Margo Karsten, CEO of Banner
Health’s three Northern Colorado hospitals, in her office at North Colorado Medical Center in Greeley. (Michael Brian
UCHealth Greeley Hospital president Marilyn Schock poses in the physician’s clinic section of the new facility
in the final stages of construction in west Greeley. (Michael Brianfirstname.lastname@example.org)
The two Greeley hospital executives both are 56 years old. Neither woman has
a “classic” hospital chief administrator’s background. Their climbs to leadership began in direct patient
care, not in business office wings crunching numbers.
North Colorado Medical Center’s Margo Karsten was raised in St. Paul
and began as a nurse at the Mayo Clinic in Minnesota. Later, after nomadic dues-paying at several places, she was CEO at Creative
Health Care Management in Minneapolis, at Poudre Valley Hospital in Fort Collins, and at Cheyenne Regional Medical Center.
Since June 2016, Karsten has been CEO of Banner Health’s three Northern Colorado hospitals — NCMC, McKee Medical
Center in Loveland and Fort Collins Medical Center — and offsite facilities. In January 2018, she added another title,
also taking over as president of the organization’s 11 acute and critical access hospitals in six states.
I started, I didn’t even know what a CEO was, for heaven sake,” Karsten told me in her office at NCMC. “I
never, ever thought I would be in this job. I’m grateful.”
UCHealth Greeley Hospital president Marilyn Schock, a native
of Cody, Wyo., broke into health care in 1986 as an occupational therapist at McKee Medical Center, when the Loveland hospital
was owned and operated by Lutheran Health System. Her hard-working roots were as the girl on a unicycle, delivering newspapers
on the largest Cody Enterprise route in town, then driving heavy equipment for a state road crew to help put herself through
Colorado State University, for bachelor’s and master’s degrees.
She worked in several roles at McKee and eventually became
CEO in 2009, or 10 years after a merger of Lutheran Health System and Good Samaritan Health created Banner Health. She moved
to UCHealth in 2014 and was chief operating officer at Medical Center of the Rockies and PVH before taking on the task of
shepherding the new UCHealth Greeley hospital through construction, hiring, and June opening — and likely beyond.
wanted to be in administration or management,” she told me at the hospital coming down the homestretch of construction.
“My dad was an accountant for an oil company. He had opportunities, he was also climbing, but he was, ‘Don’t
go there.'” But he also kept telling his daughter the key was to be at the “right table” to have influence.
and Schock — M&M, Margo & Marilyn — outlined the awakening of their ambition to climb, the narratives
were similar in that: a) they were hungry to learn; and b) when they encountered and witnessed entrenched hospital practices,
they often said, “Why … ?” or, “Why not … ?”
Years later, not only have Schock and Karsten
both been executives at PVH in Fort Collins, each has worked for both Banner
Health, which operates NCMC, and for what now is UCHealth.
Karsten and Schock are friends, not life-long, but close enough to sit down,
talk about their mutual passion for health care. Or, heck, to talk about football. Yet they are about to become direct competitors
on the Greeley health care scene, when UCHealth’s Greeley facility opens. NCMC is deep-rooted in Greeley and UCHealth,
at least on the hospital scene, is more the upstart.
“Margo and I have had this conversation,” Schock said. “We’re
going to compete, but we’re going to compete within the merits of what we think we have. It makes you step up your game.
isn’t the first market I’ve been in when a second hospital has come in. I was at McKee in Loveland when MCR came
in. I watched that. There’s a benefit from the competition. That’s being able to say that everybody’s reaching
for the top in how we deliver care.”
Karsten, who despite wearing multiple hats and also having offices in Fort Collins
and Loveland, mostly is based in Greeley.
“I shared this with Marilyn,” Karsten said. Then she related how a magazine
in the 1990s showed competing regional hospital executives in boxing gloves with a story. She said that when she returned
to northern Colorado from her stint in Wyoming, she was on a panel with Kevin Unger, president and CEO of UCHealth’s
PVH and MCR and Unger joked about the boxing gloves.
“I looked at Kevin and I said, ‘He’s like my brother, we
went to PhD school together, I hug him all the time,'” Karsten said. “Come on, we’re in health care. Bankers
get together. Real estate agents don’t fight. I think we’re going to keep each other on our toes in a good way.
High-quality, low cost, great care.
“We can’t be disparaging about each others’ systems. I worked there for eight
years. Marilyn worked (at Banner) for a long time. I think of it like Brett Favre, actually. He played at both Green Bay and
with the Vikings. We’ve both played in both arenas. We give great health care.”
