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Kenneth G. Simone, DO, FHM, grew up as the son of a revered pediatrician. As a child, he often accompanied his father on hospital rounds and house calls, developing an appreciation for the “old-fashioned” medicine his father practiced.

Already inspired to follow in his father’s footsteps, Dr. Simone became even more convinced of his calling when the physician-patient roles were reversed: His dad developed a kidney disorder that cut his career—and ultimately his life—short. “His illness and my exposure to hospitals added to my desire to pursue medicine,” Dr. Simone says. “It instilled the drive to help others, to make a difference in someone’s or some family’s life.”

He has done that by developing multiple private medical practices, building the hospitalist program at St. Joseph Hospital in Bangor, Maine, and offering consulting services to more than 100 practices.

“It has always been my nature to challenge myself and put myself in situations that take me out of my comfort zone,” says Dr. Simone, president of Hospitalist and Practice Solutions, a practice-management consultancy in Veazie, Maine. “I enjoy building things from scratch, creating, rebuilding, thinking outside the box, and networking with other healthcare professionals.”

Many programs experience problems due to ineffective leadership, poor implementation and follow-through, and lack of both a short- and long-term strategic plan. Some programs are victims of their own success. The program is not properly prepared to handle the demand for its services and grow accordingly.

Question: What made you decide to start Hospitalist and Practice Solutions (HPS)?

Answer: HPS was established because of the demand for my services. Initially, word spread locally and then regionally about the work I did at St. Joseph Hospital. As a natural offshoot of my growing interest in helping other programs, HPS became a national consulting firm.

Q: Why did you think this venture could provide a valuable service?

A: I believed there were more effective healthcare delivery systems with which to provide both quality and cost-effective medical care. As time went on, I gained a very unique perspective working as both a hospitalist and referring PCP in private practice. This experience, coupled with my work as an administrative director for a hospitalist program, allowed me to develop applications to help hospitalist programs on a broader basis. I realized the advice I offered to other programs consistently rendered a positive effect.

Q: Which do you find more enjoyable: building a hospitalist program from the ground up or rebuilding a struggling program?

A: I truly enjoy the challenges of both equally. Projects that involve building a program de novo appeal to my creative side. These projects enable me to work with professionals to build a customized program that meets the needs of the community.

Q: What challenges are unique to each?

A: Rebuilding an established program involves critical analysis of the current program to identify what has gone wrong, what has been successful, and what will work in the future. It calls upon one’s skills to build consensus and instill trust in the process because the stakeholders may be apprehensive to have a consultant critically review their program and hospital. In many instances, conflict management is necessary.

In both the creation and rebuilding of an HM program, it is imperative to implement strategies that guide the program to future success. Both projects also require strategic planning and the development of tools and tactics that emphasize collaboration and collegiality.

Q: Do the failing programs you help to rebuild have characteristics in common?

A: Common themes include lack of planning and consensus-building before program start-up, inadequate tools and strategies to support effective practice management, and failure to align the hospitalist practice and sponsoring hospital’s goals and vision. Another common problem is the absence of a hospitalist recruitment and retention plan, which may lead to provider turnover and program instability.

Many programs experience problems due to ineffective leadership, poor implementation and follow-through, and lack of both a short- and long-term strategic plan. Some programs are victims of their own success. The program is not properly prepared to handle the demand for its services and grow accordingly.

Q: You help programs create effective recruitment and retention plans. You also wrote a book on the subject. Why are recruitment and retention challenging for so many programs?

A: The primary contributor is that [hospitalist] supply falls significantly short of physician demand. A secondary contributor is the generational expectations of the younger physician workforce. … In addition, leaders may not prioritize recruitment and retention because they lack an appreciation for the consequences of failed efforts.

Q: What advice would you offer hospitalist program leaders about how they can improve those aspects of their programs?

A: No. 1, create an effective recruitment and retention plan and execute the plan with precision. No. 2, approach recruitment and retention with the same attention to detail as you approach patient care.

Q: You’re offering best-practice advice to help your clients develop and sustain effective programs. What advice do you find yourself giving to your clients that you wish someone gave to you early in your career?

A: From my perspective as a hospitalist administrative director, the advice I would offer is for individuals to believe in themselves and stay engaged. If you feel you have something to offer to the practice or healthcare system as a whole, share it with the appropriate parties. If you experience problems within the workplace, seek resolution in a timely manner. Stay positive and be part of the solution, not part of the problem.

Q: You have written two hospitalist books and coauthored two others. Do you have plans to write another?

A: I wouldn’t say I have immediate plans, but I am always thinking about topics and other projects that would provide value to readers. I’ve got some exciting ideas for future projects, but they are in a very early stage of development.

Q: How would you compare the feeling you get from finishing a book with the satisfaction you derive from other aspects of your career?

A: Writing a book is a highly personal accomplishment for me, while caring for patients is more of a team accomplishment that involves the patient, family, and other healthcare professionals. Typically, the completion of a book is a finite event, while caring for a patient is a long-term commitment.

Q: What is your biggest professional reward?

A: Helping people, whether they are patients in my role as physician, or other professionals—physicians, practice administrators, and hospital administrators—in my role as a practice management consultant. Whenever I reflect on my career, I tell myself how lucky I am. There are not many professions or individuals who have an opportunity to close the door behind them and have other human beings entrust them with their most intimate information. Also, there are very few individuals who are able to impact the delivery of medical care from a systems perspective. I get to do both, and for that I am most grateful.

Q: What is your biggest professional challenge?

A: Saying “no” when someone asks for help. There is nothing more rewarding for me than to help others. With that said, I try not to overextend myself, because that wouldn’t be fair to my family, colleagues, friends, or clients.

Q: What’s next for you professionally?

A: I will continue to concentrate my effort on building my hospitalist consultative practice and expanding the services I offer. In addition, I’m always tempted to explore the valley of the unknown. What excites me is venturing into new areas and to challenge myself to grow as both an individual and professional. TH

Mark Leiser is a freelance writer based in New Jersey.

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