<p>hello everyone this is Cole from the American Journal of healthc care strategy and I'm here with Todd Hamilton Todd please introduce yourself hi everyone uh my name is Todd Hamilton I'm the current secondy year administrative fellow at Norton Medical Group at Norton [Music] Healthcare thank you so much for joining us this or this evening rather I appreciate you coming on you have a vast amount of experience you went through an administrative residency you of course have your mha and your bachelors's in Care Health and Society uh please share with us what uh you know you you started off as what your plans were when you went into undergrad and why you chose to go to the University of Arkansas and what that looked like yeah absolutely so I I am originally from new Louisiana and I always wanted to go to an out ofate school was looking for a school that had unique opportunity and I always really wanted to be in healthcare had that passion for Health Care had you know at least for the helping professions and then what pawn going to the University of Arizona for my undergraduate um looked at a variety of different majors and actually started off as a biology major I really wanted to be a physician you know practice medicine of some kind and always always had a real interest in Orthopedics and the Orthopedic Service um and so really looked at that as a future career but you know as got as I went on in the you know switch Majors into Care Health and Society I realized that there was so much more to healthc care and the bread of of what's going on in in terms of the human relation side the actual medicine delivery side then also the whole piece of you know the government's role the role of Health Care Systems and really just the inner syncrasy that go on within the healthcare sector so the careal society major I ended up uh going into and um it's hous within the uh the College of um Behavioral Sciences and it really had an emphasis on Healthcare sociology and philosophy so uh took a lot of classes that were taught by nursing leaders by people who were thought leaders in the philosophy World um people who uh work in the public health sector and so was able to get really a round a real brownhouse view of of what Healthcare was and what it means to be in the helping professions and I think back to so many of my professors who were able to kind of shape who I am as a leader now from that experience and then you're right yeah I went on to the University of Arkansas for medical Sciences where I was able to get my mha and got involved with a lot of different programs early on it was a little bit of a smaller program which is you know that was the intention to really get involved as much as possible and really to you know connect with my professors but also connect with my classmates and was able to really look at the opportunities that were around me so able to do a residency there and then uh went forward so yeah thanks for having me today and that's just a little bit about my background is you know talking about education at least of course and then during your uh mha you did a res and was that a required part or is that something that was optional yeah it it is definitely a required part of the of the program it is uh really extends from the beginning of your second year I would say so that summer after your first year you dive in as a full-time employee with uh a array of systems so I was able and lucky enough to work with um the Arkansas Ro Health Partnership which is a Consortium of critical access and Regional hospitals in the Delta rural region of Arkansas and it was very unique um experience it was in the height of Co when you think of these communities they're very small rural communities but also ones that are very close-knit so being able to work with all 16 of those those hospitals across 22 counties in Arkansas and seeing the great work that they do both with the government the national government the state government but also those rural communities and those communities those close close knit communities themselves was was truly beneficial and you know getting to see the different parts of how Care Management and working to get patients to the places that they need to go in a timely fashion but also back home close to their loved ones uh it provided a a very very unique experience for me at least absolutely it seems like a very valuable experience I I know that I like the programs when they include that residency portion I think that's always a good a good idea and but with that though one of the questions I ask when people have they've gone through the residen see as well as you know you've done a few other things as well before your fellowship why did you decide to apply for the fellowship given the experience you know you already had and with that in mind has the fellowship been a big educational kind of level up from your past experiences oh absolutely and the reason why I really want to do a fellowship is you know you go into you know a graduate program and you think you come out you know you you learn all the in I would say intangibles and those tangibles you know you talk about Finance organizational leadership Human Resources all of those great things and health policy whatever it might be and you learn like the what what it what is it right what what is it about you know how is it relate to healthcare you know those kind of things and then really what the fellowship is is putting those intangibles into practice and really refining your skills you know organizational leadership well there's a whole piece to organizational leadership from the actual structure structure but also how do you interact with people you know how do you have an executive presence but also how do you show people that you're also a human being and relate to them on an individual level you know whether it's your you know your peers as in