Corresponding author: Tim Parris, MS, Executive Office, Baylor Health Care System, 3500 Gaston Avenue, Dallas, Texas 75246.

William Clifford Roberts, MD (hereafter, WCR): Tim, I appreciate your willingness to talk to me and therefore to the readers of BUMC Proceedings. We are at my house on August 29, 2000. I appreciate your coming over here. Could you talk about your early upbringing? Where were you born? What were your mother and father like?

Mark Timothy (Tim) Parris (hereafter, MTP): I was born in Jackson, Mississippi, in the Baptist Hospital (an old brick building that once stood on the hill on Fortress Street, which was the fortress of the city during the Civil War). My mother, Donna, was from Eureka, California. Her father, John Smith, was of Irish immigrants who moved west in the 1840s. He lived to be a couple of days over 100 years and died in 1983. He was a very interesting man in that he worked for General Bragg, of Civil War fame, in some of the gold mines in California. He attended Stanford, when they were known as the Stanford Indians, and he played on the football team. He was onetime sheriff of Humbolt County. Later in life, he worked for the Redwood National Forest, and his job was to clean up the campsites on the Ell River in the redwoods. He was 1 of 2 men who carved out one of the famous redwood trees on Highway 101 that one can walk through. He was quite a man in his time.

My dad is David Parris, and he was born in Picayune, Mississippi, which is about 50 miles north of New Orleans. He retired from the US Post Office after working for them for about 35 years. We lived in the south part of Jackson. My dad always ran a paper route before he went to work at the post office. He delivered the Commercial Appeal until I was in college. He liked football and baseball and coached when I played baseball. I have one sister, Sandra, who is 10 years older. Growing up, during the summers, I was home alone a lot, and that encouraged a lot of backyard baseball, tree houses, and playing in the woods.

WCR: When did your father move to Jackson?

MTP: My father moved to California in the early 1950s with his parents and met my mother there. They moved back to Jackson before I was born.

WCR: Did you ever live in Picayune?

MTP: No. We liked to visit there. All my father's family lived there. It was a sleepy old railroad town then. My grandfather on my father's side retired from the railroad. He was one of the people who sat up in the caboose. He was in a train crash and retired on railroad disability. I've always liked to go visit Picayune. My sister married her husband from there. That gave us more reason to visit over the years.

WCR: What was the population of Jackson, Mississippi, when you were growing up?

MTP: About 130,000.

WCR: You played sports in junior high and high school.

MTP: We attended Hillcrest Baptist Church every Sunday and Wednesday. My mother was a Sunday school teacher. That part of town was rural at that time. After school, sports were the only entertainment available. I played baseball, basketball, and football.

WCR: Were you good?

MTP: I was pretty good. In high school, I played baseball and was on the high school team in the ninth grade. I was a pitcher. When you are a young kid on a high school team, you get to pitch batting practice every day. This actually led to quite a successful career for me. All that hard work paid off. We won 2 state championships in my 4 years of high school.

WCR: And you pitched the whole time?

MTP: Yes. In both the 9th and 10th grades I was 6 and 0; in the 11th grade I had an arm injury and I did not pitch; in the 12th grade I won 6 and lost 3. We won our state championships when I was in the 9th and 10th grades.

WCR: How many games did you play in high school?

MTP: We played 22 games a year and another 18 during summer league.

WCR: You pitched a third of the games. Could you hit?

MTP: Yes, I was a good hitter. I led the city of Jackson in home runs for 2 years in the summer league.

WCR: Did you play somewhere in the field when you were not pitching?

MTP: Yes. First base.

WCR: How fast was your fast ball?

MTP: We didn't time it. Pitching is about control and variation of speed, so if you could throw a curve, a drop, or a fast ball with accuracy you could win. I actually threw 2 perfect games, which is something I have always been proud of. Not very many people ever have that opportunity.

WCR: Twenty-seven batters. Were you in the ninth grade then?

MTP: It was 21 batters. We played 7-inning games in summer ball.

WCR: That's impressive. Was there any possibility of your going on to professional baseball?

MTP: I didn't really think so. After rehabilitation for my 11th-grade arm injury, I never came back to the same level of fast ball. We had a good team in my senior year, and I had a good year. I had actually developed a lower back problem, but I didn't know I had it then. Later in life, I had surgery for it, and I believe it was a sports-related injury. I didn't pursue professional athletics.

WCR: What about basketball?

MTP: I loved basketball and played until the eighth grade, when I didn't make the eighth-grade team. It broke my heart. Just the boys on the seventh-grade team made the eighth-grade team. I didn't play in the seventh grade because it was a new school for me. I always thought I should have made the team.

WCR: You played football, too.

MTP: Yes, through the 10th grade. I quit then because our baseball team really practiced year round. Being a pitcher, there was always the concern about hurting my hands or fingers.

WCR: How big was the high school?

MTP: My high school class was about 150 students.

WCR: What was your mother like? What kind of influence did she have on you?

MTP: My mother always worked. Neither my mother nor my father went to college. They both had to work to make ends meet. She is an artist. She always had me involved in crafts. She paints today.

WCR: What kind of paintings does she do?

MTP: She likes still lifes and flowers. Her mother was a painter. She has quite a talent. When my son and daughter go over to visit during the summer, they always come home with a picture they've painted.

WCR: Did she have a great impact on you? Did she push school and learning on you?

