From the Loading Dock to Mahogany Row

The story of Janice Dabney’s career is a long and remarkable one. In 2012, at the age of 66, she was named CEO of Springs Memorial Hospital in Lancaster, SC, a place that has been the center of her world for almost her entire life.

Growing Up in the Hospital’s Orbit 

“I was raised around this hospital,” Dabney explained. “My dad was the business office manager when I was in elementary school, so I was here a lot. We'd come pick up my dad after work. Of course, sometimes I'd come and he'd take me around to different departments and introduce me to people. You know how parents show off their children. So I was really sort of raised around here.”

Dabney and her family moved to Columbia when she was in third grade, but found their way back to Lancaster by the time she was a teen. After high school, the future CEO enrolled in the University of South Carolina Lancaster for business and started looking for a part-time job.

“I wanted some extra work to do so I came over to the hospital,” she recalled. “I was so naive back then, I didn't have a clue about protocols and all that good stuff. So I went straight to the CEO's office like I knew what I was doing. I said, 'I'm going to school during the day and I'd like a part-time job.’ He said 'well, I think we might be able to help you out.' So he took me across the hall to the director of nursing and said 'this young lady would like a job.' Within about a week, I was working second shift in the emergency room as a nursing assistant.”

That candor and pluck became a hallmark of Dabney, who has a warm yet no-nonsense demeanor that made her a natural fit for leadership roles. But first, she would spend a few years learning the ins and outs of how hospitals worked, circa 1965.

“It was on-the-job training back then,” she said of her first job staffing the emergency room. “They didn't have certified nursing assistants back then. There wasn't even a certification process. So I was an NA trained on the job. And, literally, I was the only person on duty in the ER. In fact, the ER was on the first floor of the hospital back then. Medical records, radiology, a lot of the ancillary departments were on that floor, and they were all gone at night. So I was the only human on the entire first floor of the hospital! If somebody came in, we had a ledger book and you literally opened up this book and entered in the date, name of the patient, didn't mention insurance or anything like that, just who their doctor was and their chief complaint.”

It was at this point that Dabney realized some of the less than savory aspects of clinical work. She still has vivid memories from that time period, of seeing teenagers killed in automobile accidents or men arriving with severed limbs. But it wasn’t enough to scare her out of the hospital altogether. 

“After working there for a while, I realized I couldn't handle this blood and guts stuff,” she admits. “I realized I was definitely not going to be clinical material. Being as naive as I was, I went back to the CEO and asked if there was anything else I could do.” 

That’s how Dabney ended up on the loading dock, lugging supplies into the hospital’s warehouse. She would hold that job throughout college, pulling in just 65 cents per hour. (Hospitals were exempt from minimum wage requirements until 1967.) She liked the work, but didn’t necessarily see a future there. 

“I was going to school for business,” she points out. “I had no idea I was going to end up in healthcare.” 

Entering the Executive Suite

Dabney’s entry point into the administrative world was something that made intuitive sense back in the ’60s, but seems alien to us now: shorthand. 

“While I was in school, we learned shorthand if you were on the general business track,” Dabney explained. “[Executives] needed somebody who could take dictation, because that's the way they did it back then. They didn't have transcription machines and the computers and technology we have today.”

As it turned out, when the CEO’s secretary moved away, Dabney was the only one in the building who had that particular skill. 

“So the job was mine if I could do it,” she recalls wryly. “I came up [to the executive suite] and it was the CEO, CFO, and Vice-President of Administration, and I was going to work for all three of them. I said, 'don't give up my warehouse job until I'm comfortable I can do this.' So I came in here and it was a fancy place—I called it going from the loading dock to Mahogany Row.”

The transition to her new role took some adjusting. She missed the camaraderie and social contact from the constant movement and interaction with other staff that she got in the warehouse, but her experience there proved to be an unexpected benefit to the hospital leaders she was serving. She encouraged the CEO, Dace W. Jones, to engage the employees more directly and take a more active interest in the day-to-day activities of the institution.

“They don't even know who you are and they're scared to death of you,” she told Jones. “There was nothing to be afraid of—he was one of the nicest people I had ever met. So he started making rounds every day. He ended up being there for 28 years and he's remembered still to this day for rounding every department, every day, speaking to the employees.”

From Secretary to CEO

Dabney’s rise up the ranks of the hospital’s leadership is largely connected to Jones’ mentorship, who gradually promoted her and expanded her responsibilities throughout the 1970s and 80s. 

“He was a tremendous mentor, and he also told me that timing is everything—that when the right time came, he would give you that next promotion,” she said of Jones. “And I listened to him. People today, they don't think like we did back then. They are looking for instant gratification, not always wanting to work in the trenches first. I wasn't on some kind of career ladder, looking to be this next or that next. I had no thoughts about ever becoming the CEO. That would have never entered my mind. And when the time came he promoted me to the next level, then the next level.”

It was Jones’ constant encouragement and support that allowed Dabney to find her way as an executive in an industry almost entirely dominated by men.

“I used to go to the South Carolina Hospital Association annual meeting years and years ago, like in the early ’70s, and I didn't see any women there at all! I just looked around and said ‘wow, I'm fortunate to be here,’” she says. “Mr. Jones would take me so I could get exposure to it, and he sent me to leadership conferences and encouraged me to get my certification through the American College of Healthcare Executives.”  Dabney ended up being a Fellow in ACHE.

