Would you hire a county prosecutor to run a hospital network? If you knew Mike Duggan, you might.
A blunt, hard-playing deal-maker, Mike Duggan is known in governing circles around Detroit as a good man to turn to when things get sticky. But even those who admire Duggan's record of fixing broken systems were a little surprised when they heard about his latest venture. In January, Duggan left his post as the elected prosecutor of Wayne County, which includes Detroit, to become chief executive of the financially troubled Detroit Medical Center. A failing hospital system seems an odd perch for an ambitious, well-connected political insider.
Still, the move makes a certain kind of sense for Duggan. With 10 hospitals and institutes, 12,000 employees, a top-level trauma center and a hand in training many of Michigan's doctors, the DMC sits at the center of health care in the Detroit region. The $1.6 billion operation has been hemorrhaging money, losing $400 million over the past six years despite laying off thousands of employees, restructuring its operations and closing some facilities. Turning it around would be a highly visible coup, and it's one Duggan believes he can pull off despite his lack of formal experience in the convoluted world of medical administration.
Duggan isn't entirely a stranger to health care. In 1986, when he was 28, he signed on to work for Wayne County's new executive, Ed McNamara. Among other things, McNamara had inherited a $135 million deficit, caused in no small part by health care overruns that were costing the county $50,000 a day. McNamara handed the problem to Duggan. The result was a complete restructuring of indigent health services. "The county had the responsibility to pay for the emergency room bills of the unemployed poor," Duggan explains. "We took the money we were spending on that, put it into an HMO, issued them cards and got them in to see doctors early. We dramatically cut our costs by keeping them healthy, and that's how we got Wayne County's budget balanced."
Apart from that episode, Duggan's trouble-shooting has taken place in arenas far afield from health care. He was point-man in the intense negotiations that lured the NFL Lions from suburban Pontiac back to Detroit. He spent a year on loan to the Detroit city government after then-Mayor Dennis Archer took over the schools and needed someone to oversee his effort to rebuild the dilapidated buildings. And Duggan has been at the center of Wayne County politics for years. He led the successful 1995 drive to win suburban backing for a tax increase to improve transit service, managed McNamara's reelection efforts, and steered county attorney Jennifer Granholm's campaign for Michigan attorney general, the post from which she rose to become governor.
Along the way, Duggan built a reputation for being an irresistible force in local government. "He was of the type of drive and personality where Ed could stay out in front and Mike was always in the back making sure everything got done, and very aggressively driving it," says Dick Blouse, president of the Detroit Regional Chamber of Commerce.
Duggan, who is now 45, will need to call upon his entire skill set as he tries to put the medical center back on course. He has a reputation for holding co-workers to high standards, and he is already doing that in his new job, charting their progress in an intense weekly staff conference much like the "Compstat" process made famous by the New York City police under former chief William Bratton. "They dread Wednesday mornings at 7:30 if they haven't hit their target," Duggan says.
He dismisses critics who say that his skills may be fine for politics but that hospitals should be run by medical professionals. In 1998, he points out, he was asked to apply for the same job, then was passed over. "Instead," he says, "they hired a doctor and lost $400 million. So they fired the doctor and came back to me."
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