Providence Health and Services Western Montana, the health care system that administers St. Patrick Hospital in Missoula, has named Dr. James McKay to its newly created position of chief physician executive for acute care.

McKay, a radiologist with Missoula Radiology, came to Missoula in 1999 and now serves as president of the medical staff at St. Patrick Hospital. He will assume his new role on Dec. 27, but will continue to work at least one day a week as a radiologist.

“I was part of a group of 12 doctors that got together last spring to talk about coming up with a new administrative structure to give the physicians (in Providence Health and Services Western Montana) more voice, both in the hospital and at the system level, which we haven’t had in this region,” he explained. “And being part of a big group like Providence, it’s important to have that voice at that table.

"A lot of decisions are made at the system level, so you need to have physician input and influence on these decisions, specifically for a smaller region like western Montana. Some of our issues are a little bit different than say, what docs are dealing with in Seattle or in Portland or whatever.”

In his new role, McKay will join the western Montana executive team, integrating the administrative and medical staff teams.

“This enhanced physician leadership model will help deliver on our vision of establishing comprehensive care coordination throughout the patient journey, as well as improving clinical outcomes and patient satisfaction,” said Jeff Fee, chief executive of Providence Western Montana. “Since coming to Missoula 16 years ago, Dr. McKay has emerged as an extremely capable, articulate and thoughtful leader. He is the perfect person to build on the positive and mutually supportive relationship between the administration and medical staff throughout our region.”

McKay will also partner with St. Pat’s chief operating/nursing officer Joyce Dombrouski on the clinical and operational oversight of the hospital.

“Dr. McKay is a highly skilled physician with a reputation for excellence,” Dombrouski said. “We are thrilled to welcome him to the executive team, where his clinical experience and longstanding relationships with our medical staff will be a source of strength as we work to improve the quality and value proposition of the health-care delivery system throughout western Montana.”


McKay said that when the advisory panel was meeting, it wasn’t even on his radar to apply for the position.

“I became president of the medical staff last January and was interacting more with the administration and sort of seeing what their culture was like, because there is a difference in the culture between physicians and the administration,” he recalled. “And I saw that there was a need to have more of a bridge and an understanding between those two cultures. The only way we’re going to move forward is if people can talk to each other and understand each other. So that was my goal.”

McKay, who majored in English in college and spent several years as a smokejumper in Missoula before going into medicine, also saw an opportunity to do more good for more people.

“I didn’t take the ‘straight arrow path’ into medicine,” he explained. “It sounds corny, but I wanted to be able to look back at the end of my life and feel like I did something that was worthwhile. And so I thought for me, medicine would fulfill that and make a difference and be something that was worthwhile. And that’s why I went into medicine in the first place.

"And what I see with this new position is that I can do that on a sort of a bigger scale. Instead of doing that sort of one patient at a time, I can have more influence and do that just basically in a broader scale.”

McKay said the details of his new role have yet to be completely ironed out, but he envisions himself being a facilitator between physicians and the hospital administration.

“What I would hope to do is give the docs more of a voice than they have and sort of remove barriers and obstacles to them being able to do their job on a daily basis and give them the tools they need,” he said. “At the same time, helping the docs understand why certain things might have to be done a certain way, you know, from a systems perspective. It’s kind of a crazy time in health care.

"It’s hard to be a doc right now, because it feels like everything is shifting under your feet. All this talk about new payment systems, new ways of measuring quality. Some of the ways docs have been able to think about autonomy and everything are getting difficult to sort of sustain.”

McKay is a graduate of both Dartmouth Medical School and the University of California-Davis Medical Center. In the past, he has served as medical director of the Broadway Imaging Center and chair of the Department of Radiology at St. Pat’s. He lives in Missoula with his wife and three children.