SANDRA HARRISON
Retired Manager, Radiology Department
Pitt County Memorial Hospital

Interviewer: Doug Boyd

Doug Boyd: What year did you start working at PCMH?

Sandra Harrison: In October of 1967.

Doug Boyd: Are you from this area?

Sandra Harrison: I am originally from Bath and went to school there and went to xray school in Washington at the hospital-based program there and then came here. When I went to xray school in Washington there was only one radiologist in Greenville which, of course, covered the areas and there was only one radiologist in Washington and every other weekend Dr. Poland and Dr. Stanley would cover for each other and that is how I met Dr. Taylor. He would go down to Washington and fill in for Dr. Stanley and his technologist at the office was pregnant and was going on maternity leave so he got me to work that summer at his private office to replace his technologist. So when the time to leave I started putting out applications Dr. Taylor was having a million things going on so one day he told me I couldn't leave. I told him I had to go somewhere and he said they had openings at the hospital and I had checked up in Raleigh and all of that and he said the salary was a little bit better up the road and the living was so cheap here that would offset the difference of the salary.

Doug Boyd: Was the salary $15.00 a week?

Sandra Harrison: No, it was a month. It was a ridiculously low rate.

Doug Boyd: What about food?

Sandra Harrison: Well, you would eat there at the hospital and that was one of the reasons too. It has been so long I cannot remember I am not going to say they gave us free meals because I don't think they did but it was so economical. Of course you didn't want to eat there all the time. Of course they had three good meals a day and the cafeteria was down in the basement so when you were on call you would run down there to the coffee shop and get something and go trucking back up and do the best you could. When I started at the hospital within a year or so the guy that was chief technician resigned. Me and one of the other techs there were designated as the Chief Technologist. We were still working techs but we were co-chiefs so we were in charge together; we were co-supervisors. Then they went about six months give or take a little bit as I don't remember exactly and they hired another man. Well, he stayed six or nine months and he left and then they hired another man and he didn't stay a whole year and then he left. I had gone through literally three different situations. I had probably been there about three years as I think it was 1970 and Dr. Taylor started talking to me about applying for the job. The lady that was in charge was relocating to Durham and up until then it would have been a real deadlock on which one of us would even be considered. She was a good friend and one of us would have been as good as the other. Dr. Taylor encouraged me to apply.

Well, I was torn because about five or six months or so before that Dr. Hardy came aboard. It might have been a year before that. When he started there previous to that we had the Nuclear Medicine Department and Dr. Fore who was actually Internal Medicine, but he came on board and started the Nuclear Medicine Lab. Back there we got training. Dr.Fore had talked to me about learning nuclear medicine. I did the first arteriogram in Radiology and I loved it. Jackie, the other lady, for about six months or a year, and me we did all the arteriograms. When Dr. Hardy had a patient to be done we were the ones who were called. We were literally on call like sometimes we would take two nights but it was just about every other night.

Doug Boyd: Which Dr. Hardy are you talking about?

Sandra Harrison: Ira Hardy. That was late 1968 or 1969 and it was 1970 or 1971 when Jackie left because I had been doing this, but I still did routine xrays. I remember the first year I was chief tech and I made less than I did the year before because I didn't get paid overtime and I bet you all could relate to that too. In 1970 I made $10,214.62, in 1971 I made $9,048.64. As a staff tech I was making $4.30 per hour and as the chief tech I made $4.62.

Doug Boyd: Things have come a long way since then.

