About 20 years ago, on the rain-forested edge of West Africa, a young doctor waited for a patient in a tiny makeshift hospital. Located 50 miles from the nearest paved road, powered by a gas generator and filled with villagers he had recruited and trained to approximate a nursing staff, it was a ramshackle operation. Still, it was all pretty impressive for a 24-year-old recent med school graduate working in the ancient village where his father was born. And when a local man arrived with his 9-year-old daughter — spiking fever, lots of pain — he saw how even his improvisation of a hospital could change a community.
Into the converted operating room the little girl went; out she came, minus one appendix.
“That was the light bulb moment,” says Dr. Andy Agwunobi, far away from that place, sitting in his new Spokane office. “I realized that if that hospital hadn’t existed, that child would have died. Many children would have died.”
It’s not just any office; Agwunobi — “Dr. Andy,” he insists — is Providence Health Care’s new CEO in Eastern Washington.
Getting from Azia, Nigeria, to Spokane with his wife (Elizabeth Nega, also a physician) and two young daughters has been a wild ride, and Agwunobi has an impressive mix of credentials to show for it all. After growing up in Scotland (yes, you can still hear a little brogue in his voice), he attended med school back in Nigeria, where his hospital-building days followed. Later, he became a pediatrician, with a residency at Howard University, then an executive with hospitals in Atlanta and Boston. Finally he oversaw a nearly $20 billion annual budget as head of Florida’s Agency for Health Care Administration. Oh, did I mention he has an MBA from Stanford?
Now he’s calling Spokane home.
“We love it here,” he says. “I came to Spokane for two big reasons: I wanted a safe, family-oriented community to bring up my children, and I also wanted to join what’s known as one of the best Catholic health care systems in the country, and that’s Providence.”
“He’s a unique individual,” says Jim Falkner, chairman of the board of directors for Providence Health Care and a member of the search committee that hired Agwunobi to replace Skip Davis after his more than a decade of service. “His being a physician wasn’t the primary key, but it was very helpful. I think you’re seeing more physicians who are getting into administration, but it’s not common.”
Agwunobi, 43, says he’s happy to have made the career transition from for-profit health care to state health care to a faith-based system. “I feel blessed to have that convergence — bringing people and systems together, but also working for the vulnerable. That’s my mission as a Catholic and as a doctor.”
Then he pulls down the plaque from his wall that holds Providence’s mission statement: “There’s nothing in it about money,” he says.
Of course money is a big part of health care these days, and as Falkner says, the new CEO needs to continue to run a tight ship. “We came off a pretty good year, but everybody is concerned about the future,” Falkner says. “We are always going to have patients, it’s whether they are going to be able to pay.”
Agwunobi says his challenge is to continue the legacy of service. “We are constantly faced with making sure we are living the mission of the Sisters [who founded Sacred Heart],” he adds. “So during these tough economic times, especially, we must stay true to our mission — that we take care of all people in our community.”
The zeal for the mission is the real deal, Falkner says, after having watched Agwunobi in action over the past year since taking the job. And if you ask, Agwunobi will tell you it comes from the usual places: faith and family. “My parents taught us that even when you don’t have any money, there are others even more worse off. And you still need to reach out to them.”
If you’re detecting something a little nontraditional in Agwunobi’s upbringing — Nigerian kid raised in Scotland — you’re onto a big part of who he is. With a life story eerily similar to another man of mixed-race you might have heard of, Agwunobi had to find his way in a world that didn’t always know how to categorize him.
As a student at St. Andrews University, his father met his white, Scottish mother. Both were from wealthy families, but the interracial marriage led to them both being disowned by their own parents. The result was that the Agwunobi family was raised quite poor as dad finished medical school. But, Agwunobi says, their Scottish neighbors were very welcoming, and he and his brothers and sisters had a “magical” childhood fishing and hiking around the village of Strathmiglo.
Still, with feet rooted in two separate worlds in a way few of us can understand, he has coped by healing, overachieving and by embracing his inner wonk — all quite Obama-esque.
On the what-needs-to-get-fixed-in-health-care front, he’s quick on policy points: Affordability is the most obvious and toughest problem. “It’s become so costly that it’s decreasing the competitiveness of business and employers who have to pay for it.”
Agwunobi also worries about the lack of primary care physicians coming out of med schools — only 20 percent of all future docs are choosing that path today. “Without enough primary care doctors, too many people don’t have a medical home. And that means people are just coming to the hospital at a point where their illnesses have progressed and are serious for them and costly to treat.
“Right now,” Agwunobi adds, “we are in a wait-and-see mode, to see what comes out of Washington, D.C. But I am optimistic, because for the first time in many years, the Congress, the president, the business community and the health care community are all aligned in the knowledge that we need health care reform.”
And Agwunobi’s wild ride continues, especially the day after we first met, on Dec. 17 — the first huge dump of the series of snowstorms that pummeled the region.
So, Dr. Andy, missing Florida yet?
“No, no — we’re still loving it,” he laughs. “There were some practical realities about that much snow, like getting back to shoveling driveways. One day I was saying how beautiful this all is; the next day I couldn’t get out of my garage.
“But now we feel like survivors — we can take anything.”
Surviving tough times has always been an indicator of future success, and his culturally diverse background is a bonus, too. Agwunobi still thinks about another survivor — that little girl back in Nigeria — and how she taught him that while it’s always about that individual patient, it’s also about the whole village, an entire city or even a nation.
“I got back a whole lot more than I gave,” he says. “I realized a small organization — a 12-bed hospital in a small schoolhouse — could change the lives of so many people. I realized the power of not being an island, of being able to bring different people’s skills and talents together, along with infrastructure, and from that to be able to dramatically improve health care for whole communities.”