MTP: My parents never did push school or education on me. I'm not sure why. They expected me to do well, and they left a lot of that up to me.

WCR: What about your father? Did you have a lot of activities with him? Did you go fishing and hunting together?

MTP: We did some. We would fish together, and it always was a special occasion. He worked most of the time, and there was not a lot of free time. He was a baseball coach during the summer.

WCR: Where did your mother work?

MTP: She was a secretary for the Visiting Nurses Association for a while. She would work for 4 or 5 years, take a summer off to be home, and then start the cycle again.

WCR: When was your mother born?

MTP: I believe in 1932. My dad was born about 1935.

WCR: Your mother is still living?

MTP: They both are.

WCR: Do they still live in Jackson?

MTP: Yes. About 10 years ago, they sold the house and moved to the country, where they have a 6-acre lot. Dad cleared the lot and built the house. My sister and her husband live across the street from them on a 10-acre lot.

WCR: Does your sister work?

MTP: She is a nurse. She's in the antique business right now--going to auctions and entertaining herself with that.

WCR: Were there any teachers or coaches in junior high school or high school who had a major influence on you?

MTP: The most memorable was a baseball coach I had in the ninth and 10th grades. He was very physical from a training standpoint and demanding. When I was in ninth grade, 140 boys tried out for the high school team. By the time the season started, only 14 were left standing.

WCR: It is impressive to be a top pitcher on a high school team as a ninth grader. How big were you back then?

MTP: The same size I am now minus 60 or 70 pounds.

WCR: I gather that during high school you worked periodically.

MTP: I mowed yards when I was little. Work was expected if you wanted to have some spending money. I had my lawn-mowing business and then graduated to working down the street at the local service station.

WCR: By the time you were 9, your sister had gone. You grew up, at least the latter half of your teenage years, more or less as an only child?

MTP: Right.

WCR: Were you and your sister close?

MTP: Yes, despite the large age difference.

WCR: How did college come about? You started out at Hinds Junior College.

MTP: It was not too far from where I lived. Right after high school, I didn't have the ambition to go off to a big school. It just wasn't in my thought process. I had a good part-time job. I thought I'd go to junior college and try to make some good grades. A lot of my friends went there. There was not a master plan behind it.

WCR: Raymond, Mississippi, is close to Jackson.

MTP: A suburb.

WCR: Did you live at home?

MTP: I did.

WCR: There wasn't a lot of difference between high school and college at that point.

MTP: I went to junior college in the morning and then worked every afternoon from 1 to 5 in Jackson. I was not an outstanding student in high school. I didn't put the time, energy, or effort into it. In junior college, I made half B's and half A's the first semester. I figured out that it was not that difficult.

WCR: After the first semester it sounds like you had all A's.

MTP: I started figuring out that unless I wanted to work at a service station all my life, there were some doors that I needed to go through. By the time I finished my 2 years of junior college, I graduated with a 3.8 average on a 4-point scale.

WCR: You had no problem getting into the University of Southern Mississippi for your last 2 years. Where is the University of Southern Mississippi?

MTP: It is in Hattiesburg, Mississippi.

WCR: How far is it from Jackson to Hattiesburg?

MTP: 100 miles.

WCR: There you lived on the campus, of course. That was the first time you had been away from home. How did that strike you? Did you enjoy that?

MTP: I never missed a beat. I joined the Kappa Sigma fraternity. I knew some people there that I used to compete against in baseball.

WCR: You liked it?

MTP: I enjoyed it.

WCR: Did you play any sports in college?

MTP: No. My back really started bothering me my first year out of high school. I was even bothered by it when I was pitching as a senior, but I didn't realize what it was. The back injury finished my career in sports.

WCR: What did you study at the University of Southern Mississippi?

MTP: Business administration.

WCR: Did anybody there have a major influence on you?

MTP: I met a physician who became a friend in Jackson. We lifted weights together. He influenced me toward business administration and ultimately toward hospital administration.

WCR: At Southern Mississippi was there anybody who really encouraged you or any teachers or classmates who made a significant impact on you?

MTP: No. I enjoyed my friends at the fraternity and made good grades, which they all resented. I simply developed the discipline that I'd get up early and do my work. I played with the rest of the guys on intramural sports. I was my own motivator through college. I was the first person in my immediate family to graduate from college. My sister later returned and received a BSN degree.

WCR: That must have been a major confidence builder when you went to junior college and then to Southern Mississippi and did so well.

MTP: It really wasn't a confidence builder. It was more like getting my life into focus.

WCR: When did you decide to go on to get your master's degree in health administration?

MTP: When I graduated from college, I had not quite landed. I looked at the job market. There were not a lot of job opportunities at that time in Mississippi.

WCR: What year did you graduate?

MTP: In 1978. I then took a year off, moved out, and lived with some family in Cheyenne, Wyoming, for about 7 months.

WCR: What part of the family was this?

