Marguerite Young

Marguerite Young served on the Mary Washington Healthcare (MWH MediCorp) Board of Trustees from 1988 to 2000. A founding member of the Healthcare Assembly, Young was a leader in and advocate for Mary Washington Healthcare’s community benefit programs. She began her career as an educator in Fredericksburg in 1957. She was a teacher, an assistant principal, a principal, and director of instruction for Fredericksburg City Schools. She continues to work with Mary Washington Healthcare on community benefit. She is a current member of the Central Virginia Health Services Board of Directors.

Marguerite Young was interviewed by Jess Rigelhaupt on September 25, 2013, and July 21, 2014.

Discursive Table of Contents

Interview 1
00:00:00-00:15:00
Joining MWH MediCorp’s (Mary Washington Healthcare) Board—First board meeting—Negotiating with insurance companies—Board discussions of employee bonuses

00:15:00-00:30:00
Serving on different committees on the board—Learning about health care and Mary Washington Hospital—History of the “colored ward” at Mary Washington Hospital

00:30:00-00:45:00
Racial diversity in the board and administration—First visits to and experiences with Mary Washington Hospital in the 1950s—Moving to Fredericksburg—Connections between Mary Washington Hospital and Fredericksburg’s African American communities in the 1950s

00:45:00-01:00:00
African American employees at Mary Washington Hospital in the 1950s—Fundraising with the Twelve and One Club for facility improvements at Mary Washington Hospital—History of desegregation at Mary Washington Hospital and in local schools

0:00:00-01:15:00
Origins of the Healthcare Assembly—Healthcare Assembly as a precursor to Community Benefit Fund and the Citizens Advisory Council

01:15:00-01:30:00
History of the Healthcare Assembly and the Community Benefit Fund—Dental care is a community need

01:30:00-01:49:00
Board discussions of the new Mary Washington Hospital (opened in 1993)—Board and administration discussions of the new hospital—Working relationship between the board and the administration—Working with the City of Fredericksburg to build the new hospital—Upgrades in equipment and technology at the new hospital

Interview 2
00:00:00-00:15:00
Values and mission of Mary Washington Healthcare—Board discussions of the values and mission during an era of expansion—Board discussions of Stafford Hospital

00:15:00-00:30:00
Board and community discussions of Mary Washington Healthcare’s expansion—Mission and values reflected in new clinical programs—Working with the administration

00:30:00-00:45:00
Board, administration, and community relations around racial diversity—Board and administration discussions of gender and hiring women

00:45:00-01:00:00
Organization has improved in its hiring of women and racial minorities—Working with community organizations and the Community Service Fund—Identifying community health needs while on the board—Origins of the cardiac surgery program

01:00:00-01:15:00
Expansion of clinical programs, ambulatory surgery, and the development of the hospital campus—Board-administration-medical staff relations

01:15:00-01:30:00
Origins of the Community Service Fund—Mary Washington Healthcare’s work with the Moss Free Clinic and community health centers in the region

01:30:00-01:45:00
Fiduciary responsibilities of the board—The challenges of providing care in underserved communities

01:45:00-01:59:14
Community Health Needs Assessment—The effects of public policy debates and Medicare and Medicaid reimbursements—Changes in board governance

Transcript

Interview 1 – September 25, 2013

01-00:00:00
Rigelhaupt:
It is September 25, 2013. I am in Fredericksburg, Virginia, doing an oral history interview with Marguerite Young. I would like to begin by asking you how you became involved with the board of Mary Washington Hospital and MediCorp at the time.

01-00:00:29
Young:
I received a phone call from Layton Fairchild, who was on the board and was going to have to get off of the board because the lunchtime meetings interfered with his business. He said that he had either recommended or somebody had asked him about it, about my joining the board. He was calling to encourage me to accept that position when somebody called me. I gave it some thought, and I did receive a call, from either Bill Poole or Bill Jacobs. In fact, both of them called me and then asked if I’d come for a meeting, and I did. That’s how I got involved with Mary Washington Hospital board of directors.

01-00:01:33
Rigelhaupt:
Could you tell me a little bit about Mr. Fairchild and how you two knew each other?

01-00:01:40
Young:
Layton lived in Spotsylvania and I didn’t know him very well, but I knew his family better and I knew that name. He knew my family. I didn’t know him very well. [background conversation]

01-00:02:24
Rigelhaupt:
[break in audio] Now, do you remember who called first, if it was Mr. Jacobs or Mr. Poole, and what that initial phone conversation was like?

01-00:02:40
Young:
You know, I’m eighty-five, so I can’t really remember who called me first. But I knew Bill Poole. [03:00] His daughter was at Maury School when I was principal. I knew his wife better, but I knew him. He may have been the first one to call to ask for a meeting, or it might have been Bill Jacobs. I’m just not sure. I did not know Bill Jacobs, but I did know Mr. Poole. I knew that somebody was going to call me, because Layton had said that, and so I was aware. They said, “Can you come for a meeting?” and I did. I went to that meeting.

01-00:03:39
Rigelhaupt:
Could you tell me a little bit about that meeting and what you talked about?

01-00:03:43
Young:
Yes, I can. They told me the kinds of things that the board did and what the board was responsible for. I knew that, if it’s a board of directors—I’d had experience with the school board and other boards—that we might set the policy and that kind of thing, but not the day-to-day operations. So at that meeting, they took me on a tour of the hospital and talked about what our responsibilities would be. I did indicate to them that day, to Bill Jacobs that “You might need a token black, but I want you to know that if you’re looking for a yes man, you’ve got the wrong man. I will say how I feel. I will ask questions and I will give my opinion.” And it went well from there, from that point.

01-00:05:01
Rigelhaupt:
Do you remember if, at that initial meeting, you had conversations about some of the issues that the board might be undertaking in the near future? Did they give you a sense of what might be some of the first things you would be talking about?

01-00:05:20
Young:
I don’t remember that we discussed anything about the issues or the things that would come up at that time. I don’t remember that that came up during that first meeting. I learned quickly what the issues were when I was at that first board meeting. I’m not sure that I remember all of the issues, but I remember some of the things.

01-00:05:58
Rigelhaupt:
Could you tell me a little bit about that first board meeting?

01-00:06:02
Young:
[6:00] I’m not sure it was the first board meeting, but one of the things that was a problem was this business with the money from Medicare. I mean Medicaid. We were trying to get some money back that Medicaid owed the hospital. We did finally get that one million dollars. I’m not sure this issue was at the first meeting, but it was early on—the business with insurance companies. I can remember very clearly that we were in a board meeting late, and they were not happy with the percentage we were going to get from, I guess, Blue Cross/Blue Shield. I remember Hunter Greenlaw said, “Go back in there.” We sent in probably the CFO—I’m not sure if he was the CFO. But he sent him back in to Bill Jacobs’ office to talk with the insurance company. He would come back with the percentage. [Greenlaw said,] “No, we can’t accept this.” I remember because Hunter Greenlaw was a businessperson and he knew something about how to deal with insurance companies. Those were a couple of things that we were dealing with. Not too long after that, pretty much maybe in that first year, we were talking about bonuses for people, and not giving a bonus. I had my first argument with Joe Wilson. He said, “This is bottom line.” I said, “The bottom line is patients. It’s people. And you’ve got people here who are working for little or nothing. If they get twenty dollars, or a few dollars, at Christmastime, you’re going to get loyalty from them. I’m not so worried about the people who make big bucks. Maybe they don’t need it. But you have to remember, a loaf of bread for these people who make very little per hour costs the same as those who make big bucks. So I’m saying we need to do something. [09:00] Give that bonus, especially to those people who work, who take care of the patients who are here, who keep this building clean, and who work in food service. Those are the people that I’m concerned about.” That was my first argument with Joe Wilson. There were issues that came along that maybe I can’t even remember, but if I were to hear about it, I’d know my part in it.

01-00:09:36
Rigelhaupt:
Were the bonuses paid that year?

01-00:09:38
Young:
Yes, they were. Yes, they were. They have made it possible that people have received bonuses, I believe, every year. Every year, they have gotten bonuses in some fashion. The bonuses now, I believe, are probably in connection with performance for the department. The people did get their bonuses, and that, I felt, was very good. It was something that I felt strongly about. I work along with people—yeah, I do. I’m in organizations and so forth with people who are up there, but I also walk among people who don’t have and who have to struggle. And so I knew what it meant. These people were pleased to have a job. But to give them a bonus meant something, and they would be loyal as long as you let them work there. I knew that.

01-00:11:03
Rigelhaupt:
Did you get the sense that this was one of the first times that the board had undertaken a conversation about bonuses for, frankly, the majority of the people that work at a hospital, from nurses to food service to environmental services?

01-00:11:23
Young:
I got the impression that they were trying to save money. At that particular time, I wasn’t aware of how much the hospital had or didn’t have. I knew, and I said to them, “I’ve never made $50,000 in my life. I’ve never made it. There are people in here who are making way above $50,000. But there are people working at this hospital who are not making $50,000 a year.” [12:00] I was an administrator and had not ever made $50,000. I retired and had not made $50,000. Those people up above there, that was something. I knew that there were people making big bucks, but I thought that maybe they needed to watch the hospital’s money. The hospital needed to watch its money, and so they weren’t going to give anybody bonuses. Well, that’s the wrong thing. I’m saying, “Uh-uh. That is wrong. You have people who are going to make it if they don’t get a bonus, but there are these people who will love you, who will work hard, and they need that bonus for Christmas.” I didn’t know what the funds were as far as the hospital was concerned, but I felt that the hospital could afford the bonus for the major portion of those people working in that hospital. And don’t give big bonuses to people who make big money. It’s okay. That’s the way I felt at that time.

01-00:13:34
Rigelhaupt:
One of the things that I think I’ve learned in terms of doing some research on hospitals and the way they’re structured is that often the board interacts more with administration than at the level of nurses and environmental services and food service. Was the administration in on this meeting and discussion about the bonuses, and do you remember where they were, or were they removed because they were the people making the big bucks, as you said?

01-00:14:11
Young:
There were some administrators, of course, Bill Jacobs, the CEO, and president would be there. You would have the president of the medical staff, who would be a part of it. You would have other administrators as part of the board meeting. There are those who would be there. And yes, they were all a part of it. They heard every word I said. But you remember, too, that we have the lay board. There’s a lay board. [15:00] Many of them are businesspeople and they are people who make money, who decide whether or not to give their employees bonuses. They have major decisions to make to keep their businesses going. They are thinking bottom line. I’m thinking people. I’m thinking, the bottom line is not going to be hurt that much to take care of these folks. If you decide that you’re going to give a twenty-dollar bonus, or you’re going to give a thirty-dollar bonus, and not a two hundred-dollar bonus to these people who would get certain percentages. I’m saying, “Think about this.” I know that they heard me. I know they did. The administrators didn’t feel bad about it, I don’t think, and they could find a way to say to the board, “It’s not going to hurt us that much.” I know that there were board members who heard what I said, and I can name a few.

01-00:16:26
Rigelhaupt:
Who heard what you said?

01-00:16:27
Young:
Joe Wilson. Joe heard. Hunter Greenlaw. Homer Hite, probably. Carson Rhyne. Carson Rhyne was a minister. I know he heard. There were others on that board that I might not be able to name at this moment, but I know they heard me. The workers got the bonuses. I made statements about just about anything that I felt strongly about. Once I heard Joe Wilson say, “Marguerite is the conscience of the board.” I knew that I was there. I knew they heard me, including the doctors. We had doctors on the board, too—Dr. Ryan, Dr. Hollister—during that time.

01-00:17:44
Rigelhaupt:
What do you remember learning about hospitals and health care when you first joined the board?

01-00:17:54
Young:
Let me tell you this. We got big packets of material for the board meeting. [18:00] I read every word. Every word. I jotted down questions that I needed to ask. I remember learning just about everything: what our role was, what the doctors’ roles were, and what the administrators did, each administrator. But every issue, every packet that I got, I read it. Because I had a big mouth, I got asked to serve on committees—and I was the only black. I was the only black person. We didn’t have any other minority at that time. So I got to serve on different committees. I hadn’t been on that board about three months, I guess, when I was asked to chair the Quality Assurance Committee. If I’m asked to do something, I do as much research as I possibly can so I can do the best job. I had to find out about the quality assurance committee—what does that committee do? The reason I was asked to chair it is that the person who was chairing it was leaving and going to Florida or something. I can’t tell you what I learned. I just learned everything that came my way. Whatever we had to do, I learned about it, I cared about it, and I loved Mary Washington Hospital. I did. They brought me in and let me learn all the things—I learned about everything, all kinds of things. I would write letters. When we were working on redoing the emergency room, I was involved in that. There’s not much that I wasn’t involved in when I was a board member.

