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Outgoing MeritCare's CEO's mark was change

Dr. Roger Gilbertson, who has been president and CEO of MeritCare for 16 years, plans to retire this year. (Dave Wallis/The Forum)

FARGO - Roger Gilbertson's interest in medicine got its spark from a family doctor who often stayed for coffee after making a house call at their farm near Lake Park.

Old Doc Andy Midthune served as an early role model for Gilbertson, a farm boy and college football quarterback who became a neuroradiologist and ultimately the head of the region's largest health care system, Fargo-based MeritCare.

At age 72, Gilbertson has decided 2009 will be the year he retires, an announcement he made late Tuesday to staff of the organization he has shepherded since its inception 16 years ago with the merger of the former St. Luke's Hospital and Fargo Clinic.

The search for Gilbertson's successor will begin immediately, with the board of trustees expected to hire a national search firm by March and have a new chief executive officer in place by the end of the year.

Gilbertson's tenure was one of building a regional health network in eastern North Dakota and western Minnesota. The acquisition of the former Heartland Hospital on South University Drive is the most noteworthy example of evolutionary growth that unfolded in phases.

"Dr. Gilbertson has the vision and the talents both to recognize and develop each of those new phases," said Ellen Chaffee, chairwoman of MeritCare's board of trustees. "It takes a fine set of internal skills to pull those together."

Gilbertson spent part of Wednesday reflecting on the myriad changes that have marked his 30 years of practicing medicine, years that saw a sweeping transformation in the delivery of medical services.

His own career trajectory illustrates many of those changes, as doctors and hospitals were compelled to join forces to offer a full range of health services as medical technology became more sophisticated - and more expensive.

"I have not minded change," he said. "I have never feared change."

In many ways, in fact, he has embraced changes that in retrospect seem inevitable, but didn't always seem that way at the time.

He came to Fargo in 1971 when he joined The Neuropsychiatric Institute, which was affiliated with Fargo Clinic and St. Luke's Hospital. Four years later, the organization acquired its first CAT scan - one of just a handful in the nation at the time.

Gilbertson later formed a small radiology clinic with partners, seeing the need to seek strength in numbers - an advantage that grew in scale when Radiologists Ltd. merged in 1987 with Fargo Clinic.

In between, in partnership with fellow radiologists, he indulged his entrepreneurial inklings by launching Mobile Imaging, a business that sent CT and MRI scanners mounted on semi-trailers.

Although affiliated and next-door neighbors, St. Luke's and Fargo Clinic were very separate organizations when they merged in 1993 to create an integrated health system - one large entity to deliver health services and negotiate with insurers.

"I thought this was ultimately the correct model," Gilbertson said of the merger. It was a time of upheaval for both organizations, which were forced to eliminate the considerable duplication of positions.

"I would say it's fair to say it was chaotic, almost, at the time," he said of the period following the merger. It took several years of consolidation to wring out the benefits of joining forces.

One of the most painful changes Gilbertson confronted came last year, when 90 employees were laid off and 120 vacancies went unfilled as MeritCare slashed its costs.

The challenge now is one of true integration, Gilbertson said, eliminating the organizational "silos" created by each medical specialty. Cardiology, oncology and surgery, to name three examples, must work together to treat the patient holistically, he said.

That's not easy for a health system that has more than 7,000 employees, 583 hospital beds on two campuses, 73 medical specialty areas and 47 clinic locations in two states.

If done well, integration means that, "When patients are seen, it's smooth and seamless," Gilbertson said.

What's next for Gilbertson, who serves on several boards and has earned a paycheck since the age of 13? He predicts retirement won't be an easy adjustment.

"It just is emotional for me almost," he said. "I've never seen my role here as a job. I've seen it more as a passion for what I do. I'll look around to see what else I can do."