you know you have if you have an additional fellow that is with you in your organization how you do that with your boss or even when you're rounding in clinics or hospitals those Frontline workers and really connecting with them and you know you you may be oh part of administration and some people have a negative connotation to that I'm fortunate that that really does not happen here and that's intentional right so really wanting to go into the fellowship piece of learning how to do all of those additional things that you really don't get in your program as well as the executive exposure right to really refine those skills in front of leaders who are ultimately going to hire you are really going to have your their interests or your interests aligned with theirs and really bring you along in your career really grow you into the leader that one you want to be but also one that is going to be successful within the organization that you're joining so that's that's really why I wanted to do a fellowship I really wanted to get that advancement into into my career and I I looked at it as more of an investment into what I wanted to do after after my mha you know fi figuring out what whether it's a specialty whether it was going into you know executive practice of some kind within a medical group and how to work with Physicians how to work with uh nursing leadership all in one bucket I think this this experience has definitely expanded my knowledge and education and really put me in a new place that had it been two years ago I don't think I would have been in so well worth the the value then of those those two years absolutely absolutely and well well worth it that's really good to hear and then so why did you go with Norton specifically and how many other fellowships did you apply to so when I was applying I was app I applied to about 12 other Fellowship programs really wanted to my the advice that I got from so many people who did fellowships was really look at casteret wide but not too wide right you don't want to blanket apply for all of these places because you know you may end up getting a a offer from a place that you really don't want to be and it really May limit you or you know really put the time into your application and that's what I that's what I took from that is yeah there was a few places I really wanted to be and then there was a few places that I knew I wanted to get a fellowship and I applied there and maybe I didn't really want to be there so I did that a little bit but didn't really uh try to as much I really tried with the places that I wanted to be and I knew I really wanted to be those you know six programs those six places Norton Healthcare was one one of those at that time Norton Healthcare I you know you could hear little fringes of things and I was talking with my professors about just some of the opportunities that I was looking at and you know you go down the list and my Human Resources professor at the time and was a chro at U and she's now uh doing some other things and Consulting but you know she stopped me and you know she pointed right at noron Healthcare and said that's a phenomenal company so as I go through and did more research and you see the leap frog A+ scores you see the best places to work in Forbes all of the things at that time we're going to build the first uh Hospital West Side of Louisville in 150 years and you just look at that company you say okay that's an Innovative company that's one that's growing that's one that I want to be a part of because they invest in their people they're investing in the community and they're investing in in really the advancement of of the community and their people and the organization so you gave yourself you a good amount of options with the 12 but you still were pretty targeted about it you didn't apply to like random programs you did a lot of research and you said like a few of your resources were like Forbes you also looked in like the news articles to try to find out what the different institutions was doing and then you also consulted with your faculty right those were kind of the three resources you used yeah and I would also say use your Alumni network the Alumni network is huge when it look when you're looking at organizations and definitely talking about their experiences so I talked to a few of the alumni that uh that went on and did fellowships in the organizations that they're at and obviously I applied to a couple of those places because they had nothing but great things to say about them and they seeing where they are now in their career and continuing to see where they are now their career it had to have had a profound impact on them and their career so obviously want to apply to those places but really leveraging leveraging the Alumni network and you know people who have been in your position been in your shoes know what you're thinking with regard to where you want to be you know 5 10 years after after a fellowship definitely and and then so you get into the fellowship one of the ones you said that was one of your top you know few choices there and then when you get in what was that first year like yeah so nordon Healthcare uh is a not for-profit Community Based system where heavy emphasis on Innovation research but also really into what the health of our community we're the second largest employer in Louisville and we are rapidly expanding to provide healthare across the across the organization well obviously across the organization but across across the communities we serve so our our first year is predicated on rotations and you have Project work that you know things that come up that may go from rotation to rotation as you work with service line vice presidents as you work with other leaders directors managers across the service lines um but also you know the rotations give you a really good opportunity to see the systemness