01-00:20:44
Rigelhaupt:
Thinking about maybe that first year you were on the board, was there anything you learned about Mary Washington Hospital, in terms of how it served the community, that you hadn’t known or would have only learned by being involved with the organization? [21:00]

01-00:21:06
Young:
I can’t tell you the things I learned. I didn’t think about how the hospital did anything. I didn’t think about what the hospital did. You went to the hospital and you got made well and so forth. When I first started knowing about the hospital, we had the colored ward. We had a colored ward. Early on, we had one black nurse, and she controlled whatever the black folks did at that hospital. You were all going to be in this particular floor, the 4th floor, in these wards, the colored wards. That’s all. You weren’t allowed to go anywhere else, I thought. So you didn’t know anything else. We had one doctor, Dr. Ellison, who had some privileges at that hospital at the time, I believe. That’s all we knew. We didn’t know very much. Living close to me, we had a young woman who worked at the hospital. She might have worked where the babies were or something like that. She walked to the hospital every day. Then we had another young woman who I knew had worked there. They all walked to work up there. Then, that’s all I knew about the hospital. Years later, years later, many years later, I got asked to serve on the board. In fact, I never thought anything about a board for the hospital—I just didn’t think about that. Way before my time, my sister-in-law was one of the first nurses that worked at the old hospital on Caroline Street, I think it was, or Sophia Street, one of those. I’ve heard people say she would put on that cap and that starched white dress. She would be dressed in white with her white cap, and she’d swing around the corner of Charles and Hawke streets with that cape lined in red and go to work at that place. [24:00] She was one of the first. She could tell us some of the persons that she was allowed to work with, and they were white. I don’t know that they had any black patients at that time. That’s the concept that I had as far as the hospital was concerned. When I went on the board that first year, I learned a lot of things. I knew what a board was going to be like because of the school board. When I got there in 1988—and see, I came to Fredericksburg in 1957, and we had that colored ward and my brother would pick up bodies from the hospital. He was a mortician. That’s the kind of thing that I knew. I knew nothing as to how a hospital operated, what they had to do, and how they had to charge or anything like that. In fact, I didn’t even know that insurance paid for people to go to the hospital. I didn’t know any of that. But that first year, I learned a whole lot because I was serving on lots of committees, lots of different committees. I hadn’t been there very long when I was the board member on the eligibility committee. Doctors would apply to work at the hospital. I would be on that committee, just the board’s representative, and I learned a lot. I was allowed to go to a conference with Dr. Ryan, Dr. Hollister, and somebody from the administration when we were talking and learning about what you needed to do for, I guess, eligibility. That’s not the word. It’s not called “eligibility” now. But I have to tell you, when I went to Boston—this is just how country I was. We were going to go out that evening and we were going to get the subway. Dr. Hollister wanted to know, “How did you get in here if you still got your token?” You know, the token to put in? I still had it. I don’t know how I got in there. [27:00] I was there. When they went, I was there. We were up in Boston at the time, going out in the evening. I can’t tell you all the things I learned. I learned everything, everything about the hospital. And when you do, you get to love whatever it is you’re learning about. That’s what I can tell you. I haven’t told you much about Mary Washington, but if you were to ask me something specific, I probably could tell you what I know about it.

01-00:27:51
Rigelhaupt:
I’ll get to some of the specific milestones, but my questions will be more open-ended. Do you remember anything in particular you came to love initially and early on about Mary Washington Hospital?

01-00:28:09
Young:
Yes. The fact is that they heard me when I talked. I felt that I could make complaints. I went to Bill Jacobs and said, “You have no minorities working up here on this fourth floor. No minorities.” He gave me the impression that maybe he couldn’t find anybody to fill the positions. I remember saying to him, “I can find you somebody to fill any position that you got here. I can find you somebody.” I said, “You asked me about John Green. We call him City Green. City Green is from Fredericksburg. He has the same position at Washington Hospital Center that you have in Fredericksburg. He has it in D.C.” They had become friends. I said, “Okay. I can find you somebody to do any position that you got at this hospital.” Okay. Bill Jacobs went to working with MediCorp at another building and his vice-president, I think, took over as the administrator at the hospital. [30:00] He finally went to Florida. I can’t recall his name. I’m eighty-five. When the new administrator came in and took Bill Jacobs’ place at the hospital—Bill was working over in another building—I told the new hospital administrator that, “You don’t have anybody, any minorities working in the administration.” He did get an assistant. One Sunday morning, he was passing by my church as I was going in. He stopped. He said, “Marguerite, I have somebody and she’s not token. She was the best person for the job, and she’s black.” But not only that, she was his assistant in the office. That was good, because she was really good. Then I went to Bill Jacobs over in his building. I said, “Bill, we still haven’t gotten anybody in administration. The NAACP for Fredericksburg and Spotsylvania are getting together. They’re going to have a meeting. I know that one of the things coming up is that there is nobody in administration at Mary Washington Hospital.” Bill was gone in about six weeks. There’s Xavier Richardson. I put forth Xavier Richardson’s name, but Bill was gone. In comes Fred Rankin. One good thing that Fred wanted to do was to find out how the board felt about certain issues and if they had anything he needed to know about. He would come to your home or you could meet with him in his office. I was in Fred’s office very often. I invited him here and I told him about what I saw as far as the hospital and minority employees. Then I brought up Xavier. I put out Xavier’s job description. It went from there. Nobody threw me out of their offices. [33:00] You asked me what did I like: what made me like it is the fact that they heard me. Any kind of issue that I saw, I would take it to the person who I thought would handle it, or should handle it, and they heard me. They didn’t always do what I wanted done, but they did something. That’s what I like—what I loved—about Mary Washington Hospital and Mary Washington Healthcare.

01-00:33:36
Rigelhaupt:
This is going back. You mentioned moving here in 1957. I know this is going back over fifty years. If it’s possible, do you remember the first time you became aware of Mary Washington Hospital? That you might have visited, or you heard about it after you moved here?

01-00:34:00
Young:
Yes. My nephew. I was living with my brother and his wife. My brother is a mortician. At that time, he was a mortician. His wife was a teacher, but she was pregnant at the time. My brother was out of town. He was picking up a body in southwest Virginia or something and his wife went into labor. She had to go to the hospital. That’s when I knew Mary Washington Hospital. She had to have a cesarean. When he got back home, when my brother got back here, I said, “Thelma’s in the hospital, and visiting hours are over.” He said, “Can air get in to the hospital? If air can get into that hospital, I’m getting in there.” He and I went to that hospital and he knew all about how to get in there. We were able to get to her room. That’s when I really became aware of the hospital. Another thing was we had an outbreak of tuberculosis around 1957, I think, in the city, and in the schools. We were getting people—students—tested. The principal sent me with the buses. He sent me when we were taking the children up to the hospital to be tested. I think they were being tested. [36:00] I went then and one of the persons up at the hospital said, “I can get you to your sister-in-law’s room.” Then I was aware of Mary Washington Hospital. That was in 1958, I guess. Maybe it was October 1957, probably October 1957. I hadn’t been here very long. I was living with my sister-in-law and brother, so it was October 1957.

01-00:36:51
Rigelhaupt:
Where were you living before you came here?

01-00:36:54
Young:
My home is Eastern Shore. It was Accomack County in Virginia. However, I had been teaching in Emporia, Virginia. That’s south of Petersburg, close to the North Carolina line. I had been there for nearly eight years, but I had decided that I was going to go home to teach and I got a teaching job in Accomack County. I came up here for Labor Day, just to visit with my brother and sister-in-law. I was going to live at home with my parents. I was going to stay there and teach because I was having to help out with expenses at home anyway. But I met a young man up here when I came up here to visit. My brother said, “The business teacher is getting married and she’s going to leave.” He said, “If you type a letter, I’ll take it to the superintendent’s house.” That’s what he did. I typed that letter, asking for a job. He took it to the superintendent’s house, but the superintendent was away on vacation for Labor Day. He put it in the superintendent’s screen door. I guess it was Labor Day. He got back home. When the superintendent got back home, he called the funeral home, where I was, because I gave that telephone number. [39:00] He said, “Can you go to Richmond for an interview tonight?” I said, “Yeah.” I did. I went there. I did tell him that I was under contract in Eastern Shore. He said, “I want you to go to Richmond.” I went to Richmond, and then I left here and drove home to Eastern Shore. I was living on Eastern Shore. The next day, I was going to—that day—I was going to have to go in to school. During that week, the superintendent here called my home and said, “Come back here this weekend for an interview with me.” I did. Then I went back home. He called and said, “You can start here. I’ve talked to the superintendent in Accomack County. You can start here on September 12. Can you do that?” I said, “Yes.” That’s what I did. I was living on the Eastern Shore, but for nearly eight years, I had lived in Emporia and taught in Emporia. That’s where I came from.

01-00:40:34
Rigelhaupt:
Do you remember other people from the African American community in Fredericksburg that worked at Mary Washington Hospital? You mentioned a nurse. Were there other physicians?

01-00:40:49
Young:
No. I knew a lady whose husband was pastor of Shiloh Old Site. Mrs. Hester worked with babies up there. The young lady that I was talking about on my street that worked up there, she worked in something called central something. She worked up there. There were two people, three people, that I knew who worked—I knew them—who worked at Mary Washington Hospital that were black. Dr. Ellison had privileges at one time, I think, but I never saw him at the hospital. In fact, I’m not sure whether he had, really, privileges. The reason I question it is that when my sister-in-law went in to the hospital, he didn’t go there. [42:00] He had a white doctor to work with her and she had to have cesarean. He had a white doctor to work with her. Dr. Ellison had been her doctor all along during the prenatal thing. I’m not sure whether he had privileges or not. I do know that he was the black doctor, but I never saw him in the hospital. But we didn’t go to the hospital, like anything. I went to the hospital for the first time when my sister-in-law was in there and when I had to take those children to be tested for TB. I think the principal got me to go along on that bus so that I could see my sister-in-law. He knew who I should ask for. I should ask for Mrs. Hester’s daughter, Mrs. Bridgewater. She was there and he knew that she could get me in my sister-in-law’s room. That’s the kind of thing that you had to do. We just never knew much about the hospital. I know my brother did because he would pick up bodies. He would go and get bodies from there. If somebody died at the hospital, he would go and get them, but I don’t know that he knew anything else.

01-00:43:48
Rigelhaupt:
In terms of thinking about medical care, you said Dr. Ellison treated many members of Fredericksburg—

01-00:43:55
Young:
Yes, and we had another doctor, Dr. Payne. Dr. S. O’Brien Payne, I think. He was the other black doctor in town. I don’t know that he had any privileges at the hospital or not. I don’t know about that.

01-00:44:23
Rigelhaupt:
So if someone was sick and the physicians couldn’t treat them in their office, what did they suggest people do?

01-00:44:37
Young:
I guess people went to the hospital and the doctors might have said go. I don’t know that, but I just assume that that happened. If you went there, I know that there was that colored ward. If you had to stay, you were in that colored ward. [45:00] Later, there was this lady. I’m not sure if she was a nurse, but we called her a nurse anyway. She ruled that colored ward. That’s all I know. I assume that the doctors would say, “You need to go to the hospital.” You went to the hospital and got well and came home. I had been there to visit only. I had been there to visit and there were all black people in the ward—we had wards then. No whites in there.

01-00:45:51
Rigelhaupt:
When you say wards, open floor?

01-00:45:53
Young:
Yes. Not rooms like we have now. Whooo. We have single rooms. I was on the board when we were planning this hospital. I was co-chair of the advisory committee when we were trying to open up Stafford Hospital, trying to get Stafford Hospital. But that’s been many years, many, many years, later.

01-00:46:27
Rigelhaupt:
I’ll try and fill in a little time before coming up to Stafford. You had this initial impression of Mary Washington Hospital, with your sister-in-law having a baby there. Was it a pretty consistent impression about how the hospital interacted with Fredericksburg’s African American community in the subsequent decade? Was there a time you would mark a change?

01-00:47:09
Young:
There had to have been a change. I was not as involved with that change, but we had other people who were working there. I can’t tell you exactly what positions they had, but I know families of people who had one or two persons working at the hospital in the ensuing years. More than what I found when I came in ‘57 and ‘58. But I don’t know enough about it. [48:00] I know some people who retired from Mary Washington Hospital and who have lived a fairly decent life because they were able to work consistently. That’s the job they had. Just like I worked in education, they worked at the hospital. They did well, as far as I knew. I don’t know when the changes came. I suspect they were incremental, so to speak. That’s what I think. I have a feeling that the people at the top made the difference. I don’t know that. I know that we had an administrator whose name was Mr. Bach. I did not know him, but I taught his son. I was in a club of black women, thirteen black women. We called ourselves Twelve and One Club. One of the members of the club said, “They’re looking for people to furnish rooms.” So we did. We put together money. We didn’t have a lot, but we would have fundraisers and we furnished a room at the old hospital, at 2300 Fall Hill. We furnished a room. It was like $1,100 or something, and that was big money for us because we were Twelve and One Club. What we did, any money we raised in the community went back to the community. We gave scholarships for Walker-Grant students. At that time, we had some people working at the hospital. I don’t know when it all changed, but I just imagine the administrators allowed people—they got some jobs there. [51:00] In 1988, I didn’t know that Layton Fairchild was a member of the board because I knew nothing about the board. I just guess that all that happened incrementally. In different years, people applied and got jobs.