Sandra Harrison: Oh yes, but I think when I actually started it was probably somewhere between $3.00 and $4.00 an hour, $3.25 or $3.75, something like that. That was in 1967 now. There has been a lot of turnover in Greenville and I thought about Greenville and I thought about coming here and working with Dr. Taylor and I thought about the hospital but I hadn't aggressively pursued it. People talked about it being not the greatest, etc. etc. It was referred to as the Pitt of the East and of course you met some people just working at Eastern Radiologists and you had some relationships with people at the hospital, and then actually before I even took a job at the hospital they were so short staffed that I actually started doing a little part time about a month or so before I went full time. Once we got some stability in that and the other things, sure there ups and downs but I think that things over time did get better. Sure there were tough times and there were times when you would look at wanting salaries to be better and so forth but I do think that once you stabilized that and then the program. They had a small program in Washington, there were only three people in my class which was not atypical for a hospital but you got to understand that radiology was a small department in nursing. Many hospitals would have three to five or six and if they had over that it was a big hospital based program. Things began to change and the education began to move to the community college and actually I started talking with people at the hospital and then we started talking with people at the community college probably in the late seventies and we started off in the community college. It was interesting and we started off with, I think, Lindsay Beddard in one of the first classes if not the first class actually graduating. What we did was we started off with the students that were taking classes and I taught just a smidgen of it and I oversaw the paperwork. A lady by the name of Judy Rivenbark actually was the Program Director and Judy is up in Burlington now and I haven't seen her in some years but she taught the majority of the classes in the classroom and I helped with the administrating.

We got Pitt Community College involved and started fixing it so the students would go over there and take some general ed courses and particularly when we knew there was going to be a transition date but they could start a year ahead taking the general ed and then they could transfer the xray courses that were up; in other words, we went ahead and structured it.

Doug Boyd: Are there any hospital-based programs?

Sandra Harrison: There is a hand-full of them left. They have an excellent program at Moses Cone Hospital in Greensboro. I'm not sure if Presbyterian Hospital still has a program. They used to have one but by and large the vast majority are in two year and there are a fair number of four-year programs.

Doug Boyd: Does PCMH accept people who have been through hospital programs still?

Sandra Harrison: The way it works is the approval agency is the same as long as the program is approved by the Joint Commission on Accreditation of Radiology Programs. They all have to meet the same criteria. In other words it is not unlike nursing. There is probably still somewhere some hospital-based nursing programs but very few if any and they are more into two and four-year programs. One year in the late seventies or early eighties they had a big statewide study of not just radiology but health programs and articulation, how they could put them into the community colleges and how they could let them transfer credits between community colleges and four-year colleges. All of those that I know of when all is said and done, it is a state license process or it is a certification process that may be national and most of those are. You have to meet the same criteria. Basically the difference is people would go into a lot more depth but the core curriculum is going to be the same irrespective of the environment you are in. By and large the vast, vast majority now are going to two-year community college type programs, four-year programs and a few of them are still hospital-based.

Doug Boyd: Let me back up a minute. You started in 1967 and over time there was a lot of turmoil and change in our area, how did the Vietnam War and the Civil Rights Movement affect PCMH?

Sandra Harrison: Well, different people will tell you different things, I think first of all my perspective is this. A lot of the things that you see on TV now and in the history books of the demonstrations you always sort of see things that start in California and come over like a slow or fast wave. The Vietnam War, of course, I had people that I went to school with that were there and you were concerned and everything. The wave had not really hit, I didn't feel, and I guess if you don't get caught up in that it never really affects you.

As far as integration and that type of thing we had the first day that I ever started at Pitt Memorial Hospital I will never forget when I went over to meet the people; there were two ladies that worked in the department and one of them retired probably three, four or five years ago and one of them passed away probably longer than probably eight or nine years ago. We used to tease her and tell her she had retired twice because she retired and then she volunteered and then retired from that. But one of them was Thelma Tyson. Thelma had transported patients and ran the dark room at the time I got there. That was her chief job was running the dark room-I mean you had to have somebody go down there and process the film and that is the room where the film is processed. The other lady's name was Dorothy Hatch. The first time I ever met the staff, I'll never forget, it was a small room that was behind the room where the physicians viewed their films in where the secretary typed and it was also sort of a break room all in one room, and I went over there and Thelma and Dot were there and as I said there were not but four or five techs and most all techs-some of them had to bob in and out while they were doing things. See I was raised in eastern North Carolina and I worked on the farm. My father did not farm but I always worked on a farm and I always worked with black people and we did the same thing. We didn't go to the same school but as far as working and all this, that and the other, we got along fine. But from day one those two people were two of the best employees in the department and as time went by and as I moved from a staff technologist to chief technologist and I began to get involved in the state association and I went through from secretary to president and served twice as president of the NCSRT, served twice as Board Chairman, I was on the state board something like nine or ten years and had the support of the physicians. It was Thelma, Dot and Linda Worthington who were the most senior techs there. Kathy Dutton's mother, she retired about six years. It was those three people when I would leave and have to go out of town to a meeting, you always have to have somebody to cover, if anything gets out of kilter, if I was going to be gone, I wanted to make sure that they were going to be working that weekend because they knew how things were supposed to run and they would run fine. So, I don't know if this is answering your question or not but I didn't see, sure there were undercurrents I'm sure in the community and everything you hear, but as far as our working relationship we got along great.