MTP: It was my father's sister. Her husband had retired from the National Guard. I got a job with a mining company, Morrison-Knuteson, that paid a lot of money per hour as a laborer. They were blowing up mountains and reducing the size of the rocks to use as beds for railroad tracks. These big rocks would go to different conveyor belts and then to different crushers. They would ultimately end up in a railroad car. My job was to be under those conveyor belts because dirt flew off and to keep the dirt shoveled clear in order for the conveyor belts to work. I did that for a week. That was a near-death experience or, should I say, a life-changing experience. I was making good money, but I didn't see myself doing that for long. I was also doing that with a bad back. It was a nightmare. I had to tell my uncle that I really appreciated his pulling the strings to get me that job, but I wasn't going to do it anymore. I then got a job at a sporting goods store. I was looking for something to keep me busy. I was assistant manager of the sporting goods department, and it was a lot of fun. That occupied me for several months. I spent some time in the mountains and enjoyed myself. I had a great time. By the time I had moved back to Mississippi, my thoughts were focused as to what I wanted to do. I wanted to go to graduate school, and I wanted to get my master's in hospital administration.

WCR: How did you settle on the University of Alabama in Birmingham?

MTP: I applied to the University of Mississippi and to the University of Alabama. I talked with the administrator of the hospital in Hattiesburg and subsequently moved back there and worked at the hospital for several months. I was accepted with a full scholarship at the University of Mississippi but waited to see if I could get into the University of Alabama, which had a stellar reputation in that field. I ended up getting accepted into the University of Alabama without any scholarship.

WCR: One would have been free, and you had to pay for the one that you chose. What made the program at the University of Alabama at Birmingham so good? Why did it have a stellar reputation?

MTP: It had and continues to have the reputation as one of the top 2 or 3 in the country in this field. The program at the University of Mississippi was through the pharmacy department and was more focused on public health than hospital administration.

WCR: You spent 7 months in Cheyenne, Wyoming, and then came back to Hattiesburg and worked in the hospital for 5 months.

MTP: I had to take a couple of night courses in biology that I didn't have because I needed some prerequisites to get into graduate school. I took a couple of science courses.

WCR: What was the University of Alabama's master's program like?

MTP: It was a 12-month academic program and a 1-year residency program during which time I did my master's thesis. I went to school from 8 am until 4 pm. It was a full load. We had 27 or 28 people in my class, and generally the same students were in every course. A few courses were intermingled with other groups. It was a very focused and demanding year. I worked awfully hard. I entered with a fear of not being successful, and I'm sure that that increased my anxiety about the whole thing. It was a tough year.

WCR: Did you work in addition to going to school?

MTP: No.

WCR: You borrowed money and went to school. Did any of the teachers there have a major impact on you? Or your classmates?

MTP: Not really. Teachers are teachers. We all had good relationships.

WCR: The school is in Birmingham, not Tuscaloosa, at the medical center?

MTP: Right.

WCR: That is a huge medical center. Very impressive. Your internship was at Baylor?

MTP: Yes. The process is interesting. About the spring of the academic year I started trying to make a match where I could do my residency program. There were 3 or 4 hospitals I wanted to interview at, Baylor being one. My first interview was with an organization in Houston and I was offered a residency there, but I wanted to see how the Baylor interview would go first. Baylor was a real plum and still is. There were quite a few from my graduating class who interviewed at Baylor. I ended up being 1 of 2 at BUMC who were selected from the University of Alabama at Birmingham.

WCR: How many residencies in hospital administration does Baylor have?

MTP: Some years only 1; other years, 2.

WCR: The year you came both slots were filled by University of Alabama graduate school students?

MTP: That is correct.

WCR: How did you hear about Baylor, Dallas? How did you find out that it was really one of the plum programs?

MTP: Other students from the University of Alabama program had done their residencies at Baylor, and they spoke very highly of the program. As I researched the opportunities, it was pretty obvious from the publications that Baylor was an outstanding organization in size and scope. It was enhanced by being in a community like Dallas. Dallas was a big place compared with Jackson and other cities in Mississippi. Later, in Washington, DC, as a White House fellow, I was given an opportunity to speak before the Washington Roundtable. They asked how I got from A to B to C. They asked how I got to Dallas, and I commented, “I had the opportunity to find employment outside the Deep South and moved to Dallas.” The whole room roared. I never did understand why. Afterwards, I asked what they were laughing about. They thought Dallas was still part of the Deep South and that that was a joke. If you have lived in the Deep South, in Mississippi or Alabama, you would have a very different perspective on it.

WCR: You mentioned that during that residency year you had to write a thesis. What did you write a thesis on?

MTP: I did an employee attitude survey, the first one that Baylor had conducted. The master's thesis was on correlating responses to certain questions with the probability of unionization.

WCR: How did you happen to pick that topic?

MTP: Unionization was a hot topic at that time, and Baylor needed to do an employee attitude survey. I grabbed that project. I asked if I could take this topic as my thesis project, and they let me develop it. I worked with Steve Trowbridge and Glen Clark and others. I was the lead person, so there was a phenomenal opportunity to engage an organization because I had to coordinate lots of events that are part of something that comprehensive.

WCR: Who was your major advisor at Baylor during that year?

MTP: My preceptor was Bob Hille. It was a combination between Bob Hille and Glen Clark.

WCR: After that year you were offered a position to stay at Baylor.

MTP: Yes.

WCR: How did that come about?

MTP: In 1981 there was a lot of growth in the hospital sector. I came to Baylor in 1980 at the same time that Boone Powell, Jr., arrived at Baylor. There was a lot of excitement and a lot of maneuvering going on. He initiated the health care system. I was offered a position as administrative assistant to Glen Clark, one of the senior vice presidents, when I graduated.