01-00:51:31
Rigelhaupt:
In the decade following your moving to Fredericksburg, ‘57 to ‘67, and certainly through ‘68, in this city, it was a time of profound change in terms of ending legal segregation, from lunch counters to schools—certainly famous cases. Was the question of the hospital ever part of the discussions? I know there were lunch counter sit-ins. I know the schools had to desegregate. But if there was a colored ward, then the hospital was segregated.

01-00:52:09
Young:
Oh, yes. The hospital was definitely segregated.

01-00:52:12
Rigelhaupt:
So was there discussion about that being on the civil rights agenda?

01-00:52:18
Young:
I don’t know that. I suspect that we had some people who would apply and get a job, but they weren’t up in the administration or anything. They had jobs, regular jobs. I think that you’d get more people going in, and that may not have been one of the things, because as we were desegregating, my thing would have been schools. People were saying, “Can your son go to James Monroe?” My son was getting ready to go to St. Emma’s. People were saying, “Can you type? Can you do this? Type this.” Or, “We’ll have a meeting.” The meeting would be at my house or somebody else’s house, and I’d be there. There were students who were sitting in at the lunch counters and so forth, but my son was getting ready to go to St. Emma’s, which was a Catholic military school. He wasn’t sitting in, and not getting ready to go to James Monroe or Lafayette or Maury School. [54:00] I don’t remember that the hospital was one of the things discussed because at that time we didn’t have any other black doctors here. I don’t know that we had any nurses here. I don’t know that because if they took nursing, they went somewhere else. They got employed somewhere else. That’s what really happened. If they were young and had that kind of training, they took jobs where they could get a job. I don’t know that we had any doctors at that time, not at that time, or nurses at that time. Now, later on, the hospital came as one of the things that we were trying to desegregate and work at. I was part of that.

01-00:55:14
Rigelhaupt:
Could you say more about that?

01-00:55:19
Young:
My thing was to go straight to the top, and anybody running that hospital heard from me. I would have people who could fill certain positions, and that’s what we did with Xavier Richardson. That’s exactly what we did. Let’s talk about Xavier. Xavier could do anything anybody could do. I believed he could do it better. That’s just the truth. I told somebody, Xavier came on my radar screen when he was about in the sixth grade and I was director of Title I program here. We got that program into Fredericksburg. The teachers at Walker-Grant, we wrote the program that got Public Law 89-10 [Elementary and Secondary Education Act of 1965] in here. We did the survey and we did the work to get that money here. One of Xavier’s teachers, his third-grade teacher, came to me—I was the director—and said, “Xavier Richardson needs to come to this program. He can’t qualify as educationally disadvantaged, but he certainly can as economically disadvantaged.” She had me believing he was almost a genius. He came. We got him in because he qualified; his parents, they qualified. I had him tested. [00:57:00] It was somebody from Mary Washington College who tested him. We were doing testing anyway because we were doing math and reading and bringing up the scores and all. I had him tested by himself and he did score high. Then when he got into high school, I was up in the high school. I was an assistant principal up there at James Monroe. I knew what was going on. I knew what the boy could do. We helped him get into Princeton. He got himself into Harvard. All that. But anyway, he wrote me a note and said that he was coming back to Fredericksburg. We did all those things to get somebody into administration. I talked to Bill Jacobs. Bill Jacobs thought about getting Xavier at Snowden at Fredericksburg. That wasn’t a thing for him. Fred Rankin came and I talked to Fred. He didn’t have a position. We had a man that we hired—I was on the board when they hired him—who was something, a manager at a bank. We hired him and he was paid big bucks. We know he came onboard and he was getting ready to retire. I called up Joe Wilson, chair of the board, and said, “Joe, you need to invite me and Carson Rhyne to lunch.” He did. He took us out to lunch. I said, “We need to hire Xavier Richardson.” He said, “Well, we don’t have a job. We don’t have any position for him.” That’s Joe Wilson. I said, “Well, you hired so-and-so and gave him big bucks, six figures. Anything he can do, Xavier Richardson can do better. I will give you his resume.” I got his resume. Of course, Fred Rankin had it. When the position came out, it was Xavier Richardson’s job description. I knew right then they were considering him. He had to go to Richmond and I knew that they were sending him to a psychologist to be tested or something. [01:00:00] Anyway, I know that that happened. They didn’t tell me. Xavier said they were sending him and he asked my mother to pray for him. I knew that they were putting him through the ringer. Then, finally, he got that job. We were pushing all the time to try to get people into positions. All I said to Xavier is, “You bring somebody else along. You bring other people along.” He has done that. That has been what I would do. Fred Rankin said, “Marguerite Young was in my office all the time.” He said that publicly, “Marguerite Young was in my office all the time.” I’m not there now all the time. I’m getting ready to write him a letter. This is not a complaint. Well, I have a complaint, but this is to let him know some people that did some good stuff for my son. Many people don’t know that I do that. They don’t know that. I’m sure there are other people who were doing things. My thing on that board was do what’s best for the patients in the community. Not just Fredericksburg, but in the communities that Mary Washington serves. Early on Joe Wilson got to be chair of the board, and he asked me, “Marguerite, stay back a minute.” Then he asked me to try to set up the Healthcare Assembly to be made up of lay people. Our job was to find out the needs, health needs of the people in the community. I told him, “Joe, I’ll do the work, but it’s not going anywhere unless you put a white male in there. It’s not going to go anywhere. But I can do the work. I know how to organize and get all that done.” He put Carson Rhyne, a minister, in with me. Carson stayed there a couple of years, maybe. [01:03:00] It worked. It worked. Now we have the Citizen Advisory Council. But we worked on that for a while.

01-01:03:21
Rigelhaupt:
Was the Healthcare Assembly the precursor to the Citizen’s Advisory Council?

01-01:03:25
Young:
I would say so, yes. One of the things that is happening now is called Community Benefit. One of the things that we did as the Healthcare Assembly was the board allowed us to get a survey done to determine the health care needs of the communities served by the hospital. They provided the money for us to get a survey done. Then, when we got that million dollars, when we got that money, I know that Carson Rhyne argued hard for it, that we need to put it back into the community. Carson, and the man whose place that I said Xavier took, and I, we kind of set up the Community Service Fund, the money that the hospital gives to organizations that are working in health care. We set up the criteria for that. Those two things help us to give back to the community. The Healthcare Assembly met at the hospital, but we also had a meeting in King George and we had a meeting in Caroline County, down in Bowling Green. We did that so that people would know what we were about. We got some good ideas. The dental program that we worked on came out as a part of that. The medication assistance program came out of the Healthcare Assembly. There were things that we were doing in those days. [01:06:00] Now, the Citizens Advisory Council, it could do the very same thing, I guess. It could ask that things be done, just like the Healthcare Assembly did. The Healthcare Assembly was directed by a board member, and when we started, I was that board member, and Carson Rhyne as well. It was Carson Rhyne and I. But that’s because I said to Joe, “You got to have a white male in here to make it work.” And I did the work.

01-01:06:43
Rigelhaupt:
Mr. Rhyne—did I hear you correctly that he was a pastor?

01-01:06:47
Young:
Mm-hmm.

01-01:06:48
Rigelhaupt:
What church was he affiliated with?

01-01:06:52
Young:
Carson Rhyne was the pastor of a Presbyterian church in Hartwood. It was up in Stafford, up in Stafford. I’m not sure what it was called, but it was a Presbyterian church. His last name is R-H-Y-N-E. Carson. R-H-Y-N-E. Then he left here. He stopped being a part of the Healthcare Assembly. Later he went to Richmond, I think in some advisory or administrative kind of something in the Presbyterian Church. I think he’s still there.

01-01:07:53
Rigelhaupt:
To try and get this right chronologically, was the advisory—let me make sure I get this right. The Healthcare Assembly, did that precede the founding of the Community Benefit Fund with what you were describing as that million dollars? Or did the Healthcare Assembly come immediately after that money that ended up becoming the seed for the Community Benefit Fund?

01-01:08:30
Young:
It’s called the Community Benefit Fund now, but it was called the Community Service Fund before. I believe that they were working on getting it. They were working on getting it, the million dollars. The Healthcare Assembly was not connected to the Community Service Fund and we didn’t have any money to do anything. We just did the work. [01:09:00] We were finding out what were the needs of the community, and we had people from Caroline, Westmoreland, King George, Stafford, Spotsylvania, and Fredericksburg. We went into those communities and found out what the people felt were the needs of the community, the health needs of the community. We didn’t have any money. When we went to King George, we probably drove our own cars. When we went to Caroline, to Bowling Green, we got the board to get the FRED bus to take us to Bowling Green. We met up above in one of the buildings owned by one of the board members—Billy Beale had a building with a community room, or a big meeting room, up above the bank or something like that. It was some building like that. We met in there. I believe the Healthcare Assembly might have been operating before the hospital received the million dollars. The Community Service Fund was something separate from the Assembly. The hospital was working on trying to get the money from Medicaid when I came to the board. It was decided that when the money comes in we will put it back into the community. Bill Jacobs was here at that time. When the Healthcare Assembly came into being, Fred Rankin was here. Fred was here.

01-01:11:10
Rigelhaupt:
It sounds like the Healthcare Assembly was—well, under-resourced—but charged with trying to find out the needs for populations that were underserved.

01-01:11:25
Young:
That’s true.

01-01:11:27
Rigelhaupt:
Wealthy people would find ways to let the hospital know what they wanted. But it sounds as though the hospital at this stage was very interested in learning about the needs of underserved communities. How did that happen?

01-01:11:51
Young:
I don’t know where it came from to start with, but Joe Wilson was the person that asked me to stay back. [01:12:00] I suspect that he and Fred Rankin had talked about it because Joe has an understanding—he and I went on the board at the same time, same year. When he talked about the bottom line for the hospital and he and I had that argument right there in the board meeting, Joe seemed to have understood what I was saying. He understood the feelings of people and what people didn’t have. I don’t know if it was Joe’s idea, or Fred Rankin’s idea, or what, or who it came from, but it came to me from Joe Wilson. The board supported what we did. When we came up with something that we could prove, the board supported it. We had a good board, good administrators, and good doctors. Really. Let me tell you this. My husband passed away—it’s almost twenty-three years ago. Anyway. We buried him on a Friday. On that Monday, I had to make a report to the community. It’s supposed to be a community membership meeting. I was making a report. Administrators would make reports and all the reports from departments would be given. I had one to make. My voice was trembling, but I said to them, “We have good administrators. We have good doctors. We have good associates.” At that time, I didn’t call them associates. I said “the staff.” I said, “We have outstanding people working here. We have good doctors.” I was saying to them what Mary Washington Hospital did, and I was a lay person on that board. As chair of the Quality Assurance Committee at the time, I went on to tell them what the hospital did to provide quality care. And yes, my voice was trembling because I had just buried my husband. But it’s true. We have good administrators, good people working there, and good doctors. [01:15:00] The nurses are the people who make you well, anyway. Good associates. It is good.

01-01:15:18
Rigelhaupt:
How did things change for the Healthcare Assembly once the Community Service Fund was established and provided new resources for the needs that you had identified?

01-01:15:31
Young:
I don’t know too much about that. When I left the board in 2000, I was no longer chair of the Healthcare Assembly. I was no longer there. I’m not sure how things went on. I’m not certain that the money in the Community Service Fund—what’s now the Community Benefit Fund—I’m not sure that that had a lot to do with it because the purpose of the Healthcare Assembly was one thing. The Healthcare Assembly was still operating when we got the Community Service Fund, and we were giving money to organizations in the community. The Healthcare Assembly could even get into some of those organizations and find out what their needs were. I don’t really know what happened. I don’t think that it was doing as well or the kinds of things that we were doing when we began, the six or seven years that I was there. Now, there is no Healthcare Assembly. I’m not sure that the people who come to the Citizens Advisory Council feel that they have that kind of a role to play simply because I’m not sure there is a board person that’s passionate about it, that organizes it. It’s a different kind of thing. [01:18:00] I’m not sure that the administrators, the board, or whatever, are getting the feedback that they used to get, that they got when we began the Healthcare Assembly. I’m thinking. Now, if we can get the people passionate about stuff, I think they’ll get it. You really have to have somebody who gets to know something about the hospital things, like I did. Then you go in there with these lay people from these different areas, you talk about what it is, and you bring in people to make sure that they know we need your input—you go out and find out. Go out and ask about this. See what they’re saying out there. We would do that, and we’ll see whether Mary Washington Hospital can do it. One of the things that they said from Westmoreland is that they needed primary care that could be open certain times and the hospital put somebody down there. They did. Mary Washington opened up a little place, I believe in Colonial Beach. So you see what I’m saying? I’m not sure that that’s happening right now. I’m not certain about that.

01-01:19:53
Rigelhaupt:
You mentioned the need for primary care. Were there other things that the Healthcare Assembly found out about—early, in the first couple of years? I know it’s hard to date exactly, but in the first couple of years, do you remember bringing back to the board and saying, “This is an important community need that we should try and do something about”?

01-01:20:18
Young:
Dentists. A dental program. That was the thing. It was for children as well as adults. They did come up with helping to do dental programs in the different communities. They did come up with some of that. In Fredericksburg, we got a trailer and a dentist. They put up some money to do that. [01:21:00] But one of the things that we did, once we found out that there were so many communities needing that dental program, is we went back to the board. Then I think they went to the health department. They brought in the health department for Planning District 16 and found out that the health department could do some of that. That, I think, helped us. I’m positive that we got that information out. We went with the health department and they brought in those trailers and dentists. Now, this year, they’re giving it up because of the money that has been cut. That’s going to happen.

