Current title: Chief legal officer, Piedmont Healthcare.

College: University of Pennsylvania, 1987.

Law school: University of Michigan, 1992.

Most recent lawyer positions: Associate general counsel, Providence Health & Services, 2012-2017; Associate general counsel, Swedish Health Services, 2001-2012.

How big is your legal department, and how many internal clients do you serve?

Although we have employees who are trained as lawyers throughout the organization in different departments (risk management, supply chain and business development, for example), the legal department itself is fairly small—seven attorneys, two paralegals and additional support staff. We are hoping to expand, though, due to the organization's growth. The Piedmont system consists of 11 hospitals, nearly 660 locations, and more than 23,000 employees.

How did you come to get this position?  

I spent the first several years of my career in private practice in Seattle, eventually specializing in health care litigation. Somehow, I was able to convince one of my clients that I could become a transactional lawyer and do their work, in-house. I have been working as in-house counsel for nonprofit hospital systems ever since; almost 20 years. At the hospital systems in Seattle, I worked closely with Kevin Brown, who came to Atlanta to become Piedmont's president and chief executive officer in 2013. A few years later, when he had an opening on his executive team, I took the opportunity to throw my hat into the ring.  

For what types of matters does the legal department hire outside counsel?

We use outside counsel for the legal work associated with large transactions—hospital affiliations or acquisitions, for example. We have done several of those since I arrived in 2017, and the use of outside resources for due diligence, regulatory review and deal documents is critical; we could not handle that volume of work in-house. We also rely on outside counsel for all matters that turn into litigation. Our internal legal team, however, is the first line of defense, to prevent matters from turning into litigation. With as many locations as we have, real estate and construction matters are often ripe for outside counsel expertise.

What firms do you use and for what kinds of matters?

I hate to name names, because doing so will inevitably leave some out—there are so many great lawyers and firms that have ably represented us. We have long-standing relationships with many firms in town, both big firms like King & Spalding; Alston & Bird; Morris,  Manning & Martin; and Arnall Golden Gregory and smaller firms like Wilson Brock & Irby, Patrick Law Group, and Stembridge Law. We also use lawyers at firms outside of Atlanta and across the country—relationships that either I or someone from my team has developed over the years.  

What's the biggest challenge among these health care issues? Personnel issues; potential and actual malpractice claims; the Affordable Care Act/health insurance; or acquisitions of doctors' practices?

Health care is one of the most heavily regulated industries there is, so a primary challenge is just keeping up with ever-changing, and often conflicting, regulatory requirements. It is even more challenging when the regulatory environment doesn't keep up with the changes in the industry. Declining health care reimbursement means that health systems need to look at things like affiliations and other innovative partnerships in order to achieve economies of scale, but the laws impacting when and how hospitals can work together haven't evolved to address that new reality. Likewise, insurance companies, including government insurers, are looking to move away from fee-for-service payments and toward “bundled” or “episode of care payments,” but the laws addressing how hospitals can pay physicians, including whether those payments can include incentives to reduce the cost of those bundles or episodes of care, haven't been brought up to speed. It is difficult to explain to our clients why something that makes intuitive sense isn't yet permitted.  

What is the latest book you read?

“The Outsiders,” by S. E. Hinton. I read it a million times when I was teenager, but I just re-read in order to help my middle-schooler study for exams. I was surprised by all the things I didn't pick up on back in my day!

Please tell us about your family:

My husband, John, and I have been married for 16 years, and we have two amazing teenagers, William (13) and Hayden (14).