Exhausted after his shift as a waiter, Richard P. Miller, then a 21-year-old college senior, jumped into his rickety Volkswagen bug and headed back to his school.

He didn't make it.

"I fell asleep at the wheel and hit a bridge abutment going about 40 m.p.h.," said Miller, now 62, president and chief executive of Virtua Health Inc., the three-hospital health system based in Marlton.

Helicoptered to a shock-trauma unit in Maryland, "I actually ended up on a ventilator and I ended up on dialysis and wasn't given much chance," he said.

Ultimately, obviously, Miller did make it - after seven weeks in the hospital. But his experience has become his personal touchstone in developing his management philosophy at Virtua.

"I'm a staunch patient advocate," he said. "I tell this story to my team, because I want them to understand where my patient fervor comes from."

Question: You said you saw great health care and bad health care. What was bad? After all, they saved your life.

Answer: I was a patient, but I couldn't speak because I had a tracheotomy done. The residents would come in and stand at the end of my bed with their care team and never speak to me. They'd speak about me. You didn't feel like a person.

Q: But you couldn't answer.

A: But I was a 21-year-old kid who knew what was going on. I could nod. I could write. I was in bed for six weeks. Mentally, I was kind of depressed.

Q: And what was good?

A: I had a great nurse. I was a huge Flyers fan. So she actually got The Philadelphia Inquirer and read me the accounts of the games. Keeping people engaged mentally so they don't slip as people is very important.

Q: How has that translated in your hospitals?

A: Our patients can select a care partner from their family that has 24/7 access to our facilities. The rooms in this hospital all have pull-out beds.

Q: What financial challenges do hospitals face?

A: There was a time back in late '80s, early '90s, where New Jersey was under a fixed payment system and we had run out of money. I was the chief financial officer at the time. I had $5 million in payables and $35,000 in the bank.

Q: Yikes, scary.

A: I'll never forget. I needed a bridge loan and I met with three bankers. I remember the sweat falling down the small of my back, because if I didn't get this loan, I couldn't meet payroll. People were depending on me. That's pressure, when you have to get money and you can't find someone to loan the money to you. I finally got the loan. I vowed that I'd never be in that financial position again.

Q: How has the Affordable Care Act impacted Virtua?

A: The good news in New Jersey is that we had a lot more enrollment in Medicaid in 2014, so patients who were not covered are now covered by Medicaid through the Affordable Care Act. That has been a real positive for us and for a lot of health systems.

Q: But aren't Medicaid government payments low?

A: Yes, but they are something. It's either 60 percent [of costs] or nothing.

Q: You undertook a Six Sigma improvement program and eliminated more than $30 million in inefficiencies. Like what?

A: We looked at the process of when a patient comes into our emergency room. How quickly do they get to a bed? If the process is not efficient, your emergency [room] starts backing up. It not only affects dollars, it also affects patient satisfaction.


Title: Chief executive, president.

Home: Center City

Family: Wife, Mary Lee; daughters Kristen Lacroce, 31; Heather.

Diplomas: Bishop Eustace; Mount St. Mary's Univ., business; Southern Illinois Univ., master's in business administration.

 Saturday mornings: Cooking pancakes, listening to Siriusly Sinatra on the radio.

In the batter: Vanilla and blueberries.

Seats: Walnut Street Theatre, Eagles.

Most admired coach: Dick Vermeil. EndText


 Hospital beds: Virtua Marlton, 198; Virtua Memorial, 383; Virtua Voorhees, 398.

Also: Many doctors' practices, outpatient and wellness centers in Gloucester, Camden, Burlington Counties.

Dollars: $60 million net on operations on $1.2 billion revenue in 2013.

Admissions: 782,000 outpatient visits, 58,700 inpatient in 2014.

Payer mix: 40 percent government.

Employees: 8,700. EndText


Rich Miller's lessons from shadowing nurses and medics www.philly.com/jobbing


Interview questions and answers have been edited for space.