01-01:22:05
Rigelhaupt:
Is this the dental program that’s now with the Lloyd Moss Clinic, or some of the ones in the outlying?

01-01:22:12
Young:
In the outlying. This was a dental program for school children. The health department would provide a trailer and a dentist for children and if the county or city would provide the transportation, those children would get all kinds of help. Now, I know the health department put dentist in a trailer or something or other in Stafford, Spotsylvania, and I think in Caroline. I don’t know about King George. But Caroline had a very good program because the county bused those children in from many different areas to that dental trailer in Bowling Green. This year, the health department will stop doing dentistry. They can’t do it anymore because the state money has been cut. Caroline County will still provide dental services for children. I happen to know this because I’m on the board of Central Virginia Health Services. The Central Virginia Health Services, the community health center program, is taking it over and the county is going to still go ahead and bus those children in for the dental program. I know that. [01:24:00] I know that the health departments all over the state are having to cut. If they had a dental program, they’re having to cut. I’m positive, for our area, that Mary Washington Hospital—I guess we can call it Healthcare—had something to do with helping to get it started. You asked me was there an issue from the very beginning, and that was one major theme. Later on, one of the young persons from Mary Washington worked with United Way to come up with a survey to determine what the needs are for our area, Planning District 16. I was on that committee because I remember Xavier said, “Ms. Young, you got to go help.” He wanted me to help the young man who was heading it up. He was from Mary Washington Hospital, Healthcare. Xavier said, “Ms. Young, you need to go and you need to be a part of it.” So I did. I helped with the United Way survey committee headed by a Mary Washington Healthcare employee. We did come up with some issues. I’m not sure what the second issue was, but we did find out what the needs were.

01-01:25:50
Rigelhaupt:
I want to go backward in time a little bit and ask a question about—questions related to schools. You mentioned some of the Caroline schools coming up in terms of dentistry, and so there’s some connection between schools and health care. But also, I’m curious, in the early years that you were an educator in the area, first two decades maybe, did Mary Washington Hospital have any connections to the schools? Sponsor field trips? Part of the reason I ask is Mr. Richardson mentioned, in seventh grade, taking a hospital tour, or having a field trip there. I’m wondering if you recall the ways in which the hospital might have had interactions and played a role with the schools.

01-01:26:44
Young:
I’m not certain about that. In the early days, when Xavier was coming along, teachers would set up field trips. [01:27:00] They would get the children to wherever it is, but teachers would do that. If it got approved by the school system, they could do it. Sometimes, if you had some kind of relationship you could get that done. I don’t know about the hospital and the schools as such, just like I don’t know about the banks. I was a business teacher, and I took my children to the banks all the time. I took different children. I can remember the president of the bank would take us to his office and show us all around, and where he kept his stash of stuff, of things. That’s the way it was. So I’m not certain that the hospitals had that kind of relationship where they would say, “You come and bring this.” Maybe a teacher would have a relationship and get that done and that may be how Xavier got that tour. Most likely, that’s what happened back in that day. I don’t know who organized it, but when I came to Fredericksburg some children from Walker-Grant School were tested at the hospital for tuberculosis.

01-01:28:33
Rigelhaupt:
Going back to your early time on the board, so starting in 1988, and probably right around then, in the first year or so, there had to have been discussion of the potential to build the new hospital. What do you remember about the first conversations or discussion about the new hospital?

01-01:28:58
Young:
I don’t remember. I don’t remember about the first discussions. I do remember that we discussed something a lot. We discussed different areas, different things, different reasons why we needed it, and how we were going to persuade the community that we needed it. We also had to persuade some of the doctors. Some of us would be going to community meetings, as well. But I don’t remember the first discussions, except that, yes, they did discuss why we needed it, what we needed, how much it was going to take, and all of those things. [01:30:00] All of it was just a part of the discussion. I don’t know what the major discussions were, but I can tell you that we did talk about it. I made practically all the meetings. I was seldom ever not there. I made right many committee meetings, too. I just can’t tell you what they discussed.

01-01:30:30
Rigelhaupt:
In your recollection, was some of the energy, or push for the new hospital, coming from board members, or was the administration recommending this as something that the board should take seriously and discuss and perhaps approve?

01-01:31:01
Young:
I’m not sure that it was the administration. The administration was with us, but I think the board was just as—they were very much into it. It was the board that really did the pushing. When we went out into the community, we were the ones. Now, we had to get information from the administrators and the staff. We had to know whether we were crowded. We also had to know about money. We also had to know whether we were able to provide certain kinds of medical services, why we needed certain things, and we had to have the doctors with us. We weren’t always having the doctors with us. That was not always the case. But you’re asking whether it was the administrators pushing. No, I think it was the board pushing. I think it was the board. That was the case: we would ask the administrators or the staff to get certain kinds of information to us, so that when we did go out into the community, we would have the information. I think a majority of the board was doing the push.

01-01:32:56
Rigelhaupt:
How would you characterize the working relationship, particularly around the new hospital and in this era, between the board and the administration? [01:33:00]

01-01:33:06
Young:
I think that was good. I think that the relationship between the administration and the board was good. I’m not so sure that it was all that good out there in the community. There were people in the community who didn’t agree that we should have a new hospital. And I’m not sure that all the doctors—well, I know all the doctors didn’t agree. But I don’t know that they had an association, or the Medical Society or anything, against it as such. I can’t remember that. But I do know that the administrators worked with the board. The administrators worked with the board. I don’t think the administrators pushed the board, but I know they worked with the board. I know that.

01-01:34:08
Rigelhaupt:
What do you remember about the apprehensions from some of the doctors and the community about the new hospital?

01-01:34:19
Young:
First place, can we afford it? That’s one thing. Do we need this? Do we need a bigger hospital? Do we need to provide all these different services? We were going to be getting equipment to do certain kinds of things. I’m trying to think about a piece of equipment to crush kidney stones, or some kind of stones. All this stuff is very expensive and we didn’t have it before. Now we were trying to get it. We would get our information from the administrators. Remember, now, on the board, there were going to be maybe four doctors. You got some of the information there. We had to have a lot of meetings. We had a number of meetings—I’m talking about in the community. Then, as things went along people started to come around, but there were some who didn’t come around. [phone rings] [01:36:00] My phone rings a lot.

01-01:36:04
Rigelhaupt:
It’s okay.

01-01:36:06
Young:
I’m sorry. Sorry about that. But anyway.

01-01:36:13
Rigelhaupt:
What do you remember about elected officials, particularly in the city of Fredericksburg, saying about trying to keep the new hospital in the city? Who do you remember being active in that?

01-01:36:34
Young:
I know we had elected officials wanting to keep the hospital here. I just can’t remember other people, other than the mayor. I don’t remember other people. At that time, I can’t tell you who was on city council, but I believe city council supported it being here. If we had to have any kind of exemptions—the word is not “exemptions”—but tax-exempting or waivers and all that kind of permits and stuff like that. I think that we didn’t have so much trouble because I believe city council members supported it, for it to be here in the city. There are those of us who know how to get at city council people and show them why something needed to be done. I guess that was done. I was starting to say, later on, Joe Wilson became a city councilman, but he was off the board at that time and he was still on the board when we made the move, when we were getting the move. I just think city council was with us. I know the mayor was a part of that. I don’t remember elected officials being against that. But, you know, I’m eighty-five.

01-01:38:52
Rigelhaupt:
You said you went to meetings, other board members went to meetings, community meetings, to talk about what this new hospital would be, why it was good for the community. [01:39:00] Do you remember going to any meetings with Mayor Davies?

01-01:39:09
Young:
You mean, was he there?

01-01:39:12
Rigelhaupt:
Certainly he’s represented himself as an advocate for having the hospital stay in the city. Do you remember sharing a panel or being at a meeting and both of you spoke about why this would be a good thing?

01-01:39:26
Young:
I believe so. I’m sure that we did. I wasn’t on a panel. He might have been, but I would be a part of the audience to speak. In many instances, people who were, say, a board member, would have information that an ordinary citizen, not on the board and not involved wouldn’t have. You might get up and say something so the people would get that information and make a better decision. I probably was at more than one meeting where Reverend Davies would speak for it. He was mayor for twenty years.

01-01:40:37
Rigelhaupt:
Trying to go back to 1988, 1989, what would have been your response to an apprehensive community member about why Mary Washington needed to build a new hospital and why it should be in Fredericksburg?

01-01:41:03
Young:
I’m not certain that, in ‘88, or maybe ‘89, that I would be speaking about it because I was getting to know what the hospital was all about. My thing at that time was getting more of us involved. Once I got into it, I could tell them why we needed a new hospital and the positions. [01:42:00] It depends on the audience. Let’s say I’m going to a Mayfield Civic Association meeting and I want them to start going to these community meetings. “We’re going to have a community meeting, and it’s going to be held at the library. We need you to be there. We need you to hear why we need this new building, but let me tell you why. There are going to be more positions available. We need for you to have people to apply for some of those positions.” Now, that’s not what I would say at the library meeting. You see what I’m saying? So it depends on the audience as to what you say and why. There are different reasons. Now, in 1988, I probably wouldn’t be saying anything until I learned a little bit more about that hospital business.

01-01:43:09
Rigelhaupt:
One of the things that the hospital represents now is a kind of anchor of a regional medical campus. Certainly part of the reason that there’s a new one was simply that 2300 Fall Hill was too small, out of date, out of space, couldn’t renovate it at a price that would have been comparable to building a new building. So there were some very practical reasons for building something new. Do you remember early conversations and trying to think about what it meant to go from a community hospital to a regional medical center?

01-01:43:57
Young:
When we were talking about building a hospital, we were still going to be a community hospital. We were going to be a community hospital. Now, there were a few things outside, but not what we have now. We have some for-profit things going with it. Talking about “we.” [laughter] But there are some for-profit agencies [that are subsidiaries of MWHC; at the time MWH MediCorp]. Then we have more things. That’s not even including Stafford Hospital, but we’ve got emergency centers. When we were moving and doing this, we were talking about more services for Mary Washington Hospital. It was not the regional medical center that it is now or that it came to be later on. It has evolved. It has evolved into that. [01:45:00] When we were talking about Mary Washington Hospital and moving, we were going to provide up-to-date equipment. When I say up-to-date, I’m talking about upgraded and different kinds of equipment and more services for the hospital. In order to do some of that—I believe we might have had the cancer center at that time—in order to do that, we’ve had to come up with some other agencies and so forth. It all has evolved, and that was not a part in those early days, I don’t believe. To get to a regional medical center, in my estimation, is a great thing. But that’s more recent, and we have become bigger since I’ve been off the board. We’re doing many more things since I’ve been off the board. However, I have been involved in some of the committee work and some of the committees there. Once you get involved with Mary Washington, they don’t turn you loose. You stay on it. Just like University of Mary Washington.

01-01:47:02
Rigelhaupt:
What do you remember about your first visit to the new hospital after it had opened?

01-01:47:12
Young:
I was thrilled to pieces. I was so pleased because each person had a room. The rooms were single rooms. I thought that was fantastic. We had a tour and we went to the heart operating department. I’m not sure, but this was maybe not the first day. Somewhere in there we were going through the heart operation business and I saw one of my former students from old Walker-Grant. [01:48:00] That means she was a black student. She was one of those nurses in there. Everything had come together for me. Here’s somebody here doing this kind of work, with the open-heart surgery people. That may not have been the first day, but as we went along we were getting to see more and more. For me, the first day, seeing the new building, seeing the people that they had employed, seeing that I had been a part of this, the feeling was a great one. It was just good. Just good.

01-01:49:13
Rigelhaupt:
I’m going to pause for one second.

01-01:49:14
Young:
Okay.
[End of Interview]

Interview 2 – July 21, 2014

02-00:00:00
Rigelhaupt:
It is July 21, 2014. I’m in Fredericksburg, Virginia, doing a second oral history interview with Marguerite Young. And I want to ask about some of the things we didn’t talk about in our first interview. And the first question I have is related to values and mission. It’s one of the things that I have heard emphasized in the interviews over the year-plus that I have been doing them now—Mary Washington University Health Care’s values and mission very much have been emphasized. And I’m wondering if you can think back to when you joined the board and if you can think of some of the earliest discussions—maybe not the first, but some of the earliest discussions—you heard and participated in related to the mission and the values of the organization.

02-00:00:59
Young:
I guess I can remember discussing the mission. We talked about how we ought to be stating the mission. And I believe we came up with something like, “Mary Washington Hospital exists to improve the health status of the people in the communities we serve.” Something like that. On some of our retreats, some of the conferences away, we might discuss whether it says what we wanted it to say. Most likely, I was still on the board when the one that we’re using today [was decided]. You know, we were wordsmithing part of the time. As far as the values go, I believe we talked about values and what values we had. But I believe that we see them written more now than we did in those early days. I was a part of the board in 1988. During that time, we were wordsmithing and coming up with words to say what we stood for and what values we expounded on. Okay.

