Led by Passion, Making Life Better for Others

When you learn from the lessons of life, your story becomes an inspiration. It is not about the wealth you earned, but the lives you touched through your work. When she started her journey, she had only one motive which was to serve people. With passion and dedication towards her goal, Nancy Agee, CEO of Carilion Clinic, has made a significant impact in 26 counties in Virginia serving over 1 million people. Carilion Clinic is a $2 billion not-for-profit integrated health system with seven hospitals. With a history of 120 years of care and support Carilion Clinic remains mission focused even today. As she shares a few inspiring insights with us today, we are certain that her words of wisdom will stir up our thoughts to help those in need. In conversation with our Newsmaker, Nancy Agee:

What was your goal while growing up? Did you always want to be where you are today?

From the time I was about 5 years old, I wanted to take care of things, take care of dogs, take care of people. When I was a teenager, I had a health scare and wound up having major surgery on my knee. It was serious – not life threatening – but I found myself hospitalized, on crutches or in a wheelchair for the better part of two years. That was life-changing. I wanted to be like those people who cared for me. They were so wonderful and great caregivers. I think those early experiences all coalesced when I became a nurse.

What are some of the most important achievements, highlights, biggest challenges or roadblocks of your journey as a leader? If possible, kindly help us with statistical insights as an overview of your individual achievements.

A little more than 10 years ago, right before the recession started, we decided to change Carilion’s operating structure and become more of an adaptive clinic delivery system with many more employed physicians. We put physicians in leadership roles, significantly expanded our campus and hired about 350 new doctors. We made some sweeping changes that cost a lot, all of which were planned and thoughtfully done, but without the notion that we’d be heading into a recession.

It was a little bit like stepping off into the great unknown, and that was tough. As the chief operating officer at the time, I had to lead the transformation as well as make sure our day-to-day operations were running smoothly. Also, as we adapted to the clinic model, we strengthened our partnership with Virginia Tech and built a medical school and the research institute. All of those pieces coming together at the same time was challenging, and there were moments when we thought, ‘maybe this isn’t the right thing,’ or ‘we’ve gone too fast’.

In hindsight, it was the right thing to do, and it was a hard thing to do. It took the courage of many, including our board. Our operating margin went negative, yet our board saw the vision and they believed this was the right approach. We emerged from the recession with the right operational model to ensure our operating margin would be healthy. More importantly, we were well-positioned to improve the health of the communities we serve.

Have you achieved all that you had desired? Tell us about the moment when you realized that your hard work has finally paid-off. What keeps you driven and determined towards work?

In some ways, yes, though the very human work we do is more a journey and far less a destination. In retrospect, I could never have imagined the success that we at Carilion have seen. For example, ten years ago, the land that now houses the Virginia Tech Carilion School of Medicine and the Fralin Biomedical Research Institute at VTC along with several clinical buildings was a brown field in a flood plain. Today, it’s the center of the Roanoke Innovation Corridor – a burgeoning district that is combining clinical care, education and research and lifting up a community. The excitement is building in Roanoke.

And yet, when you’re in the moment, it’s hard to have a broad perspective. Our hard work over the past decade is starting to pay off now, but that payoff is nowhere near over, and I expect it to outlast my tenure.

If you asked me what I am most proud of, I have to say, our staff. They’re talented, caring and resilient. That’s really our North Star – what’s most important. I’m proud of a lot of other things as well: certainly our relationships with Virginia Tech and Radford University, our ability to innovate, our nimbleness, the quality health care we provide, the work that we’re doing – especially in the ambulatory space – to help patients stay out of the hospital.  There are myriad things that I think we do well.

In the end, it’s all because of great staff, great leaders, great physicians, great nurses — the whole team. It’s a credit to them that we’re able to do what we do. And quite honestly, maybe even more importantly, we’ve got a great board that expects us to innovate, expects us to do the right thing.

At the beginning of every day and the at the end of every day, what drives me – what drives us – is a laser-like focus on our patients. They are the reason I got into this business and they are the reason I stay. 

What seeded the vision of Carilion Clinic? Brief us about the services that Carilion Clinic provides and tell us why customers choose you?

Carilion Clinic has a 120-year history of supporting those in need in our community. We began as a not-for-profit hospital and remain mission-focused today. Our stakeholders are our community members and every bit of our operating margin is reinvested in the communities we serve. That’s important to us – it’s a great responsibility to shoulder, and one we gladly take on.

We serve about one million people in 26 counties in Virginia. Carilion Clinic’s seven hospitals and more than 200 practice sites provide the full spectrum of care to our community. The only two services we don’t offer are transplants and burn treatment. Carilion is the largest private employer west of Richmond in Virginia, and as such, we provide for both the physical and economic health and wellbeing of our community members.

Amidst all your responsibilities and roles at Carilion Clinic, how do you manage to balance between professional and personal life?

I am so lucky. It’s not said often enough, but family really should be the first priority. And without that touchstone you’re missing out. My husband, my son, my daughter-in-law: they are the people who will say, ‘You really screwed this up!’ They’re really going to give it to you, and they’re going to be there again tomorrow.

My other recommendation: get a dog! They’ll love you no matter what! I was traveling last week and when I got home [my dog] was just crazy. And when I get home tonight, he’ll be crazy and excited. It doesn’t matter if you’re gone 10 minutes or two weeks, dogs love to see you. There’s a lot you can learn from a dog.

From a professional standpoint, finding a moment of calm in a stressful time is important. Often you’ll find me visiting patients, listening to them, learning from them. That’s where it all began for me and it’s where I find the greatest peace.

What are your individual plans going ahead? What does the future hold for Nancy and Carilion Clinic?

Remember the brown field and flood plain that I talked about earlier? Now it’s home to Virginia Tech Carilion School of Medicine and the Fralin Biomedical Research Institute at VTC along with several clinical buildings. Ten years ago, it was difficult to imagine that empty field as a center of innovation, but here it is, acting as a hub for research, education and care. The possibilities are limitless.

I expect to see more growth, as an organization and as a region. So much has changed over the past decade, and we’re only just beginning to reap those benefits. We just announced a planned billion-dollar investment in our service area over the next seven years, which will include a major expansion of Carilion Roanoke Memorial Hospital and a new Behavioral Health Hospital. Our partnerships with Virginia Tech and Radford University are flourishing. Internationally renowned physicians and researchers are moving here to work. Exciting things are happening in Virginia!

We’ll continue to evolve. What’s not going to change is our devotion to patients and doing our best to help people have the best health outcomes they can possibly have.