Lori Wightman

 

President Lori Wightman helps guide 500—employee New Ulm Medical Center and 13,000–citizen New Ulm toward healthy living.

Photo by Jeff Silker

It’s German for “Entrance to the Clinic.” New Ulm Medical Center has a healthy number of these Eingang zur Klinik signs in its hospitable hallways to help send ailing German tourists to the appropriate doctor. The signposts are fitting indicators. In heavily Teutonized New Ulm, after all, people would expect hospital and clinic signs to speak auf Deutsch.

And here, to your left, Fargo-bred redhead Lori Wightman becomes your Klinik guide.

Wightman became president in 2002. Almost completely surrounded by Mayo Health System clinics and hospitals, she has helped this 500-employee, solitary regional outpost of Allina Hospitals & Clinics tower above New Ulm, the region, and in some aspects, the nation, not unlike copper-clad statue Hermann the German.

She and New Ulm Medical Center have dazzling resumes. First, Wightman’s peers last year elected her the sole Minnesota regent of the American College of Healthcare Executives, a healthcare administrators professional organization. In years past, she has been deputy director of the North Dakota Department of Human Services, North Dakota Gov. Ed Schafer’s campaign manager, general manager of the Fargo Beez semi-pro basketball team, and an Eide Bailly consultant. She is active in Brown County politics
and civic affairs.

With her at the helm, New Ulm Medical Center (NUMC) continues nurturing the nationally recognized New Ulm Model, a highly successful hospital/physician partnership unique to the Midwest. Alongside Allina Hospitals & Clinics, NUMC has been gaining additional national fame developing The Heart of New Ulm, an innovative program tasked with reducing to zero the number of local heart attacks. On top of all that, NUMC has a life-saving program to helicopter heart attack victims to Abbott Northwestern and have blockages repaired within two hours.

Wightman enjoys showing gemütlichkeit. Let her be your Klinik guide.

 

You grew up in Fargo?

These last seven years in New Ulm have been the longest I’ve been away from Fargo. However, I haven’t completely cut the cord because I have a boyfriend, mother, and brother there. In 1964 when I was four, my father became the administrator of Fargo’s new Dakota Hospital. He started the hospital from scratch, arriving with the last load of bricks and staying 26 years. My mother is a nurse—and I’ve had both careers.

What were they like?

My father passed away four years ago. He had quite a reputation in the healthcare community for being a great mentor to young executives. He taught me the importance of giving back to my profession and I’ve taken that to heart. My father also had the reputation of being tough but fair. In other words, he was willing to make the difficult but necessary decisions, and wasn’t afraid of having hard conversations with people.

Can you give an example of his being tough?

One time, a nurse was having a romantic relationship with a physician and perhaps thought she had more pull than other hospital employees. She came in demanding something of my father. He thought her demand was unreasonable and didn’t like being held hostage. She backed him into a corner, so he fired her on the spot. (Laughter.) He was tough, but he knew everyone’s name and was usually the first one there in the morning and the last to leave at night.

Did you get your toughness from him?

Absolutely. I wear it as a badge of honor being known as a person able to make difficult but necessary decisions—and not afraid to have the hard conversations.

Can you give an example of when you were tough?

I was an interim administrator in Ada, Minnesota, for nine months and had to make some difficult decisions. The hospital was city-owned, so I had to deal with the city council. They wanted to take one path, and I felt strongly that path wasn’t good for the organization in the long run. I felt pressure from physicians and many staff members. I stood up—pretty much—to everybody. And it cost me. Several managers and two physicians quit. But in the long run, that hospital remained viable and is now with the Benedictine System.

What did you stand up for?

The disagreement was over safety and quality of care. They were pushing for taking the path of least resistance and I was absolutely against it. Their idea of care wasn’t the type I wanted to deliver. In fact, nearly every time I’ve taken a tough stand it has been because of standing up for patient care or service.

And you usually side on the side of the patient?