02-00:02:47
Rigelhaupt:
So again, thinking about those early years—and I don’t have a really specific definition, but the first year or two, perhaps, you were on the board—were there things that you [03:00] talked about in meetings and you wanted to see prioritized that you saw as reflecting the values of the organization?

02-00:03:13
Young:
I guess. I guess we did. One of the conversations I can remember so much was about a bonus: whether the hospital could afford to give a bonus at Christmastime. That was early on. And we had a robust discussion about whether or not we could afford that. I remember saying, “You know, this is a people thing. And maybe the people with the highest salaries don’t need a bonus, but you have people making $3.75 an hour or some such thing as that, and they have to pay the same amount for a loaf of bread. We need to say to our associates that we care. You’re important. And so if you give them $20, that would be something important.” But we also think about the patients. We talked about the fact that the patient was the whole reason why we had that business. We ended up saying, and everybody agreed, this is a people business. It’s not the bottom line. It is a people business. We did have discussions about what this hospital meant, and at that time it was the hospital. Yes, we were expanding—in the years ensuing, we were expanding to other things. But it was the one hospital at that time. It was not two hospitals, not all of these extra “patient first” or whatever, and not the extra emergency room that we now have. We were talking about it. We were talking about it. Even expanding to take care of people in the communities we serve.

02-00:05:52
Rigelhaupt:
In your recollection—so I’m not asking you to quantify— did the board [06:00] spend a significant amount of time discussing both patients in the community who you were serving and the associates, the way you described it as a “people business.”

02-00:06:13
Young:
Yes, I think we did discuss it. I don’t know that it was a whole lot of time, but let’s talk about. It did matter about the patients, especially when we had to—you know that Medicaid wasn’t paying a whole lot. We got some money in, and the board discussed what we were going to do. During Clinton’s time, they were talking about the new health care. If it did not come in, we had someone on the board to recommend that that money be used to serve the community. We thought of the community service fund. We were discussing what we were going to do for patients and people in the community. I guess it’s maybe the beginning of community benefit. We were discussing a lot about patients as well as the associates. You’ve got to think of the associates: if you don’t have them, you don’t have that business. You might have the doctors, but the associates keep that going. You must have a staff. We did do some discussion about the care that we need to give, the quality of care. We talked about how we take care of our associates as well as our patients. And when the patients couldn’t pay—what? Those issues came up quite a bit, quite a bit.

02-00:08:29
Rigelhaupt:
Did the board come back to the mission and the values when it grappled with the issues you’re describing?

02-00:08:35
Young:
I think we did. When I say this is a people business, we may not have come back to the words that are being used today, but we talked about what Mary Washington stood for. That was really discussing the mission and the values. [09:00] I think that the board does do that, even when it talks money. Even when it talks money and programs, things like that, they talk about it in terms of whatever is done is done according to what that mission is and what values we observe.

02-00:09:35
Rigelhaupt:
So within the first five years of your service on the board, a new hospital opens. And what follows is an era of expansion. And I’m wondering, looking back on it, if you have any sense that maintaining the same kind of values and maintaining the same mission was more challenging as the organization expanded.

02-00:10:07
Young:
You know, I’m not sure that it was more challenging. And maybe it was more challenging. But the thing of it is, though, as we expanded—me, too [laughter], and here I’m talking “we”—but as we expanded, we were doing it based on our mission to serve the people and improve their health status. It was being done for the people in the communities we serve. So it might have been challenging. I know that when we were expanding and we were talking about that second hospital, where it was going, and why and what we were going to do—when it was finally decided that it was going to go into Stafford, we had people in the community in mind, doctors and other people. I don’t know about so many associates, but we had people who disagreed that we should have a second hospital, and that it was going to be too much money. Were we going to be able to sustain it? That was challenging. We were meeting in groups. It so happened that I was co-chair of an advisory committee, I guess, along with Tom Williams. In the groups I was in, we would have discussions as to why we needed another hospital, what the staff had come up with, or it had been decided it was going to go into Stafford. [12:00] I don’t know if it was more challenging, but yes, I guess it was. Because we were busy all the time, explaining and talking to people. I guess that’s it.

02-00:12:28
Rigelhaupt:
So the Stafford Hospital was already—not exactly where it is and how it took shape, but the need for a second hospital—was it already under discussion before 2000, while you were on the board?

02-00:12:44
Young:
Oh, yes. While I was still on the board there was that discussion. Then there were other expansions. We had some other facilities, and I can’t name them—it’s been awhile. I can’t name them. We had those—some were for profit, but most not-for-profit. But the discussion about the hospital was underway. There was some discussion about that.

02-00:13
Rigelhaupt:
And correct me if I’m wrong. It sounds like, the way you just framed it, there was more controversy—and that may not be the right word, but more debate, maybe—about Stafford Hospital than there was about building a newer, larger Mary Washington Hospital.

02-00:13:45
Young:
I think so. I don’t remember having as much discussion. Then maybe they were not town hall meetings, but we had some meetings in different places. I was part of that, where people came and expressed their concerns as well as their agreements with what we were planning to do. They came to hear. I think there was more controversy over the new hospital than expanding Mary Washington. I don’t remember having as much discussion. Now, I might be wrong about that, because I’m eight-six and I’m not certain that I’ve got that exactly right. But I do remember all the discussion and debate about Stafford.

02-00:14:58
Rigelhaupt:
And do you remember any [15:00] reasons why people were saying Stafford might have been—the idea of it might have caused more controversy than simply building a newer, bigger Mary Washington Hospital and moving for all intents and purposes across the street?

02-00:15:20
Young:
I just think that they thought it was going to be too much money. Was it going to take away from Mary Washington that we had then? Did we have enough patients to take care of both hospitals? At that time, HCA had not decided to build one in Spotsylvania because I can remember the first talk was where should it be. This hospital that Mary Washington was going to build, where was it going to be? That was some of that discussion, you see. HCA had not come up with theirs when we were talking about where to place a new hospital. That was on the projected increase in the population. Yes, we knew that there was Potomac Hospital in Woodbridge. We knew that. We knew where the rest of the hospitals were and who they were serving. The decision was made and then we had to sell it. I don’t remember having to sell so much about expanding Mary Washington to 433—and I can’t remember, 300-and-something before at the old hospital. I can’t remember the number. People knew that Mary Washington was just overloaded practically all the time. The old Mary Washington.

02-00:17:18
Rigelhaupt:
Can you remember if the board came back to the mission and the values as you were having discussions about it? And your term, “you had to sell it”—

02-00:17:36
Young:
Yes, that’s my term.

02-00:17:38
Rigelhaupt:
Did you find yourself coming back to the mission and the values as part of the discussion as far as selling it and explaining why this expansion was good for the community and needed as you had those discussions?

02-00:17:55
Young:
In the back of the minds of the people who did the talking, the mission and values are always there. [18:00] The mission of Mary Washington—now health care—the mission of Mary Washington was always in the back of our minds, as well as our values. You know, what we stood for. I still can’t get it out of my head, “we.” We stood for something. As we were selling it, if we didn’t use the very words you might see written all around now, it was in the back of our heads and we used the words that explained why we needed the new hospital and what it would do for the people we serve. I just think that it’s always there, always, even today. I know, in the back of my mind, Mary Washington Healthcare has a mission. That stays with me. It has values that they always show somehow. You know, I think. Maybe, I’m prejudiced. [laughter] I’m prejudiced. I believe after I got to know something about the hospital. I got involved and I got asked to serve on the board—I didn’t know anything about Mary Washington’s board. I didn’t even know they had a board. I got asked to serve. I knew about school boards, and I knew what their jobs were—what their mission, what their values were, what they did, and what was the line of authority and all that. But I didn’t know about the hospital. When I got on the board I found out just what it stood for and why we have it, and the ethics that we have. All those things come into play. Those things used to come to the board. So, you know, I’m prejudiced. [laughter]

02-00:20:54
Rigelhaupt:
So one of the things, if I’m not mistaken, is that you’ve stayed involved with the committees [21:00] and the organizations since you officially left the board. And I’m wondering now if you can think about the era since Stafford Hospital opened. You know, it’s five, six years now that it’s been open. Since 2008?

02-00:21:16
Young:
Five? Something like that. I think it served its fifth year just this past year, I think.

02-00:21:26
Rigelhaupt:
Mary Washington Healthcare has been largely in the same form over the last five years. It hasn’t had a lot of expansion. It’s larger now, but there hasn’t been a lot of change. Trauma program, new hospital, some important milestones. Do you still see the same values in the mission reflected in the organization?

02-00:21:52
Young:
Yes, I do. I do. It’s probably because they didn’t turn me loose and I didn’t turn them loose. Even though it’s a big thing, I think some forty facilities, maybe—lots of them. And I don’t know where all of them are. I just believe that we’ve had excellent administrators. We’ve had excellent doctors. We’ve had outstanding nurses. We’ve had other associates that cared about Mary Washington Healthcare. It employs a lot of people. You may have a few people that don’t feel like I feel, but most of them do. At least, I see it. I see that the values and the mission haven’t changed in Mary Washington Healthcare with all of its facilities. That’s because the administrative staff has been outstanding. And I guess if they had some that were not outstanding, they got rid of them. [laughter] You know, I don’t know. You’re going to have some problems. But I think the main thing is that it has stood the test of time, and it’s because of the people. The people who make it work. And they make it work for the patients and for the people we serve. [24:00] Now, now we’re doing things to prevent their coming to the emergency room and all of that. Even before I left, I was telling you about the Community Service Fund and the money we put into the community with groups that work with health care and so forth. Some of that was to prevent their coming to the emergency room and all of that. I still see the values there. I’m prejudiced.

02-00:24:43
Rigelhaupt:
So let me follow up on one of the things that you said about excellent administrators. And that’s certainly one of the roles that a board has, is to hire and—I don’t think “super-biased” is quite the right word—certainly work closely with and in a kind of advisory role with senior administration. When you say “excellent administrators,” who stands out in your mind and what are some of the qualities that you see making them excellent administrators?

02-00:25:20
Young:
When I came aboard, Bill Jacobs was the administrator. He was the president and CEO. And I believe that he had the interest of the organization at heart. I don’t know. I can’t remember the relationship between the doctors and the administrators at that particular time, but he had strong people supporting him. He had very strong people supporting him. When Fred Rankin came in and when Fred Rankin got that job, he has been top-notch. Top-notch. He has brought in people that knew what they were doing, and if they didn’t, they didn’t stay. That’s a fact. The thing that you’re asking, what qualities? Well, I think they were knowledgeable, to start with. But one of the things that both of them showed to me was that they were interested in what the board expected of them. To the fact that Fred Rankin came here, to this house, to say, “What do you see we need to do? What do we need to do to improve? Because you can always improve.” [27:00] I thought that was very important. Both of them knew how to delegate. All the qualities that a good administrator has, I think they had it. They brought in people to support them. They were not yes-people, but they heard what the board had to say. At that point we were “board of directors.” They call themselves the “board of trustees” now. To start with, I believe the top administrators of our hospital have been outstanding. I think that’s why we have stood the test of time. I don’t think of Mary Washington as “they” or “them.” I think of them as “we.” You hear me say “we,” and I really ought not to be saying “we.” It’s just how I feel. They never turn you loose. That’s what it is. [laughter]

02-00:28:28
Rigelhaupt:
So I want to follow up on one of the things you just said about Fred Rankin coming here and talking with you. And it segues, I think, well into a question I was going to ask about the role of board members. One of the things I’ve learned in the interviews is that the role of the board is it has a fiduciary duty. You have to watch the finances of the organization. But I’ve also gotten the sense—and this is my hunch and this is my word, so I’m testing here and I’m seeing how you respond—but a board member is also supposed to be a conduit to the community and to be a kind of set of eyes and ears. Here’s how the community views the organization and the community needs. And I’m wondering if there are things that you could think back on that you saw or emphasized that you had heard about and wanted to bring back to the board’s attention, to the administrators’ attention—perhaps, as you described Fred Rankin being here, some of what you talked about.

