It wasn't just Dr. Thomas Smyth's impressive résumé that made Francis X. Kelly, chairman of the board of the University of Maryland St. Joseph Medical Center, covet Thomas Smyth to become the president and CEO of the Towson hospital.
It was Smyth's intimate knowledge — from patient to practitioner — of the 232-bed acute-care hospital located on 39 acres in the heart of Towson, which provides primary care as well as specialized cancer, heart and orthopedic needs. Kelly said the choice of Smyth was a "no-brainer" as the person to lead the 2,300 allied health professionals that make up the staff of the medical center.
Smyth, the former director of Chesapeake Urology Associates, started his new job in September, managing the hospital with operating revenues of $426 million with a bottom-line profit of $3.4 million in fiscal year 2015-2016. He took over after Dr. Mohan Suntha left the position to become president and CEO of the University of Maryland Medical Center. The University of Maryland Medical System has been a separate entity from the University of Maryland since 1984, and is a private, nonprofit health system.
"I had Tom Smyth in mind from the beginning," said Kelly, chairman of the Kelly & Associates Insurance Group. "When I went around and talked to people in management about Tom, their eyes just lit up. They were 100 percent behind it."
One member of the medical center's management, Gail Cunningham, an emergency medicine practitioner, who is the senior vice president of medical affairs and chief medical officer, said that she was also fully behind making Smyth CEO.
"There's an inherent value in having another physician as the CEO," the Butler resident said. "And Tom is compassionate, gentlemanly and attentive. He knew a lot of the doctors and he knows the culture. That makes things a lot easier."
Smyth, 57, practically grew up at what was then-known as the St. Joseph Hospital making rounds when he was a kid with his dad, urologist Dr. J. Walter Smyth.
In those days, the hospital was run by the Sisters of St. Francis of Philadelphia, who were in charge until 1980.
Moreover, the younger Smyth, the sixth of eight siblings growing up in Guilford, volunteered at the hospital when he was a sophomore at nearby Calvert Hall College High School.
After graduating from Princeton University, where he was a lacrosse defenseman for the Tigers, Smyth returned to Baltimore to attend Johns Hopkins Medical School.
He completed his residency at Stanford University before once again coming back to Baltimore to join his father's practice in 1992.
Unfortunately, just months after his return that year, his father was diagnosed with a rare neurological illness that forced the younger Smyth to take over his dad's private practice. His father died in 2000 at age 70.
"It was a baptism of fire," Smyth said, learning quickly that a medical practice is also a business that needs attention to remain financially viable. "I learned a lot about the business of medicine."
Smyth also discovered that he enjoyed working on the fiscal side of things.
"I liked it and I had an aptitude for it," said Smyth, a Towson resident who has raised three sons, Taylor, Sam and Burk, with his wife, Tina. "It was all on-the-job learning."
Smyth said that he and many of his colleagues, as medical practitioners, prefer to pay the bills themselves rather than out-sourcing the work.
"Typically, physicians tend to be fiercely independent," he said.
By 1997, he had helped band together a larger practice, Maryland Urology Associates.
In 2006, that group merged with other practices to form Chesapeake Urology Associates, which started with 29 physicians and currently has more than doubled that number to 65.
At Chesapeake Urology Associates, Smyth, the new practice's interim chief financial officer and chief operating officer, was also responsible for a couple of different initiatives, particularly integrative patient care, which focuses on understanding whole persons and assisting with lifestyle change, rather than using a one-size-fits-all approach.
The idea is to make sure that when a patient has a particular clinical problem, they are sent to doctors with the best expertise in a specialized area to solve the problem.
"This gives the patient the best chance of receiving the highest quality of care in the most cost efficient manner."
Smyth also championed the cause of a physician wellness program at Chesapeake Urology.
"Doctors are human," Smyth said. "They work under tremendous stress. As a result, burn out, suicide and alcoholism rates are much high than those of executives in other industries."
Beside the other factors he mentioned, watching his father's health deteriorate and suffering his own debilitating illness nine years ago were enough to add to his passion for better physician health care.
Smyth was diagnosed in 2007 with Guillain-Barre syndrome, a rare auto-immune disease that attacks the body's nervous system. He landed in St. Joseph Medical Center's Intensive Care Unit for six days. He was in critical condition for 24 hours during the ordeal.
Being a patient gave him an even greater appreciation for the hospital and a staff he already admired.
"I was the recipient of amazing care," he said.
Most people recover from Guillain-Barre and, after a complete recovery and rehabilitation, Smyth returned later in 2007 to his practice and clinical privileges at St. Joseph's Medical Center.
In 2010, the hospital was shaken by lawsuits against St. Joseph alleging that hospital cardiologist Dr. Mark Midei put hundreds of patients through unnecessary heart stent procedures. In April 2014, after a four-year-legal battle, the hospital's former owner agreed to pay up to $37 million to resolve the claims. Midei, a star physician at the hospital, lost his license.
Under terms of the settlement, Catholic Health Initiatives, which owned the hospital when the alleged problems occurred, did not admit any wrongdoing. Midei was not named as a defendant in those lawsuits. St. Joseph Medical Center was acquired in 2012 by the University of Maryland Medical System, which did not take on any liabilities arising from the lawsuits.
"We lost 30 percent of our patients and doctors after that," Smyth said, noting that the hospital turned a $73 million loss to a $3.5 million profit under his predecessor Suntha. "But I saw the perseverance of the staff that stayed."
Smyth added that no one was fired during the downturn and the employee base has grown back to the size it was before the settlement.
"We are now a dynamic low-cost hospital," Smyth said. "We have improved quality metrics and deliver high-quality care with what I call 'special sauce' — faith-based care, and our patients feel it. Every day it becomes more apparent to me what faith and spirituality can do to an institution. It's amazing."
Smyth said that the medical center is now ready for its next phase, including what he termed "Population Health," meaning that the hospital will be more involved in managing the health outcomes of a clearly defined group of individuals, including employees, ethnic groups, disabled persons or any other similar group.
Cunningham called Population Health "the management of patients through their healthcare journey as opposed to only looking at episodic care."
"This means we are working beyond the walls of the hospital and reaching out into the communities to keep patients healthy and focusing more on anticipating their health needs and psychosocial needs," she said.
Smyth said, "We want to wrap our arms around our patients long before they arrive here and long after they leave."
Smyth also pointed to the hospital's breast cancer, cardiac and orthopedic surgical services, that "define us, to a degree. We are just a strong comprehensive hospital with compassionate care."
Smyth's transition to his new job has been "seamless," according to Vicki Deyesu, president of the hospital's auxiliary.
"It can be a rocky road [when a new leader arrives]," she said. "But it's been clear sailing. He listens to everything going on around him before he contributes his ideas."