Four days into a nursing strike that has cost her Allina Health system millions of dollars, Dr. Penny Wheeler offered prescient advice at a meeting of women leaders in health care.

“Sometimes,” she said in the Sep. 8 talk, “you need to choose courage over comfort.”

Courage aplenty has been required on both sides of a contract dispute pitting Allina Health against more than 4,000 of its nurses over the cost of health benefits.

The nurses have risked their livelihoods, striking for a week in June and for three weeks and counting since a walkout that began Labor Day.

And as Allina’s chief executive, Wheeler has put on the line her reputation as a consensus-builder whose success has benefited from the support of doctors and nurses.

“This is the biggest thing I’ve faced since I went from being a full-time practicing physician into a health care leadership role,” Wheeler said in an interview, “and it’s because I know that organizations are illusions — that they are built on relationships … to keep and foster.”

In her first round of nurse contract talks since becoming Allina’s CEO, Wheeler has become a lightning rod, deciding to take on the nurses’ costly health insurance benefits even as competing hospital systems punted on the issue and quickly reached three-year contracts that only changed nurses’ wages.

Her stance, to some, has put her in conflict with her own views. In the past, she has questioned the value of high-deductible health insurance, and yet now she wants to move nurses from their low-deductible union plans to a menu of lower-cost Allina corporate options. Two of those options are high-deductible plans.

She supports collective bargaining, and yet critics accused her of union-busting this week when, in an open letter in the Star Tribune, she reminded striking nurses that they are due to lose their health benefits if they don’t return to work by Oct. 1.

Wheeler also has contributed to DFL politicians, and yet two dozen of them stood with nurses last week — including Rep. Erin Murphy, DFL-St, Paul, whose campaign has received $2,000 from Wheeler since 2014.

“The things she said about health care in the past, I would agree with,” said state Sen. John Marty, DFL-Roseville, who picketed with nurses last week but also has worked with Wheeler on a state health reform task force. “But what she is doing here seems contrary to what she believes.”

A high-profile leader

Wheeler, 58, says she takes pride in a career that started and stayed in Minnesota. She notes that she was born at Abbott and graduated from the University of Minnesota before practicing locally as an obstetrician for two decades.

Her ascension into administration started when hospital peers elected her president of Abbott’s medical staff. She then became Allina’s chief clinical officer and was named CEO in 2014.

Wheeler acknowledges her prior views, but she said a greater concern is that Allina has allowed too many growing expenses such as nurses’ health benefits to linger and threaten the organization’s long-term future.

“There’s been kind of a can that’s been kicked over the years in dealing with some of these issues,” she said.

Wheeler has gained attention nationally, particularly for leading Allina into novel partnerships. Allina and Children’s Hospitals and Clinics of Minnesota collaborated on mother-baby obstetric centers, for example, while Allina and the competing HealthPartners system allied to improve the health of the economically and racially diverse population in the northwest metro area.

Modern Healthcare honored Wheeler as one of the nation’s top 50 executive physicians and top 25 women in health care. Married to Minnesota Supreme Court Justice Margaret Chutich, Wheeler is one of the only LGBT women in the country running a large health care system.

Empty chair

Her interest in a progressive style of health reform shows in a long list of volunteer posts, including Gov. Mark Dayton’s health care reform task force and the boards of Portico Healthnet, a charitable organization, and Minnesota Community Measurement, an agency that ranks doctors on quality and cost.

Fellow board members described her as skilled at making complicated health information understandable.

“If I were a nurse, yeah, I would want a person with her background and dedication and sensitivity to the tradition of nursing ... sitting across the table from me every day,” said former U.S. Sen. David Durenberger, also a former Allina board member.

All of which has frustrated striking nurses, who see a CEO they have respected taking a hard-line stance against them. Some pickets view her role in the strike as betrayal; others wonder if she is carrying out orders from Allina’s board.

“Why she has become the devil incarnate, so to speak, is because of the love and trust that [nurses] did have for her,” said Mary Turner, president of the Minnesota Nurses Association, which represents nurses on strike at five hospitals: Abbott, United in St. Paul, Mercy in Coon Rapids, Unity in Fridley and the Phillips Eye Institute in Minneapolis.

Nurses have asked Wheeler to participate more directly in negotiations.

Nurse Vicky Robinson used to work with Wheeler in Abbott’s OB unit. She hugged Wheeler the last time they met, a few years ago. Now Robinson isn’t sure she would acknowledge her at all; the nurse is worried about switching health plans, given her medication needs for diabetes and after a kidney transplant.

Nurse Robin Rush also worked with Wheeler years ago and feels conflicted: “Most of us nurses, when she got the CEO position, were thrilled, thinking, ‘My God, she gets us!’ So for me, this is very difficult.”

When Wheeler first took charge at Allina, some worried that she would be too empathetic. Now she hopes empathy will help when it comes time for “relationship repair” with nurses.

“We’re in the healing profession, so I hope that works both ways,” she said. “I totally appreciate and value their work. These people have often given me much better ways to take care of my patients, have saved many of my patients from suffering. I hope the understanding I have for the value of their work will come through.”