Dr Graman is CEO of PeaceHealth Medical Group, a 700-provider multispecialty group with operations in Oregon, Washington, and Alaska. He is helping to lead the transformation of a 9-hospital healthcare system with regionally distinct medical groups into a single medical group with closer integration into the hospital system. For the 5 years prior to this position, he served as Chair of Primary Care and Regional Medicine at Carilion Clinic, in Roanoke, VA, as an integral part of Carilion's senior management team. There he was engaged in transforming a traditional hospital system with employed physicians into a physician-led multispecialty "Clinic Model" organization. Before being recruited to Carilion, Dr Graman was at Cleveland Clinic where he served in roles as Medical Director of Cleveland Clinic Strongsville, a family health and surgery center and then as Executive Director of Cleveland Clinic Florida in Weston. Dr Graman joined The University of Vermont as a clinician educator in the division of general internal medicine in 1978 after completing his residency at the University of Michigan and serving 2 years in a medical shortage area as part of the National Health Service Corps. At UVM, his focus was in practicing and teaching medicine with a specific academic interest in the doctor-patient relationship. He helped create and taught in UVM medical school's interviewing course and was instrumental in bringing the use of videotaped interactions into residency training. Dr. Graman has also trained physicians nationally to teach interviewing skills in their respective institutions and has served as a consultant for several large medical groups by providing seminars to their employed physicians on doctor-patient communication skills as a Fellow of the American Academy on Communication in Healthcare.