At 12:40 am on March 9, 2020, Scott Smith, MD, MBA’20, got a call. The CEO and medical director of Adams Health Network in northeast Indiana, Dr. Smith is also an emergency medicine physician, and he was the administrator on call the night that his 25-bed, rural hospital system received one of the first COVID-19 patient admissions in Indiana.
“Our ER director said, ‘Hey, Scott. I have our first COVID case, and the patient needs admitted,’” remembers Dr. Smith. “I realized this was a big deal, and I began thinking about how we were going to protect our staff and what happens if our ER team contracts the virus.”
Dr. Smith got in the car and headed to the hospital, where the patient was still in the ER. The patient was the second admitted patient in the state, and Dr. Smith got to work reaching out to his network, calling the hospital where the other patient was admitted, contacting the Indiana State Department of Health (ISDH) and bringing in his leadership team.
“We couldn’t have predicted that our hospital would treat the second admitted patient in Indiana — we expected it would happen in Indianapolis or Fort Wayne,” he says. “Our first case was really a wakeup call that made us much more vigilant about COVID-19 than many of the other hospitals in Indiana because we were already dealing with it.”
Having worked at the hospital for 20 years, Dr. Smith had just taken over as CEO two months earlier. “I read the book The First 90 Days a couple times, and I don’t remember the chapter about pandemic,” he quips.
Although there had been a gradual succession plan that led Dr. Smith to his current role, he recognized the need for gaining greater business leadership skills and enrolled in the Indiana University Kelley School of Business Physician MBA Program. As an emergency medicine physician who effectively provided shift work for years, Dr. Smith hadn’t seen much value in networking. But it was a skill he acquired during the MBA program, and one he activated the morning that COVID showed up at his hospital.
“As a hospital leader, I’ve realized that making connections with other leaders in hospitals, government and advocacy organization, like the ISDH, Indiana Hospital Association and Indiana Rural Health Association, have been very beneficial as we all share information in the midst of COVID,” he says. “This is new for everyone, and to shoot off an email to another leader or text my state representative to voice my concerns: These are capabilities of an importance I did not anticipate. The MBA program really helped me value that.”
COVID-19 is new for everyone, and to shoot off an email to another leader or text my state representative to voice my concerns: These are capabilities of an importance I did not anticipate. The MBA program really helped me value that.”
That first morning, Dr. Smith assembled his team and opened emergency operations before dawn. He says leadership communication skills from the Kelley Physician MBA were useful from the start and only grew in importance as the pandemic evolved over the next five weeks.
“I appreciated Professor Tim Baldwin’s Leading Organizational Change course I’d recently completed because we discussed how to lead an organization through change,” he says. “The takeaways about clear communication with the board, staff and community were on my mind as I took over in January. As a result, I’d made an effort to develop and foster these relationships. We are a county hospital, so I reached out to the county commissioners, individual board members, medical staff, hospital mangers and senior leadership and worked to have a consistent, clear and calm message about COVID-19 with all the different groups.”
Dr. Smith says he’s also using lessons gained from a leadership course with Christopher O.L.H. Porter, professor of management, to highlight the strengths of his team. While he’s worked with many of his staff for several years, he says a crisis like COVID-19 has made him reconsider team dynamics and how to leverage the strengths of his various team members.
“It’s leadership versus management. If I’m sharing consistent messages with every group, then I can lead without having to manage all the parts and pieces, like the emergency operations center,” he says. “Our incident command has been working nonstop since early March, so I’ve helped coordinate that effort. But I can’t be involved in every discussion, even in a small hospital like ours. That team dynamics piece has been important, and I’m not sure I would’ve had such insight if it wouldn’t have been for the MBA program.”
Though there are specific lessons from his Physician MBA that Dr. Smith is applying directly during this healthcare crisis, he says the greatest benefit from the Kelley School program is accumulative. Individual course work in accounting, finance and economics weave together a knowledge framework that physician leaders can use to manage several different roles.
“By being well rounded in leadership, finance and the business of medicine—not just clinical care itself—I’ve learned that the clinical solution to a problem is certainly not the only angle to consider,” he says. “Being a physician who has clinical leadership skills is great, but an improved understanding of the business aspects of healthcare has given me credibility with the board and credibility with members of senior leadership. My chief financial officer can drop off the monthly financials without having to explain to me like he would’ve a couple years ago.
“This degree has helped me understand the big picture better, and I’m able to have those conversations on a much higher level than I could’ve had before.”
Being a physician who has clinical leadership skills is great, but an improved understanding of the business aspects of healthcare has given me credibility with the board and credibility with members of senior leadership.”
In the final two months of the class of 2020 Physician MBA Program, the in-person monthly weekend residency sessions in Indianapolis were replaced with videoconference courses as the world practiced social distancing. Peer learning amongst physicians from various backgrounds and specialties is often considered by alumni to be one of the greatest takeaways of the program. Dr. Smith says it continues to be insightful to dial into a call with 40 physician peers from across the country in the midst of a pandemic.
One takeaway he’s had as a leader is that sometimes concerns voiced by fellow clinicians don’t disappear once the physician becomes the administrator. Instead, the physician is better equipped to tackle tough challenges when he or she possesses both medical and business expertise.
“Many of us have been frustrated by the lack of personal protective equipment (PPE) and having to compromise—or not provide care in the way we feel we should—and much of that frustration is directed at administrators,” says Dr. Smith. “As a physician leader, I understand both sides. I understand there’s a national shortage of PPE, and we’re all competing for the same supply. We must figure it out on our own because help is not coming. Being a physician helps with credibility among my medical staff, but those tough calls must still be made.”
In the first five weeks of the pandemic, Dr. Smith says he’s learned more than he probably would have in several years in the C-suite. While most hospital crises like a tornado or snowstorm might last a day or two, a global pandemic is forcing physician leaders to confront challenges and questions they may never have had to experience in normal circumstances. Dr. Smith says it has helped to have done the work at the Kelley School.
“I enrolled in the Physician MBA Program to be better at this job, to be a better administrator for Adams Health Network,” he says. “A crisis like COVID truly makes clear how much better equipped I am to handle the challenges of the problem because I earned my MBA. There’s no doubt about it.”