My goal during that time was to be involved in the international hospital delivery arena--to put hospital administration experience together with a background in international management studies. At that time, Humana and Hospital Corporation of America were big in Australia and Great Britain. There was a lot of exporting of hospital and health care concepts internationally. My feeling was that if I could put together a good, high-quality educational background or hospital experience like Baylor along with a master's in international management studies, that would be a very marketable set of talents. When my residency program ended, I enrolled at The University of Texas at Dallas in international management studies.

WCR: You did that at night. How long did that take you? Did you get another master's degree?

MTP: I didn't finish it. I did it for 3 years, and I was within 3 courses of completing the master's degree when I applied and was selected to be a White House fellow in Washington, DC. I never finished that degree, but the knowledge I gained through the process was absolutely instrumental in my being selected as a White House fellow in 1985.

WCR: Could you discuss the White House fellowship? That was, of course, a major honor.

MTP: It was a 12-month experience. The program was initiated in the Lyndon Johnson years, and its purpose was to bring gifted people from the community who had already achieved a high level of success and recognition in the private sector or in the business world (it is not an academically based program) to Washington, DC, and give them experience working in the capital so that they could then go back and be a resource to their communities. I had read about the program. Most recipients had been selected either from the east or west coasts and had degrees from Harvard or Stanford.

WCR: You were 29 years old at that point?

MTP: Yes. In 1981, I worked initially for Glen Clark, and then I was appointed the first administrator of what became the Baylor Institute for Rehabilitation. We relocated the rehabilitation program out of the Collins Hospital and made it a freestanding hospital. Creating and marketing a rehabilitation hospital at that time was a tremendous opportunity for me. Baylor was ahead of the trend. In 1986 or 1987, the rehabilitation industry exploded, and Baylor had already gone down that road and had created a rehabilitation hospital, which in the late 1980s and into the 1990s had become known as one of the country's finest.

WCR: You were in charge of that rehabilitation hospital within a year after you had become full-time at Baylor.

MTP: That's right.

WCR: Baylor's rehabilitation hospital really impressed me when I saw it for the first time.

MTP: There were many who came after me who have put together what you see. I was involved in the beginning of it. We did some interesting things. We hired the first marketing person in the Baylor Health Care System. We developed the first marketing plan and promotion program of the Baylor Health Care System, which initially gave Mr. Powell indigestion but ultimately was very successful. We took a hospital and opened it, and within the first 6 months it was operating in the black. It was and continues to be quite a success story.

WCR: Did you have a lot of contact with Boone Powell when you first came?

MTP: Quite a bit of contact. He was a visionary, and he was and is a leader of people. The health care industry was going through radical changes at that time. He was the one who had the vision of the Baylor Health Care System. It was easy to become part of his vision and his leadership team because it was a vision of growth and excitement.

WCR: Let me ask you a bit more about the White House fellowship. How did the selection process evolve? After being selected, what did you do every day? Where did you work?

MTP: The process of getting there may have been the most interesting part of the journey. The White House Fellowship Commission, which manages this process, divided the country into 6 regions, and Dallas was the hub for this region. I didn't tell anybody at Baylor that I was interviewing or applying. The application itself is equivalent to putting together a master's thesis. Many questions have to be answered and many references supplied. You have to write 2 or 3 policy statements as if you were president of the USA or as if you had the opportunity to recommend policies to the president. It was a very in-depth application process. I didn't want to share with a lot of people that I was applying, mostly because of the fear of rejection. There were 1800 completed applications that year! In this region there were probably 200 applicants.

We met at a hotel, where panelists were set up. These were people who had been asked by the president to serve as volunteers to interview us. There were 10 or 12 rooms set up, and in each were 2 or 3 interviewers. Applicants went into the room, and the interviewers went over their applications. They would ask questions about whatever they wanted to ask about--national policy, defense policy, human interest issues, etc. They judged the applicant on his or her ability to answer the questions. When exiting this process, an applicant never knew what the outcome would be because obviously it was very subjective.

If an applicant made it through the region, he or she would go on to a consolidated region and go through the same process again. I'll never forget that next level. There were probably 50 candidates who were still in the process from several regions. We went to a lunch after all the interviews. We were served our meal, and then our host stood up and said, “Under your plate is a question. You have to turn that question into a 4-minute presentation, and you can have no notes. We are going to start with this table over here, and we will start with so and so.” Every question was different. It was the most remarkable thing I've ever seen because I would watch these superintelligent people who had unbelievable academic credentials and were from top companies. Many could not speak to the question for 30 seconds, much less 4 minutes. You would watch people wilt before your eyes. These highly trained and highly gifted people were horribly humbled in a situation like that. It was simply a process to find out how people would work under pressure.

WCR: What was your question?

MTP: The question I had was “What do you consider the greatest military risk to the United States?” It couldn't have been a better question for me to have been given because I had just completed a course at The University of Texas at Dallas on Latin American studies, and it was during the Iran Contra scare. I was able to stand up and talk, what I thought was intelligently, about the biggest threat that existed with the Sandinistas and their concept of putting revolution and theology together, the concern about the communist infiltration of Central and South America, and the proximity of our border.