Then, of course, as time went by we had more of black people and frankly in those days they were transporters and the first black was a young man we accepted, he is not so young now and I haven't seen him in recent years, by the name of Jerry Ebron who was the first black xray student. Of course, after that we had two or three in the hospital-based and then several more in the others. Anyhow, Jerry came in and in the beginning when I first came here you rarely saw anything but females, so the first real change was to get a first male student, black or white.

The first male student was Steve Jones and Steve is in charge of the day clinic in Rocky Mount and has been for some time. Then the next big break, I guess, was having the first black student and if I remember correct, Jerry was the first black student. Lindsay's memory may be better on that than me but Jerry was good and he was qualified. He had been in the military so he certainly was structured and he came in and he was a good student. Once in a while you had to get on him, and once in a while when I would have to get on him and I would remember having several conversations with him and he would say it was because he was black and I would tell him it had nothing to do with that and he was expected to do this and that.

I remember the first meeting we went to and on the state level we had not a lot of black people that were technologists period, but we had two or three people that were. One of them still works at Chapel Hill and he is a Ph.D. now he is just a fine gentleman. There was a lady who installed me in my first position as President from Durham. Anyhow, there were two or three role models not just for blacks but particularly for blacks since they were the only ones there you know. You know what I am saying, they were role models for all of us but for black people they were the few role models there. We went to a meeting in Durham and I think Jerry about got wiped out one night and the next day he was moaning and groaning about something and I made him get up and go but he would tell you to this day that I made him tow the lines then and kept him straight and narrow. That was in his junior year. In his senior year we had the meeting in Wilmington and Jerry was just so laid back and there weren't many black students in any programs and they always had like a student technical vote where they could have questions and answers - it was like a spelling bee but they were asking questions about radiology, and to make a long story short, he won and he was the most laid back person you have ever seen and he won the technical vote. But we all pushed him and I was always just very proud of him because he did well and would have done well, black or white, but he did well because it was really just a statement not just for him and not just for Pitt but it was a statement for breaking that barrier.

I'm trying to remember if he worked here at all, I really don't think he did, I think he went around Washington, D.C. I haven't seen him in several years. He comes by the department every so often as he still has family down this way. The last time I talked to him he worked as a staff tech and then he got a job with Squib Pharmaceutical Company. To my knowledge he still works there and has done very well.

I guess the next big breakthrough was and I don't remember the exact year on this as we were making that transition from Pitt Memorial to Pitt Community. We had this gentleman come down to Greenville and his name was Garry Morre. He is now assistant to the dean at ECU. Garry came down to Greenville and we talked and we talked and continued to talk and good God, it was about 5:00 p.m. or 6:00 p.m. I remember so well we were talking about various and sundry things and he was originally from Pantego and I was originally from Bath. We started talking and again I had gone as chief tech and I wanted to say it was around 1971, maybe as late as 1972 or 1973, but I think it was 1971, but I remember vividly thinking the longer I talked to him the more I liked him and see.