Yes. We exist for patients. When conflicting things come in contrary to it, I will always land on the patient’s side. We are the third-largest employer in New Ulm. Almost everything I do is to create an environment in which employees choose to work, physicians choose to practice, and patients choose to receive care.

A couple things you do now could be considered tough. For one, periodically, you go to the State Capitol to testify in front of legislators. What are your feelings when you’re in that situation? What do you do when you’re in front of them to get your point across?

First of all, due to my background in North Dakota politics and government, I don’t feel out of place at the State Capitol. I’m a newcomer to Minnesota, but not to testifying and working with legislators and policy makers on the agency side. I know legislators very much appreciate hearing from real people in their districts. All day long they hear from lobbyists and special interest groups. Being there as a constituent from their district, I have their attention. I only testify on things I feel very passionate about. I come to the Capitol to paint a picture in people’s minds of the effect a specific law will have on real people in our community.

Last election, you appeared in a television commercial for Norm Coleman. Did you catch flak for that?

The only flak I caught was with people who hadn’t carefully watched the ad. They assumed I was representing Allina and New Ulm Medical Center, which I wasn’t. I was an independent citizen who happened to be a hospital administrator talking about my personal positive experience with Norm Coleman. There is a very definite line you don’t cross and I didn’t cross over. I was careful to be identified as a private citizen. I’m proud to be a Republican and know why I’m one. I respect anyone taking a side in debate. I certainly have friends who are Democrats and respect them because they also have taken a side. The more people that can get involved with the decisions affecting us all, the better we’ll all be. Thank God there are two parties. It wouldn’t be much fun if there wasn’t.

Do you like New Ulm?

When I started here, I was an interim administrator with no intentions of staying. I didn’t want to be single and living in New Ulm because I thought it was too small of a town. But within six months, I began thinking it was a great place. I really like New Ulm Medical Center’s relationship with the local physicians group and think that relationship should be replicated across the country.

I’ve never been attracted to anonymity. I like the fact my meat market man knows where I live. I’ve never had a problem meeting people in town. I know New Ulm has a reputation of being hard to break into unless you grew up here, but that hasn’t been my experience. I have developed what I know will be lifelong friendships. Part of having that happen probably was the path I took when first arriving. I immediately became involved in the community. I was on the Chamber board, joined Rotary, and became active with the Brown County Republican Party. I met many people and found them extremely friendly and welcoming.

So you’re saying the notion of people being “Auslanders” in New Ulm is likely more myth than fact and that if people moving here just became more involved they would find it a very different town?

Absolutely that’s true. Some people get involved in their children’s activities, usually through church or school. For the most part, I’ve met people through community organizations and my dog, Katie. She is a 12-year-old Newfoundland. She is my buddy. She used to go on my weekend trips to Fargo all the time, but now goes only to have her hair done once a month. (Laughter.) The trip has become too hard for her to tolerate every other week. In New Ulm, it’s easy finding people I can trust to care for Katie while I’m gone.

Could you describe the New Ulm Model for physician/hospital partnership?

It wasn’t that long ago when New Ulm had separate, independent physicians groups. In 1974, those groups came together in a common office building and created New Ulm Medical Clinic. In 1991, Sioux Valley Hospital and the Clinic joined together to build the new clinic building in its current location next to the hospital and physicians moved their clinic services there that year. In 1996, Sioux Valley Hospital merged with New Ulm Medical Clinic to form New Ulm Medical Center. At the same time, we developed with the Physicians Group of New Ulm a formal relationship called a “professional service agreement,” which I’ve dubbed our marriage contract. Like any marriage, the relationship takes care and feeding. Under the agreement, staff who had been employed by the physicians became Allina employees. The Physicians Group of New Ulm doesn’t own any brick and mortar, and doesn’t employ anyone at the Clinic. This agreement dictates that the physicians will be involved in hospital and clinic governance and operations. Of the ten-member board, half are from the Physicians Group of New Ulm or community members nominated by them. On the operations side, we have hospital and clinic physician members that sit down weekly with New Ulm Medical Center leaders to make decisions about how to operate the clinic and talk about strategic planning. Every decision made here has physician fingerprints on it.

