a health plan.
"A lot of us didn't start out as physician leaders, but we saw the need and stepped up to the plate," Ray says. "I've always been an advocate of physicians being involved. I think that always having quality and patient safety at the forefront, we need to be at the table where the decisions are made."
John Whitelaw, M.D., a retired OB/GYN and past president of the California Medical Association, remembers Ray's salesmanship as he recruited Whitelaw to join Ray's Sacramento medical group.
It was 1974, and Ray focused his closing arguments not on the young physician fresh out of residency, but on Whitelaw's wife, Carol, a native of Sacramento who wanted to return home. "He asked, 'What would it take to get him to come to Sacramento?' She said, 'Offer him the job and I'll get him here,'" Whitelaw says. "He identified who the boss was and went right to her."
Early in Ray's leadership career at Sutter, Whitelaw says, he first witnessed Ray's unflappability in the handling of a high-profile disciplinary action. "It was Hal's baptism by fire." An anesthesiologist had engaged in sexually inappropriate conduct in a hospital operating room, Whitelaw says. The physician eventually went to prison. But Ray was steady, a trait Whitelaw says he's seen time and again.
And Ray comes ready, Whitelaw says. "He's highly obsessive-compulsive," he says. "I am, too. It directs itself to being very detail-oriented. You've prepared the answers to questions before you face a crowd.
"Hal has always been a proponent of change, for improving, for quality control, for bettering medicine, and frankly, that's not always popular."
Ray, a native of Kansas, graduated from the University of Kansas Medical School in Kansas City in 1958 and completed his internship at the University of Oregon Medical School Hospitals in Portland in 1959. He served as a general medical officer and captain in the U.S. Air Force through 1961, which led to a lifelong interest in astronomy.
He returned to Oregon in 1961 and completed his residency in OB/GYN in 1965, entering private practice in Sacramento that year by joining about 20 other physicians at the multispecialty Sacramento Medical Clinic. Ray left the clinic in 1982 and became managing partner of a four-physician group. He retired from medical practice in 1995.
He was a clinical professor of obstetrics and gynecology at the University of California Medical School at Davis, chief of staff and member of the board of trustees at Sutter Community Hospitals, board chairman of the Sacramento Physicians Medical Group Network, a member of the board of trustees of Sutter Health, and a director and chairman of the board of Omni Healthcare, a 125,000-plus-member HMO owned by Sutter Health and Catholic Healthcare West.
He worked a two-year stint as a consultant with the Pace Group and for another year with CHI before hiring on as senior vice president and CMO in 1998. CHI, with its 68 hospitals in 19 states, is one of the largest not-for-profit hospital organizations in the U.S. Ray oversees six physician vice presidents.
"Because he's been there and done it, he brings credibility to the table that gets other physicians to sit down and listen," says Kevin Lofton, CHI president and chief executive officer. "He's dogged about issues of quality and patient safety. He has a low tolerance for things he knows that can be avoided, but he does it in a style that works around one our core values of reverence."
At CHI, Ray has led an effort to establish intensivist programs in the intensive-care units of all urban hospitals in the system, developed evidence-based performance measurements, and established advisory teams for accreditation by the Joint Commission on Accreditation of Healthcare Organizations. He also better than halved the losses of hospital-owned physician practices, from $150,000 per physician to $70,871 last year.
"I've had a great team backing me up," Ray says. "They don't need anyone to lead them. They need someone to block and tackle for them so they can do their jobs."
Such self-effacing remarks are vintage Ray, according to Barry Silbaugh, M.D., who was recruited by Ray to come to CHI in 1998 as vice president of medical operations. (Silbaugh, secretary-treasurer of the American College of Physician Executives, was a judge this year for the Physician Executive Award of Excellence but recused himself from the balloting on the Lifetime Achievement Awards.)
"He doesn't take credit; he always gives credit to others, which means there is no limit to what our team can accomplish," Silbaugh says. "He makes the members of the team feel valued, and so much about medicine is teamwork." But Silbaugh says Ray, a stickler for punctuality, isn't simply a cheerleader. Leadership team members submit to 360 evaluations and annual meetings where the discussions can be quite frank. "He's able to bring the team--and himself--to look in the mirror. It takes a lot of courage to do that."
The bottom line is that Ray engenders trust. "I think I know what his values are," Silbaugh says. "He puts the interests of the patients first, and I know I can rely on that like clockwork."
Ray had racked up 100,000 air miles annually for six years--before backing off to 68,000 miles last year--traveling the vast CHI system, which stretches from Maryland to Washington state. Silbaugh says he can tell when the doctor is in by looking for the candy dish in his Denver office, which Ray fills himself for the enjoyment of office colleagues. "He loves M&Ms," Silbaugh says, and he knows wine, too.
Having practiced so long in Sacramento, just a 50-mile drive on Interstate 80 from Napa, the American wine capital, Ray learned and "taught us a lot about vintage wine," Silbaugh says.
Ray, who has kept a home in Sacramento, says he is looking forward to retiring June 30 and hopes to spend a lot more time there with three of his six children and three of 11 grandchildren.
But Ray says that thinking he could make a difference in improving quality has kept him pumped up about his job. "I'm energized by my work and enjoy work, so it's easy to get up in the morning."