The NVRH complex sits atop a hill in St. Johnsbury known as Hospital Drive. There have been many changes at this site since 1972, the year the hospital opened. Currently, it comprises the hospital building, doctors’ offices in the hospital or in the immediate vicinity, a new Business Center with offices and conference rooms, a new heli-pad for the DHART (Dartmouth-Hitchcock Advanced Response Team) helicopter to land behind the Emergency Room, and a community garden. Beyond that, there is the building that houses the ambulances for CALEX, and across the road from the hospital is the St. Johnsbury Health and Rehabilitation Center.
Inside NVRH, there have been recent renovations to the imaging center, laboratory, waiting rooms, surgical areas, and chapel. Colors in light shades enhance the walls in the main hallway where students from area schools showcase their artwork. Skylights and windows bring in plenty of light to brighten the atmosphere. It is a place where people come during medical emergencies, where babies are born, patients have surgery, and at times where life ends. It is a place of possibilities which is true of all medicine– always changing, always growing.
The Chief Executive Officer (CEO) at NVRH is Paul Bengtson. He was born in Racine, Wisconsin, one of eight children.“We had 10 people living in a small house with one bathroom,” he says. Paul attended public school and graduated from Wheaton College in Wheaton, Illinois, in 1968. He was drafted into the Army and spent two years in the infantry, part of which was in Vietnam. He graduated from City College in New York City in 1972 with a Master’s Degree in Arts and Literature. He attended the Baruch College Mount Sinai School of Medicine in New York City and received an MBA in health care finance in 1978.
Paul’s interest in health care developed during the 1970s when he worked in Harlem, the South Bronx, and Long Island City with the New York City Department of Health and the Department of Social Services.
“My work there was basically providing support services for elderly people, working in child health clinics, and also working with drug addicts who needed to get into treatment. It’s where you wore sneakers to work and, if you needed to, you ran fast. Sometimes you had to tackle patients because they were high on drugs. There were policemen in the hospital. Gangs would attack the Emergency Department with guns.”
Paul also worked for two years at the Lutheran Medical Center in Brooklyn and the Beth Israel Hospital in Manhattan.“I had a very in-depth, intense work life experience in health care in New York City. I had a lot of front-line experience working with people in the most destitute and desperate of situations.”
His first job outside of New York City was working at the hospital in York, Maine. He worked there as Assistant Administrator until 1982. He then worked at a new 200-bed hospital in Missouri as vice president and eventually as acting director. Paul also worked at an Arkansas hospital to help turn the hospital around financially.
It was in York where Paul met his wife, Christine, during a softball game as he was sliding into second base.“She was trying to tag me out,” he says with a smile. She worked for a pathology laboratory as a medical laboratory technologist. They were married in 1983 and have three grown daughters, Ingrid, Anna, and Grace.
Christine is from Manchester, New Hampshire, and Paul had worked in New England, so“we really liked New England and we decided to come back here. I got a call about the job at NVRH. The job of leadership in a hospital is so intense there is a lot of turnover. I figured we would be here for five years and then move on, but we really liked it. It seemed like a great place for a family. I think people have to reach some to get the lifestyle they can have in Vermont. I have traveled all over and seen a lot of different places. People who live here in my opinion are lucky.”
Paul and his family live a short distance from NVRH. His office is decorated with family pictures and a bike leans against the wall. He rides his bike to work.“I would say work never stops, but I don’t sit here all the time. I am usually on the premises an average of eight to nine hours a day. I send home documents on the computer and work from a distance. The whole idea for me was to get a balanced lifestyle and to spend time with my family. That is the highest priority - to have a stable, healthy family life.” The family has done a lot of camping and traveling, some in Scandinavia and Iceland, and also enjoys alpine skiing.