If so good, why hasn’t this model been replicated elsewhere in the Midwest?

Many physicians groups have visited here to kick the tires on our model, but for one reason or another our model hasn’t been replicated. For the model to work, the physicians have to let go of the idea of owning bricks and mortar, and of having their own employees in order to feel they will be loyal to their practice. Our physicians have learned since 1996 that any fears they had then were unfounded. For it to work, the really important piece is the physicians—you have to give them a seat at the table for governance and operations so they can have control over their own destiny. On the hospital side, there may still be a mindset of this being all ours and we’re not willing to share. You have to get past that, too. Now we spend our energy and time on the really important things. Are we providing adequate services to our community versus spending our time and energy duplicating expensive high-end technology? I certainly don’t have to worry about the physicians starting their own imaging center or surgery center and they don’t have to be worried about us starting a competing clinic and hiring physicians to compete with them.

Like what happened in Mankato?

Yes. There are a lot of reasons why our model works and also why it would be difficult to replicate. For this to work, you have to date before you get married—meaning you need trust as a base before you even begin talking. As for here, I walked in on a solid relationship and we have built upon that to make the relationship stronger. Ours is a great model. In fact, sometimes our patients don’t know where the Physicians Group of New Ulm starts and New Ulm Medical Center ends.

New Ulm Medical Center currently is introducing The Heart of New Ulm, which is a program with a goal of reducing heart attacks in New Ulm from 85 in 2007 to 0 in ten years. How did that come about? And why New Ulm?

At this very moment, the executive director of The Heart of New Ulm is in the auditorium here holding an employee forum to make sure every employee knows about The Heart of New Ulm. There will be lots of over-the-fence discussion about it. We need our employees to be ambassadors.

How did it happen? It began as a hallway conversation between Dick Pettingill, the head of Allina, and Dr. Kevin Graham, a Minneapolis Heart Institute Foundation cardiologist, who has been coming down here as a cardiologist the last 18 years. They were talking about innovation being done mapping rural population grids in parts of Florida, specifically, a United Healthcare project noting where people had higher than average cholesterol levels. Then they started talking about replicating that project in Minnesota and using it to improve the health of a specific community. At that same time, Dick Pettingill was working with the Allina board to create a Center for Healthcare Innovation. The Heart of New Ulm became one of the Center’s three lead projects. Allina Health System has committed close to two million dollars annually to New Ulm each of the next three years for this, and we can match that with grants and philanthropy to do even more.

Why New Ulm? We are a self-contained community. Most people living here work here. Also, we have had an electronic medical record for about four years and 93 percent of the people in 56073 are on our electronic medical record for one reason or another. We also have a fairly self-contained medical community. Nearly all the care delivered in this town is coming from the Physicians Group of New Ulm. Finally, this community is very interested in improving its health. A community retreat we had last year identified “improving the health of the community” as one of its top three priorities.

Is it because of all those brats and beer?

Beer, brats, and butter. The program is absolutely voluntary and free. The first step is to take a snapshot of where we are. Just last month in April, community assessments began. Anyone in New Ulm can be screened to receive a “New Ulm score” to measure their risk for heart disease. At the screening, people are given information on how to decrease their risk of heart disease. If in a risk category, they will be referred on for additional screening. That’s the easy part.

The hard part: We’ve all made bad lifestyle and behavior choices and we’ll continue to be free to make those choices. The really hard part will be moving the needle on behaviors. We’ll help with that by reaching out to people with education programs and providing a supportive environment for making good decisions. Small changes make a difference in decreasing the incidence of heart attack. We won’t overnight have everyone jogging. This country and state has become very good at decreasing the chance of dying of a heart attack—we have had dramatic decreases over the last five years. However, what we haven’t done well is influence the number of people developing heart disease and having a heart attack. That number is going up. The Heart of New Ulm wants to see a decrease.

