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Standing out front on the provider’s future

See correction below.

At a point where the railroad bridge straddles Main Street in Brockport a few blocks south of the village’s downtown, two billboards vie for the attention of southbound drivers.

"Unity, how health care should be," reads the left-hand sign, erected by Greece-based Unity Health System. "Expert surgery close to home," reads a right-hand rival, extolling Brockport’s smaller, hometown health care provider, Lakeside Health System.
The competing ads reflect a sometimes tense history between Lakeside and Unity that predates by at least several years the tenure of Lakeside CEO James Wissler, who stepped into the role of chief executive last spring.
A big man standing over six feet tall, Wissler, 64, exudes a genial courtliness reminiscent of the George Bailey character in "It’s a Wonderful Life." His attempts to mobilize local resistance to a Unity clinic’s proposed expansion has been somewhat less than genial.
In a 2009 interview, Wissler’s predecessor, former Lakeside CEO Michael Stapleton, who left last fall for Thompson Health System in Canandaigua, cited the Unity billboard as an indicator of the competitive pressures Lakeside faces from the area’s larger health systems.
Wissler came to Lakeside as interim CEO last March shortly after leaving Nicholas H. Noyes Hospital in Dansville, Livingston County, where he had been president and CEO since 1997. The Lakeside board voted him to the position permanently last fall.
Stapleton had been promoted to CEO from chief operating officer and head of nursing services in 2009 after his predecessor, Kevin Nacy, died unexpectedly of a heart attack at 53. Stapleton’s departure for Thompson three years later did not leave time for Lakeside to hire a replacement before he left.
Most of Rochester health systems’ hospitals-University of Rochester Medical Center’s Strong, Rochester General Hospital and Unity’s Greece hospital-have for several years been chronically overcrowded, often seeing more than 100 percent occupancy.
Lakeside and some other outlying systems, meanwhile, are chronically underoccupied. If more patients who can be appropriately treated at outlying hospitals were to choose them instead of city hospitals, Strong and the others could reduce emergency department backups and other strains resulting from an excess of patients. 
As many as 40 percent of Lakeside Hospital’s 61 beds are typically empty, Wissler says, an occupancy rate that helped put the health system in the red last year.
Lakeside Hospital contributed $41.7 million to the system’s 2011 revenues and lost money. The system’s 120-bed nursing home ended the year in the black but not enough to offset the hospital’s losses. Wissler declines to put a figure on the red ink. 
"I don’t want to give anybody ammunition," he says.

Ongoing clash
Unity has long seen its mission as serving the west side of Monroe County, where in addition to its Greece hospital it runs satellite clinics. It has a women’s health center just outside the village of Brockport in the town of Sweden.
After several years of relative quiet, the tension between Unity and Lakeside bubbled to the surface last month, when Wissler mounted a highly visible campaign against Unity’s plan to significantly expand the Sweden clinic by adding services including primary care, specialists and physical therapy.
Unity vice president Stuart Putnam in an interview last month defended the expansion. He described it as needed to serve a population in Brockport asking for services from Unity and Brockport-based doctors who practice at Lakeside and Unity. There is room in Brockport for both health systems, Putnam said. Unity is not trying to drive Lakeside under. 
Wissler is dubious. He calls the move an undisguised attempt by Unity to grab market share.
Ten years ago, Wissler says, Lakeside had a thriving maternity ward, delivering 400 to 500 babies a year. After Unity started offering obstetrics in the area, Lakeside’s deliveries fell off and the hospital no longer does obstetrics.
Residents of Monroe County’s east side, Wissler says, may sometimes fail to appreciate the degree to which the county’s west-side residents, as well people living in Genesee and Orleans counties’ eastern reaches, look to Brockport more than Rochester as a center. For such people, having a hospital in Brockport is vital. Lakeside also serves the student population of SUNY College at Brockport and is seen by the university as a vital resource.
In addition to lobbying state and local officials and winning a resolution supporting Lakeside’s position from the Sweden Town Board, Wissler has organized well-attended community meetings, where he has portrayed the proposed Unity clinic expansion as a possible death blow to Lakeside.
Lakeside’s board is "absolutely behind Jim Wissler" in his sounding the alarm and opposing the Unity expansion, Chairwoman Nancy Plews says.
Wissler also has organized a petition drive that has sent hundreds of signatures opposing the expansion to the Finger Lakes Health Systems Agency, the first stop in what could be a yearlong progression through the state Department of Health’s approval apparatus of Unity’s certificate of need proposal for the Sweden expansion. A link to the petition is on Lakeside’s website.
FLHSA several weeks ago sent a recommendation to the state that the Unity proposal be approved.
The conflict between Lakeside and Unity takes place in the context of an FLHSA push to rationalize services among larger hospitals serving the city of Rochester and smaller outlying facilities serving the area’s less densely populated regions, notes URMC vice president Steven Goldstein.

