First the announcement. Then the applause. Now, the questions.
When outgoing County Administrator Fred Karl announced Monday that he would accept the interim presidency of Tampa General Hospital, members of the troubled hospital's board responded with near-unanimous enthusiasm and praise.
Karl, 70, has a reputation for tackling seemingly insurmountable problems, and his move to the hospital was cheered by many as an inspired addition to a facility plagued by discord. Embattled hospital president David Bussone resigned Monday after repeated clashes with hospital trustees.
But Karl's successes have been in the fields of law and government. Whether he can transfer the skills of a lengthy public service career to solve the problems of a financially and philosophically troubled public hospital remains to be seen. Along the way, he will have to address whether the health care system holds such unique challenges that its leader must have knowledge specific to the field to succeed.
Health care professionals and government leaders who considered that question Tuesday had much the same answer, whether they knew Karl or not. They say that he has the leadership skills the job requires and that he can pick up the technical knowledge along the way.
"Being a CEO of any organization requires a certain set of skills and attributes, and many of those skills and attributes are not business-related," said Dr. Richard Hoffman, associate dean of the University of South Florida Medical School.
Hoffman, who was speaking about leaders in general, not Karl specifically, said character and people skills are most important. Experience in the field helps, he said, but isn't immediately necessary to do a good job. As an example, Hoffman cited chief executives who move from one company to another in an unrelated field.
"From the academic point of view, the CEO must have CEO attributes," he said. "(The president) can build the technical attributes" needed.
If Karl is approved to take control of Tampa General, there is little question he will need the knowledge of details he used as a county administrator, the fairness he needed as a state Supreme Court justice and the political savvy he developed in his years of working in the public spotlight.
It also wouldn't hurt for him to surround himself with people who know a lot about hospitals, medical professionals say.
Dr. Thomas McKell, medical director at Tampa General and a strong supporter of Karl, said the county administrator's public service background will certainly be a plus.
"I'm sure his experience as a public servant will help him in dealing with different people," he said. "While (health care) is different, I'm not sure that management is different. He can get an education about the health care situation _ where we have to go and move."
McKell said there is no question Karl is up to the task.
"He is an urbane gentleman, and I mean that in the finest sense of the word," he said. "He listens to everybody and does not hurt people's feelings. . . . He's able to deal with problems and (different) positions in an even-handed way."
Members of the Hillsborough County Hospital Authority, a normally divided group, were uncharacteristically solid in their vote to offer Karl the job as Bussone's replacement.
Hospital board member C. Blythe Andrews Jr. said "the man himself" was enough to convince him that Karl was appropriate for the job, and Karl's lack of medical experience was not "a major negative."
"I think he is a proven leader. A person who obviously can get things done," Andrews said. "He should be able to adjust and get all parties that need to get together, together, and learn very quickly about health care."
Even Burton Lowe, the only board member who voted against offering Karl the job, said Tuesday his dissenting vote wasn't to express dissatisfaction over the choice of Karl. Instead, he felt the hospital board was avoiding hard choices about Tampa General's future by getting rid of the messenger, Bussone.
"I was simply expressing my reaction to the situation, and what had transpired was in no way a negative commentary on Mr. Karl," Lowe said. "I just think that Mr. Karl has wisdom and vision enough to recognize there is a wide range of possible ways for TGH to fulfill its public mission."
As for Karl himself, he pointed out that he was the county attorney when he took the job as county administrator in 1990, and had no previous experience at an administrator's job.
"I was coming from the county attorney's office, and I knew a good deal about internal operation, though not the details," he said Monday.
Karl said that the hospital president's position was "fundamentally an administrative undertaking," and that though he does not have experience in running a hospital, he has dealt with other aspects of health care. He worked for the Florida Medical Association as a lawyer, he said, enacted the first HMO legislation, handled Medicare and Medicaid disputes and oversaw the county's indigent health care programs.
"I'm no stranger to medical things and medical people and medical facilities," he said.
_ Staff writer Marty Rosen contributed to this story.