Along those lines: New Ulm Medical Center developed a program five years ago with Abbott Northwestern in which you can helicopter a heart attack victim from here and have the blockage repaired in less than two hours. If the Heart of New Ulm works, that special service you have will not be needed.

That program was driven by the cardiology program at Minneapolis Heart Institute Foundation and Abbott Northwestern. We were one of the first outstate locations to start Level 1 protocol. From the moment you enter our emergency room to when you are in Minneapolis with your vessels opened is averaging 113 minutes. That’s less time than it takes me to get ready in the morning. (Laughter.) Therefore, your chances of surviving a heart attack are similar living in New Ulm as living right across the street from Abbott Northwestern. It truly is amazing. The research being done is showing dramatic decreases in people dying of heart attacks. We have had dramatic “saves” the last five years.

Take me through your career path. You finished Fargo South High in 1978?

Yes, and graduated from North Dakota State University in 1980 and Moorhead State in 1982. Then I started working, as my mother would say, as a real nurse. I worked at St. John’s in Fargo and St. Ansgar in Moorhead. When I finished my bachelors I was an infection control/employee health nurse. I did that for seven years. I also worked in the operating room. I became a manager of quality/ risk management and began working on a master’s degree in healthcare administration. I wanted to get into general management.

As a little girl, I was always take-charge. My second grade teacher will tell you I was organizing second graders on the playground. I have always been an entrepreneur and organizer. In high school, our graduation year, I sold t-shirts with our school design to classmates. In a way, I have parlayed being a bossy [girl] into a career. (Laughter.) I have many friends still close from kindergarten and they will attest I have always taken charge.

You relate to Lucy Van Pelt in the Peanuts comics?

Oh, yes, a little bit. But I don’t just tell people what to do. I am also the organizer of a party, event or class reunion. I’m the person stepping forward to say I will organize the class reunion, which I did at Fargo South—every reunion except for this last one and that’s only because I no longer live in town.

You earned your master’s degree in 1993?

By then, I was director of quality risk management at a Fargo hospital. Then I was appointed by North Dakota Governor Ed Schafer to be deputy director of the state department of human services. So here I was at age 33 as the No. 2 person of a billion dollar agency. While in that position, I had the opportunity to be on the Governor’s plane to see Hillary Clinton holding a townhall meeting in South Dakota. How many people get to fly in the Governor’s plane to sit front row and meet a First Lady backstage? This was 1994, the last time healthcare reform came around. I worked for the State two years while commuting back and forth from Fargo. It was hard on my marriage.

Then I returned to Fargo to become the part-time project manager to build a clinic in West Fargo and did everything from buying land to hiring physicians and staff. Concurrent with that, I was the general manager of a semi-pro basketball team, the Fargo Beez. My husband at the time was an owner. In the four years owning them, we won the league championship twice.

I didn’t know a thing about basketball—didn’t even know how many people were supposed to be on the court. But that’s why you hire a coach and then get out of his way. I wasn’t telling the coach whom to play. But I did know how to make sure he only had to worry about basketball and not about what the team was going to wear, or if there was going to be people in the stands, or how to create a fun event for fans. We had a Minnesota Gophers star, Townsend Orr, who played for us the two years I was general manager. In between stints with our team, he played for the Harlem Globetrotters. All the players had been Division I stars and weren’t ready to give up on their dream of making the NBA. When first starting the league, we assumed finding talent would be difficult but that was the least of our worries. If you ever think it might be fun to start up a semi-pro sports team, just take all your money and throw it out onto the street—because it will be less painful. (Laughter.)

I certainly am a living example of transferable skills. Whether running a political campaign, building a clinic, or running a basketball team, I learned to get work done through others, organize, provide a vision, and motivate.

Then you became involved in politics?

