For more than a year, Don Snell was the most unwanted man in Augusta.

While politicians and community leaders debated a change to the Medical College of Georgia that shifted control of its hospital to a nonprofit corporation, Mr. Snell spent 1999 and much of 2000 in an office down the hall from the psychiatric day room.

"I always say that was fitting. You have to be crazy to be in this kind of field and environment," the CEO of MCG Heath Inc. said at his office, which is now on the second floor with the rest of the hospital's executives.

Back then, he was a corporation of one, the leader and sole employee of MCG Health -- eventually assigned one-eighth of a secretary, which meant he had an assistant for five hours a week.

Though it seemed the community didn't want MCG Health Inc., the nonprofit corporation that would operate the state school's hospital system, the governor and the Board of Regents did, so Mr. Snell wasn't fearful of losing his job before it really began.

Since the 1970s, the native of upstate New York has made a name for himself in fixing hospitals.

And MCG, with an annual operating loss of $35 million, needed fixing.

In fiscal year 2007, MCG Health earned $23.1 million, half of which it donated to the medical college to support teaching and research.

After seven years in Augusta, Mr. Snell might still be unwanted in some areas of the MCG campus. His tough decisions resulted in restructuring, outsourcing and early retirements for some employees.

"I think he's seen as the person who has inflicted pain," said his wife, Amy Snell. "He still has to explain MCG Health. He still gets that 'Why are you here?' attitude."

Satire fills his office. There's the mock Time magazine Man of the Year issue. There's the money tree by the door, which is a fern with dollars attached by paper clips. What really raises eyebrows are the two Barney dinosaur dolls, an inside joke spawned by Dr. Peter F. Buckley, the chairman of the Department of Psychiatry and Health Behavior on arriving at Mr. Snell's office for a meeting.

Terri Pryor, Mr. Snell's executive assistant, recalled his remark: "He's not mean; he's like Barney."

With some conspiring, Mrs. Pryor's husband bought some Barneys for Christmas last year.

"What makes me laugh when I hear people talk about him is they forget why he came here," she said. "He's a caring person, but not a health care provider. He makes it possible for providers to do what they do. ... If he wanted to sit around and be fluffy and nice, we wouldn't be here."

Fee fi fo fum

Donald Frank Snell isn't called Little Frank because it is his middle name. He is the culmination of the good and bad qualities of his mentor, Frank Iacobell, his boss for 13 years at Detroit Medical Center through the 1970s and 1980s.

The bad: drinking Scotch, smoking cigars and playing golf.

"I can sometimes be impatient like he is. Sometimes I have a temper like he has," Mr. Snell said.

He has impatience for people who aren't pursuing organizational excellence. In those cases, "I can be testy and demanding."

The good: Devotion to the field and a quest for excellence.

"I watch him every day. He does the same thing every day. He is as committed today as the first time I saw him. ... The first thing on his mind is the success of this hospital," Mrs. Pryor said.

Before the birth of Little Frank, the hospital administrator, there was the birth of Katherine and Donald Charles Snell's first child in 1954 in Little Falls, N.Y., a small city at the foot of the Adirondack Mountains, 70 miles east of Syracuse.

Mr. Snell's parents were a two-income family in an era where that was uncommon.

Donald Snell was a welder who spent his weekends racing stock cars and playing drums. Katherine Snell worked in offices and in home health care.

"Mom was tough, and she instilled that in us, a lot of inner strength," said Mr. Snell's sister, Patty, who is a social worker in New York.

The kids were taught independence and responsibility, she said. The need to sometimes fend for themselves was the origin of Mr. Snell's love of cooking.

He got his first set of drums when he was 4 years old. Eventually, there was a point in his life when he had to decide whether to become a professional drummer.

"He was at that crossroads when he graduated college. He was that good," Amy Snell said. Instead of moving to Nashville, Tenn., to break into the world of professional music, he chose a less risky path.

Mr. Snell's first exposure to hospital management came from his high school Explorers post, which was created by the head of a hospital.

Mr. Snell was befriended by the administrator and worked a series of summer jobs there, from maintenance to food service.

"I think it is an asset to his career," his sister said. "If someone ever challenges him that he doesn't know what it is like to work in the laundry or the lower levels of the hospital, he has worked his way up."

At State University of New York in Albany, Mr. Snell pursued a degree in sociology, concentrating his electives toward a career in health administration.

In 1976, Mr. Snell left his college bands and Blue Oyster Cult-style rock to go to Washington, D.C., to get a master's degree. After one year of studying at George Washington University, he went to Detroit to do his residency, to a place that was considered tough because so many had washed out there.

"He had high expectations," Mr. Snell said of Mr. Iacobell, who is still running a hospital in Detroit. "He felt that choosing hospital administration was like entering a monastic order."

People who didn't eat, sleep and drink administration were seen as not being serious about it.

"I was convinced it was my life's calling, so I put in my time," he said.

Mr. Snell was hired within three months.

The road to MCG

"What I got involved in early was a financial turnaround of the Detroit Medical Center," Mr. Snell said. "I liked that. I liked the challenge of fixing something that was broken."

In 1991, after 13 years in Detroit, Mr. Snell was recruited to Atlanta to be the second in command at Grady Memorial, which was under political pressure to bring its budget under control. Then it was off to Philadelphia to help the University of Pennsylvania build a health system.

