Medicine Woman

Melinda Estes brought just what the doctor ordered

by Virginia Lindauer Simmon

Melinda EstesMelinda Estes, the president and CEO of Fletcher Allen Health Care since 2003, brought a background as a physician and a savvy, no-nonsense approach to help return the ailing institution to the position of trusted community resource.

To  find an example of Melinda Estes’ practical, no-nonsense approach to life, one needs only to hear how she chose her major in college.

“I started out as a music major,” she begins, “but I realized after about the first 18 months that music is 90 percent hard work and 10 percent talent, and without the full quotient of talent, it doesn’t matter how hard you work.” She switched to biology and chemistry, taking to heart her father’s advice to study something from which she could make a living, and graduated in 1974.

By the time 30 years later, when she was hired as president and chief executive officer of a beleaguered Fletcher Allen Health Care, Estes had earned a medical degree from the University of Texas Medical Branch in Galveston; completed her internship at Baylor University Hospital; finished a neurology residency in Galveston; completed special training in pediatric neuropathology at the Children’s Hospital of Philadelphia; and earned a master of business administration from Case Western Reserve University Weatherhead School of Management in Cleveland. 

It’s possible that Estes had an early role model for using a strategic approach to life: Her father was a military office, now retired. Born in Memphis, Tenn., where her dad was stationed at the time, she grew up “all over,” she says, “mostly in the U.S. We moved a lot until I got to be in high school.”

During her father’s second tour of duty in Vietnam, knowing he was planning to retire when he completed it, Estes and her mother moved to Victoria, Texas, where the family planned to live. After high school, she followed her path through medical school, internship, and residencies to a neuropathology fellowship with The Cleveland Clinic Foundation, a position she held from 1982 to 1984.

When the fellowship was finished, the Cleveland Clinic asked her to stay on. “What the organization oftentimes does is send people somewhere to get special training,” she says, “and we decided it would be useful for me to have special training in pediatric neuropathology at the Children’s Hospital of Philadelphia.”

In medical school, she had met and married Harold Hollingsworth Morris III, a neurologist, a Philadelphia native. 

Theresa Alberghini DiPalmaFletcher Allen has launched an electronic medical records project, called PRISM, with the aim of becoming entirely paperless by the end of 2010. Theresa Alberghini DiPalma is senior adviser to the chief executive officer and senior vice president of marketing and external relations.

Morris remained in Cleveland for the months of his wife’s training, and Estes commuted, occasionally staying with his family members in Philadelphia. In 1985, she returned to join The Cleveland Clinic.

“We landed in Cleveland because it was a place with jobs for both my husband and for me,” she says. 

In 1990, after she was elected to the board of governors, Estes became very involved in the running of the organization, and went on to become the associate chief of staff. Finding she enjoyed the administrative aspects of medicine and believing that medical professionals had “a unique perspective” that was needed on the administrative side, she decided to go for her MBA “so I would know what to ask,” she adds with a grin.

In 1997, Estes left The Cleveland Clinic to work across town at the Metro Health System, Cleveland’s large city-county hospital, but three years later, she returned. 

She was appointed executive director of business development at the foundation in 2000, and in 2001 she was named chief executive officer and chairwoman of the board of governors of Cleveland Clinic Florida, overseeing practices in Naples and Fort Lauderdale.

In 2003, she was approached by a headhunter about interviewing for the position at Fletcher Allen Health Care. “Florida has many, many wonderful things,” she says, “but I really missed the sense of community I had had in Cleveland, but not in Florida, given the transient population and the explosion in population in the winter. Hearing that Burlington is a wonderful community really appealed to me.” 

Estes had never been to Vermont before her interview. What she found, she says, “was a wonderful organization that had its head down. That was probably natural, given all the ups and downs going on at that time, but I thought that all of the pieces were here, from a high-quality physician staff associated with the University of Vermont, an engaged and dedicated work force, the fact that this organization is really essential to Vermont and the north country of New York, and that, even in those dark times, the community really wanted to support and have this organization succeed.”