I then went to the national finals and again there were about 50 people. This was at the very secluded Wye Plantation outside of Washington, DC, a very famous place for dignitaries and others. We met in Washington, DC, and took a bus out. Everybody was excited. It was 2 days of intense interviews by very well known people. Each candidate was interviewed by panels. They would ask anything they wanted to ask and would grade you. There also were a couple of social events to see how we would interact socially. After 2 days of nonstop activity, the candidates were emotionally and physically exhausted. We returned to Washington, DC, and sat in a hotel lobby there until they made their decisions. (It was like the eighth-grade basketball team cut.) They walked out and said they would like to congratulate each of us and then announced the White House group for 1985-86. My name was one called! That was quite a remarkable event for a kid from Jackson, Mississippi!

The process continued after moving to Washington. Interviews were set up with cabinet-level individuals to make a match where we would spend the year working with a member of the cabinet in his inner office. During the year, there were 3 or 4 formal educational events each week, and there was an international trip. It's a very organized educational and work process. I interviewed at the Department of Agriculture, the Federal Emergency Management Agency, and the Federal Trade Commission with Jim Miller who had just been appointed to move to the Office of Management and Budget to replace David Stockman in 1985. He was from Georgia. I guess he liked my accent. We hit it off, so I had a match with him. I had 2 months in the Federal Trade Commission, which was great experience. I moved with Jim Miller to the Office of Management and Budget, which is the president's vehicle that attempts to manage all the components of government. It's a microcosm of government in one agency. It is next to the White House, the old naval war building (the Gothic building). I had a little cubbyhole office on the third floor that overlooked Pennsylvania Avenue. Walking into those offices was an event. When you had your security clearance into that office you could go to the White House grounds. At least once a week I'd go over and watch the president come in in his helicopter. Those were wonderful years for the country. I remember the book Where Did All the Heroes Go? I have always considered Ronald Reagan to be a hero. It was an honor and an experience to be able to do things like that (Figure 2).

WCR: You were there in 1985 and 1986. What did you do every day?

MTP: Jim Miller had a staff meeting every morning at 7 o'clock. I had the honorable jobs of taking minutes for the staff meeting and distributing position papers among the “pads,” the agency heads in the Office of Management and Budget. They would develop position papers for the president. My job was to move those papers from section to section so that we could end up with a single position within the Office of Management and Budget. My other job was to move papers back and forth between the economic policy council and the domestic policy council, which were the president's 2 policy bodies for decision making. It was not as though I was developing position papers, but it put me into a process where I could read and understand what was going on. It was a remarkable job!

WCR: You would get to work every morning at 6:30 or so?

MTP: Yes. I'd ride the subway, which in itself was an event. I'd have to get there early and get the room set up, get the coffee ready, and get ready to take minutes. I was there pretty early every morning. Washington, DC, is not generally a town that starts early. The normal workday starts about 9 am and they usually go to about 6 pm. But many of our government agencies, not the bureaucrat components but those appointed by the president, get to work early and work late, and they are excited and proud of it.

WCR: What time would you go home?

MTP: Normally about 7 pm.

WCR: You had full days. Did you work on the weekends?

MTP: We worked on Saturdays some.

WCR: Did you get the opportunity to get to know some of the other White House fellows?

MTP: Oh, yes. We became a very close and intimate group because of the continuous education engagements, which were always done as a group. I had friends who worked at the Departments of State, Transportation, Agriculture, and Defense. These were all top-level appointees.

WCR: What were some of the other questions in that regional meeting when the questions were under your plates? Do you remember the questions that some of the others had?

MTP: There were questions that if I had been given, I couldn't have responded to at all. There were several questions on Japan. Japan was hot on the international scene at that time. There were some international trade issues related to Japan and particularly noncompetitive trade practices. I could probably stand up and talk 45 seconds on one of those topics, but to have a 4-minute conversation is a very different situation. Four minutes is a lifetime if you do not know your topic.

WCR: There were not many people who had gone to school in Hattiesburg, Mississippi, or Raymond, Mississippi, who ended up in the 400 or the 150.

MTP: I'll give you the names of some of the past White House fellows--Walter Humann, a significant leader today in this community from Dallas; Henry Cisneros from San Antonio; Robert C. McFarlane, former security director; Colin Powell; Senator Wirth from Colorado. Over the years, very distinguished individuals have had the opportunity to be White House fellows.

WCR: Do you have any meetings of White House fellows now?

MTP: There is an annual meeting where we all get together in Washington, DC, and there are presentations by cabinet- or junior cabinet-level sections of government to keep the group updated as part of the ongoing lifetime of education.

WCR: It has been a fantastic organization to be a part of?

MTP: It has been.

WCR: Baylor must have been enormously proud when you won that honor.

MTP: I continued to be successful through the different events, and I never wanted to tell anybody because I was afraid of failure. Patti and I went on a ski trip, and while we were there the winners were announced in the Dallas Morning News before I had the opportunity to tell anybody that I had been selected. That made for some interesting conversation the next Monday back at work.

WCR: You went from Jackson, Mississippi, to Hattiesburg, Mississippi, to Dallas, Texas, and then to Washington, DC. How did the capital hit you?

MTP: Washington, DC, is a great city if you have political contacts and money. I did not have a lot of money, although the fellowship did pay. I had taken what retirement I had saved to use that year because I wanted to get the most out of it. Being a White House fellow gave us a lot of access to events going on in the city literally every night. Washington, DC, is a fabulous place if you can live in the world that exists there.

WCR: Did you have children then?