In 1996, I became the campaign manager for North Dakota Governor Ed Schafer. By then, I was finished building the clinic and the first basketball season was over. I moved back to Bismarck for Gov. Schafer’s successful reelection campaign. (He later became U.S. Secretary of Agriculture under President Bush.) When the election was over, I began working for Allina in Duluth, but my position was eliminated after five months. So I returned to Fargo to run the basketball team again—a second season. After that, I decided to return to my initial career choice, healthcare. I started as a consultant with Eide Bailly, a regional accounting firm. Their healthcare headquarters was in Fargo and I did consulting in a five-state area for healthcare clients, such as hospitals, clinics, and nursing homes. I really had a great experience with Eide Bailly.

Now you are in New Ulm. Where do you see healthcare headed? You mentioned Hillary Clinton before. Now healthcare is coming up again.

We’re going to have a different outcome with this healthcare reform. We’re in a completely different situation as a nation. Nipping around the edges with incremental reform isn’t going to cut it this time. We’re talking about necessary transformational change. It’s going to be a painful process to move where we need to move. If we really want to decrease healthcare costs, we have to move into prevention and chronic disease management. Right now, our time and money is going into managing acute episodes. The only way we’re going to be successful in cutting costs is to do better at preventing and managing chronic illness—such as with The Heart of New Ulm. This means turning upside down the way we currently finance healthcare. That’s why I’m saying it’s going to be a painful process. In the new world, it will be a failure if someone needs hospitalization. The new world will involve prevention programs out in the community and care navigators. If we do The Heart of New Ulm with the research and rigor it needs, it can be replicated all over the country and world. But who will pay for programs like this?

Right now, the way the system is designed, insurers don’t reimburse for prevention. But we’re already paying the cost—we’re just going to pay in different ways in the future. For instance: Care navigators. For people with a chronic illness, a care navigator is someone helping them navigate among different specialists, different medications, and how to take care of yourself so you can stay away from expensive emergency room visits, etc. The care navigator model saves people from having expensive episodes, but right now it’s not a reimbursable expense. Allina has a care navigator pilot program, but no one is writing out a check to it. It’s one way to have better patient outcomes.

Finally, you’ve done well raising money for hospital expansions. Can you reveal any tricks of the trade?

We have a great story to tell and aren’t afraid of telling it over and over. If people tell us no, we don’t take it personally. Also, I’m not afraid to beg for money. (Laughter.) That’s really what it takes. You have to ask. If you don’t ask, they just won’t magically write out checks to you. This is our community hospital—I’m just the current messenger.

 

Allina and New Ulm

CONNECT: Describe the scope of Allina. Most people in our region are familiar with Mayo Health System, which dominates area healthcare.

WIGHTMAN: Allina has 11 hospitals, 24,000 employees, and 5,000 physicians. We’ve had our stake in the ground in New Ulm a long time. In fact, New Ulm was acquired by what became Allina—back in 1984.  As for distance: New Ulm is closer to Abbott Northwestern in Minneapolis than to Rochester. Our natural referrals patterns from this area have always gone to the Cities. Many of our physicians trained there. I don’t necessarily feel surrounded by Mayo Health System because our market share hasn’t changed much over the years.

Minnesota Head-Ache

CONNECT: You were appointed to the Council of Regents of the American College of Healthcare Executives. Why did they appoint you?

WIGHTMAN: Actually, I was elected regent by my Minnesota peers. ACHE is a healthcare administrators professional organization. There is only one regent from Minnesota. Before being elected, I thought I’d reached a point in my career when it was time to give back in terms of service to my colleagues in the field and those entering. As the Minnesota regent, I promote membership and advancement in the College. A member can become a Fellow in the American College of Healthcare Executives. I also promote continuing education among members, help early careerists network, and help executives in transition find new job opportunities.

Getting To Know You: Lori Wightman

Age: 49

Born: February 19, 1960.

Education: Fargo South High ‘78, North Dakota State ‘80, Moorhead State ‘82, and University of Colorado-Denver in ‘93 with master’s degree in healthcare administration.

Boyfriend: Darren Grove.

Dog: Katie.