By 1994, Dabney had been named Vice President of Administration. That year, the hospital made the shift from not-for-profit to a for-profit institution and she became an Assistant CEO.  

“I stayed in that role for years and years and years. Being in that number two slot was the most comfortable slot you could be in,” she said. “You had all the power you needed, but the buck didn't stop with you.” 

A number of CEOs came and went over the intervening years, and Dabney was often called to serve as an interim chief executive. Then, in November 2012 at the age of 66, she was named the leader of Springs Memorial Hospital. 

“I've always enjoyed every minute of everything I've ever done. I look back at those other jobs that I had in the beginning and I was just as happy then as I am now. And I'm still having fun today,” she said. “It's difficult at times, because healthcare is tough these days. I can truthfully say I get up every morning and I come to work in a good mood because I like what I'm doing. And at my age, I could just go home!”

On Breaking a Glass Ceiling

“I don't know that I understood it [as such],” Dabney says of her unusual position as a female leader in the healthcare world. “I'm not one of those who wanted to break the glass ceiling. I never thought of it that way. I worked hard and I think my working hard is what got me where I am today, not that I was on a path to break a glass ceiling somewhere. That has never been my motive. I always wanted to be happy doing what I was doing, and whatever role I was in. If I could not add value, I did not want to be in that role.”

On Starting from the Bottom

“The advantage of coming up through the ranks like I did is that I've never lost sight of where I came from and who I was at that point in time. I look back now, and if we're developing policies and procedures and things like that, I want to know how it's going to impact the frontline. It's really easy to sit here and think what I think, but I'm not the one putting my hands on the patient every day and doing some of these other tasks that people do every day. That's really important to me because I was there at one time.” 

On Where Her Work Ethic and Drive Come From

“I grew up in a working family. My mother worked all her life, my dad worked all his life. I never saw them out of work sick, never saw them in a lazy state. And both of them did very well in their jobs. My mother worked for a credit company, and they got bonuses based on how many late fees they could collect. My mother won trips all over the country because she just had a way about her that people didn't mind paying her their late fees.

“I watched her power of persuasion, that influenced me some. Then I watched my dad. I never will forget when he left this hospital and went to the hospital in Columbia, they were 'in the red.' Back then I didn't know what ‘in the red’ meant, but I do today! He was one of the first finance officers to turn that hospital around. It almost killed him doing it. I can remember he was pretty stressed out and worked some really long hours, but his goal was to get the job done. I think a lot of my work ethic just came from watching my parents.”

On The Biggest Changes to Hospitals

“I think the simplicity of everything. Just like I was saying, you walked into the ER and you had a ledger. You wrote down five things. Come into an ER today, you’ve got to give every bit of information you can imagine. There's form after form after form, and there's all these privacy laws, regulatory requirements and consents. There's just no comparison to then and now.

“And when you think of managed care. Back then, the healthcare plans and insurance paid almost a hundred percent of everything—at least they were 80/20 plans. And you know, there's nothing like that anymore. 

“There have been so many regulatory requirements. It's all different. It was so simple back then. Of course, you didn't have private rooms back then. You might be in a semi-private room or a ward with four people. We were one of the first hospitals in the state to have all private rooms with our new facility in '70. Our private room rate was less than what BlueCross BlueShield was paying for semi-private so we thought for sure they would cover our private rate, but not the case.  We ended up negotiating and wound up with a good rate.

“Of course, you didn't have the emphasis—and I don't think we understood—quality and safety like we do today. We didn't realize that hospitals could be unsafe places to be, that you could catch some major bugs in the hospital. Because after all, we're taking care of sick and infectious people and they are bringing in all types of germs. So quality and safety, along with improved technology, are probably the best things to happen in this industry, even though it's highly regulated and sometimes these regulations drive us all crazy.

“You talk about nurses today—if somebody followed a nurse around today and saw what he/she does, they would absolutely be blown away. It's not just checking on the patient and giving out meds anymore. Their documentation requirements are absolutely unreal. I admire them so much for how well they can take care of the patient and at the same time meet all of the different measures and metrics that they are required to meet and every day to keep patients safe and keep the quality high.  

“There are really just so many facets to healthcare now, and it's so regulatory-intense. This is probably the most stressful, because you want to make sure you get your core measures just rightand that your patients are highly satisfied.  If any of these elements fall short, it could mean the difference between receiving 100% or much less in the amount reimbursed for services.  These aren’t the types of things that we had to worry about years and years ago. Years ago, you worried about being financially viable. In fact, in those early years when I was coming up in healthcare a 5% profit margin was absolutely fantastic if you were a not-for-profit. Back then that really looked good, but you couldn’t live off that now. The price of technology alone—and the fact that it's obsolete so soon—it’s just so expensiveand everybody wants the latest and greatest.”

Final Thoughts on a Lifetime in Healthcare

“I love to tell people what it's been like, because it's been a wonderful experience. I'm still as passionate today as I was 50 years ago. It's unreal that I'm in the same place that I started. I look back at that and say, the Lord has really blessed me. That's all I can say. It's been a phenomenal experience.”