Another turnaround was presented to him in 1996. When he took the job at Long Island College Hospital in New York City, he thought it was losing $1.5 million a month. It was worse. Previous executives had cooked the books to hide additional losses. They had spent all the endowments and research money for operations.

Mr. Snell didn't make many friends in his first few months in charge.

"I had to lay off 700 people," he explained. "But this place was going to be bankrupt in three to four months."

He and the chief financial officer sat down every morning and discussed who could be paid that day and which invoices could slide for a few weeks more.

The hospital received a $400 million gift in the summer of 1998 from a patient who was a friend of Warren Buffet and had been investing wisely.

The facility eventually merged into the New York City system. When Mr. Snell's role altered because there were new leaders, he was able to pull the "golden parachute" clause in his contract and leave.

A recruiter brought a new fix to his attention -- a medical college in Georgia that wanted to separate its hospitals and clinics from its classrooms.

"I was here on the campus when the fit was hitting the shan, as I say," Mr. Snell said of his first job interview.

The people who least embraced the change were the most vocal, recalled Don Leebern, the chairman of the board of MCG Health Inc.

Mr. Snell bubbled to the top of the five candidates trying for the new post.

"No one was has an ability to set an agenda and get people to buy into that agenda like Don does," Mr. Leebern said. "Don is the type guy who will always dwell on opportunities."

He dwelled for months on how to make MCG's hospital and clinics a money maker. He developed a plan for the ideal hospital system, crunching performance numbers and checking market models.

The separation was set to begin July 1, 2000. On June 30, Mr. Snell sat in the office of then-Chairman Tom Allgood, waiting for any last-minute injunctions to shut down the process. None came.

Mr. Snell said he still can hear Allgood's voice: "Don, it is yours and my ass on the line now."

The first few years of MCG Health Inc. were full of heartburn, Mr. Leebern said.

Staff levels were reduced through early retirement. Some services were outsourced. Salaries were increased, coupled with some merit-based raises. It was a culture change. More importance was placed on financial performance, clinical quality and patient satisfaction.

When Mrs. Pryor moved to Augusta in 1989, most people told her not to work at MCG, filling her ears with negative comments about the facility.

The environment started to change with Mr. Snell at the helm.

"I was mesmerized because that was the first time I'd ever heard anything positive about this hospital," Mrs. Pryor said. "We did things that helped people. We had wonderful doctors. Where did this man come from that knew so much about this hospital? He's an outsider, here two or three months, and he could tell this to employees and motivate them."

Patty Snell said she admires her brother for the fact that he'll go after what he wants.

"He's the fighter and the lover of the family, that's why I'm the therapist," she said.

Chez Snell

Cooking is Mr. Snell's way of relaxing. So much of his energy is devoted to something that won't show results for years, but cooking is instant gratification, his wife explained.

"He's my grill chef," Amy Snell said. "He's funny. I'll be in the kitchen doing something and he'll wander in and take over."

While his wife was in law school in Detroit, he needed to cook four nights a week. During his residency in Detroit he'd been putting off marriage, saying he was a lowly student without a job. When he got the job, he got the ultimatum.

"I thought about it for five seconds and said OK," Mr. Snell said. "She was my best friend even when we were dating."

They met in college in Albany, N.Y., on a blind date. It was April 4. Every year they celebrate the day they met with pizza -- what they ate on that night in 1974.

They had music and athletics in common. The drummer saw something different in the clarinetist than the other girls he was dating.

She became the trailing spouse, following him from place to place, even before they were married. Six moves in 29 years, she said, is enough, though she was able to get good jobs in every city they landed.

Before MCG Health officially took over the hospital, Amy Snell remained in Philadelphia. They spent the weekends together during those two years, alternating who flew to see whom.

They are a mixed religion couple. Amy Snell has Hanukkah candles in their den, across the room from the Christmas tree placed there by the Baptist.

The couple has no children.

"We decided early on that we were going to be a two-career couple," Mr. Snell said. "She was going to put a lot of energy into her law career. I had been bred by Frank Iacobell to think of health care administration as a monastic order. We decided not to have kids. We can't even give a dog a life because of the hours we work."

One of their big dreams is to get a dog the day one of them retires.

Mr. Snell said his wife is a tough cookie, a breast cancer survivor who fought the disease for nine years. She's been cancer free for six years.

She said she's learned to have more confidence in herself through her life with Mr. Snell.

"He has a lot of inner strength. He doesn't need to rely on people for his strength, motivation, courage. It is in the way his parents raised him. I admire it because I don't always have that. He is a principled person, does what is right even if people disagree with him," she said.

She tolerates his smoking, banishing him to the back porch to smoke his Opus X cigars.

As to his bad habit of golf, it's her habit, too. It is their Sunday morning activity together. Mr. Snell acknowledges that she has beaten him a few times.

He doesn't play the drums as much as he once did, maybe touching them once in three to four months. Returning to steady play is another retirement dream.

He comes from a musical family. Not only did his father play the drums, but Patty played the clarinet and saxophone. They have a cousin who plays cello in a New Zealand symphony and another in a symphony in New Mexico.

Amy Snell said she wouldn't be surprised if her husband stays with MCG Health until his retirement.

"He has so much experience and so much to offer he may never 'retire retire.' What he'll do is step out of the CEO role and take more consulting. I don't know if he'll be truly happy because he likes being the king. He likes being the boss."

Reach Tim Rausch at (706) 823-3352 or timothy.rausch@augustachronicle.com.