02-00:29:40
Young:
The board is made up of community people, lay people. And yes, I saw it as my being the liaison to the community that I walk among. You know, I walk among a certain group of people. [30:00] So yes, indeed, I can tell you some of the things that I talked with Bill Jacobs as well as Fred Rankin. That is, to start with, we had no minorities in our administration at all. None. I told Bill Jacobs, “You don’t have anybody, any minority—no black person, no African American on this fourth floor. You don’t have it. I can name you somebody black that can do anything in this organization that needs to be done, including your job.” I said to him, “You talk to me about a young man whose name is John Green. He has pretty much the same job in the D.C. area that you have here in Fredericksburg. You met him. He has it up in D.C. Guess where he’s from, and guess where he came to school? His home is Fredericksburg. His schooling was here. He went to black Virginia State in Petersburg. I can name you people. I can name folks who do that.” Then Fred Rankin came and we talked about it. I’m sure you know the name Xavier Richardson. Xavier was applying, and I said to Bill Jacobs, “The community has a concern about the fact that we have nobody in administration, okay? The NAACP for Spotsylvania County and Fredericksburg are meeting, and one of the topics will be Mary Washington Hospital.” Six weeks later, Bill Jacobs was gone. He left. He got a better job, I guess. He left and we got in Fred Rankin. Fred wanted to know how we felt. I was able to talk to him about the fact that, you know, we need not just to have somebody in administration, but we need diversity. Diversity is good for business. Diversity all the way up and down the line. And I think he heard me. [33:00] And of course, I was able to get the chairman of the board. I called him up and said, “You need to take me and Carson Rhyne to lunch.” He did. I said to him, “We need to do something about diversity, and Xavier Richardson has applied.” He said, “But we don’t have any position.” I said there was a man that we had brought on board and paid him six figures. We had brought him on board and he was in the administration, but he was going to be resigning, retiring, or leaving. I said to the chairman and all the rest of the folks, “Anything he [the person retiring] can do, Xavier Richardson can do better.” Xavier got the job. Not because of the president, but Xavier earned that job. I mean they put him through the ropes. But that’s the kind of thing that the community could talk about. And I could bring it to the administration. It was not just about the fact that we didn’t have minorities in certain places—not just that. It was about programs and about health issues. They heard us and they would get people involved, and people more knowledgeable about stuff than I was and than the board members were. The board members really hear what’s out there, you know? There were very few who walked among the people that I walk among. I walked among a lot of poor people, people who had no insurance, who had nothing, and whose primary care doctor was the emergency room. Things like that. Board members listened to ideas: even if I didn’t have an idea of the program, I could tell them what I saw in the community. They came up with things. The administration has been—and I guess maybe they have to—but they hear what the board has to say. They try to figure it out or they investigate or they do whatever they need to do. If it’s not a feasible idea they can come back to the board and say it. And that’s what they did. You see, at my time, I was the only African American on the board at that time. [36:00] And I had a big mouth. I didn’t know how to keep my opinions to myself. I would somehow get to be put on lots of committees, practically any committee. I hadn’t been on the board very long when I became chair of the quality assurance committee. [laughter] Quality assurance. That meant questioning what—and I believe it got to be Medical Affairs Committee—questioning what was happening medically. But the point was, I was a board member with concerns and they heard me. That’s the key. And that happens for practically all of the board members. The board now has a few more African Americans. In fact, the vice chair is African American and she is going to be chair next. She is heading up the recruiting for Fred Rankin’s position. But you asked me a question and I went off and didn’t answer it, I’m sure.

02-00:37:38
Rigelhaupt:
No, but let me follow up on it, as well. Because what you said is that the questions of an administration and who was employed in terms of racial diversity needed to change from the early years of the board service. And it seems like the administration was receptive to that.

02-00:38:00
Young:
Oh, yes.

02-00:38:05
Rigelhaupt:
Well, let me ask another question, then. One of the things that I think is fascinating. I am talking with Dr. Bigoney. She was really the first woman to regularly practice at the hospital and is now the chief medical officer.

02-00:38:22
Young:
Yes.

02-00:38:27
Rigelhaupt:
But more than her personal accomplishments, there’s been a profound change, say, in the number of MDs that are women now. I mean, the last statistics I saw from 2011—it was roughly fifty-fifty in terms of the number of MDs [graduating].

02-00:38:41
Young:
Really? Oh, okay.

02-00:38:45
Rigelhaupt:
So things have changed a lot since she started practicing medicine. Were there questions about women in leadership roles, either on the medical staff or the administration?

02-00:38:58
Young:
You know, I don’t remember hearing anything about women. [39:00] In fact, you didn’t hear anything like that, like the business about African Americans, as far as the board was concerned. I went straight to the administrators who could make a difference. I might talk to two or three of the board members and see how they felt about it. If they were influential members, I knew I had it made, which is probably what happened. I don’t remember hearing discussions in the board meetings about women or minorities at one point. Because you probably know that at one point—and even in my time, we didn’t have many women and we didn’t have many African American in the medical part with privileges at the hospital. That just hadn’t happened. I think that might have changed with these administrators that I was talking to, or maybe with Fred Rankin, I’m not sure. I’m also not sure about the relationship between the administrators and the physicians. That can be something as well. But I don’t think there was a lot of discussion about it. I didn’t know that we had approximately fifty percent, but I knew that I could see in the paper that we have a lot more doctors having privileges and with practices in the area.

02-00:41:08
Rigelhaupt:
And my close to fifty percent was about the number of —

02-00:41:14
Young:
Women.

02-00:41:15
Rigelhaupt:
— graduating with MDs.

02-00:41:16
Young:
Okay.

02-00:41:16
Rigelhaupt:
So I don’t know the numbers on the staff. It’s just that in her lifetime, and as of now, roughly half the people graduating from medical school are women.

02-00:41:33
Young:
Are women.

02-00:41:33
Rigelhaupt:
From the time you started on the board, that’s a profound change.

02-00:41:36
Young:
Oh, yes.

02-00:41:44
Rigelhaupt:
So let me try to tie that back into what you said early on about the organization being in the people business. Did the board have discussions in terms of policies, be it related to pay, bonuses, benefits that could be offered to associates that [42:00] had an eye toward bringing in racial minorities and women and making the people business in terms of the organization more receptive to people who otherwise had not been working there?

02-00:42:20
Young:
In my time, there didn’t appear to be any board discussion about that. Now, we did discuss bonuses. They would talk about increases in pay, benefits—those things came in. We would hear about those. They would talk about it and there would be some discussion, but there didn’t seem to be discussion about whether we had women or whether we had minorities. Now we’ve got all kinds of minorities. There was not that kind of discussion. However, the people—perhaps the ones who were interested in that went to the people who make the difference. The board doesn’t hire. The board doesn’t hire the associates. The board doesn’t hire the associates, but there are administrators. They’ve got a human resources department. The top person, I might say in the board meeting, or in important committee meetings—the philosophy of the administration permeates the whole organization. If the philosophy is not right, does not promote diversity—and I probably have said that more than once in a board meeting: if it does not promote diversity—we won’t get it. It’s just like if you do not promote giving bonuses throughout the organization, people don’t get it. I just feel that we didn’t have enough discussion about it. It might just come up, but the administrators knew there were enough board members who agreed with having diversity in the organization. [45:00] Now, I can remember that there have been arguments. There’s something we were doing and there were not enough minorities taking advantage of it. One of the board members said, “Well, they probably don’t even know who”—some senator or somebody who represented them. And I said, “Joe, they do not need to know that, but they can tell you such-and-such, and that’s what this organization is about. They don’t need to know that, who represents them. They need to know who’s going to take care of them if they have a health problem. That’s what I’m saying. That’s what this organization is about.” We did have some discussions and some arguments. Somebody I like a whole lot—we argued all the time. I think he came my way. [laughter] But we didn’t do enough about diversity. However, I believe the organization has gone the other way. We’ve got more women and we have more minorities. They’re not all African Americans, because they come from other countries and so forth, but they’re minorities. We’ve got all of them working at the different places. Not just at Mary Washington Hospital, but in the facilities that we have. Of course, we got a woman who was the administrator of the hospital at one time.

02-00:47:11
Rigelhaupt:
So again, going back to where I asked about the board serving as a kind of conduit, kind of eyes and ears, are there instances you can think back on when the communities, as you’ve said, you walk among, began to recognize that Mary Washington Healthcare—your organization, maybe not just the hospital—was reaching out to other communities, that the hiring and the staff was noticeably changing and you were hearing that, that people saw that. Is that something that happened, that the communities sought?

02-00:47:54
Young:
Yes. [48:00] The people around here, whites and blacks, young and old, rich and poor, recognized that something was changing the minute they hired Xavier Richardson. They did. And just before Xavier came, we had the Community Service Fund. It was serving people out in the community. There were organizations that the people who I say I walk among, they knew that they were a part of it. For instance, Shiloh Old Site Wellness Center, Bragg Hill Family Life Center, and Hazel Hill Healthcare Project. Those are three groups that got money that I know of that the Community Service Fund helped. It gave them money, and they served the people who had not been getting service. They didn’t know anything about access to different groups where they could get help. They didn’t know that. Now they do. But I could see that, and that was happening just before Xavier got his job. But when Xavier got his job, you know, Xavier has been among them. He’s been part of them. They knew that: okay, Xavier’s in there. And Xavier, he has a big mouth too. We found out that he walks among everybody. All the folks. Different groups. People used to come to me to ask questions or whatever and now they can go to Xavier. I just happen to have been a school administrator and people knew me. They would ask me to do different kinds of things. Well, now Xavier is back, and they can ask him to do some stuff. He is walking among the people with money, who can make it happen. So I saw the change, and I don’t hear as much of a problem as we had before. [51:00] The one thing that we were concerned about back in the day, and Reverend Davies’ wife had to get into it, was that most of the people here didn’t know what to do with sickle-cell anemia. A number of African Americans had it, and folks didn’t know that these people went through crises that were so very painful. Then they had to find ways to help these folks. We got that brought to them and to the medical community with getting people to sit on the boards, sit on the committees, and getting the word to the physicians. Maybe one physician will sponsor something to get people to know and so the emergency room doctors get to know. That’s what I’ve seen happen through the years. The community became aware of what was happening because Mary Washington—well, I always say the hospital, but Mary Washington Healthcare brought some of that to the fore. I mean, it has been done by Mary Washington Healthcare.

02-00:52:35
Rigelhaupt:
You said there’s a transition in terms of talking about something like sickle-cell anemia. I mean, part of what happened after 1993 is an expansion of surgical sub-specialties—open-heart surgery, cardiac surgery—that, in terms of medical specialties, the hospital could provide a different level of care. And thinking about after it opened, post-1993, what are some of the primary care, like sickle-cell anemia—primary care is not the right word, but perhaps a chronic condition—versus a highly technical surgical sub-specialty that you saw also expanding? Or can you think of other programs, as you were on the medical affairs committee working with physicians, that you saw the organization trying to emphasize?

02-00:53:41
Young:
I don’t know if they are medical. We had things about asthma, tobacco usage, and obesity. [54:00] Now, that’s continuing because even children—they started back there a long time ago. At one time, they had a committee that I was on, and it had to do with cardiac stuff. Heart things. They were emphasizing, out in the community, heart and stroke, heart and stroke things. Let’s say the Community Service Fund that we had—the wellness center I was talking about that involved some churches and some organizations—and we brought people from the hospital to a completely filled church in Mayfield. You know where Mayfield is? Okay. It was a completely filled church to talk about heart and stroke and what you need to do and those things. And so that was one of those things. I said asthma. Obesity, smoking—maybe that has to do with asthma, I don’t know. I’m trying to think. They have done lots of things, and some of them are doctors, some of them are nurses, and some of them are maybe technicians or something, but they would go out into the community if invited to spread the word and put out educational material. They’ve been very helpful. On health care Mary Washington has been very helpful, including employing people, you know? The employment is huge. It’s been something that’s been good for us. But I can’t name you so many programs. And I remember when we got that doctor for open-heart surgery. I was still on the board. We were getting him. And I’m trying to think. Hospitalists. When hospitalists came, the first one—I was still on the board when we got that. I remember their discussing the word “hospitalists,” and I wanted to know, “What are you talking about? What do you mean, ‘hospitalists’?” And they explained it. And I told a doctor today, in my brother’s room—he’s in the hospital—that I was on the board when the first hospitalists were employed. I mean, when we got the first hospitalists. [57:00] But I can’t remember some of the other programs. I probably could, but not just off the cuff.

02-00:57:15
Rigelhaupt:
Well, you mentioned cardiac surgery, and bringing in the first cardiac surgeon.

02-00:57:20
Young:
I can’t call him his name, either.

02-00:57:21
Rigelhaupt:
Dr. Armitage?

02-00:57:26
Young:
Armitage. Mm-hmm.

02-00:57:30
Rigelhaupt:
What do you remember about the initial discussions and the board’s involvement at the startup of the cardiac program?

02-00:57:39
Young:
We were talking about it. I don’t know who thought it up, but the fact that we were getting it, and we needed the equipment and all of that. I just remember that there was some discussion. And then we were given a tour. We were given a tour and the thing that impressed me was that Dr. Armitage had all of these credentials and he was working with the staff and so forth. They gave the board a tour. When we went in there and we were seeing some of the equipment and staff. There’s a young lady, a nurse—I didn’t know she was a nurse, but she lived in Mayfield. I knew her parents and I knew her brothers and sisters. And here she was in this highly technical kind of thing and she was one of the nurses. I don’t know whether you’d call them a technician or what, but she was in there. And I thought, “Look at Mary Washington, where we’ve come.” Here was this young lady and she was a part of that staff. I don’t know about others that were in there, but I knew her. I knew her by name. It meant something to me. Even with all the credentials that Dr. Armitage had, I said, “This man dared to put an African American in here with this highly technical work.” I figured she must have earned it because he was doing the training for what they were going to have to do and here she was. I don’t know how much discussion we had about it, but we knew that we were bringing in this person, Dr. Armitage, who could make that program work, and work very well. [01:00:00]

02-01:00:01
Rigelhaupt:
What was her name?

