November 2003

William D. McGuire - A Change Agent for Health Care in WNY

by Kris Ann PIAZZA and
Joseph H. RADDER

Character is defined by the way a person deals with life's challenges and uses the wisdom others have shared. As the oldest child of a busy traveling salesman, William Dennis (Bill) McGuire learned at an early age to shoulder family responsibility and adopt important family values. He began developing the seedling characteristics of leadership as a child, assets that paved the way for his unique talent as an agent for change.

Bill's parents on their wedding day..	Bill's dad, John Williams McGuire, Jr., was in the Army Air Corps during World War II.
Billy and his mother Kathleen - 1943.	Billy - age 2.
Bill - age 8.	Bill's sister Sherry, age 3, brother Bruce, age 1 and Bill, age 6 - 1949.
Bill's family moved to Dansville, NY in 1956.	Sherry, Bruce, Bill's dad John, Bill's mom Kay, Bill and his wife Nancy - 2000.

Nowhere has there been more evidence of his ability to change things than right here in Buffalo at Kaleida Health.

Kaleida had lost $112 million before Bill “parachuted in” as he describes his arrival, and had lost $62 million in 2001 alone. In less than a year’s time, Bill and his team had cut that loss to $13.3 million in 2002, and have Kaleida on track to produce a modest annual surplus in 2003 - a dramatic and remarkable turn of events.

Kaleida is one of the area's largest employers, with 10,600 people on the payroll. Turning around a ship that big isn't easy.

If you ask Kaleida's CEO, William Dennis McGuire, now on the job less than two years, how it was possible, he'll tell you it was the result of "a lot of people pulling on the oars in the same direction." In other words, Kaleida's board of trustees, management, doctors, nurses, and support staff are working together at every level. However, if you ask any knowledgeable observer, he or she will tell you the credit goes to Bill McGuire's leadership, his ideas and his communication skills.

His reputation as a trouble-shooter is well-known in hospital circles. Indeed he has been President and CEO of two academic medical centers and five different multi-hospital organizations in the past twenty seven years. In every one of these situations he "parachuted in" to a host of fiscal problems and within a short time managed to turn them around.

His relatively short stay in each of these positions (an average of 3 ½ years) worries some of our local leaders. "He's great, but we can't expect to keep him long", is a typical comment.

Bill McGuire's answer to comments like these is reassuring. First, when he left all of those previous positions he was able to turn over leadership to people he had hand-picked and who believe in his philosophy; in other words, people likely to build on his success. Second, he loves Buffalo. "I kept my retirement home in San Antonio while working for the Catholic Medical Centers of Brooklyn and Queens, and I maintained my membership in the San Antonio Country Club, planning to retire there for the second time when the job was finished in New York. This time, however, I've sold the property in San Antonio." The McGuires love Buffalo and plan to stay here. Indeed, Bill has always called Western New York home. Growing up in Dansville, New York, he made frequent trips to Buffalo and learned to love this city.

"Buffalo has so many pluses", he says. "Great architecture, great arts, wonderful theater, great restaurants at affordable prices, major-league sports, great recreational opportunities, remarkably affordable housing. And the best thing of all, the people. The people are ‘off the charts friendly’. My wife says, 'Buffalo is very much like the mid-west'. I correct her and say the mid-west is like Buffalo in its friendliness."

Surprisingly perhaps, McGuire says, "Buffalo is the easiest place to recruit quality people, persuading them to move from other cities. While we often hear just the opposite, people quickly recognize all that Buffalo has to offer and they want to move here."

However, he believes passionately that the quality of medical care is critical to the future of Buffalo. "If the quality of medical care deteriorates here, there's no way Buffalo will ever attract new business of any size."

Collaboration is the key to Bill McGuire's management style. "I am by nature a good partner and a collaborator," he says. For example, unlike some hospital administrators, he genuinely admires doctors and enjoys working with them. "When I was in college at Notre Dame I wanted to be a doctor and studied pre-med, but I couldn't pass pre-med chemistry. The guidance counselors seemed to think I had business talent and gave me some good advice. They suggested I study hospital administration, so after Notre Dame I went on to the University of Michigan where I earned a Masters of Hospital Administration."

According to McGuire, six elements contributed to Kaleida's transformation:

1. Leadership - A good leader knows when to direct and when to serve; keeping the needs of the people as the primary compass that directs decisions. The Kaleida Health Board of Directors' decision to downsize itself by nearly half and hire the Hunter Group consulting team for hard-line recommendations for change, are two examples of tough choices Kaleida's leaders have made.

2. Vision - Identifying goals to challenge the organization to stretch itself beyond what it thought was possible. This provides a road map to excellence. Kaleida's new vision is to be one of the leading regional health systems in the nation.

3. Collaboration - Working in partnership on every level is the key factor that is responsible for Kaleida Health's recent transformation. Initiating collaborative relationships with Erie County Medical Center and the Catholic Health System through the Group Purchasing organization, and reaffirming Kaleida's relationship with the University at Buffalo School of Medicine and Biomedical Sciences are partnerships designed to improve quality and better serve the community.

4. Reinvigoration - Enthusiasm is contagious and promotes a positive attitude about the future. This is necessary to achieve momentum for positive change, as evidenced by the voluntary downsizing of the Board and addition of new and diverse trustees. Reinvigoration of management and medical staff has occurred through the recruitment of new talent with exciting fresh perspectives.