and going to the hospitals going and working with Managed Care going to work with nursing coordin the nursing coordination teams or the care coordination teams going to work with nursing admin going to work with you know materials management and supply chain and getting to see the entire breath of the organization and all of the great things and that the organization does all of the great things that we're able to that we're able to do together so that you know I our Institute for Health Equity you know looking at you know getting to spend some time with them and you know hearing what we're doing for the underserved communities working hand inand with some of our Managed Care folks who are looking at not just our contracts and you know capture rates and other things but also working with those patients who are uh economically disadvantaged on you know what we just announced was an expanded financial assistance program because we are not for profit uh organization that we're able to do that we we wholeheartedly believe in in accessibility to care for everyone so being able to see all those things firsthand you know in the cancer institutes and everything it's been phenomenal and you really take that and really leverage that into your second year as you as you elevate so again was involved with projects but the rotations I I cannot recommend more for a system like Norton but also um for your fellowship program I think that's a good way of doing things and then can you tell me a bit about that elevation you're talking about in that second year I know You' me talked a little bit before we started recording about what that second year looks like and I think this is one of the unique fellowships that does this in the second year can you kind of explain what that looks like and also what the transition was like you know how hard it was or or anything like that absolutely uh yeah so our in our second year you know our our uh our boss or our preceptor if you will the vi he's a vice president of operations for the medical group for the division and he's very intentional about challenging us you know he'll tell you in our first year that's like okay we're going to push you to a limit and then we'll see how comfortable you are and that when when I say a limit it's like time allocation like how much more time do you spend with uh rotations and then are you balancing the project work that you are given so in the second year really taking that uh with the with int ality of knowing really where you want to be because if you had those experiences but also you got a little taste for the project work and the actual operations that are going on you're able to align yourself with a leader uh that is a service line leader who wants to take you on in an interim capacity whether it's the organization's need you know we may have a couple practice manager positions open and it may be a benefit for you to go and get that interim uh practice manager operations role uh under your belt and to really work in the weeds with your Physicians with your PR uh with your practice employees with the service line itself and really leverage that experience into what could be a job at the end of your fellowship some other things you know you work well with a certain leader and you want to continue work with them and so there may be some projects that you work on for with them that that actually does turn into a position and so you really don't know what's going to happen your second year until you're there um because there's just so much that Chang and as we know in healthcare A lot changes but working with working with those leaders and and figuring that out because your interests they do take in into into mind so I've always had an interest in Orthopedics and that's where I'm taking I've taken on an interal manager role um within the orthopedic service line but um before that I was actually with Women's Health Services for five and a half months and never thought I'd be with Women's Health Services I actually work really well and you know I am so thankful to uh this service line leader the service line vice president at Norton Healthcare for Women's Health Services for taking me under her wing and really showing me all of the different things that that go on with women services but also some of the unique operational challenges right in physician operations you have an OBGYN uh who will see patients in clinic will see uh who will do gy surgeries and then also is on call at least you know once a week probably for delivering babies and so so the operational challenges that presents in terms of seeing patients in all three of those phases of of operations is truly unique and then some of the more High complex things with maternal and fetal medicine and some of the different things that we're doing there so that that whole experience for five and a half months was truly something that was an organizational need and uh connection that I had with a with a service line leader that I was able to leverage for you know five months and really got I mean profound uh experience out of and then was able to transition to Orthopedics where there was a need for a little bit and also area of interest of mine um was able to work with with our service line leaders here and you know worked in a few different of the practices turned around a couple things operationally and getting you know getting to see what that's like and then hopefully we'll transition into a job uh very soon exciting so does that job is that job going to be within the the Orthopedics Sports Medicine service line we'll we'll see I've interviewed in a couple place a couple different uh places within the within the organization with regard to staying in the medical group but you know it's a couple different positions that are open and seeing what what options are available but I truly hope so it's a great service