Mardian Blair; healthcare legend

My friend and mentor, Mardian Blair, has died. Yesterday, I attended his memorial.

No person, outside of my family, has had a greater impact on my life and my career than Mardian Blair. I was greatly privileged to have worked closely at his side over the last 15 years of his career. Although we had our share of social interactions that I treasure, my relationship with Mardian was more professional than social. The period of our professional relationship was probably the most difficult of his career as he lead AdventHealth from financial weakness to financial strength. Perhaps more than anyone else, he and I shared this struggle; I was in the rooms during this period when most of his difficult decisions were made. It is the Mardian in those rooms that I know. And it is that Mardian that I want to tell about.

When I was 30 years old, Mardian appointed me to be his CFO at AdventHealth; at that time AdventHealth was about half a billion dollar company that was very troubled; it was cash poor and capital starved and the future seemed bleak. When Mardian assumed the presidency of AdventHealth, I was being recruited by two organizations that looked a lot more attractive to me. Mardian asked me to stay at AdventHealth to help him turn AdventHealth around. Few thought Mardian would succeed in saving AdventHealth. As I considered my options, I concluded that AdventHealth could succeed if it made significant changes that would be very tough to make. I purposed in my heart that I would stay and work beside Mardian for AdventHealth so long as, whenever I believed a tough decision had to be made, it got made. I remained beside Mardian as CFO till he retired, which means, that each and every time I believed a tough decision needed to be made, Mardian made it. When Mardian retired, AdventHealth was a strong company with a bright future. During the intervening period, a lot of hard and tough work got done. It was not easy, and much of it was not fun. Mardian did not shrink from hard work. And he never faltered at a tough decision.

Mardian was particularly effective when he had good information, particularly information based on numbers. I learned that if I could provide him compelling numbers, he would act on the numbers. I was particularly skilled at numbers, and I found that I could be especially helpful to him by making numbers speak - I was good at making numbers speak. We worked very well together by following numbers.

I thrived under Mardian’s mentorship - I needed a lot of mentorship, and Mardian was happy and eager to provide it. Early in our relationship, Mardian told me that I was very rough and needed lots of polishing. He told me that, if I was willing to take unvarnished criticism from him, my career could accelerate quickly. I told him that I was used to lots of criticism because my mother was my biggest critic and that I loved her for it; so, bring it on. He cautioned me that this would only work if I never pushed back on his unvarnished criticism - if I pushed back by defending the actions he was criticizing, it would cause him to hold back… I told him that I would never push back and never did (even if I felt the criticism was unwarranted). For 15 years Mardian became my biggest critic, and I never pushed back. My career did accelerate. And we fixed AdventHealth. I’m still rough and not as polished as I should be; I embarrassed Mardian - a lot. He took a lot of criticism for my roughness from other colleagues. But he never quit polishing; neither did my mother.

One of his polishing actions was to write a memo to me about my signature; as the memo circulated through the corporate office on its way to me, I got lots of snickers from secretaries that knew my signature was sloppy. Back then, documents had to be signed in wet ink. Mardian and I had to sign thousands of documents every time we closed a bond issue. So, he thought mine should be legible. His was impeccable; mine is still not very good…

Mardian was a legend in healthcare. Probably his legend is not widely recognized or appreciated. I want to tell you why he is a legend to me. I like to think of healthcare like a car; the car is full of lots of people doing healthcare. The AdventHealth car was built by Don Welch and Ed Reifsnyder by cobbling together a group of hospitals and driven by Don Welch. It was the result of Don Welch’s vision of what Adventist Healthcare could and should be. It was bolted together by Ed Reifsnyder’s genius and persistence. Then, Don and Ed decided to leave it and build a new car for Adventist US. When Mardian got into the drivers seat the AdventHealth car was falling apart. Mardian had to fix it. It had almost no access to capital. And it wasn’t operating well. And Mardian fixed it. Not only did Mardian fix it, he made it into a race car.