I was the first female chief of the department. I was the first female department manager at Pitt Memorial Hospital beside the director of nursing because everybody knew you had to be a woman to be the director of nursing that was then and the radiology department manager had always been males, so I was the first female manager and I told Garry that a lot of people thought a woman could not run a department and blacks cannot make it in the profession so we were both there. We have laughed about that over the years. So, I hired him and he was great and he worked at the hospital about two years to help us with the transition over to Pitt Community. He was program director for the radiology technology program. I think he was like assistant director when he first came in. Remember I said I did the administrative on that, see on paper I was the program director, I did all the administrative reports and Judy and they did part of it. I was sort of like a vice president now who might send out and say how I want people to do these reports. When we transitioned to the community college for the first few months I was actually the first program director through the Pitt Community College because we had to do that for the transition. Just as soon as we got everything straight then I backed away from the community college and it was Garry's, he was the man because he was the person leading the effort anyway but it was like a transitional thing to get everything straight. I helped them through all that but in the end he did the lion's share. Then it became the Pitt Community College program and he was program director there for several years and then he went from that to being Dean of Students.

Anyhow, that was a significant change when the rad tech program went from the hospital to the community college but it was done for a very simple reason. They had and have the facilities through a community college that the hospital never could or should be funding. The role of the hospital was to be there and be supportive of educational programs with health care programs but it was also the role of the hospital to make sure that the patient was not paying an inordinate bill and half of that bill wind up being the cost of education for somebody and there is a tender balance there. I am sure to this day there is a tender balance there. So, it made a lot of sense to move it over there and I think that it has worked out very well. That is probably one of the best things we ever did.

Doug Boyd: I wanted to ask you, when you said you were the second department manager, you mentioned that health care has always been a profession that largely is dominated by women but it is not always a management role. There have been a lot of changes in that though as there are a lot of women department managers. How would you describe that? How do you remember it coming about?

Sandra Harrison: I would say as the hospital grew and when you say department manager, you have to remember that in the old hospital you had what was classified as departments. You had the director of nursing and then you had radiology, etc. etc. within nursing services which, of course, was a larger department compared to other departments in the hospital. You had nursing supervisors who were not necessarily in the early days designated as department managers but as the hospital itself grew then they began to say that the person who was director of nurses is really an administrator and then the title changed from administrator to vice president and these supervisors were really department managers so as that occurred then obviously there became a big addition to the number of females.

Mattie Bryan would be an excellent resource to talk about that relative to nursing. She is a retired nurse. Mattie was supervisor on weekends, nights and everything and I am trying to remember how many of them went to the department manager meetings. It was sort of like a name game you had to get beyond. There really were not any benefits that we got. The truth of the matter was that you hoped that you had a better salary because you didn't get overtime and this was just the world you lived in which was again not atypical for other professions, but that is just the way it was.

As we moved from the old hospital to the new hospital. I guess in a nutshell, the administrative staff at the top restructured then the whole hospital organization restructured. There must be several volumes of organizational charts if they saved them all. How many times have you seen changes since you have been here? But as that changed and the titles changed. When I went to work there, C. D. Ward was administrator that hired me and when I became chief tech when I actually applied for that job I talked with Jack Richardson who was an assistant administrator. He asked me why I wanted to do this job and I told him I was from eastern North Carolina and I thought that we could do better and I told him I knew the doctors and how to get along with them. I had a six-month trial period and at the end of six months if I didn't like it I could go back to what I was doing. If they didn't like what I was doing then I would go back to what I was doing. It was sort of a mutual thing. I asked for it in my letter and I guess the rest is history. I was satisfied and they were satisfied. Not that there weren't days when neither one of us were satisfied.

Mr. Richardson was assistant administrator and Mr. Ward was administrator. Then I remember when Buck Sitterson came and I remember when Rick Gilstrap came and went. I remember when Bob Barnes came and went and that would be one of the things in history that they would put a spotlight on. Then I remember when Dave McRae came when we got the Rehab Center and I remember when Bob left that Dave replaced him and then from Dave it was to Debbie Davis and then after Dehbie assumed Senior Vice President, Mark Gordon for a year or so had an opportunity. So I worked for all of them, at least eight different ones. Again, picking up on what you were just asking me, every boss I ever had was a male until Debbie who was the first female boss I ever had. Two of the last three were females. They were all good and you learn something from all of them. I never knew what it was like to work for a female because I had always worked for males.