02-01:00:05
Young:
Her last name was Davidson. And right this minute I can’t recall her first name—she had a nickname, and I can’t recall her first name to save my neck. She was a good-looking young woman. Her last name was Davidson. She left here and went to Texas, I think. She got married, and I think she’s in Texas. I think she was out there in a hospital or some program in Texas, and she was able to get a job out there. But her last name was Davidson. I just can’t call her first name. I can name one of her brothers. [laughter] Two of her brothers.

02-01:01:08
Rigelhaupt:
That’s okay. So in addition to the cardiac program, were there are a lot of markers of growth and expansion?

02-01:01:28
Young:
Neurosurgery? Mm-hmm.

02-01:01:23
Rigelhaupt:
What do you remember about the start of neurosurgery?

02-01:01:24
Young:
I just can’t remember a lot. I can’t remember a whole lot, but I remember when we got it and every time we would bring in people whose credentials were—but I can’t remember very much about neurosurgery. I’m just trying to think of other programs.

02-01:01:53
Rigelhaupt:
Well, perhaps—and correct me if I’m wrong in framing this incorrectly—but perhaps some of the individual markers and milestones for the expansion don’t stand out individually because they all made sense. You expanded the emergency room because it was overcrowded.

02-01:02:18
Young:
Yes.

02-01:02:19
Rigelhaupt:
But along those lines, do you remember any of the discussions around the emergency room or building the parking deck or the ambulatory surgery center, moving it to the hospital campus—that the board was very active in or advocated for?

02-01:02:35
Young:
I don’t know where the idea came from for some of those things, but everything you just named got discussed at the board level. [01:03:00] The first thing you named [emergency department], I know there was a lot of discussion about it. And yes, we did talk about the parking deck, whether we should have it, and the fact that we were going to need all of that. The thing about it is we talk about it a lot before it gets done. [laughter] It gets discussed and investigated and all those things. Information gets brought back. If the first information is not satisfactory to the board, the board says, “Go back and do so-and-so.” Just like insurance rates. We discussed lots of things.

02-01:03:56
Rigelhaupt:
Do any stand out in your mind as controversial, or was there a kind of synergy between the board and the administration?

02-01:04:10
Young:
I don’t think I knew of much controversy. If the administration thought one way, there would be enough people on the board who might think the same way so that you didn’t have a whole lot of controversy. But you might have a lot of debate, you know? Whatever came up—for instance, I told you about the bonus. That got to be some discussion. I mean, that came up. And you know, I could be an advocate: “Wait a minute. You’re not taking care of your associates.” Or insurance rates. I remember Hunter Greenlaw, who was a businessman. Hunter Greenlaw said, “Uh-uh, that’s not acceptable. You go back in there.” He would send the person in charge—not the top administrator, not the president. He would send the person who would be working with the insurance company to go back into that office and say, “We will not accept those rates.” He knew something that I didn’t know. I didn’t know you could argue with the insurance company about the rates, but he did. He forced them, and so we’d sit right there and wait. The person would come back and say, “They say no, we don’t pay 65 cents.” Hunter Greenlaw said, “No, you go back.” We would have all kinds of discussions about what’s good for the hospital and what we can accept and what we cannot. [01:06:00] Most of the time when the administration brought something to us there could be robust discussion, but we wouldn’t say there was controversy. Not as much controversy as discussion and debate. If the majority of the board did not agree, it didn’t get to be. That was just the way it was. The board at that time was very involved. The administration brought things to the board and we were very involved.

02-01:06:54
Rigelhaupt:
Well, let me dovetail on that question. Because one of the things I’ve learned in researching on this project is that not-for-profit hospitals are run by three groups: the board, the administration, and the medical staff—the physicians. And I’m wondering if you could think back to your early years on the board. What do you remember about how those three groups worked together when you first joined the board?

02-01:07:28
Young:
I didn’t know a whole lot about how the medical staff operated with the administration when I first got on the board. But I knew pretty soon that the administration and the medical staff were not necessarily in lockstep. Not necessarily. They didn’t always agree on some things. The board had some doctors on it, but out of sixteen members, you could have only one-fourth. That would be no more than four. We would have the president of the medical staff and maybe another medical doctor or two on the board and that would be it. So they knew how the majority of the board felt about certain issues. Some of us had very little contact with the medical staff, but some of them had a lot of contact with the medical staff. Some of them might have had a chance to get administration and medical staff kind of closer, you know, on some issues. [01:09:00] But I know that they were not in lockstep. I don’t know how it is today. I sit on two committees, but that’s not one of them. I used to be on governance and I’ve done several when we were expanding the emergency room. I’ve done lots of committees.

02-01:09:40
Rigelhaupt:
Well, rather than trying to assess where the medical staff and the administration is currently, did you see any change in the years that you were on the board? Did the medical staff and the administration develop new synergies? Did they work together better? Was there more trust?

02-01:10:12
Young:
I believe that there got to be more trust. But then I thought, “Mm-hmm, it’s changing back again.” Part of my time on that board, in those twelve years and some, I believe there was a little bit more trust between the board, the administration, and the medical staff. I just believe that. And I don’t know that I have any real evidence to prove it. It could be that, you know, my eyes are pie-in-the-sky or whatever. It could be that. But I believe that that changed. Then I thought, “There’s something not going exactly right with Fred Rankin and the medical staff”—Fred Rankin’s administration and the medical staff before I left, but I don’t know that for sure. I really don’t. I don’t have any real evidence. I knew that at one point in my service, during my service, the medical staff and the administration were not together.

02-01:11:45
Rigelhaupt:
Looking back on it, can you think of things that improved the working relationship between the medical staff and the administration?

02-01:11:54
Young:
I have a feeling that the medical affairs committee helped. [01:12:00] When the physicians, especially the surgeons, wanted certain pieces of equipment and the administration would follow through, I think that changed some of the thinking. I’m thinking pieces of equipment, something like that is what changed it, I thought. Mary Washington did spend a lot. It came from the physicians. It came from the physicians. What they would like and Mary Washington did provide it. They did what the physicians needed, or said they needed, anyway. I believe that that helped. That helped, I think. I’m not sure, but I think so.

02-01:13:23
Rigelhaupt:
One of the things that I’ve learned about the board that has been fascinating to hear about is that people have so many different kinds of expertise. And they bring that to the board and in board meetings. And I’m wondering if you could think back on an instance sometime in that dozen years you were on the board where it was really beneficial around solving a problem. As you described, Hunter Greenlaw had a business background, you have an educational background, there are physicians. Was there a problem that came up that the board brought the different kinds of expertise together, where the problem solving that was needed benefited from that?

02-01:14:12
Young:
Yes, I think so. We had a minister on the board whose name was Carson Rhyne. When we got some money back from Medicaid—I think it was because of Medicaid or Medicare. I can’t tell you the whole story. He thought, “We need to take that money and give back to the community.” That’s the idea of the Community Service Fund. He was working with people, and he and I were working with groups of people out in the community. His was in the churches, the Presbyterian Church. [01:15:00] He got to be something at the district level. He knew something like that. But I worked with people in the community, and we had integrated. We had integrated the schools. I got to know lots and lots of people, all kinds. We had that— [phone rings, break in audio]

02-01:15:33
Rigelhaupt:
So you were saying you got to know lots of people in the community.

02-01:15:38
Young:
Yes. We got to know different people. We had a lawyer or two. We had a banker. We had somebody from the college, an official from the college. As I said, we had a lawyer—a couple of lawyers, two or three. And businesspeople. The thing of it is, you could see and you could hear that everybody made some contribution. I might not be able to contribute on this business about insurance rates, but I could tell you about how people feel about things. That didn’t include only poor black people, either. That included people from all walks of life because I was out there dealing with them in different organizations as well as in the school system. I had built a reputation. I’m saying that all those people—you could see the advantage of having people with different expertise on that board, especially in my time. I don’t know what it’s like now, but I can tell you what it was like during my time and it was so very important, I thought.

02-01:17:32
Rigelhaupt:
So tell me a little bit about the origin of the Community Service Fund. After it starts with that kind of seed money you describe, how did the board continue to advocate for its existence, its growth, and it becoming a core part of the organization?

02-01:17:57
Young:
It got put into the foundation. [01:18:00] That money got put into the foundation. It was decided that Community Service Fund would be used out in the community. I was a part of it and so was Carson Rhyne when we got it started. Community organizations had to apply. We set up criteria. The interest on that money could be used and that’s how it can continue—the interest on that million dollars, 900-and-some thousand, I guess close to a million. You could use that each year for people who apply, and the applications had to show that the programs helped to carry out the mission of Mary Washington, see? That’s still the case today. If Mary Washington Healthcare is working on specific programs—let’s say they’re working on diabetes and obesity, or they’re working on senior safety or something, and this is to help keep people out of the emergency room, maybe. If you apply and that’s what you’re working on, you might get some funding. They have been able to keep it going because at one point they were using the interest off of that money that we got way back. I’m not sure whether they’re adding to it or how they’re doing it right now. It has now become what they call the Community Benefit Fund.

02-01:20:00
Rigelhaupt:
One other organization that’s connected to this, if not directly then at least peripherally, is the Moss Free Clinic. What do you remember about your first interactions with and learning about the Moss Free Clinic and its origins?

02-01:20:22
Young:
I was on the board and there was a meeting at the health department. Somebody had the idea that we needed to have a free clinic for the people who did not have access and resources, especially no insurance. That is how it began. [01:21:00] Now, I can’t tell you how the Moss part came in right now because I’m forgetting, but I remember being a part of it, being a part of that committee that met at the health department. I’m not sure whether the idea came from the Fredericksburg health department or whether it came from Mary Washington, but they began to work together. Then part of that money for getting it done and working with it came out of the foundation, the Mary Washington Hospital Foundation. They still do give money to it. I did not continue to serve on the committee, but I was part of that very beginning when they had a couple or so meetings with my being there. I might not have been representing Mary Washington. I might have been representing a community or a nonprofit or an agency within the community. I knew about it, but I was also a board member.

02-01:22:27
Rigelhaupt:
What do you remember about the board’s decision to donate the land on the new campus to have the Moss Free Clinic be literally a block away from the hospital?

02-01:22:39
Young:
I don’t remember that. I don’t remember about the land part. I remember getting the Moss Free Clinic, but I don’t remember about the land. I don’t remember that. That’s a technical kind of—it’s something that didn’t stick with me. I do know that we support that Moss Free Clinic. I remember that part.

02-01:23:18
Rigelhaupt:
It sounds like if you don’t remember anything specific about the discussion of the land, then most likely there was not a lot of debate about having the Moss Free Clinic on the hospital campus. Or was there consensus about that?

02-01:23:33
Young:
I think there was consensus about that. I think there was consensus because they had the space. It was almost like a foregone conclusion: “Oh, yes, we can support that.” I think that’s how it went. The hospital (MediCorp) was involved in getting the Moss Free Clinic started. When the clinic needed to expand, they didn’t have to worry about buying the land, they didn’t have to worry about buying the space. [01:24:00] MediCorp, MediCorp Properties, or one of its subsidiaries already owned the land. If we could have it, it didn’t cost a lot. People would be donating services, then we could provide that kind of health care. And so I don’t know that there was a lot of discussion, because I don’t remember. I just thought it was a foregone conclusion that it was going to be. I think that the board supported it, wholly and solely. That’s what I think. I don’t remember any real discussion. I know that there had to have been some discussion, but it’s not in my head.

02-01:24:57
Rigelhaupt:
So the next question I want to ask is a big, open-ended question. I’m not looking for any specific answer, but to try to learn more about some of the thinking about the board and the organization’s values. Hospitals, particularly not-for-profit hospitals, have a long history of community benefit through charity care. This is a long-established practice: hospitals treat patients who cannot pay, and Mary Washington has a long history of doing that. And yet the Community Benefit, and originally Community Service Fund, is something different. This is distributing funds out into the community around health care. And there’s a lot of un-reimbursed care. There’s a lot of charity care given. It would be a perfectly rational decision by the hospital and the foundation to say, “Whatever funds we have are going to support the organization through charity care.” And yet the organization has chosen to distribute funds out into the community. Why?

02-01:26:15
Young:
I think that somewhere, the people who got the hospital started got it started to help the community at the hospital. As they grew and they had different kinds of people on the boards, the values didn’t change: they expanded. Also, Mary Washington’s emergency room became the primary care physician for many people. [01:27:00] Many people in the area. You remember Mary Washington was the only hospital for a good while in this area. I believe that they felt if we do something out in the community, we can have fewer people coming to the emergency room every time they have a headache. That will help. But also, Mary Washington’s mission is to improve the health care of the people in the communities we serve. We will do different kinds of things. And so they came out with the Community Service Fund. But they also helped out with the Moss Free Clinic. They’ve also helped with the community health center. We’ve got a community health center—it’s called the Community Health Center of the Rappahannock Region, across from Carl’s Frozen Custard. And they put that money out to get it started. I’m talking about Mary Washington Hospital. It supports them right now. It supports that community health center, right now. They’ll put an intern in there to help. There are ways that Mary Washington can help to improve the health of the people in the communities that hospital serves, or that Mary Washington Healthcare serves. Rather than just keep it there, pay higher wages or—they can continue to bring in specialty kinds of things and still help with the community. This is why I think they came up with that Community Service Fund or Community Benefit Fund now. That’s why, because it’s carrying out the mission of Mary Washington Healthcare. I think it’s a great thing. I know they give money to that Christian center out in Spotsylvania. [01:30:00] They used to give some money to the YMCA so that people could go and get exercise. They give money to these organizations because they are improving the health of the people in the community served by Mary Washington Healthcare. So that’s why it’s being done. I like the idea. I like the idea. I’m so glad they’re keeping it going.

