Reflecting on his first six months as chairman, Mr Millar said the board was under pressure to get its books balanced during an economic downturn, and there was similar stress on community healthcare providers including rural hospitals and primary health organisations.
All groups needed to be able to look at better ways of delivering services within the amount of funds available.
"We need to find smarter ways of doing what we do, within the money we've got. The status quo can't prevail."
Mr Millar said the board had to do more to get its perspective across.
Asked if those in the community might consider their perspective was not being heard, Mr Millar said he could not accept that was the case.
There had been a lot of "haranguing" in the last six months and he had done an "awful lot of listening".
He accepted the board could improve the way it engaged with and consulted other groups, but that was a two-way process.
Some people appeared to think if they "shout and yell loud enough we will cave in because they are making a lot of noise and throw money at them".
More debate and less shouting and screaming would improve communication and consultation.
The board and other organisations needed to work together and he believed progress was being made in areas such as mental health services, where there had not been a good relationship.
There had also been "a couple of good debates" with rural hospitals, but there was still some way to go.
Good ideas were also coming from forums which had been held with community health providers.
It had taken some time for him to establish himself in the job, but he felt it was necessary to take time to come to grips with it before "running round pontificating".
Now he was becoming more visible in the job, people had appreciated that, he said.
Mr Millar, who was a Government appointed member of the Otago board following the last election, was appointed to the chairmanship in late February after Health Minister Tony Ryall sacked Richard Thomson, an elected member, over the $16.9 million fraud of the board.
His appointment is expected to continue until at least November next year.
Board elections will be due in October 2010.
