Dr. George Bussey could practice psychiatry or law if he wanted to. But he prefers the administrative side of medicine.

In medicine, says Bussey, the new chief medical officer at FirstHealth of the Carolinas, it's easier to figure out who the bad guy is.

"You always know who the enemy is," he says -- "disease."

Bussey, who took his present position in May of this year, first came to FirstHealth in 2001 as medical director for FirstHealth Behavioral Services, moving to Pinehurst from Kailua, Hawaii, a little beach town where he and his wife had lived for 20 years.

While in Hawaii, he was medical director for Queens Health Management in Honolulu and vice president for The Queen's Health Care Plan, a preferred provider.

It was hard to leave Hawaii, he readily admits.

"I was doing a fair amount of forensic psychiatry," he says, "dealing with the legal system, and testing out legislative and federal rules and regulations, including Medicare. I thought it would be interesting -- and would complement my knowledge of medical legal issues -- to have a grounding in the law."

So he earned his JD (juris doctor) degree from the University of Hawaii and passed the bar exam. Since coming to Pinehurst, he's found the time to earn a master's degree in health-care administration from the University of North Carolina at Chapel Hill.

"We came here to Pinehurst not knowing how long we'd stay," he says. "But we've made good friends and work with good people."

A plus in joining FirstHealth, Bussey says, was the opportunity to see patients again as a clinician at Behavioral Services. Although his promotion means he no longer sees patients, he's still enjoying his job. His wife, Moira, is a senior clinical analyst at FirstHealth, responsible for the information systems side of the electronic medical records.

'A Wealth of Experience'

Resettled in Pinehurst, Bussey became senior medical director in 2002, with responsibility for corporate risk management and medical-affairs activities at Montgomery Memorial Hospital and Richmond Memorial Hospital, while continuing his previous responsibilities. He also served as corporate medical director for FirstCarolina Care, a medical insurer for local businesses and FirstHealth itself.

Bussey was promoted to vice president for medical affairs in January 2005. In May 2006, he replaced Dr. Michael Lachina as chief medical officer at FirstHealth, when Lachina left to accept a similar role with St. Francis Hospital in Memphis, Tenn.

Legal training has given Bussey a "better understanding of law and how various aspects interact with the practice of medicine," he says. And his critical thinking and reasoning skills, different from medicine but complementary to it, have been sharpened.

FirstHealth CEO Charles Frock said he found Bussey's varied experience and training a major plus.

"Dr. Bussey brings a varied background and a wealth of experience to the role of FirstHealth's chief medical officer," Frock said in a news release announcing the psychiatrist's appointment to chief medical officer for the whole operation. "He is not only a physician with an extensive background in psychiatry, but a trained lawyer as well. As our Vice President for Medical Affairs, he has observed how FirstHealth works from the ground up.

"Having been a practicing clinician on the Moore Regional Hospital medical staff, he can identify with our physicians. His previous leadership role with a managed-care organization brings a unique perspective to his new position, and his degree in health administration adds a management dimension to our executive team. I appreciate his willingness to take on this new challenge."

FirstHealth's vice president for quality and vice president for medical affairs report to Bussey, as do a variety of departments, including Home Health Services, Hospice and Palliative Care, Dental Care Centers, Family Care Centers (seven), Centers for Health and Fitness (six), the Cardiac Rehab/Diabetes Self-Management Program, Risk Management, Community Health Services, Behavioral Services, and Hospitalist Services.

Illinois Native

Bussey grew up in Naperville, a small town outside Chicago. He completed his medical education and training at the Eastern Virginia Medical School, the University of Miami and the Eastern Virginia Graduate School of Medicine. He served as chief resident in psychiatry at Vanderbilt University in Nashville.

While earning his under-graduate degree at the University of Denver, Bussey met Moira, a Manhattan native.

On her first visit to Hawaii with her new husband to visit his grandmother, Moira had just left the airplane when she stopped in the middle of the concourse and exclaimed, "A horrible mistake has been made."

"I thought we'd left something important behind," he says. But that wasn't it, as he learned when she added: "I was meant to have been born here."

Having been used to the cold climate she came from, Moira was instantly impressed, as was he. From then on, their shared goal was to relocate to Hawaii. Two years later, in 1981, when their son Andrew was 2, they made the move. Twenty years later, almost to the day, they moved from their ocean island to Pinehurst.

A Compassionate Initiative

At FirstHealth, Bussey is spearheading an initiative of his own to build up a special fund to help pay for substance abuse and addiction treatment for medical staff, including nurses, whose problem may have caused them to lose their employment and medical insurance.

The fund would help pay for treatment that could get them back to work.

The purpose of the fund has another goal.

With the current nursing shortage, Bussey thinks if the institution can help essential medical staff return to productive employment by financing treatment they couldn't afford otherwise, it will help alleviate the shortage of nurses afflicting the area.

"In the health profession we are not immune to addictive substance abuse," he says. "It happens even to the best of the nursing staff."

Another Hawaiian import that the Busseys brought with them is a family love affair with kayaking, which Bussey still practices on the waters of Lake Pinehurst as often as he can.

The Busseys' son Andrew and daughter Megan are also avid kayakers.

Andrew was a member of the U.S. 2004 Summer Olympic Team in flatwater kayaking. He's a graduate in computer science from the University of California at Irvine and this month plans to enter Officer Candidate School with the Marine Corps.

Megan was a competitive junior kayaker in Hawaii through her high school years with the U.S.A. Canoe-Kayak Organization, the Olympics sponsoring body for the United States. She had to drop the sport upon entering Dartmouth College in New Hampshire because the cold New England climate didn't lend itself to much kayaking. She earned a degree in physics there and currently is a second-year law student at Chapel Hill.

'Bit of Wanderlust'

Although he likes his job and lifestyle here, Bussey still fondly remembers a couple of things unique to Hawaii.

His favorite characteristic of America's 50th state is that no single group is in the majority. The mix of races, nationalities, and ethnic groups in Hawaii contribute to a cosmopolitan, tolerant spirit that discourages bigotry, he says.

As for the practice of medicine, Hawaii is big on Oriental treatment methods, acupuncture being one of many options acceptable to mainstream medicine.

For his part, Bussey comes from a long line of teachers, social workers and preachers, from places as far apart as South Carolina and the Midwest. That makes him a natural in a helping profession, combined with "a bit of wanderlust," he acknowledges, allowing him to readily follow professional opportunities wherever they are.

Now he occupies a large office high up in one of the FirstHealth corporate buildings in Pinehurst, far away from actual patients and hospital functions. He deals mostly indirectly with medical issues with multitudes of employees, physicians and executives in a five-county area.

The overall impact of Bussey's office is indistinguishable from those of other top business and institutional executives across America. The big desk is well ordered but not empty, the tall bookcase filled with hard-backed books in muted, solemn colors.

Bussey had the intelligence, curiosity and energy to earn three degrees in demanding fields while carrying a professional workload. During a photography session, though, he chose to be pictured next to a framed United Way poster from the 1970s, showing his grandmother as a senior citizen with a waif nestled under her wing.

Maybe that's because he comes from a family tradition of nurterers who find their satisfaction in helping other people.

Sara Lindau may be reached at slindau@thepilot.com or 693-2473.