The Utah Department of Health employees and their families showed up for the early Saturday morning walk despite gloomy clouds and the threat of rain. Sundwall started the monthly weekend hikes in late April to encourage fitness and camaraderie among his workers, with the ultimate goal of scaling Mt. Olympus together in October.

Along the four-mile maiden trek, the new executive director shared stories about everything from his recent trip to China for an HIV/AIDS conference to his life in Washington, D.C., for the past 24 years, where he worked on health care policy. He asked his new employees about their families and interests, learning more about Carol Masheter's plans to climb the Himalayas this summer.

"I think this is an excellent idea," said Masheter, who works in the Office of Health Care Statistics. Sundwall "has a really positive energy, and he's very personable."

Sundwall, 63, has only been on the job since January, but is making an impression as an approachable administrator with a clear vision for his agency.

Among his top priorities: reversing the childhood obesity trend, which he calls an "impending disaster with immense costs to the health care system," possibly merging health department and Health and Human Services programs that overlap, creating a Medicaid preferred drug list to "save money with collective buying power" and improving health insurance coverage.

The last interest helped Gov. Jon Huntsman Jr. court Sundwall to lead the health department in October, before Huntsman was elected. The Murray native said he was lured back to Utah when Huntsman said his goal was to provide health insurance for every Utahn.

"Universal coverage - that cinched the deal for me. I thought it would be a wonderful opportunity to work with the governor," he said.

Following a summit on the uninsured this week, Sundwall is evaluating options for the governor to include in his 2006 budget.

Despite his extensive experience, Sundwall realizes he is on a learning curve with his new duties - including dealing with state legislators. His confident style has ruffled some feathers in the Legislature, with at least one lawmaker accusing him of being a brash Beltway insider who aggressively charged into his new job.

Sundwall intends to collaborate more often with legislators - but keep the lead-by-example style that had him at the head of the Saturday hike.

Some of his employees "are not in the best shape," Sundwall confides, quickly adding that he could stand to lose 20 pounds himself. "I want to show that people who are old and overweight are not over the hill."

During the 1980s, a homeless advocate threatened to form a human chain around the offices of the Health Resources and Services Administration if Sundwall, its leader, didn't provide more physician volunteers at D.C. shelters.

"He was a good advocate but a bully," he said. "I said, 'If you think I'm going to take doctors out of Appalachia or Harlem, you're crazy. But I'll volunteer.' That shocked him."

For the next 18 years, Sundwall spent a half day every Monday treating the homeless at the HealthCare for Homeless Project, a public clinic near the U.S. Capitol. Most patients were black males; about 15 percent to 20 percent of the clients were HIV positive, and many died before the advent of anti-viral drugs in the mid-1990s.

"He came here faithfully every Monday morning when he was in town," said Sister Eileen Reid, health center manager at the shelter site. "He was a delight to work with. He demonstrated the best way to be of service is to be of service."

Sundwall didn't set out to work in the nation's capital. He intended to follow the paths of his physician father, brother and uncle, and earned his medical degree at the University of Utah College of Medicine. He completed his residency training at Harvard University, then practiced at his father's primary care practice in Murray before overseeing the residency program at the U.

Sen. Orrin Hatch offered Sundwall his first job in D.C. as a health care adviser in the early 1980s.

"Hiring him was one of the best decisions in my early career," Hatch said. "He had the perfect résumé that impressed the medical schools, and he was a family physician. He had a sincere desire to help others."

Sundwall advised Hatch on everything from prescription drugs to AIDS. He found he was drawn to public policy because he had the opportunity to affect more people's lives and be a leader.

Since then, he has held private and government health positions. He has served on national committees involved with health policy and quality, including those connected with the Centers for Disease Control and Prevention and the Food and Drug Administration.

From 1988 to 1994, Sundwall was vice president and medical director of American Healthcare Systems, an alliance of nonprofit hospitals. He most recently was president of the American Clinical Laboratory Association.

Sundwall took a considerable pay cut to return to the Beehive State. The Legislature recently rejected Huntsman's proposal to increase Sundwall's $112,465 salary, and pay for other Cabinet members, by up to 30 percent.

"I left a job that was considerably more lucrative," he said. "I think I should be paid at least as much as health department directors in other states because I'm responsible for the Medicaid part and the public health policy part."

Other states have separate Medicaid directors.

Sundwall said the pay issue "would not be a reason right now to leave. I was disappointed that the amendment failed, but I have confidence that the governor will work something out."

Tammy Kikuchi, the governor's spokeswoman, said the governor and Michael Young, president of the University of Utah, are in talks to arrange an additional position for Sundwall at the U.

"It is the desire of Gov. Huntsman to bring Dr. Sundwall's position to at least the average salary of his peers around the country," Kikuchi said.

As director, Sundwall manages a budget of $1.7 billion and 1,300 employees. The department administers the Medicaid and Children's Health Insurance Program, investigates and diagnoses public health hazards, responds to disasters and outbreaks of diseases such as influenza, West Nile Virus and food poisoning.

Sundwall knows his job will be challenging and controversial at times; he has already faced opposition to his proposed preferred drug list for Medicaid recipients.

He says he gleaned a lot about leadership working for former Surgeon General C. Everett Koop. "I learned a lot from him because he was a serious Christian against abortion," Sundwall said. "But once he got in his job, he made a distinction between what was right in public health and his own personal views.

"My No. 1 priority is to make policies based on science. I don't want to be persuaded based on popularity, philosophy or religion."

chamilton@sltrib.com