Practiced as an Emergency physician in Michigan and New York since 1987. Have held administrative positions in emergency departments. Was the Chief of Emergency Medicine at Columbia Memorial Hospital in Hudson, NY from 1999-2008. Accepted role as Medical Director in 2008. Has developed expertise in many areas of healthcare, including lean management, patient safety, clinical informatics, medical staff development, and quality management. Also active in EMS as medical director of several rescue squads.