His daily schedule is always different.“One morning I came in at 7:30 and started immediately with a departmental meeting with the ER staff. It goes for maybe an hour and 15 minutes but the better part of that meeting I’m simply listening and absorbing information about what people are experiencing and working with them to see how we can continue to do better day by day on the job. I’m working with staff all the time on ideas. The staff around here is just incredible.” He spends time on the computer corresponding because“we work not only on local things but there are national things going on and statewide things where we are interacting all the time on policy issues. I’m on the phone and often online working with others on health care policy.” At other times he is meeting with different people on issues of all kinds.“I work a lot on strategy and trying to fit current actions to future strategies so that we have a good idea of where we want to be in a year or five years.” There is always paperwork, preparing for the next meeting, and physician recruitment that brings a lot of variety and complexity to his job.“Because we employ over 500 people in our business, we are not only paying attention to people in this building but there are people in other buildings such as the physicians’ offices along Sherman Drive and across the street from the hospital, and at Corner Medical. We are working on lines of communication all the time. If you are going to do a good job, you have to coordinate care across all different kinds of systems like doctors’ offices to nursing homes to home health. This is a 24-hour, 7-day a week operation. The employees include physicians, nurses, and other medical professionals as well as support people and information technology people.”
Volunteers are an important part of daily life at NVRH. There are currently over 130 volunteers.“They are a huge part of our operations here and are a great part of our life. If you are going to have a community hospital, you have to have community people in here volunteering whose job is just to be purely caring. They are good eyes and ears. They give us a good measure of who we are and they give us a lot of good ideas.”
When asked about his management style, Paul says without hesitation,“I try to be direct, personal, and approachable. The phrase I use the most is that we have an open door policy. Maybe it’s the way I grew up. I don’t need a whole lot of privacy in that sense. The door should be open. If someone really wants something, they should be able to speak up about it. There ought to be mutual respect. Another part of my style is to be persistent but not in an irritating way. You really have to stay on task to get some of these jobs done. They sometimes take years unfortunately. I like creativity. I like flexibility and adaptability.”
Paul has been a field ornithologist, or bird watcher, since he was a child.“I have always loved exploring things but for some reason bird watching fascinated me so I was always asking questions. People got annoyed with me because I asked too many questions. I watch birds locally but have also traveled all over the world doing this. In 1999, I put together a group of six other men and organized a three-week camping trip through Botswana, Zimbabwe, and Zambia. I’ve traveled to Mexico, the Caribbean, the Upper Amazon, Africa, South America, Southeast Asia, the Pacific Islands, New Guinea, Australia, Europe, and Russia.”
The rarest bird Paul has seen is a Cocha Antshrike.“The male of the species had been rediscovered after I think maybe 50 years of no one having seen it. We saw the first female that had been seen in many years off one of the tributaries to the Rio Napo in Amazonian Ecuador. Many of the most interesting things are the people you meet along the way because they wonder what you’re doing.”
Other hobbies include writing poetry and reading. Paul used to give poetry readings in the East Village in New York City. He reads books about ornithology and scientific literature. He likes reading about math and physics as well as fiction by some of the American and Russian novelists.“I read the Bible because I think it’s good reading. It’s extremely human. I read it for wisdom.” He does not watch much television.
If Paul had not worked in health care, he probably would have become involved in conservation efforts.“When you are interested in bird watching, you notice everything that is going on in the environment. I’m amazed at what people do not see happening around them in the environment. We think we can manage everything. I have always been of the philosophy that we are so conceited and arrogant that we are in many ways destroying our own health by destroying our environment. I would probably get politically involved in that sense. I think there is no excuse at all for what is going on in the Gulf of Mexico, but that’s just one example. Humans, I think, are on a crash course with the planet. We are not capable of listening.”
There have been many changes at NVRH since Paul’s arrival in 1986. The hospital has gone from no computers to state of the art. Images and information can be sent anywhere -- even outside the U.S.“If you want to get an authenticated reading in addition to the ER physician at 2:30 a.m., we can have an image read by licensed physicians during their daytime in Australia and get a reading back within minutes.” Many cancers can be treated locally with the addition of the Norris Cotton Cancer Center North, part of Dartmouth-Hitchcock Medical Center. There is also Fresenius Medical Care for people who need dialysis services. Many surgical procedures are now done on the same day and are minimally invasive where people used to stay in the hospital for days.“Medications are more complicated, but people are surviving longer on these medications. There is a movement toward wellness and prevention. Pain management technologies are much improved. We have overall an aging population, and it is going to need more and more services.”
If Paul could give only one piece of health advice, it would be to exercise.“When we talk about health care reform, my whole message is eat right, sleep right, exercise, and think good thoughts. Take responsibility and you don’t have to have a lot of money to have a healthy life. All things in moderation.”