Carilion Clinic CEO Nancy Howell Agee leads transformation through collaboration

Over the past decade, Carilion Clinic has gone through a transformation. Leading these changes has been Nancy Howell Agee. As current CEO and previously chief operating officer, Agee has used her skills building teams and trust to clear hurdles and reach goals. The former chair of the American Hospital Association takes pride in what she’s accomplished despite having gone through personal criticism and public attacks to do so.

WHAT WAS YOUR RISKIEST DECISION? Transforming Carilion from a collection of hospitals to a model of care delivery adapted from organizations such as Cleveland Clinic—at the height of the Great Recession. The move required significant changes to our operating structure. At the same time, we created a public-private partnership with Virginia Tech to start a new allopathic medical school and biomedical research institute.

WHY WAS THAT MOVE RISKY? The “clinic” model of care delivery, including a strong role for physician leaders and physician employment, was unfamiliar to people in our region, so there was a lot of misunderstanding. Many physicians were critical of “corporate medicine” and organized to halt our plans, even attracting national media attention. We modified our plan and talked about it for hundreds of hours, but we moved forward with the strong support of the Carilion board.

DESCRIBE THE OUTCOME Our transformation is widely viewed as a success and has earned Carilion a national reputation. We’ve attracted top talent and brought the latest, most sophisticated care to our region. Our medical school is one of the most competitive in the country and our research institute’s external funding has leapt from zero to more than $100 million in just a few years. Our growth is helping to transform our region’s economy.

RESPONSE FROM THOSE INVOLVED Clinicians and staff are excited about being part of Carilion and part of healthcare during a time of such dramatic change. Even those who were once naysayers have become collaborators and champions. As a healthcare provider and the region’s largest employer, the community recognizes that our success is their success as well.

ADVICE TO EXECS IN SIMILAR POSITIONS Don’t be afraid to think big. Be willing to take risks without being reckless. And think “outside the box.” Just because something has never been done, doesn’t mean it can’t be. And you don’t have to do it alone. Look for others you can partner with to build something together that neither of you could do alone.

DESCRIBE YOUR LEADERSHIP STYLE I’m a servant leader. I think leadership works best when it flows from the bottom up instead of the top down. It’s a style that comes naturally to me. I also believe in bringing along the next generation of leaders.

HOW WOULD OTHERS DESCRIBE IT? A servant leader leads with integrity, judgment, fairness and heart. Leading with heart draws on values of trust, empathy, forgiveness, understanding and love.