MTP: We did not.

WCR: That was nice from the activities standpoint. After the White House fellowship year, you came back to Dallas?

MTP: No. I had injured my back while I was there. We were sitting in the World Bank. The chairman of the World Bank was giving us an educational presentation, and I felt my back go into spasm. I ended up back in Dallas at Baylor and had surgery on my back during that time period. Thankfully, I was only away from Washington for about 2 weeks. I had injured my back in taking the budget books that the Office of Management and Budget prepares and hand-carrying them up into the Capitol Building where they are distributed. Everything is always in such a frantic pace, nobody bothered to have dollies or anything like that.

We had an opportunity to meet with all the cabinet-level people. A good story: We had an educational session with George Schultz, secretary of state at the time, in the State Department. The State Department suites are extraordinarily luxurious with antiques and fine carpets. We were there one morning and Secretary Schultz was talking with us. He opened it up for questions. Somebody asked, “What are we going to do with this Kadafi problem?” George Schultz just smiled and said, “Omar Kadafi's time will come.” The session ended and by the time I got back to my office (about 30 minutes), it had just come over the radio that the American fighter jets had gone in and bombed Kadafi in his tent. The remarkable thing about that is obviously George Schultz knew exactly what was going on, but he did not cancel his breakfast meeting that morning. I'll never forget the smile on his face when he said “Kadafi's time will come.”

WCR: While in Washington, DC, did you get an offer from Memphis? How did that come about?

MTP: My year was coming to an end. I had stayed in contact with my friends at Baylor. The job that was available at Baylor for me to come back to was in the rehabilitation area, and I felt that I wanted to do something outside of rehabilitation since I had run that program for 4 years. Bill Carter was recruiting to open up freestanding outpatient rehabilitation centers. A friend of mine had told me about a position in Memphis at a children's hospital. I looked into that, and I ended up having the opportunity to have either job. I selected the children's hospital because it was a different focus, something I hadn't done.

WCR: You were the chief operating officer. That means that you were responsible for the day-to-day operations of the hospital.

MTP: Right. It was a 226-bed pediatric hospital.

WCR: How did that work out? Did you feel like that was a growth period for you?

MTP: It was a transition period. It was not easy leaving Washington, DC, and moving to Memphis. It was a small hospital but with the mission of helping children. There could be no greater mission. I never was really comfortable with what you see and deal with in a children's hospital. Seeing death and dying in the intensive care units was tough on me. It was an environment that I never really was very comfortable with.

WCR: How did it work out for you to come back to Baylor?

MTP: I had called Glen Clark to ask him to be a reference for me on a job in Chapel Hill, North Carolina, a beautiful place. I had interviewed there, and I was on the short list. Glen Clark said, “I'd love to be a reference for you, but we have a retirement coming up and we'd love for you to come back to Baylor.” When the day was done, I had an opportunity to go to the University of North Carolina at Chapel Hill or come to Baylor. At first it was a very difficult decision. When I lined it out, Baylor was a private institution vs a government-influenced institution. I knew the people at Baylor. Baylor had been good to me, and I had a lot of friends in Dallas. When it came down to making that decision, it was really not very difficult.

WCR: You came back to Baylor in 1990. What did you do initially?

MTP: I was vice president and had a number of the support service areas.

WCR: The experience at the children's hospital in Memphis, being more or less in charge of all the operations, must have been quite useful to you.

MTP: It was, but it was a smaller, more focused facility. The job with Baylor was a larger job in many respects, and other retirements would occur in the next few years. It was a position that had a lot of growth opportunities associated with it.

WCR: Things have progressed quite well for you since you've been back at Baylor. What happened in 1993? Your responsibilities changed after you had been back here 3 years.

MTP: I was made a senior vice president in 1993, and operational responsibilities increased.

WCR: What does executive vice president really mean?

MTP: In my current position?

WCR: Yes.

MTP: I have 2 roles now. Executive vice president for Baylor Health Care System and president of BUMC. The Baylor system has 2 executive vice presidents--Gary Brock and me. We are responsible for all the hospital operations within the Baylor system. For example, I'm responsible for coordination of the Baylor Institute for Rehabilitation, Baylor Center for Restorative Care, Our Children's House, and our Ellis County facility. I'm responsible for materials management and property management. Gary has the operational responsibilities for the rest of the system.

WCR: How much time do you spend on BUMC itself? You are president of this particular hospital.

MTP: I probably spend 65% to 70% of my time in that arena.

WCR: What is your day like? What time do you generally wake up in the morning? What time do you get to Baylor? What time do you leave? I know that no 2 days are exactly alike, but in general.

MTP: The meetings start at 6, 6:30, or 7 am. The day usually ends around 6 or 7 pm. One or 2 nights a week there are outside activities. Usually once every other weekend there's an outside activity. It's quite a demanding position.

WCR: You do not have many mornings that you do not have to be there at 6, 6:30, or 7 o'clock.

MTP: A rarity.

WCR: Do you have dinner with your family when you get home?

MTP: We try to have dinner as a family every night.

WCR: What time do you go to bed?

MTP: I try to get into bed by 10 pm.

WCR: You generally are up by 5 am?

MTP: 4:45 or 5 o'clock.

WCR: At most, you are getting 6 hours of sleep nightly.

MTP: I'm not like Joel Allison; I need some sleep. He doesn't sleep at all.

