New head of St. Joe's likes to focus on the work

An 'everyday person,' Smithhisler will discuss health care but not himself

ctruman@herald-leader.comAugust 27, 2012 

John Smithhisler insists there is nothing unusual about him. Really.

"I'm just your average person," he said. "I'm such a private person. I don't talk about myself, honestly."

True, he says he works 15 hours a day, but that might be because the new health market leader of KentuckyOne Health in Lexington and president of St. Joseph Hospital and St. Joseph East has not yet bought a house in Lexington.

Not only is Smithhisler insistent on being just a face in the crowd — no special hobbies, no special talents, he says — he's also guarded about his age, which he will only say is over 40.

Smithhisler is a 1977 graduate of the now-defunct Yankton College in South Dakota and received a master's degree from George Washington University in Washington.

He is a former chief executive officer of St. Vincent Hospital in Worcester, Mass.

Smithhisler spoke to the Herald-Leader recently about how he's like everyone else, the future of St. Joseph and how he came to Kentucky. This is an edited transcript of that conversation.

Question: Although you just started, how have your first few weeks been as head of these hospitals?

Answer: I run this organization, but I started out in housekeeping. So even though I've achieved a very nice position, I still haven't forgotten the roots that I have, and that's why I consider myself a very normal, everyday person who has the same interests and desires and dreams and aspirations as most people.

Q: Family?

A: No. By myself. I wish I could say I swan-dive off the cliffs of Acapulco, but I don't do stuff like that.

Q: Do you work 18-hour days at the hospital?

A: Well, at this point I haven't bought a house here yet, so the answer to your question is, probably around 15. And then I go out to eat, enjoying all the places that Lexington has to offer, and then I go home, go to sleep, start all over again.

Q: Are you an exerciser?

A: Aren't we all? We're in health care.

Q: The Lexington hospital market is in a period of intense competition. It's particularly intense now because the University of Kentucky is raising its hospital tower. Central Baptist is also expanding tremendously. There is a lot of competition going on, including the expansion of regional hospitals. How will you deal with this?

A: Being relatively new, it's hard for me to go into too much detail. What we're focusing in on is the patient rather than the competition. Our feeling is that if we give the best care in the best place at the best time, then we're doing the best for the patient, and that's where our focus has got to be. ...

My history in the health care market has been to do just that: Take care of the fundamentals, and the rest will begin to come. I think that (men's basketball coach) John Calipari at Kentucky will tell you, it doesn't matter what sort of things you do to build the building and the marketing and everything else. It's all about the fundamentals. It's about dribbling, shooting, passing, defense, that gets you the results. That's the same way I look at St. Joe's.

Q: Are the fundamentals going to become even more important or specialized in the next few years as the various parts of the Affordable Care Act start to fall into place?

A: It's so hard to predict where that goes. ... We're not sure who's going to win the election, and the Affordable Care Act may morph into something else than what it is now. Whether we end up diversifying or specializing is really up in the air. Where we begin to look at that is in the area of cost efficiencies.

Can we provide a more cost-efficient setting for the patients so that they can get high-quality care at a very affordable cost? If diversifying helps that happen, it's good. If specializing helps that happen, then that's the way we'll go.

Q: In what way am I as a patient going to notice the difference in this cost-effective yet efficient care?

A: Right now, I think the way a patient would see it is in deductibles, co-pays and the like. ... I think in the long term, you have to look at the continuum of care. ...

A good example is in England. ... They started noticing they had more people who were coming in for hip fractures. They started looking at the community, and the population was getting older, and the way the steps were built in these older homes, older people couldn't manage them as easily and were falling down. So they actually worked with the community and starting redoing the steps ... to make sure that the cost of health care was kept down. ...

It certainly gives you an indication that anything that may be adversely affecting the cost of care, we need to deal with it at the root, rather than dealing with the symptoms when they come into the hospital.

Q: One of the areas in which St. Joseph has long been held up as an example is heart care. Are there additional initiatives you see in the future to hold on to that area of expertise relative to the competitors at Central Baptist and UK?

A: Having been in the health care field for some time now, St. Joe's has a reputation outside of Lexington, a very good reputation. When I first talked to some of my colleagues about the idea of coming to St. Joe's, they all said the same thing, pretty much hands down: "It's got a great reputation. It's a good place to go."

Again, if you focus too much on what everyone else is doing, and not what you should be doing, you sometimes lose focus on where you want to go. And in our case, in cardiac care, we will continue to work with the medical staff to identify what are the new indicators ... what might be some of the new thresholds that we're trying to get to.

If right now the time from door to the cath lab after having a heart attack is 90 minutes, would the new literature suggest that it would be even better if it could be at 60? If that's what it suggests, that's where we'll be. We always want to be on the leading edge of everything we do.

So we're very well-known for cardiology. We want to be just as well known in orthopedics and cancer care as we are in cardiology.

St. Joe East has just been growing very nicely in obstetrics, and that's because they're keeping the focus on the fundamentals: What are they doing right? ...

I really don't focus too much on the competition. And honestly, I don't think the patients want us to focus too much on the competition. They want us to focus on them, and that's where we should be focusing.

Q: What brought you here? Why did you decide to apply for this particular job?

A: It gave me an opportunity to focus on a region rather than just one facility. I was at a large facility in Massachusetts. ... When the opportunity arose here to be able to focus in and strategically look at a market, that was a challenge for me.

Q: The women's care center at St. Joe East is competing against Central Baptist, which has traditionally been high in baby deliveries. Are you growing your business there?

A: I think the public and the community is saying yes, because we have been growing significantly over the last five years. No matter what I say, it's what the public shows, and what they're showing us is that's a preferred place to have babies.

Q: How long do you see yourself staying here?

A: Forever.

Q: You're going to retire from here?

A: It's a great opportunity here ... that will probably take me to the end of my career. And that would be OK with me. Lexington's a fun place.

Cheryl Truman: (859)231-3202. Twitter: @CherylTruman.

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