At 28, James H. Ross was already sitting in the executive chair. His graduate school residency led him to becoming the administrator of a community hospital in Dallas. Not just any hospital, but one which had recently filed for bankruptcy.

“The problems were just coming 90 miles an hour,” Ross remembers. “The employees were absolutely terrified about what was going to happen with them and medical staff was all torn asunder. It was, in some ways, just the worst of times you could possibly imagine.”

His experience showed Ross the power of community. When Methodist Hospital, where Ross was completing his graduate residency, bought the ailing center and reorganized it, the board of trustees, employees and medical staff pulled together and brought the institution back to life.

Leaving that hospital was one of his hardest decisions, yet he won the chance to serve a community again when he arrived in Greenville in 1990. Ross, who arrived as chief operating officer, came from St. Luke’s Episcopal Hospital, a 950-bed center affiliated with the Texas Heart Institute. It is known for its heart surgery, neurology and other programs. After visiting PCMH once, he knew he’d found a special place.

“Being in Houston and Dallas before that, I didn’t know a whole lot about the rest of the country,” he admits. “I flew out of Houston into Charlotte and then caught one of the planes over here and I remember flying in and looking out the window, and there was this great air view of the hospital. I thought, ‘Wow, this is a big deal.’ I was looking at this place spread out all over everywhere and I thought, ‘This is really something.’ ”

His enthusiasm surprised those he left behind, who wondered what Greenville, a town of 50,000 people at the time, offered that Houston, with more than 3 million, could not. “I told them that they needed to stick around for a while. I told them there was a quality of life here that in some cities you don’t get.”

Ross is aware that good decision-making is more complicated than ever in the modern health-care system. He also has tools to meet them that his predecessors could not have dreamed of. In one morning, he responded to 70 people through e-mail. He’s comfortable with other innovations, as well. Each can bring the region closer to the idea of universal healthcare.

Still, more work remains.

“We can’t rest on our laurels,” he says. “We have a legacy to continue to grow this place, not to just be complacent in it. When I say grow, I don’t mean just bigger, but, in medical programs, what is the next step?”

He’s challenged to find those answers using the old-fashioned method of placing people first. “It’s about the patient,” he believes. “I don’t mean it won’t have its moments where we jump around and have our disagreements, but that, to me, is how you take it on.”

James H. Ross