Let me explain Mardian’s race car. During Mardian’s tenure, specifically between 1987 and 2000 (the period for which I have access to data), AdventHealth grew at the compound annual rate of 16%. Since Mardian retired, Advent Health grew at the compound annual rate of 8.6% (2000 to 2022); about half Mardian’s rate; more in line with typical healthcare growth rates. Sustaining 16% growth rate over a time scale greater than a decade in not-for-profit healthcare is not heard of. Mardian built AdventHealth into a strong lean, no frills, muscle race car. His successors took it and made it into a palacial, luxurious street car; half the speed, but softer, nicer ride.

?The car Mardian drove became a race car because of its capital formation strategies. Healthcare is a capital intensive business. When Mardian took over, AdventHealth was capital starved with almost no access to capital. Mardian and I spent many years pounding the pavement of Wall Street seeking access to capital. Wall Street slammed its doors on us over and over again. For us, Wall Street was dark conference rooms with cold credit analysts (like the legendary Bob Yagi at Moodys). But, over time, we conquered Wall Street. We conquered Wall Street by finding innovative ways to do capital finance. Such that, in Mardian’s last year, the June 1999 issue of the trade magazine, Healthcare Finance, published its cover story profiling the capital finance strategies we had developed. The money quote is from Cynthia Keller, a director in the healthcare ratings group of Standard & Poor’s; where she is quoted “They are just a lot more sophisticated than most hospitals or hospital systems.”

If Mardian’s capital finance strategies had been continued, 16% growth could have been sustained. But, almost immediately, the strategies that fueled Mardian’s growth rate were abandoned, in preference to strategies benchmarked against other hospital systems. Like other hospital systems, without Mardian’s finance strategies in place, the growth rate was cut in half. Had Mardian’s finance strategies been sustained AdventHealth, would be 3 to 4 times larger than it is today; instead of $21 billion of assets (December 31, 2022), there could have been $98 billion.

I was deeply disappointed as I saw the race car Mardian had built being disassembled. It was like taking the turbochargers off.

This is why Mardian is a legend. He’s a legend in Adventist healthcare, and he is a legend in the not-for-profit healthcare industry. I’m not aware of anyone else who took a not-for-profit scaled healthcare system and sustained 16% growth for more than a decade.

You can’t really understand Mardian without thinking about Johnny. Johnny was Mardian’s severely disabled child. There was nothing more important to Mardian than Johnny. It was not uncommon to walk into Mardian’s office and find Johnny sitting in his wheel chair, usually smiling. My wife, Tami Wiese had the opportunity to care for Johnny upon several occasions when she was pregnant with our first child; she tells happy stories of packing Johnny into her car with him laughing as they drove off to McDonalds for Tami’s McNugget pregnancy craving. When Tami and I became parents of a disabled child we drew strength and inspiration from the rich example of Mardian and Joan.

Nathan Greene’s Johnny Made Whole was inspired by Johnny Blair and expresses the blessed hope Mardian, Joan and each of Johnny’s siblings, hold for Johnny and that Tami and I hold for Corbin.

?I learned a lot about the exercise of power from sitting beside Mardian. Mardian exercised power better than anyone else I have observed. A way to tell if someone exercises power well, is to observe, when they get more power, do people want to give them even more power. Mardian exercised power in a manner such that others wanted to give him more power. Society in general, and our church in particular, would be far better off if those who exercise power well are the ones that hold power. Often, those who exercise power well are not those who seek power. We tend to get people into power who seek power, and, as a result, often power is exercise poorly. Mardian did not seek more power. But, over the time I sat close beside him, I observed that he was continually sought out to exercise more power.

As Mardian approached retirement, AdventHealth engaged a consulting firm to lead the search for his successor. In the course of their work, they did extensive interviews of Mardian’s associates. In their report, they commented on the characteristics that dominated those interviews. The characterized the sentiment of those interviews with one word: RECTITUDE. Rectitude is kind of an old word you don’t hear much; the dictionary definition is something like “morally correct behavior and thinking”. I like “moral duty” - I think it perfectly fits the Mardian that I know.

Above all, Mardian was a servant of God. Mardian’s 16% growth rate reminds me of the five talent servant that Jesus told us about in Matthew 25. Mardian can rightly say:

Lord, thou deliveredst unto me five talents: behold, I have gained beside them five talents more. His lord will say unto him, Well done, thou good and faithful servant: thou hast been faithful over a few things, I will make thee ruler over many things: enter thou into the joy of thy Lord.

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