WCR: Where do you want to take BUMC now? What's BUMC going to look like 5 years hence?

MTP: I don't think you can answer that question without asking where it has come in the past few years. Today, BUMC is one of the most successful organizations in the country, whether you look at it from a clinical standpoint or from a business enterprise standpoint. We've created partnerships in oncology and cardiology that are unique in the country. We've created a partnership in ambulatory surgery called Texas Health Ventures Group that has been extraordinarily successful. Gary Brock and others created HealthTexas, which has been very instrumental to our success. What we've done and the recognition we've received in the heart, gastrointestinal, cancer, and transplant areas has been remarkable.

WCR: What has been the biggest secret of Baylor's success in your view?

MTP: I think the important ingredient that existed from Boone Powell, Sr., was further developed by Boone Powell, Jr., and continued to be developed by Joel Allison has been the understanding that the administration and physicians have to create partnerships to succeed. For one to succeed, both have to succeed. The relationships that have been established over the years between the management and the physician organizations have been crucial.

WCR: What is your biggest challenge now? What worries you the most about future success?

MTP: My biggest concern is that what is impacting hospitals and the health care industry is not necessarily within our control. I think the government has made some major mistakes with the Balanced Budget Act and the implementation of those guidelines by the Health Care Financing Administration. Those have been and will continue to be destructive to the hospital sector. What Hill-Burton did in the 1940s, the Balanced Budget Act of 1998 could do but in reverse. Congress is inebriated with savings that came out of the Balanced Budget Act, but only now is the negative impact really being felt in the hospital sector. We've spent years trying to develop a continuum of care in the health care industry. Again, the Balanced Budget Act has taken that continuum of care and has thrown it to the wind.

What concerns people who run hospitals today is this: Are we going to have the resources necessary to ensure the continued growth and development of, in our case, one of the finest hospitals in the country? Many hospitals are closing. Many hospitals are suffering huge financial losses. Much of that is because management didn't understand the impact of the Balanced Budget Act until it was too late. It's a 5-year roll-in plan, and if you didn't model it in year 1, then it's like waves on a beach. They just keep coming and coming. Then you magnify that with the past 8, 9, or 10 years of reductions in reimbursement from the health maintenance organizations and the failure of our entire delivery model to deal with indigent care. Together these factors do not provide a picture of continued growth, continued investment in technology, or development of research.

I think that BUMC is very well positioned. We just finished one of our most successful years ever! It's because we understand the business. It's because we understand the need to develop and improve our clinical programs, to grow our primary care base, and to enhance our physician relationships.

WCR: Do you think the Balanced Budget Act will be altered in the foreseeable future?

MTP: Not to any significant degree. The country is happy because it balanced the budget. The politicians are moving to add drug benefits. They are going to do that probably by taking more out of the hospital and physician sectors rather than by putting very much back in. The Balanced Budget Act has just about put the entire nursing home industry and the home-health industry into bankruptcy.

WCR: When I came to Baylor in 1993, I went to more meetings in the first 3 months than I had in my entire 32-year career at the National Institutes of Health. I find going to meetings quite tiring, and yet you are doing this, day in, day out, every day. You have to prepare for these meetings, and some major decisions are made during many of the meetings that you participate in. You must be pretty tired when you get home at night.

MTP: It's a stressful job. My analogy is: Trying to run a hospital is like the game called “pick up sticks.” You score points as long as you pick up the sticks without the whole pile caving in. That's what the job is day in, day out.

WCR: What gives you the greatest satisfaction?

MTP: Getting letters in the mail from patients who tell me what a wonderful job the people have done and how thankful they are that there are places like Baylor where they can be treated in a holistic manner. We can make an impact on people's lives. When it's all said and done, it goes back to the mission of Baylor--the ministry of healing.

WCR: What do you do to balance this enormous amount of energy you put into the carrying out of this mission? I think you have quite a few hobbies. Could you talk about them?

MTP: More hobbies than time! I spend the time I have with the kids and Patti. We do things together. I like to hunt and we do that as a family (Figure 3). We took a safari to Africa together recently, and it was an unbelievable experience (Figure 4). It's being out in nature, being with the kids, watching them grow. That is how we spend our time.

WCR: How did you and Patti meet?

MTP: We met on a blind date through somebody at Baylor.

WCR: What year did you get married?

MTP: We got married in 1983.

WCR: You had been at Baylor for a while. You were 26. Where is Patti from?

MTP: Patti is from Palestine, Texas. She was a school teacher teaching in Richardson when I met her.

WCR: How long did it take you to get married?

MTP: About a year.

WCR: You have how many children?

MTP: We have 2. Lee is 14, and Kate is 11.

WCR: Do you take vacations very often?

MTP: We like to get away for 3-day weekends as often as we can.

WCR: You don't have a place somewhere that you go to?

MTP: No. Patti's folks live in Palestine, and they are members of a dinner club that has a nice place out on the lake where we can fish and relax.

WCR: What kind of hunting do you like to do?

MTP: I like bird hunting and deer hunting.

WCR: It doesn't sound like you do it very much.

MTP: Not as much as I would like.

WCR: Where are you going to be 10 years from now? What is your age now?

MTP: I'm 44.

WCR: Where are you going to be when you are 55?

MTP: Assuming the world goes okay, I plan on being at Baylor and being president of BUMC.

