In 2004, former Wayne County, Michigan, prosecutor Mike Duggan became the chief executive of the troubled Detroit Medical Center. On day one, he was told the hospital system would run out of cash in six months unless the hospital changed course. Duggan did. Last year DMC ended last year with $2 billion in revenue and a tidy profit.

Duggan recently reflected on how to pull off a successful turnaround. His lessons should resonate with anyone managing a large public enterprise.