From the Coal Mine to the Boardroom

Jeffrey Canose, M.D., brings an ethic of servant leadership to his role as THA’s 2017 chair.

By Debbie Ritenour

Medical school interviews can be stressful. Years of preparation can come down to one conversation with a complete stranger. When Jeffrey Canose, M.D., chief operating officer/senior executive vice president of Arlington-based Texas Health Resources, was going through the interview process, however, he knew he had a uniquely perfect response to the common question, “So why do you want to go to medical school?”

“I never want to work in a coal mine again,” he would respond.

From an underground coal mine in western Pennsylvania to a high-rise office building outside Dallas, Canose’s career has been on an upward trajectory his entire life. As he takes the reins of the Texas Hospital Association Board of Trustees as its 2017 chair, Canose will use the same grit, determination and tenacity he has demonstrated throughout his career to guide the association through what’s sure to be a challenging time.

“It’s all about servant leadership,” Canose said. “We have to listen carefully to what the members need and want and then make sure we’re successful in accomplishing the outcomes that are most important to the shared mission we all have, regardless of what type of hospital we are.”

The Coal Miner’s Son

Canose grew up in the heart of the coal and steel industry in Scottdale, Pennsylvania, a small town with 5,000 residents and two traffic lights. His dad worked for the gas company, and his mom took care of him and his younger brother. His grandparents on his dad’s side, who had lost everything in the Great Depression, bought a ramshackle house and lived on what they could raise and grow on their land. After returning from the Korean War, his father discovered that his parents had been trading their chickens and produce for potable water from their neighbors. He shimmied down their well shaft and discovered that indeed, they had no water – but they did have coal.

Canose soon had his very first job.

At 11 years old, Canose was using a pick and shovel to loosen the coal, which his father would then lift into oil barrels that could hold up to 500 pounds. There was no fresh air in the mine, which was 60 feet under his grandparents’ farm, and a bare lightbulb hung from the ceiling.

“It was a character-building experience, especially when the electricity would go out,” Canose said. “There was no way to get back out of the mine until power was restored.”

When high school graduation rolled around, Canose decided he was ready for new – and safer – experiences. The first person on either side of his family to go to college, Canose enrolled at Westminster College in New Wilmington, Pennsylvania. He paid his way with scholarships and by working two jobs. He started out as a chemistry major, but after discovering he wouldn’t be able to complete a required laboratory course because it conflicted with his work schedule, he switched to math.

One of the jobs Canose held as an undergrad was working as an orderly in a nursing home. This experience, he believes, was integral to his overall education.

“Everyone who wants to have a career in health care should undertake work or volunteer experience in direct patient care so they understand what patients need and what it means to be able to take care of them in some of their most vulnerable moments,” he said.

After receiving his bachelor’s degree in 1979, Canose went on to medical school at the Medical College of Pennsylvania. He completed an internship in general surgery at Saint Francis Hospital and Medical Center in Connecticut, followed by a residency in anesthesiology at the University of Connecticut Health Center. His subspecialty fellowship training in cardiac anesthesiology and research in cardiovascular physiology was at the University Health Center of Pittsburgh.

Jeffrey Canose at work

The Right Place at the Right Time

By the late 1980s, the steel industry had collapsed and unemployment was rampant in Pittsburgh, where Canose was a practicing anesthesiologist at a large, non-university teaching hospital. The economic downturn had a profound impact on health care economics in the area and ultimately on Canose’s career.

At the time, there were six large teaching hospitals in Pittsburgh. The hospital where Canose was practicing was voted the one most likely to go bankrupt the fastest.

“That created lots of opportunities for me as a young physician and as an emerging leader to start getting involved in how the hospital was going to struggle through near-bankruptcy and, as it turns out, become one of the two surviving systems in the city of Pittsburgh,” Canose said.

Canose became a physician leader only two years after he completed his training and was promoted to department chair and residency program director a year later. A new CEO was hired to try to save the hospital, and he told Canose he needed to take ownership of the operating room and surgical services, including full profit and loss responsibility.

“I had no business experience. I had no real leadership or management experience,” Canose said. “I was a math major. I was a practicing physician. I was a research scientist. I didn’t have any qualifications to be running the single largest profit center of a big teaching hospital.”

Young and eager to try new things, Canose was happy to help. He became involved in a number of turnaround projects at the hospital and helped drive major transformational changes both inside and outside of the OR. Under Canose’s guidance, the hospital’s 12 ORs went from doing 12 cases a day to 75 cases a day, including more than 1,000 open-heart surgeries per year. The hospital not only survived but thrived.

Canose conversing with a patient (his son)
Canose, who was a practicing anesthesiologist before he entered health care administration, is pictured in 1988 conversing with a “patient” (his son).

After 12 years, Canose decided his ultimate goal was to become a hospital CEO. He finally found the perfect opportunity as vice president of hospital and health system operations at a hospital in North Carolina. The region recently had experienced an economic downturn similar to the situation in Pittsburgh and was facing the same challenges.

