Dr. John Rugge came to the North Country in 1974 and was the prime architect of award-winning Hudson Headwaters Health Network, which provides primary medical care in a service area across the Adirondack Mountains the size of New Jersey. At 80, he is now organizing HHHN's archives.

Dr. John Rugge developed a reputation as an expert in rural health care in Albany and Washington and served on state and national health councils that addressed the need for provide primary care in the rugged, sparsely populated Adirondack Mountains.

QUEENSBURY — Dr. John Rugge is a skilled canoeist and co-author of The Complete Wilderness Paddler, a 1975 book that blends a whitewater adventure narrative with a how-to guide.

Now 80, Rugge, a primary care physician, has devoted 50 years of his life to building Hudson Headwaters Health Network from scratch. It now includes 25 health centers spread across the Adirondack Park, with 1,000 employees, a budget of more than $200 million, 165,000 patients, and a service area of 7,500 square miles — roughly the size of New Jersey.

Known by the acronym, HHHN, and a distinctive red log that resembles a compass, the health centers are as ubiquitous in small Adirondack towns as a Stewart’s, post office, church, diner and tavern.

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“John created a foundation of innovation and smart growth to meet the needs of our communities,” said CEO Dr. Tucker Slingerland, 48, who grew up in Johnstown, earned a medical degree from the University of Vermont and joined HHHN in 2009 after family a medicine residency. He never left and was promoted to the top post in 2017.

“John remains an inspiration to all of us,” Slingerland said. “He probably never imagined what this would become.”

As the founder and prime architect of the sprawling health care system, Rugge has employed skills similar to those he honed in a canoe: when to use leverage to fight the current; when to save strength by resting in a........

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