WCR: Do you still work on antique cars?

MTP: Yes. Patti and I love to go to antique shops when we travel. I've got a 1935 Ford pickup in my garage. It's been restored. Both my dad and I worked on it, he more than me.

WCR: Do you ever drive it?

MTP: Not as much as I need to, especially in the summer.

WCR: After dinner at night, what do you do?

MTP: That's about 8 or 8:30. I fuss with my son about doing his homework, check to see if the Rangers are losing, read the newspaper, and go to bed.

WCR: You don't get much time to read the paper in the morning.

MTP: I try to catch the headlines.

WCR: As you look back on experiences that had major effects on your leadership development, what would they be?

MTP: The White House fellowship program was a leadership development program. I also did an interesting executive leadership development program at Rhodes College in Memphis. It was a 1-year program where mostly business people studied the humanities through the literature and applied them to the business world. Sports were a very important part of my leadership development. Sports have a major impact on how people develop and on their thought processes.

WCR: I remember reading that Jim Palmer of the Baltimore Orioles said that the smartest baseball players are the pitchers.

MTP: The pitcher has to know the batters--where they are going to hit the ball, if they can hit, or where they are weak in swinging the bat. He has to be able to control the ball. It takes an extraordinary amount of discipline physically and mentally to be a pitcher. The pitcher has to understand the game mentally. The pitcher has to understand the dynamics of the game and where the other players need to be. It's like being a quarterback on a football team. A lot of that applies to business. The opportunity for kids to participate in sports is a very important part of that leadership development process.

WCR: Do you get out to the Rangers' games much?

MTP: Occasionally. I had a wonderful baseball career, but I'm not attached to it. There's always another hill to climb. I enjoy working at Baylor very much. It's got extraordinary challenges and extraordinary rewards for what we do. The leadership now with Joel is extraordinary. Hospitals are good places.

WCR: You would have been enormously successful, it seems to me, in whatever sphere you chose. You proved that to yourself in Washington, DC. You proved it by getting that White House fellowship. As you look back on your career, are you glad that you chose the hospital administration arena?

MTP: It's been very rewarding for me in many respects. I had relatively little career guidance when growing up. I feel fortunate to work in a career where I can do good for people and be held accountable for being efficient.

WCR: I gather the endeavor of whether or not to combine with the Presbyterian-Harris system was a major energy drain for you. I gather you are glad the way that it turned out.

MTP: It was a drain for everybody. During that period, we also were executing some very good strategies--the Texas Health Venture Group and the Heart and Vascular Hospital. It was not as though the merger was the only project on the drawing board. Time has proven that it was in the best interests of Baylor not to merge. It was probably in the best interests of Texas Heath Resources for it not to have moved forward, given all the challenges that they are faced with today. We will be successful in our future. It was a valid and legitimate attempt to create something better. But as the reimbursement models changed, bigger is not better. Baylor will be a stronger and better organization as a result of the decisions that were made.

WCR: What will Baylor have to do differently in the future to continue to grow in these competitive environs?

MTP: We need to continue to make sure that we have leadership in a number of clinical areas. We have to challenge ourselves and not become complacent with our success. All organizations have life cycles. We need to understand that. Instead of completing one life cycle and going into decline, we need to invigorate and reinvigorate the organization to achieve great things. Baylor is not, and it should not be allowed to become, just another hospital. That will take commitment, resources, and vision from a lot of people.

WCR: You are always looking for areas to expand.

MTP: There are people who manage what is in front of them today, and there are people who try to manage what they think tomorrow will look like. I think Boone, Sr., was a great visionary who managed toward the future. That tradition of leadership has continued to result in some phenomenal strategies that will set us apart--not just by a little bit but by leaps and bounds--from other health care providers in the future, whether it be in the area of defining quality or the ability to invest in technology.

WCR: As you look back, what are the 2 or 3 most helpful things you took away from your White House fellowship that you are now applying to your daily activities?

MTP: The people running our country are just people, nothing more, nothing less. The great people are the ones who have created and done great things in the private sector and then have committed their lives to helping others. People can have an influence on how things are done. You need to be engaged at the local level. People can really make a difference.

WCR: Do you feel better about our federal government after that year or a little more worried about it?

MTP: It's an eclectic assemblage of people, cultures, processes, and checks and balances that rarely will take you out to the edge but will consistently keep you in the middle of a changing world and a changing society. That's probably a healthy place for our country to be as a whole.

WCR: What were the attributes that you so admired in Ronald Reagan?

MTP: I think he was a person of clear convictions. He would not speak to the polls but spoke about what he clearly believed in from his heart. He created messages and understanding that instilled confidence in people. He was an individual who dealt from the simple belief that America is the strongest and greatest country in the world and that she should be. He was the best at creating a team around him. The debate as to whether he was a genius or not is really irrelevant. When you assemble the people that he assembled around his operation, it was a very effective organization.

WCR: How did he do that?

MTP: Good people draw good people. In a lot of those positions you have to have simple messages with charisma that people will attach to and follow. I'm thankful that in his case it was the vision of a brighter world.

WCR: Is there anything that we did not cover that you would like to speak about?

MTP: I can't think of anything.

WCR: Tim, I want to thank you on behalf of the readers of BUMC Proceedings for pouring your soul out here.

MTP: It was fun.

WCR: Thanks.