5. Commitment - Honest dedication to change what has not worked in the past and self-evaluation of performance are necessary to improve effectiveness. Strengthening the commitment to health care quality through these elements is Bill McGuire's primary objective for 2004 and beyond.

6. Accountability - Performance that will stand up to measurement is important. Responsibility and accountability to both the organization and the community dictate the roles Bill McGuire expects those he works with to fill. He empowers those who work for him by offering his trust and full authority, allowing room for mistakes but requiring results-oriented outcomes.

Bill McGuire never fails to name the people and the groups that contributed so much to Kaleida's dramatic improvement.. He insists "No individual turns an organization around. An individual may be the catalyst, may be the leader, but it takes a lot of people working together."

Kaleida's management team - making turnabout happen.

He replaced a lot of people in management who were not physician-friendly. "It’s essential in this business to love working with physicians,” he says. "That's something you can't fake. You have to be a great team player, and you have to have expertise in the areas you’re responsible for."

A peek into Bill McGuire's background gives us a clue as to how he developed such strong people skills.

He was born in 1943 in Glen Ridge N.J. "I had a wonderful childhood," he remembers. "I had loving parents and a great younger sister and brother."

His Dad, John William McGuire was a traveling salesman. "Today we'd call him a manufacturer's representative" Bill says smiling. "We lost Dad this past July at 86 years of age after a full life. Mom and we three children were at his side when he died peacefully. He and my mother, Kathleen Sexton McGuire, had been married for over sixty years."

His grandfathers both died when he was very young. Nevertheless Bill credits his love of sports in general and his success as a rugby player at Notre Dame to his grandfather, George Sexton, who was a fine rugby player in the early 1900s.

Bill's grandfather George Sexton (pictured below, middle row, 3rd from left - 1916) passed on his love of rugby to Billy at a young age.	Bill (center, reaching for ball) carried on the family tradition and played varsity rugby at the University of Notre Dame.

Bill remembers both of his grandmothers fondly. He tells the story of walking around town with his grandmother. "We'd go by Schrafft's and she'd say 'Billy, I believe I'd like a chocolate sundae. Would you join me?' Well, of course I'd join her for a chocolate sundae. Years later I was telling my dad this story noting what a lovely way this was for her to treat me to a chocolate sundae. He said 'Bill, I've got news for you, it wasn't for you at all. She loved her chocolate sundaes."

Bill enjoys a pint of ice cream, a trait he inherited from his paternal grandmother (below)Elizabeth Gunster McGuire.
	Bill's grandfather, John Sr. and his father, John Jr. - 1939.

When Bill McGuire was five years old, the family moved up to Vermont, to the beautiful little town of St. Johnsbury. His schooling up until eighth grade was at St. Johnsbury. Then the family moved to Dansville, New York.

"Dad would leave home very early every Monday morning, and wouldn't get back until long after dark on Friday. As the oldest child, I was the person responsible to do a lot of things around the house. So I had a sense of responsibility from an early age. And I recall loving that sense of responsibility."

He feels it was a blessing to grow up in a family of modest means. "I remember, as a kid, I wanted a nice bicycle in the worst way, and about the only way I was going to get that nice bicycle was to earn it myself. So I recall working, mowing lawns for twenty-five cents and shoveling driveways for ten cents until I had saved the $54 to buy that Columbia bicycle, the nicest bike around in those days."

McGuire went to high school in Dansville, then on to the University of Notre Dame where he earned a BA in Liberal Arts. He then went on to the Graduate School of Business Administration at the University of Michigan where he earned a Master's degree in Hospital Administration. Then he did his residency at the University of Wisconsin Hospitals in Madison.

Bill's confirmation - 1955.	Bill worked as a summer lifeguard during the 1960s.
Bill in his senior year of high school - 1960.	Bill at the University of Notre Dame - 1962.

Bill McGuire and Nancy Hoyne were married in 1966 in Dayton, Ohio. They have two daughters, Kathleen 36, and Colleen 33. Nancy has a record of community service on her own. Indeed she ran for the Ohio state legislature in 1978.
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Bill and his wife Nancy on their wedding day - 1966.	Nancy's run for office - 1978.
Daughters Kathleen and Colleen.	Rusty, one of Bill's beloved Dobermanns.

No story about Bill McGuire's family would be complete without mentioning his dogs. "We have two Dobermans," he said, "Too many people are fearful of the breed. They're very, very smart dogs and they're very loving dogs."

Summing up he said "I am just tremendously grateful for splendid parents, wonderful teachers, mentors and friends. I say a little thank-you prayer in the shower every morning for those people. I am truly, truly blessed."

Yes, William Dennis McGuire is an agent for change, a turn-around specialist who has promised to use his skill to advance the health of this community by caring about its people. Kaleida and Buffalo/Niagara are truly blessed that he accepted the challenge.

Bill (third from left) with Pope John Paul II.	Bill and Secretary of State Colin Powell.
Bill and Governor George Pataki.	Bill and Senator Hillary Clinton.

Kris Ann Piazza is a senior writer in the Public Relations department at Kaleida Health. Joseph Radder is a free-lance writer and a frequent contributor to Living Prime Time.

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