Carolyn L. Adams is the new director of the Ralph H. Johnson Veterans Affairs Medical Center, becoming the first woman to lead the Charleston-based VA hospital system in its 44-year history.

Adams, whose appointment was announced Thursday, will oversee more than 1,600 employees at the Charleston center and community clinics in Myrtle Beach, Goose Creek, Beaufort and Savannah.

She assumes the helm of the center as the number of veterans -- including combat veterans -- seeking medical care continues to rise.

John E. Barilich, who had begun serving as director in December 2006, is retired.

In 2008, the center, which serves about 50,000 patients a year, was ranked No. 10 overall among the nation's 155 VA hospitals, and No. 2 for its quality of care. Two years earlier, it was 79th on the list, according to the Veterans Affairs' rating system.

Between meetings Thursday, Adams cited opportunities to enrich the hospital's affiliation with other health care providers and to bolster its high-tech facilities with further improvements. And she credited her mentors and colleagues at the VA for their support.

"Individuals in the VA really want you to be successful," said Adams, whose appointment as director was effective Tuesday.

John C. Hales Jr., executive-in-residence in the Department of Health Professions at the Medical University of South Carolina, and a South Carolina regent for the American College of Healthcare Executives, said women constitute about three-fifths of his classrooms, and their participation in health care professions is increasing noticeably.

"The majority of applicants are female," Hales said. "As new students move up the ladder, you're going to see more and more females in those ranks. And also you'll see a number of females who have a clinical background … who have gone on and gotten their graduate degree in health administration."

The numbers back up Hales' observations.

The proportion of women relative to men who have achieved CEO status at U.S. hospitals has increased, according to the American College of Healthcare Executives. "In contrast to the three previous studies where women achieved CEO positions at about 40 percent of the male rate, in 2006, they achieved CEO positions at 63 percent of the male rate," ACHE reported.

There are 2,106 female CEOs at U.S. hospitals, roughly a third of the total number, according to the American Hospital Association.

At the Medical University of South Carolina, significantly more women than men enroll at the school each year: 1,601 women compared with 913 men in 2009, and that ratio is typical of the last 10 years, according to the Office of Enrollment Services.

Lawrence Biro, the VA's southeast network director, overseeing South Carolina, Georgia and Alabama, said four of eight centers in his network have women directors, the result of efforts to foster diversity.

The VA launched a mentor program two years ago in response to a wave of retirements and staff turnovers, Biro said. The executive training program has cultivated a new generation of leaders, including Adams, who was part of the first graduating class. She takes over the Charleston center as enrollment in the VA system grows about 5 percent a year and the patient population changes, he said. Vietnam veterans are aging, and more than 10 percent of today's veterans are women, Biro said.

Bunny Mizzell, the VA's women's program manager, said she is glad that the hospital now provides comprehensive primary care, enabling women patients to work with one main doctor who attends to all health concerns.

Next, she'd like to see a women's clinic that consolidates all services in one area of the facility, she said.

"In the past, there were hundreds (of female patients); now there are thousands coming in for medical care and mental health care," Mizzell said.

Adams said she looks forward to expanding research, delivering coordinated care, working with health care and emergency aid partners in the community and improving hospital facilities.

The VA acknowledged in April 2008 that Biro was overseeing an administrative investigation into management practices at the Charleston VA.

An inspector general's assessment found problems with administrative details, such as completing peer reviews and patient care deficiency reviews, and recommended Barilich work with Biro to resolve the problems. The report indicated most of them had already been resolved.

In 1997, Veterans Affairs conducted an inspector general's investigation of the Charleston center that focused on misspent money and improper hiring at the center among allegations of mismanagement by the director at the time. The inspector's report indicated the misspending allegations were partly substantiated.

Women in the military

                            2005 — 2006 — 2007 — 2008

Total number of active-duty women — 203,000 — 202,000 — 198,400 — 197,900

Number of female officers — 35,000 — 34,000 — 33,500 — 34,300

Number of enlisted women — 168,000 — 168,000 — 164,900 — 163,600

Proportion of women in armed forces — 15% — 15% — 14% — 14%

Number of female veterans — 1.7 million — 1.7 million — 1.8 million — 1.7 million

Total number of female veterans in S.C. (as of Oct. 2009): 34,915

Total number of female veterans (as of Sept. 2009): 1,824,198

Total number of all veterans (as of Sept. 2009): 23 million

States with largest number of female veterans: California, Texas, Florida, Virginia, Georgia

Note: In 1950, women comprised less than 2% of the armed forces.