Passing it On

Jim Smoker hopes to give back a little to the profession that enriched his life while in retirement

There’s a song by the Kingston Trio called “Desert Pete,” whose words Jim Smoker knows by heart. The song is about taking only as much as you need, then passing the rest on to the next person.

It’s about a guy in the desert who comes across a well. “‘You’ve got to prime the pump, you must have faith and believe,’” says a note at the well, written by Desert Pete. “’You’ve got to give of yourself ‘fore you’re worthy to receive. Drink all the water you can hold, wash your face, cool your feet. Leave the bottle full for others, Thank You kindly,’ Desert Pete.”

It’s a lesson Jim Smoker has tried to apply throughout his life as a respiratory therapist and a materials management professional. Smoker recently retired as director of materiel resource services of WellSpan Health, York, Pa., after a 39-year career there.

Family of free-thinkers
Having been born in 1947 in Paradise, Pa., and raised in nearby Lancaster, it’s no surprise Smoker has some strong religious roots. His father was raised Old Order Amish, but was a renegade at heart. After serving in the military during World War II in a non-combatant role, he chose a more secular life than what the church elders offered him. “He had learned to smoke, drink and run around with loose women,” jokes Smoker. Armed with an eighth-grade education, his dad went on to be a welder, a barge builder, and a superintendent of three cemeteries in Lancaster. “That’s where I got my deadpan humor,” says Smoker, with deadpan humor.

His mother was raised EUB, that is, Evangelical United Brethren. Raised in western Pennsylvania, her father was a first-generation Welsh coal miner, and her mom was from a railroad/steel mill family. She was a little straighter than Smoker’s father. “My dad gave up drinking so he could date my mom,” he says. But he didn’t stop smoking.

First attempt at college
Smoker talks about his “first attempt” at a college education. It was at nearby Millersville (Pa.) University, where he intended to study to be a secondary-education history teacher. But “outside interests” prevailed, “and my department head advisor told me I had better drop out before I got kicked out.”

At the time, Vietnam was heating up. Having been raised in the Church of the Brethren, a pacifist church, Smoker registered for the draft but applied for conscientious-objector status, which he was granted. When he dropped out of Millersville, he was forced to either pursue civilian service in lieu of the armed forces, or to find a non-combatant role in the military. He contacted the placement service of the Mennonite Central Committee, who offered him three choices: surgical tech trainee at the University of Michigan Hospital in Ann Arbor; teaching assistant in a reservation school at Four Corners (where the states of Utah, New Mexico, Colorado and Arizona meet); or inhalation therapy trainee at St. Agnes Hospital in Baltimore. For a variety of reasons, he chose the third. The year was 1968.

Smoker married his high school sweetheart, Joanne, who had been teaching in Baltimore. After fulfilling his two-year service commitment, the couple moved back to Lancaster, and Smoker re-enrolled at Millersville as a part-time student. “I had no desire to stay in respiratory care, as it’s now called,” he says.

But it was 1970, and the country had a glut of secondary-school teachers, especially in the social sciences. So Smoker’s advisor – the same one who had urged him to leave school several years earlier – advised him that unless he wanted to sell insurance when he graduated, he should seriously consider staying in healthcare.

Career in respiratory therapy
Smoker mulled it over, and a healthcare career began to make sense. “I wasn’t a whiz in the sciences, but I did OK,” he says. “I think the bridge between [my interest in] social studies and healthcare was people. Teaching involves working with kids and young people; and healthcare is people-centric too.” And Smoker had always been interested in people. In fact, in his early 20s, he was a licensed minister in the Church of the Brethren. (Today, he and his wife are Unitarian/Universalists.) So he decided to pursue a future in healthcare.

While working part-time in the respiratory therapy department at Lancaster Osteopathic Hospital, Smoker – still a student at Millersville – learned of a scholarship/loan program for allied health professionals at York Hospital in York, Pa. He enrolled and ultimately became a registered respiratory therapist at the hospital. Later, he was offered the opportunity to head up the school of respiratory therapy, which was a hospital-based technician training program loosely affiliated with York College. A year and a half later, the position of director of respiratory care at the hospital opened up. With two children, he and Joanne decided he should take the higher-paying job. “So we moved from our duplex in Lancaster to an 1850s farm house on the outskirts of York, which was all we could afford. And I had the good fortune of servicing as director of respiratory care at York from about 1975 to 1989.”

Those 14 years were exciting from a professional perspective, he says. Together with Dean Hess, who had been recruited to head up the school of respiratory therapy, Smoker helped further develop the training program. Hess and Smoker also began publishing a peer-reviewed respiratory care journal, and conducting clinical trials and clinical evaluations of different technologies. “Folks were interested in hearing about what we were doing,” says Smoker, so he and Hess hit the lecture circuit. (Today, Hess is associate professor at Massachusetts General Hospital in the anesthesia and pulmonary department, as well as editor of a respiratory care journal, says Smoker. “A brilliant guy,” he adds.)

