Creating a culture of collaboration

April 28, 2008
Dr. Raymond Greenberg

Dr. Raymond Greenberg

“‘Health care leadership’ is a wonderful oxymoron,” Dr. Raymond S. Greenberg said — with characteristic wryness — to a group of civil engineers last year. “With the possible exception of higher education, there is no human activity more naturally resistant to leadership than the … American health care system.”� A reality show based on the lives of those who work in health care, he suggested, could be called Hospital Fear Factor.

Unexpected words, perhaps, from a man who was the founding dean of the Rollins School of Public Health at Emory University and is now president of the Medical University of South Carolina (MUSC). But Ray Greenberg’s self-effacing humor has helped him become an innovative health care leader, one who successfully brought together even health care professionals who were initially resistant to the idea.

“Ray clearly understands that the work we do is very consequential work, but he certainly doesn’t take himself too seriously,”� says MUSC faculty member Dr. Larry Mohr, who met Greenberg when both were undergraduates in Carolina’s chemistry department. “He’s able to put his life and his leadership in a very human perspective. It’s one of the reasons he’s been so effective.”

In seven years as MUSC’s president, Greenberg has built a long list of achievements, including helping the school recover from the serious financial difficulties he inherited from the previous administration. Not only did he put the school ‘back in the black’� in just one year, he has gone on to oversee the construction of cutting-edge patient and educational facilities. But he’s proudest of the collaborations he has fostered.

One of those is merging the schools of pharmacy at MUSC and the University of South Carolina into a single institution with campuses at each university. Think about that for a moment — two rival schools within the same system, each with its own administration, faculty and students, each with its own strengths and its own culture.

“People focus on change, on what will be lost, not on what will be gained,”� Greenberg says. “There was a lot of concern about losing identity, tradition, control.”�

He believed that merging the two schools would result in a whole greater than the sum of its parts, an institution that would ultimately become a top-tier pharmacy school. He and MUSC’s provost conveyed this vision through a series of town hall meetings with students, faculty and alumni groups. But, he says, it takes more than words to win hearts and minds.

“The actions you follow up with have to convince people. They have to see that what you’re articulating and the reasons you’re doing it make sense, and that you’re serious about moving ahead with it.”�

Merging the pharmacy schools, Mohr says, was “a very innovative, very creative solution to focusing resources, eliminating duplication and providing new opportunities for educational and research collaboration.” The result, in his view, is a model for inter-institutional collaboration that could very well be replicated around the country.

Under Greenberg’s leadership, MUSC also created the South Carolina Bioengineering Alliance with Clemson University. But his most striking success is Health Sciences South Carolina (HSSC), a public-private partnership among several of the state’s research universities and teaching hospitals. Greenberg saw HSSC as a way to expand medical research and improve South Carolinians’ health and economic well-being; he now chairs its board of directors.

Again, creating a culture of collaboration was critical — and it wasn’t easy. It took all of what Greenberg sees as the essential leadership skills.

“Do you have the ability to convince other people that your vision makes sense?”� he asks. “Is your personality charismatic enough to get people to want to join you? And patience, how you treat other people, has a lot to do with your effectiveness.

Especially in universities, where there is a hierarchy, most of what gets done is more by personal persuasion. A lot has to do with creating enough excitement, enough enthusiasm that other people voluntarily subscribe.”�

Shortly after HSSC got underway in 2004, South Carolina Governor Mark Sanford awarded Greenberg the Order of the Palmetto, the state’s highest civilian honor, for exceptional service to the state and nation. “During your time as its president, MUSC has enjoyed national recognition in the areas of education, research and patient care,” Sanford said at the time. Still to come, the governor predicted, were even greater achievements, “whose seeds have been planted through your efforts to build alliances with health and educational institutions, both public and private, through the state of South Carolina.”

In building these alliances, Greenberg has drawn on the examples of his parents, whom he calls one of the greatest blessings of his life. His father, the late Dr. Bernard Greenberg, founded and chaired the Department of Biostatistics in the UNC School of Public Health and later served as dean. His mother, Ruth Greenberg, has a graduate degree in chemistry from Yale. She says her son was a very determined and intelligent person from the time he was very young. In retrospect, his ending up in public health may seem pre-ordained, but he insists he had no clue as a Carolina undergraduate or in medical school at Duke that he would take that route. While doing a master’s in public health at Harvard, he developed a passion for epidemiology, which led him back to the Carolina School of Public Health for a PhD in that field. But he started to develop much earlier the leadership skills he relies on today.

“From my earliest memories, I was always around academic people, and it always felt very comfortable to me to interact and understand the culture and the values that make you successful in an academic setting,”� he says. “A lot of that I just absorbed growing up. It’s hard to say whether I inherited it or acquired it being Bernie Greenberg’s son.”

He took away some specific lessons from his father’s experience as dean during the turbulent early 1970s, when there was much anti-establishment sentiment.

He said of his father, “He worked very hard during this time to be perceived for his true values, for promoting equal opportunity, for helping the underserved population.”�

“Especially where there are differences of opinion or emotional issues, solutions are not quick,”� he says he came to understand. “You have to be persistent and consistent. You have to listen a lot. It’s important for people to be heard and to allow them to feel they’re engaged in the decision-making.”

Ray Greenberg took the lesson to heart. Colleagues like Larry Mohr say he is a leader who lets people know he’s heard them. “He has done a remarkable job in putting together very creative collaborations that have really had a multiplier effect, a synergistic effect in enhancing the effectiveness of what we’re doing here,”� Mohr says.

“We don’t have a lot of advantages in South Carolina,” Greenberg says. “But our recent ability to partner effectively — I hope that will be an important legacy.”�

– by Kathleen Kearns

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Carolina Public Health is a publication of the University of North Carolina at Chapel Hill School of Public Health. To subscribe to Carolina Public Health or to view the entire Spring 2008 issue in PDF, visit www.sph.unc.edu/cph.