Health Chief Qualities Debated ; Local Leaders Say a New Health Director Should Have Strong Administrative and Communication Skills.

When the search for a new director of the Guilford County Health Department begins next year, county officials and local health leaders say that candidate’s administrative and communication skills may be more important than clinical experience.

“I would prefer someone with a strong administrative background because you’re dealing with such a large department with so many people,” said Bruce Davis, who has served on the health board and is now chairman of the county commissioners.

About 450 people work for the health department, which has a $34 million budget. The department is responsible for numerous programs, including coordinating health programs for the poor, issuing well and septic permits and inspecting restaurants.

Dr. Ramesh Krishnaraj’s last day as health director came Nov. 30 after a turbulent 14-month tenure at the agency, marred early on when he was arrested on a drunken driving charge.

Assistant Director Merle Green has been in charge since Krishnaraj’s departure. Health board members and commissioners say they are comfortable having her run the department until a decision on a permanent replacement can be made.

That decision may take some time. The 11-member health board sets policy for the department, helps formulate its annual budget request and oversees its operations. The board also is responsible for hiring the department’s director.

Members are appointed by the Guilford County Board of Commissioners, and more than half will be new to the job come January.

Richard Gorham, a current board member who will continue to serve next year, said it will take time for those new members to study the department and help formulate a job description for the new department head.

“I think it’s important that we take what time is necessary to review the job description and make sure it’s current and applicable,” Gorham said.

Etta Mullikin, who has been the board’s chair woman but is leaving her seat next year, agreed that it could take the board a few months to settle on someone.

One of the most basic decisions that board members will have to make is whether the health director needs to be a licensed doctor.

County health directors do oversee a variety of medical programs and would be a key figure in responding to emergencies such as a bioterrorism attack or disease outbreak.

However, state law does not require a medical doctor to run a county health department. Other large North Carolina counties, such as Alamance, Orange and Wake , do not have medical doctors as their health directors.

And several people interviewed for this story pointed out that the department does have a position set aside for a medical director, a physician who could offer advice and issue medical orders. That position is currently vacant.

With the potential for a doctor to fill that No. 2 slot, most of those interviewed for this story said that the health b oard should emphasize other qualities when searching for a new department director.

“I would prefer someone who has worked in the health department or is familiar with Guilford County,” Davis said. “To be blunt, I think Merle Green makes an excellent choice.”

Green is not a doctor but holds master’s degrees in public health and business administration.

Davis said Krishnaraj had a strong clinical background but was not a proven administrator when he was hired.

“That’s pretty much par for the course when you look at an M.D. When you look at their training…they’re not necessarily taught to lead people.”

Mullikin, too, said she thought the board should emphasize strong administrative skills.

“It should be somebody who know how to interact with the commissioners, the politicians, the people in town who are movers and shakers,” Mullikin said.

Krishnaraj was sometimes criticized by county commissioners, who control the department’s funding, for not being responsive enough to requests for information.

The health director is the chief lobbyist for the department, in charge of securing money for the department’s own programs and programs that other agencies operate through department contracts.

“Clearly, I think going forward the person will have to have some strong skills in leadership, administration and communication,” Gorham said. “This is just my opinion, but clinical skills are secondary.”

Tim Rice, president of the Moses Cone Health System, also mentioned the ability to communicate effectively as a key trait of the new director.

“In an era of tight budgets, someone needs to speak for prevention and disease control,” Rice said. Many of the health department’s programs serve poorer residents, he said, and the health director frequently stands alone in advocating for programs to serve that population.

Rice said the new director would need to be able to coordinate not just his own agency, but the efforts of other health organizations in the county.

That sentiment was echoed by Brian Ellerby, who heads both Guilford Child Health and Guilford Adult Health programs and once served as health director in Anson County.

Those two Guilford County agencies are nonprofit collaborations between the government and private health care providers. Both work closely with the health department to serve the county’s poorer residents.

“We are in a period of time where one agency, one individual, cannot do it alone,” Ellerby said. “If you’re going to have success in delivering health care to any particular target group, you’ve got to have a collaborative effort.”

Leading those collaborations, Ellerby said, will be a key role for the health director.

Jeff Miller, president of the High Point Regional Health System, said he would prefer to see a doctor serve as health director.

“I think if you have a physician it’s a real advantage,” Miller said. “It gives that position a lot of credibility that’s very immediate and powerful.”

But, Miller said, he did not think the new director had to be a doctor and that whoever fills the spot will need more than just medical skills. For instance, Miller said, the new health director will also have to have political skills to lobby for money from the state and county governments.

“It’s so competitive for funds at the county level and state level, that the person has to have those skills,” Miller said. “They can’t just leave it to someone else. That simply has to be part of their job.”

The health b oard is not scheduled to meet until mid-January, and the search for director will not begin until after that meeting.

Contact Mark Binker at 373-7023 or mbinker@news-record.com {SEND}