Doug Boyd: Was it different at all?

Sandra Harrison: Oh yes, the two female bosses I had who were Debbie Davis and Linda Roberson. I think that the most significant change for me was that they would listen a little more, they would allow you to express your opinion. I would go in and, say we were discussing an issue, and I might have told them that I thought it was enough and could not understand why we were doing that and they would tell me there were a lot of reasons and so forth and at the end I might have told them I heard enough and I still thought it was crazy but I hadn't said that and I told them that if that was the direction they wanted to go in then I would go along. On the other side they might tell me that I did not understand and so forth and I would say okay that makes sense. I certainly don't want to make it sound like it was always that but the males were telling me this was how they wanted to do it and this is what you are going to do and go do it.

As I was told by one person one time that it was my job to make them look good. That was my job. Verbally I didn't respond. I always felt it was my job to give an honest day's work, to make sure I looked out for the best interest of the patient and in so doing I would in turn make everybody look good because the unique thing about health care above and beyond any job that one will have at least as I came through the years and, of course, when I went through xray school I was taught that when a physician came in the room you stood up and gave him your seat. Now a days they may stand up and throw the chair at him. I believe in respecting the physician for his education but as a human being I respect anybody based upon how they treat me, as I am sure this would be a reciprocal thing.

The point I am making is you go through the health care system and you have two sets of bosses. You have got the physicians in the clinical area and you have the physicians telling you what you have to do and how you do this and that. On the other hand you have got somebody on the other side saying you can't do this and you can't do that. In the early years as a chief tech they would give us a budget and you had very little input on the budget, we would try to tell them what we needed and as years progressed and it has come a long way, a tremendous amount of progress has been made on the amount of input one gets into budgeting. The thing that I smiled about in the latter years here, some of the newer managers now still have a stroke at budget time because changes were made in the budget without them being consulted at the last minute. Well, the reality is that if you are going to try to do a budget with several hundred people making the final decision, you won't live long. There comes a point which yes, the administrative staff has to sit down and say we are $100,000 or a million or whatever over and this is how much we are going to have to cut. What has changed tremendously in the last I say ten to fifteen years, rather than somebody just whacking it off and coming back and saying they took $40,000 off of supplies, and again it changes a little bit depending on who you worked with and how much time they had, but more and more they would come back and tell us they are going to cut another $10,000 or $20,000.

In Radiology communications would be that our cuts would be more than somebody else's budget just because it is a very expensive area. They would come in and say they had to cut so many dollars and I would say to them fine. Again, not that things were perfect, things never are, because you see to me when you are looking at the operation and it being as large as it is, when you are looking at many of the cost centers, probably many of them are a business unto themselves, I mean it would be like IBM or somebody and I mean you can't work independent of each other. You have to work together but you are responsible. I can remember the last year or two I did the budget in Radiology I guess probably just the revenue or the expenses, either one, would be way up, it was millions and millions of dollars. Many businesses don't do that much. I didn't have total autonomy but at the same time the amount of latitude that was given the managers did over the years significantly increase. Now, it would change as new people came on board and that is natural. People are going to check a little bit closer and so forth and so on.

But to pick up on the difference between the male and female, yes there was a difference in the management style of the two of them. I must say that I greatly preferred the latter. But there does not have to be a gender specific thing, I think that the lesson to be learned is that in a big, hectic environment, and we have all been there, and I think having come up in a male dominated environment in management and at the same time not having a shrinking violet personality myself, which I think was necessary to survive, mind you. Putting all that aside, I think that there are times when you don't have time you have to let people know that on a given issue, maybe not right this minute but on a given issue, if they really feel like they need to be heard or they need more information, that they can get that information but not necessarily instantaneous because if you are in the middle of putting out a fire you can't stop to answer a simple question but you have to let people know that they can get answers. I think as you move is it any better or any worse from a real small situation to the real large situation. In some ways it is actually better now than it was then. In some ways it is not. I think a lot of it really depends upon the individual that you are dealing with.

