He no longer works in a plant that makes bulldozers, but Jim Davis' mindset hasn't changed.
"I think like an engineer but I'm a real hospital executive now," said Davis.
With little fanfare, University Hospital's board passed a motion today making Davis the new President and CEO of University Health Care System.
"Congratulations," said Chairman R. Lee Smith Jr. "We're behind you."
It is not surprising that Davis would approach things this way -- his bachelor's degree is in mechanical engineering and his first job was in the Caterpillar Tractor Co. plant in Peoria, Ill.
While he was working for a chemical company, a colleague got a call from a search firm working for a hospital that needed someone to manage their construction projects. That prompted Davis to start thinking about working in a hospital.
"Let's see, it's clean. It's air-conditioned in the summertime," he said. "Believe me, the chemical plants were hot and dirty. And I thought that just might be something worth looking at."
He was hired as a staff engineer at Aultman Hospital in Canton, Ohio.
"I tell people I actually learned hospitals from the inside out because whenever we'd do a project I would sit down with the nurses or physicians and learn what it was they were doing," Davis said. "Then I would build their facility around them. I got to see a lot of the inner workings of the hospital long before I was managing it."
After working his way up to executive vice president and chief operating officer at Aultman, he took similar positions at two more hospitals in Ohio and one in Florida before landing at University as executive vice president and chief operating officer in 2009.
He was hired with the idea that he would be the successor to CEO J. Larry Read, whose last day was Wednesday.
"He's going to be a tough act to follow," Davis said.
Read could foresee the changes coming in health care reform and thought it would be a good time for new blood, Davis said.
Considering what he is facing in the years ahead, one wonders if going back to bulldozers isn't starting to look attractive.
The health care reform law is expected to generate between 70 and 100 pages of new regulations, while Medicare payments, which make up 43 percent of the hospital's net revenue, are expected to slightly decline.
"We're going to have to think very differently in the future," Davis said. "The health reform act requires us basically to keep improving our quality while also reducing our costs.
"I think the other big change that is coming is we're going to be required to manage care across the continuum.
"Rather than just handling the acute episode, we're going to have to manage ... the 30 days post-discharge as well."
That could mean contracting with doctors to coordinate care, or ramping up the chronic disease management clinic, he said.
Payments for an entire episode of a patient's care will all be bundled together in the future, so the hospital will have to work with other providers on how that is doled out, Davis said.
Medicare and other insurers won't pay for readmissions within a certain time period, so that will also be a key point of collaboration, he said.
"It's going to take a different methodology, I guess, to ensure that when we're done with them in the acute setting that they don't come back," Davis said. "It's all systems when you really think about it. It's systems of care, and we're going to have to rebuild some."
Again, an engineering approach to the problem, which Davis said is more about the process than expertise.
"A lot of engineers aren't experts but they can listen well and they can then apply their problem-solving skills that they were taught and come up with good solutions," he said. "I'm probably my best at a white board working with a group of people on how to solve a problem."
While he jokes about the snow in Ohio driving him south, Davis said he saw in University a strong market leader with a committed board and excellent physicians and staff.
"I just thought it was a winning combination that I would be proud to help lead," he said.