When the offer came, Estes said yes.

A number of things were apparent to her in October 2003, when she took the reins. “One is that I had the opportunity to recruit, for the most part, a new executive team. Then, when I arrived, there was a giant hole in the ground, where the ambulatory care center stands today, and, in fact, some concern as to whether we could complete that project in a timely manner. There was a workforce of dedicated employees who had their heads down — literally and figuratively. You would walk through the halls, and people would go about their business, but they wouldn’t look up.”

Roger Deshaies and Sandra DaltonFletcher Allen Health Care has about 6,900 employees, which includes 450 physicians who are on the UVM College of Medicine faculty. Roger Deshaies is senior vice president and chief financial officer, and Sandra Dalton is senior vice president, patient care services, and chief nursing officer.

Estes vividly recalls that, instead of “Welcome to Burlington!” the first words she often heard were expressions of condolence. “I think the community was upset, and worried whether they could be proud of this organization again,” she says.”

A major challenge was dealing with the ambulatory care center (ACC) — “to look at the footprint and figure out how to get that construction project back on track — how to get the appropriate state approvals; how to comply with the regulations and expectations of BISHCA [the Vermont Department of Banking, Insurance, Securities and Health Care Administration]; and how to fund it, because very shortly after I arrived, we were in New York finding money to complete that project.”

The footprint was set, she continues, so there was no opportunity to shrink it in size. It was a matter of building it and making it successful, “and I believe that we’ve done that.”

Chris Dutton agrees with that sentiment. The retired CEO of Green Mountain Power, Dutton is chairman of the Fletcher Allen Health Care board, having joined it just as the search committee was interviewing the finalists. 

“Mindy has been very effective in restoring Fletcher Allen to a position of strength, both financially and, I think, in terms of the quality of service that Fletcher Allen provides to the community,” he says.

“To lead a complex organization like Fletcher Allen, with as many constituencies as it has, requires someone with both a depth and breadth of knowledge and skill sets. Mindy certainly has that.”

Ed Colodny, former chairman and CEO of US Airways, former interim president of UVM, and interim president of Fletcher Allen when Estes was hired, notes that Estes is “doing this without huge resources. The hospital does not have a major endowment and is very dependent on its revenues from patients and insurers, federal payments for Medicare and Medicaid, and private fund-raising. It’s a tough business,” he adds, “but she has her hand on the throttle.”

One of the high points of her tenure, Estes says, was in October 2005, “when we had the dedication and opening of the ACC. To walk through that building, to see the light, the way in which it is configured to make it easy for people to work there ... It’s big, no question about that, but it works very well.”

Professional interests are only part of Estes’ life. Her online bio lists hiking, canoeing, and biking as the interests she shares with Morris, who’s a neurologist at Fletcher Allen. In person, she mentions a couple of other things.

“I used to be an avid runner,” she says, “but about five years ago, my knees decided they didn’t want me to run anymore, so I took up race walking. I probably do five or six half marathons or marathons a year, because I found if I don’t set a goal ....”

With her husband, she enjoys cooking. “I may be a better race walker than cook, but it’s something we do together. One of the huge perks of being in Vermont is the access to all things local — produce; meat — it’s so easy here to find such a bounty.”

Looking to the future, Estes says, there are several things going on. “Probably first and foremost is our PRISM project — it stands for ‘patient record and information systems management,’ our electronic medical record project. We had a naming contest internally.”

Through PRISM, she says, by the end of 2010, Fletcher Allen, at all of its locations, will be entirely paperless. “The first phase is the inpatient facility, and we will turn that on on June 6; we are within 100 days and counting.” Another important program is the state’s Blueprint for Health, which aims to reduce the impact of chronic disease through prevention.

“What keeps me getting up every morning and energizes me is how proud I am of this organization and what we, as an organization, have been able to accomplish; and I’m most proud of the fact that when you walk through the doors today, our employees don’t have their heads down. They look you in the eye.”•