Doug Boyd: Tell me a little bit about your experiences as the school of medicine was being formed.

Sandra Harrison: Well I remember quite well being at the old hospital and we actually got out and passed out flyers supporting the expansion of the hospital. I think that was just to get them to agree to build the new hospital. I remember that Dr. McConnell was very, very supportive of the medical school. In fact they had bumper stickers for the ECU medical school. Obviously in the early years as it was formed and as the physicians came aboard, the thing that affected us more in this clinical area was you had more doctors than you had ever had before and so you had to literally reassess as there was not but so much room in the OR for doctors but we had to sit down and reassess how we handled our displaying of films, for instance, and what equipment you had in order to be able to handle a greater number of doctors. We moved in, if my memory serves me correctly and literally within days of the move from the old hospital to the new hospital, they started tearing out the back end of the Radiology Department because of what was going on and as I remember that was what was associated with the medical school. We had to have more space and, of course, it never really stopped after that. The way we handled the films, the way we moved to the way they were displayed to make them available to the attending and everything, there have been significant changes in that. And just the numbers of doctors that you were working with, the whole issue of getting used to having residents on board. Medical students had some impact and I guess again that you start off slow because you sort of adjust to each other but medical students and residents and having people literally there twenty-four hours a day, seven days a week ordering examinations. Before they were there and before you subject to have things in the middle of the night that was going to be the most different. Obviously all of that whole increase in staff and then services around the clock and not just in Radiology but throughout the hospital had affected the type of equipment you had to have and the number of people you got to have there. The staffing, not just of staff but of physicians, all of that sort of blossoms and bloomed in there.

Doug Boyd: When you moved into the administrative role, did you have less patient contact?

Sandra Harrison: Well, you know, it was probably the same and the first year I had just the same patient contact and I just had longer hours. I tell you what, I would say for at least the early years, probably one to five or six years, I rarely left the hospital before six or seven o'clock at night.

Doug Boyd: Did you take any xrays though like your last year or two?

Sandra Harrison: Probably the last ten years is when I pretty much got out. I think I was in that role a total of about twenty-seven years, twenty-six or twenty-seven years, something like that. Administrator, the title changed and the roles expanded but the primary function remained the same. Up until the mid-eighties, or late seventies, for a long time I still had just myself and a few supervisors in the department. I was doing the entire scheduling for the department and then I started to delegate to some of the others. I can remember when Dave McRae came on board whatever year that was and he was the VP over that area, he was the one that actually supported and made the move to get more managers into the department. Then really we developed a plan for what needed to be done and along that time there was another expansion of the Radiology Department and Tom and them are doing some things right now. We sort of sat down and looked at what was there and what was going to be there. I think it was like a period of over three or four years. We needed to hire three or four managers. We brought in one and then brought in another to make things much more manageable. We were sort of at a stress point where again is that acceptability I was talking about. You had people out on the floor that were working themselves to death and if you had a question you had to track somebody down and so forth. In the first I was very heavily involved in still doing a lot of the xray. Probably started off with anywhere from seventy-five or eighty or ninety on a given day then as the years went by they just gradually moved on to where at the end I rarely, I would go in a room. Ultimately I realized there was no way that I am going to be active in all of this and I was just going to have to get good people and then as time went by and we did get more people then I wound up saying okay that I had one person that was manager over all the special areas, one person over general xray, one person over support areas and one person over nursing. Actually, they realigned a little bit since I left but I would still staff. I understood the principles of why they were doing it and I knew enough about each area but my role in the end was working with the managers and then negotiating equipment and so forth and so on. I knew enough to know what they needed and to go ask them what they needed and to understand what they were telling me. If you work in an area and you don't know what you need, they you got problems. I would say to them that if I could come into the areas where I did have expertise, the day that I can come in here and do your job better than my job then they have a problem and if you can go into my office and do my job better than I can then I have a problem. Specials and the diagnostic have changed hand over fist. My sister was over there just a couple of weeks ago and had to have xrays and some of the equipment was what we got just as I was leaving and I understood what he was doing but I had never actually used that control myself.

