Mr Butterfield and the rest of the board are waiting to learn their fate from Health Minister Dr Jonathan Coleman, who might sack them.
Mr Butterfield stood by decisions - such as hospital food outsourcing - that made the board unpopular with the public.
''You've got to be prepared to make the tough calls, and we obviously haven't made enough, or the minister wouldn't be considering these steps.
''Clearly, we upset people with our decision to go down the food track.
''Clearly, some people in Central [Otago] thought we were being tough.''
People were ''dreaming'' if they thought health cuts would be halted, as a commissioner would pick up where the board had left off.
Without changes, next year's deficit would be ''north of $42 million''.
Many of his 10 fellow board members - seven of whom were elected - were unhappy.
''Nobody likes being turfed out in the cold. So, of course, a lot of them are upset about the proposal.''
Mr Butterfield, of Timaru, agreed with his chief executive, Carole Heatly, who said this week a commissioner should be a local.
Mr Butterfield said a local would know the area, and would have less need to travel.
Association of Salaried Medical Specialists executive director Ian Powell said the South was in ''high-risk territory'' facing the commissioner prospect.
''It would depend an enormous amount on the experience and understanding of the health system that the person has, and also the brief that they have to operate under.''
Mr Powell's message to anyone wanting the board to be sacked was: ''Be careful what you ask for, you might get it''.
Something had to change at the board, but Mr Powell was not convinced a commissioner was the right move.
Asked what was learned from the aftermath of the Hawkes Bay DHB sacking, in 2008, Mr Powell said there were ''different dynamics'' and ''different issues'' in that situation.
A spokeswoman for Dr Coleman said the minister received on Wednesday the SDHB response to the proposal to consider installing a commissioner.
''He will carefully consider it before making a decision.
''We're not going to release the letter, as the minister is still considering it.
''We don't have an exact timeframe for when the decision will be made/announced,'' the spokeswoman said.