line I love the leaders within those service lines the the practice managers and the director and service line BP they really take a an interest in you as a as an emerging leader and as a fellow and truly I would say contributing to your growth uh in every way so you know those whether those those operational projects the Strategic the Strategic initiatives or whether it's just giving you the the share pratice the the latitude to make decisions within your practice and the autonomy to make decisions in your practice to achieve what I would call operational excellence you know hitting those major factors the patient experience your employees you know retention you know obviously hitting your volume goals and things like that but also you know just making it and empowering your people to do to do great things so I think the experience that I've gotten have has all encompassed encompassed that can you give some advice to others earlier on the process and what you've done that's been able to lead to such such success absolutely yeah I would say for for those students who are thinking about mhas who are thinking about Fellowship who are thinking about or even in their Fellowship now or getting ready to enter in your fellowships listen but listen not just listen listen to change there are uh there are words and things that are said to you that you may not understand and when I say understand obviously you comprehend what they're saying but you don't understand the true meaning behind it and so there's a lot of just subtle hints that people will give you around hey maybe and it may not be so obvious as literally this but hey maybe don't don't approach it in this way let's approach it in in another way and here's why and you won't really get to learn those things until it kind of comes full circle and you see maybe the the action that I took or the thing that I said or the you know uh decision that I made was not necessarily the best one it worked out maybe in that time but it wasn't the best one that really kind of leads you into to inspiring people and really galvanizing people to get on board with that decision or the things that we're trying to achieve there's many different ways to get to the place you're going and it's really about how do you do that in the most graceful manner that really works well for and you can't please everyone so I'll say that you can't please everyone but you will you know try to inspire people on on the way the second piece of advice that I would that I would give is don't be afraid to put yourself out there most of the organizations that you'll be going into and working with are accustomed to having a fellow I know when I joined Norton a lot of the uh organizational leaders know that knew that we had a fellowship program and knew who knew about the fellows but didn't really know you until you met them so don't be afraid to put yourself out there we just hired a CEO who joined us from another organization to be the CEO of our children's hospital and I was you know you get to go to a lot of these highlevel meetings and be a participant and sit there and listen and absorb all of that great information and so after there's a lot of you know hand shaking and people you know saying hi to each other and so obviously going out of your way to make those connections with those leaders because you never know that may be the leader that ends up giving you a job at the end of your fellowship or maybe the one in five years to promote you into their into their organization or into their division I would say of the organization that you're with so you know really leverage leverage that ability in your fellowship to make that Network and really establish that Network build your board your personal board of directors and this is advice that I got but really find those people who are interested in you invested in you and are those people who are going to be your sounding board because you're going to find yourself whether it's in a tough situation you're going to find yourself in Conflict you're going to find yourself in a situation that is really unfamiliar and you're really going to want to find those people who are going to steer you in the right direction those people that you can really lean on to gather resources or advice or whatever it might be and that that happens in so many different ways right that happens in Beyond so many different ways I can't even I can't even tell you how many different people that now that I think and I consider on my board of directors how that relationship uh developed but really try to go out of your way and really look for those people who are interested in you um because those are the people who are going to help guide you through your fellowship program and obviously you know your seconde fellow if you're a first year and if it's a 24mth program or you know someone who is immediately uh right outside of the fellowship those are probably going to be your you know your immediate first contacts but really leverage their their Network as well because there those people who are sticking around them are probably going to be the people who are going to stick around you as well so so so don't be afraid to do that but also that I think that's really key to being successful in your in your fellowship program and I I couldn't agree more and I haven't even been through you know the fellowship yet but you know just from my small experiences taking the advice of of individuals like yourself it's just connections and then listening to those connections and getting those mentors and champions has already you know improved you know my work life so much so excellent advice Todd and thank you so much for joining us and sharing from your wisdom and your experiences with our audience I really appreciate it absolutely I'm happy to do it and very very gracious for for you having me on today</p>