So, no, this shouldn’t require
bringing in famed ring announcer Michael Buffer to say at the hospital opening: “Let’s get ready to rumble!”
But it will be a high-stakes Banner vs. UCHealth competition nonetheless, and that has been the case in Fort Collins and Loveland
previously. Hospitals involve office politics, too, and effective executive styles can range from pit-bull assertiveness and
even belligerence, to hands around shoulders and a healing, encouraging demeanor. It all depends on time and place, but both
Karsten and Schock seem to be the rally-the-troops, generate-loyalty types.
2017: Marilyn Schock, president of the UCHealth Greeley Campus, signs her name on a beam as part of the project’s topping-out
celebration. The construction crew then raised the beam, which is one of the highest, and bolted it in.
At the new Greeley
hospital, Schock pointed out, “Margo and I have been colleagues. We’ve both been at both systems. I think that’s
some of the irony, with people thinking, ‘What’s going on here?’ We’ve flipped. It’s a fit and
a timing of a fit of where you are in your career, what you’re looking for and what fits you.
“So when I think about what
my relationship is with Margo, we can sit down and have a beer and talk.. There’s something also about having a female
colleague at a level that you can have different conversations with. We haven’t done that in quite some time, but are
those conversations about work? No, other than how you can work together and come together on some projects. But this isn’t
about two hospitals. The health care system isn’t two hospitals. The health care system is Sunrise Community Health.
The health care system is the North Colorado Health Alliance. The health care system is the health department. The health
care system is everything.”
When the UCHealth hospital opens, the post-opening issues will be many. But they begin with the
bottom line: Is there is room in Greeley for two hospitals — or, more specifically, for two thriving hospitals?
there is,” Karsten said. “I don’t know about ‘thriving’ yet. I think we’ll grow into it.
If you look at the state demographic data, I think in the next decade, it will warrant it. For right now, I personally, and
Banner Health, like investing more in the health of the community versus bricks and mortar and acute care beds. So I don’t
see the need now. I think in a decade, maybe.”
Schock, who is about to open a new hospital, understandably was more adamant
about that issue.
“Definitely,” she said. “Probably for four or five reasons. First, the rate of growth in this community
is amazing to me. … When you talk about that, just growth alone, we’re preparing for the future. People are driving.
Right now, 26 percent of business at PVH and MCR is from Greeley and Weld County. They’re already driving.”
to the non-hospital facilities UCHealth operates in the area already and then said MCR — in Loveland — “is
at capacity 80 percent of the time. We either build a new tower there or we put something closer to home.”
course, made the choice of adding another hospital and medical center on the 22-acre site.
As both Karsten and Schock plot
strategy as executives, they still will flash back to their early days in health care.
stops for a photo at the August 2018 announcement of NCMC’s partnership with the MD Anderson Cancer Center. She’s
with oncology physician executive Dr. Jeffrey Albert.
“Where I get joy is like in January,
I put scrubs on and for 12 hours was up in the ICU,” Banner’s Karsten said. “I’m a nurse at my heart.
I don’t get to see the front line staff often.”
Karsten has a 15-year-old daughter, Emily, who attends Windsor High School,
and two adult sons, Steven and Joe.
“I’m a single mom,” she said, “so I have to put boundaries on my work.
That’s my only bummer right now is I can’t get out enough. But I just have to be OK with that.
“The only work I want to
do is to make this amazing for the people who work here because I know what they do to impact human life. And because I’m
a nurse, I get that whole line of sight. I never complain about my job because you can walk out this door and someone’s
dying of cancer and they just got a diagnosis that they’re not going to live. We have physicians sitting at their bedsides,
and we have nurses crying because trauma has come in. Because of that and because I’m a nurse, I can do this work. That
brings different lines to it. It keeps me humble and grateful.”
UCHealth’s Schock has missed the interaction as she
essentially worked solo in the early days of the Greeley project and caught herself talking to herself at the computer at
times. But there was more to it than solitude. It was the void of not seeing the work of hospital unfolding around her.
in me,” Schock said. “The bedside won’t leave me. I loved being at the bedside. I love working with patients.
One of the pieces I have liked in the administration positions is that I still get to visit with families. I get to go in
and check on patients, I get to get people up, I get to answer call lights. I’m not the nurse, but, yeah, I love that.”
ride her unicycle to work.
“I still have one and I can still ride it,” Schock said. “It’s not safe,
but it’s hanging in my garage. The neighborhood kids always want me to get it out. I sold my bigger one when I realized
the ground was farther than I was OK with falling anymore.”
The hospital competition starts in June.