In 1986, at age 41, Brown was hired as CEO of Christian Health System in St. Louis (seen here at a board seminar that year). Before he was 50 CHS would become a party to one of the early megamergers in not-for-profit healthcare, and he would be the combined system's CEO.
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When approached about leading the newly affiliated Barnes and Jewish hospitals in 1992, Brown pressed them to consolidate with Christian Health System. A year later, that's what happened, forming BJC Health System. Missouri Baptist Medical Center and St. Louis Children's Hospital join BJC in 1994.