Doug Boyd: What exactly is special?

Sandra Harrison: That is vascular. We call them special procedures. The bottom line to all of that is that could I go back right now into that department without somebody assisting me and work every piece of general xray equipment and the answer is no. It wouldn't take me long, it is like riding a bicycle once you learn it and it would take me a little longer because now I understand the principles of that but I am not an ultrasonographer, I am not a nuclear medicine tech, I don't ultrasound, I don't MRIs, I don't do CTs, those are areas that I really should go back to school for.

Doug Boyd: Did you miss that patient interaction?

Sandra Harrison: Yes, I think you do. My patient interaction in the latter years was more going there and stopping and talking to somebody. That didn't stop, just stopping and making sure they were okay and making sure they were comfortable. One of the greatest patient satisfiers we ever did was adding blanket warmers in the Radiology Department to make sure that the patients were not freezing to death anywhere on a stretcher and of course that could be true of any department outside of nursing. You wonder why didn't we think about this before. They had them up on the floor and when patients were uncomfortable you put a blanket on and warm them up. I had had some personal experiences in hospitals and had somebody get me a warm blanket. I tried to walk through the areas where there were patients and just go down the hall and talk to somebody and ask how they were doing or something like that. It is not all that different than what I was talking about. No matter where you are at if you are a staff employee or if you are the president of the hospital you are going to appreciate when someone takes an interest in what you are doing or saying or asking or whatever and certainly that is really more true as a patient. We are not taking them in to get an oil change and nothing gets more personal than when you are working on that person's own physical body therefore taking an interest in them and asking them what their needs are. I think the challenge in any clinical area and it is more so now than it ever was before is doing that and know the stuff that you are giving and connecting with that patient and letting that patient know why you are there and that you care. I think that is a challenge for the clinician and I think that is a challenge for the physician. We would have much fewer malpractice suits in this nation if more people realized that.

Doug Boyd: How old were you when you started?

Sandra Harrison: Probably twenty or twenty-one. I think I was probably not quite twenty-one. I worked there thirty-three years.

Doug Boyd: Before we go, what is the message you would have or what would you say about PCMH if someone asked you what the hospital was all about?

Sandra Harrison: Well, you asked me what PCMH is all about, are you talking about PCMH or University Health Systems?

Doug Boyd: I was talking about PCMH.

Sandra Harrison: I would just say that Pitt Memorial has come a long way and it is a good hospital and as I said there are many physicians and staff that are very good and dedicated. I don't think everybody there is perfect. I don't think everybody is perfect anywhere. There is good and bad everywhere. I think the biggest thing as an institution and in all leadership roles from a supervisor to the president of the hospital, the Board, etc. you should never forget from whenst you came. If you don't remember where you came from you will never know where you're going. You don't need to forget how you got to where you are and who helped you get there. You need to listen, you need to listen to people be it the patient or the staff and the people in your community because that is what has made Pitt Memorial. That is what has made it successful and that what will continue to do so.

Health care is changing, health care is going to continue to change. We have not seen anything yet. If we think we have seen a revolution with HMOs watch what is going to happen in the next ten years when the baby boomers come to where they can step up to the plate and speak their mind on issues that they like and don't like and I think that the challenge is going to be in those entities that are successful and it is going to be to continue to involve the base, the core of people who we started with. I think that by and large the hospital here has done good but I think that there are still, I think that they need to look out for the retirees. I think they need to look for the staff and I think that they need to make sure when they are doing that it is communicated and that is the challenge. In some cases, I don't want you to think that things are not important, we have had significant improvement over the years in benefits and certain benefits that are good and people don't even know about it and in other cases benefits are not so good and one could go out on their own and improve them and they don't know about that either. I am not saying that the benefits people in their own way don't try to communicate but I am just saying that those types of things will continue to be a challenge. As you get bigger there are advantages and disadvantages.