Game changer
But in 1989, Smoker got a call that was to change the direction of his professional life. It was from Dave Greisler, a vice president at York Hospital. “He was one of those career-path influencers,” he says. Greisler confided in Smoker that he was disappointed with purchasing and materials management at York. “We have good people in place, but it’s lacking leadership and a sense of direction,” Greisler told Smoker. “I said, ‘What do you want me to do about it?’” he recalls.

“He said, ‘I think you can do some good down here. I think you can build a bridge between clinical services and support services.’” But Smoker was happy where he was, working with Hess, planning to pursue a master’s degree and someday becoming vice president of clinical services.

“But he kept banging away,” recalls Smoker, speaking of Greisler. “He told me, ‘I really think you need operations experience; you need to be broader than you are right now.’” Six months later, attracted by the challenge and yes, the money (particularly important as the Smokers’ oldest was approaching college age), Smoker said yes.

Redefining himself
“For six months [after I took the job], I had night sweats,” he says. “I didn’t understand the language [of materials management]. How do I relate to these people? But it was probably the best move I ever made.”

First and foremost, it forced Smoker to redefine himself. “I had been defining myself by what I did,” he says. Moving out of his comfort zone, in which he was recognized and rewarded, made him take a second look at his own identity.

And it was a humbling experience. He spent the first several weeks in his new position visiting with people in the department, watching them work, asking questions. “I was trying to understand what the work involved, what were the challenges, what were the strengths and weaknesses of the leaders in each area, and where they needed help,” he says.

He quickly realized that, given his lack of knowledge of materials management, he could no longer be the “answer man,” as he had been in respiratory therapy. “I had people who had far more experience in materials than I would ever hope to have,” he says. So, rather than implement a top-down management style, he and his department heads – e.g., the managers in print shop, mail room, purchasing, sterile processing, etc. – created what he calls a consensus form of management. “Things began to slowly make sense,” he says.

At the same time, he sought to address his lack of knowledge of materials management. So he got involved in the Association for Healthcare Resource & Materials Management, ultimately becoming Region 2 board member. He also helped develop the exam for the “Certified Materials & Resource Professional” designation, and he was one of the first members to receive CMRP status. With encouragement from Ron Hefner of VHA Pennsylvania, he also became involved in the regional VHA materials council.

Over the years, as Smoker grew into his job, the healthcare system he worked for grew as well. The system – renamed York Health System – built physicians offices, pharmacies, surgery centers, lab annexes, imaging annexes and more. Then York Hospital merged with Gettysburg Health Corp. to become WellSpan Health. As so many other materials professionals found, the challenge post-merger was “trying to find common ground, melding contracts into one organization contract,” notes Smoker. Then there were the “old issues of product standardization,” magnified as the number of facilities multiplied.

Reflections on the industry
Smoker believes that the development of robust materials management software, EDI and handheld technologies for inventory management streamlined the operations of materials departments, and helped those departments and the individuals in them become more strategic and less clerical.

The group purchasing industry saw some major transformations during his tenure at WellSpan, he adds. The U.S. Senate hearings (in the early and mid 2000s) dulled the patina of GPOs a bit, he says. GPOs were challenged to prove that they weren’t shutting small manufacturers or non-contract-holders out of the market. As a result of the scrutiny, they shied away from sole-source contracts. The problem is, “the multisource contracts are more diluted in terms of value to the provider,” says Smoker.

He believes that regional purchasing groups – often created with the help of a national GPO – are “capturing the value that was left on the table as a result of the multisource contracts.”

As he begins his retirement from York, Smoker looks forward to engaging in some “very independent, very part-time consulting.” One area in which he is particularly interested is organizational assessment and development, and strategic planning. “I’d like to take some of what I learned and apply it, where appropriate, to help other supply chain organizations move to the next level of performance.”

Although not a skilled carpenter, Smoker considers himself a “wood butcher” who manages to “cobble things together,” including rustic wooden furniture. He plans to keep working on his and Joanne’s farm house, and will carry on his hobby of restoring and selling old MGs. “My deal with Joanne is this: There’s our money, and then there’s MG money. This hobby has to be self-sustaining.” He is also involved in his church.

He reflects with gratitude on those who helped him in his professional career, including Dave Greisler; Ray Rosen, vice president operations, York Hospital/WellSpan Health (“probably my boss, intermittently, for the longest period of time”); and Dick Seim, former materials executive and current president of York Hospital. He also gives credit to Keith Noll, WellSpan’s senior vice president of ambulatory and post acute services. “He dragged me kicking and screaming into strategic planning on a more formal basis,” says Smoker.

“There are so many others who I’ve interacted with over the years. They’ve all added to the profession and my personal development. The list goes on and on.”

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