02-01:30:45
Rigelhaupt:
Let me ask another question. It’s a long question, so bear with me. What’s clear from these interviews is that Mary Washington Healthcare, previously MediCorp and Mary Washington Hospital, is community-centered. And it’s evident where people have talked about the organization’s culture, its day-to-day practices. And yet, going back to the 1970s and certainly during your time on the board, Mary Washington Healthcare and hospitals in general interact with incredibly powerful external forces. Financial bond markets, Center for Medicare and Medicaid Services, insurance companies and other payers, questions of technology and associated high costs of high-tech medical care. Questions of market forces and competition—for example, the hospital took on hundreds of millions of dollars of debt to build the new facility. How, when the organization is interacting with very powerful external forces, does it maintain its focus on the community and stay attuned to community needs?

02-01:32:02
Young:
I think it stays attuned to community needs through its board members, its associates, its medical staff, the people all around and the organizations that they have now become associated with. They know Mary Washington Healthcare is so involved with the whole community that it gets to know what the needs are and begin to respond to them. They bring in people who can communicate with those high-powered folks, high-powered agencies and external forces and so forth. [01:33:00] The eye of the organization is on improving the health care of the people in those communities. If they don’t do that, there’s no need for doing anything with these high-powered folks. And they know it. They deal with both at the same time. They have folks, some people on the board, who will know something about some of those external forces. Some people on the board don’t have a single idea, but they know something about the needs. So you see what I’m saying? They can keep their eye on both and work with it. And yes, Mary Washington Healthcare has had its difficulties. It’s had its difficulties. We got in a competing hospital. They have Stafford Hospital, and they knew to start with that Stafford Hospital was not going to be profitable in the first few years. They knew that. They already knew that part. They figured that it could work. They could make it work and it would become profitable after a certain number of years. And it would serve the people: there would be enough patients so that it could work. And so, to answer your question in just a few words: they’ve got people who keep their eyes on the needs and they’ve got people who deal with those high-powered external forces. I guess that’s how it’s done. But the main reason that they’re in business is what they have to keep their eyes on. And they do. I can talk about “they” when I’m doing that. Most of the time it’s “we.” [laughter] Okay.

02-01:35:29
Rigelhaupt:
Do you recall instances in which the organization was trying to bring medical care to underserved communities? And one example that came up in a previous interview was with Bill Jacobs, and he was talking about conversations he had had with Mayor Davies about the mobile mammography van, and trying to bring breast cancer screening particularly to African American communities. [01:36:00] Do you recall that program?

02-01:36:03
Young:
Yes, I do.

02-01:36:04
Rigelhaupt:
And was that something that the board talked about, if it came up, or what do you remember about it?

02-01:36:10
Young:
I remember that we were trying to get it, and they did get it. They didn’t do much succeeding because people didn’t go. The problem was, what happens when you find you’ve got a problem? We didn’t have the specialists in the community or the services to help these people who had no money, low-income African American women with breast cancer. So what do you do when you find out that you’ve got a problem? Where do you go? When people found out that they had nowhere to go, they stopped going to find out that they had breast cancer and they told other women. That program did not succeed as we had thought it might. It did not. And that was the main reason. That was really it: people had nowhere else to go. So they preferred not knowing they had cancer. If you got to the point where you couldn’t do any better, then you went to the emergency room and they did whatever they could for you. You might not get the care that you can get now, but you got something until you passed away. That’s what happened: people were finding out early on and then you had nowhere else to go. That’s what we found, and the board did discuss that. Now, many on the board could not understand that because many of the people on the board had somewhere else to go. They couldn’t see that this is a problem. Many of the people—board members and staff members—there could not see that. Those who dealt with poor folks know they don’t go to the doctor. You were never brought up to go to the doctor until you can do nothing else because you didn’t have the money. That’s exactly what happened. When you could go to this mobile clinic and you find out that you got a problem, what you could you do? You have nowhere else to go, so you wait until you can’t stand it and then it’s too late. And that’s what happened. And when you asked me before—you mentioned it—that’s the one program I was going to tell you about. [01:39:00] I mentioned something about sickle-cell. Same thing. Same thing. We’re doing better now, but not before. It was designed to be helping people, helping folks find out you had a disease. Now what? That was the thing. We hadn’t thought through it well enough to have enough doctors who would provide some service to poor people. That means they’re providing service for nothing. For no pay. These low income folks didn’t have insurance and they didn’t have money. When you go to the emergency room, they serve you and you might not pay. That happens with folks who don’t have money right now. I know that when you go to the community health center you have to pay something. There are people who can’t go to that community health center because they don’t have the $30 to pay. They don’t go until they’re too sick to do anything, and they go to the emergency room. That’s happening right now. I serve on the regional board for the fifteen community health centers in central Virginia. It’s happening all over. If you don’t have money for the access to get there—and Moss Free Clinic has a waiting list—if you don’t have the money, you don’t go. You can’t get the help. You don’t go to try to find out. The community health center has a primary care physician, which Mary Washington Healthcare helps to support.

02-01:41:49
Rigelhaupt:
And so maybe this is using today’s language, but part of what you’re describing are medical disparities—that there are disparities [01:42:00] along racial lines, along lines of class in terms of being able to pay for care. Was there discussion among the board about using the hospital to try and deal with questions of disparities in health care?

02-01:42:26
Young:
I don’t remember discussions, real discussions about disparities as such. They talked about the fact that we had a program, but people didn’t come to it. Okay? We talked about that. The board talked about the fact that people were using the emergency room as their primary care physicians. They waited until they were so sick. We didn’t discuss the real reason for all of that. And maybe the real reason is not Mary Washington Healthcare’s thing—it’s a societal problem, you see. I’m not sure that we had that discussion about disparities, unless it came to something specific. We might discuss a real specific case. I could explain why people didn’t come to those two programs that they put up, and it was for low-income African Americans or people of eastern Mediterranean descent. That was it. I could say to them, there’s nowhere else for them to go, so they feel, “There’s no need for me to go. If I have it, I can’t do anything about it. Nobody is going to take me.” And we didn’t address that. I mean, we didn’t. Who are you going to get to serve somebody with breast cancer for free? See? That’s what we didn’t do. Now, I think they’ve done a lot. [01:45:00] And it’s not just a disparity kind of thing. If you find out that you have breast cancer or something, I believe somebody pays attention now. I just believe that. I don’t know a whole lot. But at that particular time we didn’t have anybody. Later, we had the cancer center out on Route 3, but most of the people had insurance. You went out there for radiation and it was high-class, A-number-one. But people who didn’t have insurance and stuff didn’t know about it. Okay.

02-01:45:58
Rigelhaupt:
Has this been one of the benefits of doing the community health needs assessment? And I’m not sure I have the chronology right, that the mobile mammography preceded it, but that that was a program started without necessarily thinking about what people would do if they found out. But it sounds like the community health needs assessment is more organized—it’s more of a program that some of those things about three steps down the line are thought of as programs are being developed. Has that been one of the benefits?

02-01:46:34
Young:
I think so. You know, we did a community needs assessment back in the day. We had a community health care assembly. That was the beginning, I think, of the board really trying to find out what the people thought. They put up money for that needs assessment at that time and our health care assembly got it done. We got it done. We used to have meetings in different communities, most of them were at Mary Washington, however. But really, I think that once we started finding what the people felt were the real needs, then the board figured out, well, we got to do something about it. And so along the line, you would do it. The greatest need we found in my day was dental. [01:48:00] We got the information on children and adults. They did something for the children by putting those mobile units at the schools. The hospital helped with that. But to answer your question, I believe that the community needs assessment does help because you recognize that something has to be done. Once you go out there and find out what the need is, so what? We now know the need. What are you going to do? Back in the day, we started providing it, providing for some of those needs. I know they started with the dental. I know that. And I was able to say to the board, “Look, the people are not coming to find out that they have breast cancer, because there’s nowhere to go. And we don’t have those doctors.” And so they have come up with this cancer center that’s second to none, I believe. But that’s it. Yes, I do believe that needs assessment and having the different people—[ringing phone; speech cuts off]

02-01:49:29
Rigelhaupt:
So mixed in with all the questions about community health needs, questions about medical disparities, and other larger societal questions that you alluded to—and they go far beyond what any community hospital, or even now a regional medical center, can do. And so part of—but part of my question now is then to think about how those broader issues, particularly around politics, affected Mary Washington Healthcare. You were on the board when the Clinton administration talked about national health care insurance. Obviously didn’t go anywhere, but a very serious national debate. Can you think of instances in which political decisions or public policy decisions shaped or affected some of the things that Mary Washington Healthcare was able to do or undertook?

02-01:50:26
Young:
You know, practically all the things affect health care. The business about Medicare and Medicaid—whoo—and there, you know, the rates that they can pay. When we got Medicare, I was not on the board or anything. [01:51:00] It was a national thing, but nobody really thought through what it was going to take for the number of people who needed the health care and had no way to pay for it. What happened, I think, was that it didn’t pay for a lot, but the general public didn’t know that. They just knew that you would get health care, I mean Medicare—if you got to be 65, you didn’t have to worry about anything else. That was going to affect the hospitals and the doctors and all of that. It really did. The same thing with Medicaid: any kind of national debate or whatever—if it gets to be a law, or if they’re just debating it, it gets debated at the hospital level because it’s going to affect them. I don’t care, pretty much, what it is, to tell you the truth. Yes, I do remember very vividly the thing about the health care, a national health care thing that didn’t come through—didn’t get to be done.

02-01:51:41
Rigelhaupt:
To switch gears, the big thing about politics, to questions of governance on the board. You mentioned you were on the governance committee at one point, and it’s not so important if you were on that committee, but for my notes, in 1996, there were changes in the board governance. Is that ringing a bell with what you remember about it? I’m not sure exactly what it was, except to ask you about it.

02-01:53:11
Young:
I don’t know what year, but we had a committee appointed that was a nominating/governance committee. That committee, consisting of board and staff members, reviewed proposals and interviewed persons who had been nominated for the board and for committees. Also, committees have to review their charters every so often. Maybe it’s annually. The charters have to go to that committee because it governs—it’s part of the governance of the whole Mary Washington Healthcare. If the charter gets past the nominating/governance committee, it then goes to the board. Until the board accepts it, it doesn’t get to be. That’s what the nominating/governance committee does. It’s a very important one because you approve who would make good board people or good committee people from the community based on what the recommenders, the nominators, say about them. You review the charters of the committees that work for the health care system and you see that the committees see everything that’s being done as far as that health care organization is concerned. That’s the governance part. The board is the governing body, along with these committees that work under the board. But they have to be approved: their work has to be approved by the governance committee that goes up to the board. And so I think it’s very important.

02-01:55:31
Rigelhaupt:
And I think tied to that, and I did not write down the year and the specific —

02-01:55:34
Young:
And I don’t know that.

02-01:55:39
Rigelhaupt:
But there was a time when you paid two dollars and you were a member. And I think it was probably during your time on the board that that changed. What do you remember about—I mean, I think the board was for that change because it was presenting challenges. But do you remember, was there a consensus on that change and how the community received it?

02-01:56:01
Young:
The community didn’t come to many—people might pay the $2 dues, but then when it came time for a meeting, they didn’t come. What they had to say—I mean, if they had anything to say—nobody got it because they didn’t attend the meetings. It was felt that it needed to be changed and so they’ve changed it. I think they’ve had a couple of changes now. They have a community advisory committee that people could apply to become a member. I think it happened all because people didn’t come. People didn’t recognize the importance of what they had to say. [01:57:00] And there were just a few people who would come and have some concerns. One was Mrs. Massey, Dr. Massey’s mother, whose family helped to get the hospital started. I guess. I imagine. I think. Somebody in that family probably did. But Mrs. Massey was one who had some concerns. We got her on the Healthcare Assembly and had her say what she had to say. I’d pick her up. I’d pick her up and we’d get a chance to talk. She was a great lady. I was chair and I was the first one. I stayed on that committee. I stayed there as chair of that group until I got off the board. I think we did a lot. I don’t think they have it right now. It’s something different. The two dollar thing was membership in the organization because it is a community hospital—a community organization. You paid two dollars to be members. The two dollars didn’t do anything, but even the two dollars didn’t make the people come, and that was why. Okay.

02-01:58:52
Rigelhaupt:
So I’ve actually reached the end of the questions that I brought, and the way I like to end these interviews is to ask two more questions. One, is there anything you’d like to add? And two, is there anything I didn’t ask that I should have asked?

02-01:59:08
Young:
I can’t think of anything for either one of those questions. Okay?

02-01:59:12
Rigelhaupt:
Thank you very much.

02-01:59:14
Young:
You’re quite welcome.

[end of interview]

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