URMC alliance
Goldstein, who heads URMC’s Strong Memorial Hospital and Highland Hospital, has for several years been involved with Lakeside-an alliance struck by Stapleton and bolstered under Wissler that sends URMC doctors to Lakeside. The arrangement, which makes specialists such as urologists who might not otherwise practice in Brockport available to Lakeside patients, is hoped to make the immediate area’s residents more likely to seek care close to home.
URMC embarked on the program not just to benefit Lakeside but also for its own purposes, Goldstein says.
The URMC alliance is one part of a plan to stem the hospital’s flow of red ink, Wissler says. He is working on an initiative involving area businesses to reverse the flow, he adds. The plan is still in early stages, and Wissler was unwilling to provide details.
In the Lakeside board’s regional search for Stapleton’s replacement, several people, including Goldstein, strongly recommended Wissler as an experienced community hospital leader, Plews says. That Wissler is well-acquainted with the area’s peculiar problems counted heavily in his favor.
"I’ve worked with Jim Wissler for 30 years and have always been very positively impressed," Goldstein says. "I worked with him when he was at Dansville and succeeded him on the board of the regional hospital association. I’ve always found him to be mindful of staff, honest and capable."

Career path
Raised on a farm in the town of Ephrata near Lancaster, Pa., Wissler went to Boston as a young single man in the late 1960s because he had been traveling around after high school.
"I had some friends there," he says.
Wissler started his career as a respiratory therapist, working for hospitals in Boston. Friends who were working as respiratory therapists helped Wissler get a job at Brigham and Women’s Hospital in Boston, where, after four years, he was promoted to clinical director of respiratory services. In 1983, Wissler moved to New England Deaconess Hospital in Boston, which like Brigham and Women’s is a teaching hospital of Harvard University’s School of Medicine.
Wissler has spent much of his career as a community hospital administrator at a series of jobs. At New England Deaconess, he was business manager of the departments of medicine and cardiology, pulmonary services and a 54-doctor medical practice.
At Marlborough Hospital, in Marlborough, Mass., Wissler was a vice president directing services of five clinical departments. His last job before going to Nicholas Noyes in 1993 was vice president of operations and manager of owned physician practices for Southwestern Vermont Medical Center, formerly known as Putnam Memorial Health Corp., in Bennington, Vt.
Wissler’s education came along the way. He earned an associate’s degree in respiratory therapy in 1975 from Northeastern University and a bachelor’s degree in health sciences from the same school in 1978. A master’s degree in health administration from Clark University in Worcester, Mass., followed in 1985. Three years later, Wissler earned an MBA from Nichols College in Dudley, Mass.
He met his wife, Karen, a nurse, in Boston. The couple married in 1966 and has two grown sons, who live in other states.
Despite a daily 40- or 45-minute drive to work, Wissler plans to keep living in Dansville. He and his wife recently moved Karen’s father, who is in his 90s, into their home. His father-in-law is hale, Wissler says, but making him move again would be too disruptive.
Wissler plants a large, organic vegetable garden on their half-acre lot. His father raised chickens and was an early advocate of organic farming. He never considered farming as a career but sees himself as continuing the family tradition.
He grows tomatoes and garlic and freezes his homegrown peas and beans. Karen tends an herb garden. Wissler used to run but in deference to aging joints has given it up in favor of long daily walks. He and Karen also enjoy kayaking in local lakes and streams.  
Asked why he left Nicholas Noyes, a small community hospital with a profile not unlike that of Lakeside, after more than a decade, Wissler says it was time.
"I’d been with Nicholas Noyes for 13 years. The average lifespan of a hospital CEO is five years," he says.
Lakeside board members who asked their counterparts at Nicholas Noyes for recommendations heard rave reviews of Wissler’s leadership. Maintaining good relations with medical staff was an asset they mentioned as a particular strong point.

Not giving up
While FLHSA’s approval of the Unity certificate of need on a Sweden expansion would not seem to bode well for Lakeside’s hope of stopping it, Wissler is not conceding.
Wissler and Plews, with two lawyers in tow, recently met with state health officials, presenting data to support Lakeside’s claim that the doctors Unity proposes to add are not needed in the area. The officials also plan to meet with Unity representatives, Wissler noted in a recent email update to Lakeside medical staff.
Asked if collaboration with Unity might make sense for Lakeside, given the systems’ geographical closeness, Wissler says a partnership with URMC makes more sense. URMC is a tertiary and quaternary care center, he notes, whereas Unity is, like Lakeside, a community hospital, albeit a much larger one.
Still, Wissler concedes, Lakeside would find it hard to continue completely on its own. 
"Collaboration is the future of the system but without giving up local autonomy," he says. "I think we have a right to say who we collaborate with."

James Wissler
Title: President and CEO, Lakeside Health System
Age: 64
Education: AAS, respiratory therapy, Northeastern University, Boston, 1975;  B.S., health sciences, Northeastern University, 1978; M.A., health administration, Clark University, Worcester, Mass., 1985; MBA, Nichols College, Dudley, Mass., 1988
Family: Wife, Karen; sons Greg, 38, and Christian, 35
Residence: Dansville, Livingston County
Activities: Daily walks, kayaking, time with family
Quote:  "Collaboration is the future of the system but without giving up local autonomy."

A profile of Lakeside Health System CEO James Wissler in the March 2 edition of the Rochester Business Journal contains an error. Lakeside continues to offer obstetrics.



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