“I believe that was God’s hand at work in my life. That was clearly God deciding where I needed to be and putting me in exactly the right place for my second career. I give Him all the honor and glory for where I am today and for putting me in the right place at the right time to learn the right things,” Canose said.

New Adventures

Canose spent seven years in North Carolina. While he enjoyed his time there, he was intrigued by the possibility of joining a multihospital system.

“When I was in Pittsburgh and North Carolina, there were things that we would dream of doing that we never had the financial resources or the people or the technology to do,” Canose said. “The notion of moving to a multihospital system where there were opportunities to actually implement some of those innovations and advance both strategy and operations was very appealing.”

At the time, Texas Health was looking for a chief operating officer for one of its flagship hospitals, Texas Health Presbyterian Hospital Dallas. Canose got the job and quickly began moving up the ranks, eventually becoming the first physician in Texas Health to be named a hospital president. He became COO of the entire Texas Health system in September 2014.

“According to our trustees, I can’t hold a job. As soon as I get a new position and start to create relationships with people in the community, the board, the staff and the physicians, I get moved to the next position,” Canose said with a smile.

No matter his role in the system, Canose has remained focused on helping Texas Health provide the best possible care to the community it serves.

“One of the phrases that I coined when I got here at Texas Health is ‘every, every, every.’ Every day, every person in every position in every department in every part of our system across the full continuum of care must do everything we can in order to keep patients safe, to heal them, to be nice to them, and to do all of that as efficiently as possible,” he said.

Leading THA

Canose will be leading THA during a time of deep uncertainty. The 2017 legislative session promises to be a challenging one as legislators address a number of health care issues, including Medicaid reimbursement rates, trauma care funding and behavioral health services. At the national level, the results of the presidential election leave many questions about the future of health care reform.

His colleagues think Canose is up to the challenge.

“As a member of the THA board, I have been fortunate to participate in meetings with, and led by, Jeffrey Canose, M.D.,” said Phyllis Cowling, president/CEO of United Regional Health Care System in Wichita Falls. “I admire his ability to articulate a framework for discussion and to synthesize various, sometimes conflicting, viewpoints to common understanding and solution. His leadership and communication skills are exceptional, and I know he’ll bring these skills to his role as THA chair.”

“Jeff Canose has always impressed me as a very thoughtful and talented health care leader,” said Jaime Wesolowski, president/CEO of Methodist Healthcare System of San Antonio. “He consistently focuses on processes we work on to continuously improve health care services for the citizens of Texas. He is a very balanced thinker while dealing with the health-related issues at hand, including the quality and safety of our care, the enhancement of services, and the sustainability of our hospitals.”

Key to his leadership, Canose says, is understanding members’ needs and working to make sure THA does its best to meet them all.

“THA means different things to different parts of the membership. For us at a big multihospital system like Texas Health, THA is absolutely mission-critical and indispensable in terms of legislative advocacy and public policy development. For small rural hospitals, I think THA is meaningful and important as a venue for collaborative problem-solving and solution development that these hospitals need to succeed,” he said. “Ultimately, we all wrestle with trying to make sure that the cost of health care at an individual level, at a community level and at a societal level is affordable and sustainable. We cannot be successful as a fragmented ecosystem of competitors.”

Faith and Family

Canose and his wife, Kathy, have been married since 1980, but that’s not the date that’s most important to the high school sweethearts.

“We actually celebrate our going-steady anniversary instead of our wedding anniversary,” Canose said. The two celebrated their 42nd going-steady anniversary this year.

Canose and Kathy, a former nurse who now works in early childhood education, have one son, David, a clinical psychologist currently serving as a visiting professor at Gannon University in Pennsylvania. They also have two rescue dogs, Ginger and Socks. Canose’s biggest hobby is reading – or, more accurately, collecting -- books.

“I own somewhere close to 20,000 books,” he said, noting that most of the books are on science, history and theology. “I buy an average of four to six books every week. My son lives in mortal fear that he’s going to inherit all these books.”

Canose also is a deeply spiritual man. He notes that faith and spirituality play a special role in health care and in his life.

“There are five things I will always aspire to achieve: to create a culture and provide a working environment where every member of our team is equipped and empowered to do their professional best; to listen deeply and lead with questions, not answers; to frame discussions and choices based on vision, values and guiding principles; and to develop the next generation of leadership who will be capable of advancing the special, sacred, humbling and heroic ministry that has been entrusted to us,” he said. “The fifth and most important aspiration is continuing to grow stronger and more mature in spiritual intelligence every day, harmonizing head and heart and soul to become a better servant leader in every situation.”

No matter what the future holds for him, Canose is thankful for what he has accomplished so far and especially for those who have helped him along the way.

“Every achievement can be attributed to the grace of God and His work in my life; to the great teams of people with whom I have had the privilege of doing servant leadership together, especially during the last 10 years at Texas Health; and to the amazing woman who has been my best friend for more than 40 years,” he said.

Jeffrey Canose at the Texas Capitol
Jeffrey Canose, M.D., in the gallery of the Texas legislature.

This article originally appeared in the November/December issue of Texas Hospitals magazine.

Read the Chairman's Address by Jeffrey Canose, M.D.

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