by Jon Saxton

If ever there was a person who looks and carries himself like a chief executive officer, it is John Henry. He has a distinctly military bearing. He doesn't walk so much as stride, and with such determination and momentum that people are often inclined to step out of his way. His deep voice and intent gaze command attention. He strikes you as the sort of person who would have had no problem matching either now-retired General "Stormin'" Norman Schwartzkopf or Secretary of Defense Donald Rumsfeld, martial stride-for-stride and intimidating stare-for-stare.

And John Henry complements his commanding presence with an equally commanding knowledge of the business he is in. In current parlance, Henry definitely walks the walk and talks the talk. He is known as someone who can take care of business as well as any hospital chief executive around.

But if these outward appearances are all that you know about Henry, then you don't know him very well. Because to know and to work with John Henry is to understand a man who defines his mission in life not so much as taking care of business as taking care of people. With a sense of calling not unlike the thousands of clinical professionals and staff he has managed over the years, Henry is consumed with the well-being of the people he manages, from the executive suite to the cafeteria -- in this case, several hospitals full of people for whom he has a deep sense of familial responsibility.

John Henry meets you for an interview at the hospital entrance so that he can first take you on a tour of the redeveloped Emory Crawford Long Hospital (ECLH). He leads you from cardiology suite to auxiliary garden, to the emergency room, to the gift shop, the aviary, and the new employee lounge. He takes pride in everything about the new hospital and points out innumerable details of design and function in each of these venues as well as in the hallways, elevators, and concourse that connect them. Along the way, staff and visitors, even some patients greet him by name, and he acknowledges them. He makes a special point of stopping at the mural in the new lounge, which depicts the history of the buildings at ECLH. He readily gives credit to his wife, Barbara, for the mural and the employee lounge, saying it was her idea and that she designed it and saw it through to completion.

By the time you have made your way to his office, you have the distinct impression that you haven't just toured his hospital so much as been shown around his newly redeveloped home and community. You have met many of his family -- his people. And with his constant references to Emory University Hospital and Wesley Woods Geriatric Hospital, both of which he also oversees, you understand that this sense of family and community extends equally to those facilities and his people there.

Once he is in his office, his thoughts turn to his immediate family and to the people he has worked with most closely. He proudly talks about his wife and their two children and four grandchildren. He points to a large board in his conference room signed by the department heads at all three hospitals. It says, "Presented to John Henry Sr. with sincere appreciation for your leadership, enthusiasm, and support." These are things he takes to heart.

Now, settled in an armchair, Henry gets straight to the point. In a manner that is characteristically direct, yet cordial, he asks, "Well, what do you want to talk about?" But whatever the question, there really is only one subject. It can be summed up by the phrase with which he often starts a sentence, "What I worry about is this . . ."

John Henry worries, but not in the sense that he sits around and frets or wrings his hands. Henry worries, like a field commander must, about the preparation and well-being of his people as he and they perform their health care missions, day-in and day-out in a very unsettled and resource-constrained environment. Though a meticulous planner who coaches and expects (and virtually always achieves) disciplined execution, Henry understands that no matter how well he and his staff plan and prepare, any number of problems, large and small, can (and will) arise that could cause harm.

So when asked to talk about his experience at Emory (which stretches back 50 years to 1953 when he entered Emory College as a 15 year-old freshman) and to look ahead to his retirement, Henry is ready instead with a threat/opportunity matrix for Emory that he has passed on to senior leadership, including the Woodruff Board and Emory University's Executive Committee. He shares these key thoughts in six major areas of concern:

"What I worry about is . . . "

Patient care: "My fear for the future of patient care is that health care may become so driven by financial concerns and by new technological capabilities that we will lose touch with our patients. Will patients be confounded by 'hospitalists,' 'intensivists,' and other newly specialized professionals and wonder where or who their doctor is and who really understands their unique medical history and needs?"

Caring for staff: "I worry about how we can continue to attract the best staff in the face of continuing reductions in payments to our hospitals. We have to offer competitive salaries and fringe benefits. We have to have a caring organization and a healthy workplace where people feel good about the work they do and feel empowered. If our staff people are unhappy, the quality of patient care will go down. That's human nature. That's why I have put such an emphasis on open communication and building trust."

Ethics: "In the area of ethics, Emory has a very good track record, but we have to continue to be mindful and vigilant about setting only the highest expectations. This relates to all the issues we hear about in health care, from conflict of interest in research, to billing properly for services, to reporting errors (including reporting them to patients), to how we treat patients and their families. As the financial stakes and penalties keep rising, we have to ensure that we are always doing what is right. End-of-life issues are also a major concern. Where is the proper balance between preventing death and preserving quality of life?"

Systems-thinking: "Systems-thinking is very hard for universities and academic health centers, which have traditionally valued individual achievement highest. In that sense, the enemy is us. We have learned to collaborate well at Emory, but there is still a tremendous opportunity in the future to have more collaboration across departments and throughout Emory Healthcare. The more we work together, the stronger we become."

Philanthropy: "With the continuing problems with reimbursements for health care, Emory must widen its base of support. All great academic centers count on their communities, alumni, grateful patients, and friends for the extra support we need to attain and maintain excellence. There are great opportunities for us as we seek to broaden our reach, but we also need to maintain close relations with our traditional base in the Atlanta area, with the institutions and people who have helped us become what we are today."

Access: "My last big worry is the future of Clifton Road and access to the university. Traffic is becoming a serious concern for the community, for our patients, and for our own staff.

"The campus master plan that was created several years ago anticipated the use of MARTA and other alternative transportation schemes. Unfortunately, many of those have not matured to the degree we had hoped. My personal feeling is that any solution requires that Emory find a way to develop new access through the Emory campus from Clifton Road to Clairmont Road. In the end, I think all parties would see the benefit in this. And our staff who come to work here every day need this."

And so, not unexpectedly, an "exit interview" with John Henry bypasses the exit and heads straight for his family, his community, and his people. You know that he will never retire from the business of caring for them.

Jon Saxton is executive editor of Momentum magazine.