Last month Missouri Times Publisher Scott Faughn sat down with the new President of the Missouri Hospital Association Jon Doolittle. Here is part one of their conversation.
Scott Faughn: So, where ya from?
Jon Doolittle: I grew up in Albany, Mo. Up in the northwest corner of the state.
SF: And for folks that don’t know, once you get to St. Joseph, how do you get to Albany?
JD: Straight north, more or less — off highway 136 and 169 highway.
SF: So, how far are you from Tarkio, you know near where o’l Blake Hurst’s farm is?
JD: I am very familiar with Tarkio, it takes about 90 minutes, driving straight east from Tarkio on 136, that’s how you get to Albany.
SF: Ahh that Highway 136, hosting Show Me Missouri, I’ve been, almost all across there. That’s the one that goes through Memphis and goes through Putnam county and all that.
JD: If you keep going that’s where you end up. For me, it’s about halfway.
SF: It’s 142, if you go to the southern part of the state, 142 kinda snakes along the side of state line to Arkansas, 136 goes the opposite way across North Missouri.
JD: You got it.
SF: And it almost- it’s almost like if you take a left, if you’re going east, anywhere, you see a firework stand right before you get on the state line.
JD: You’ve got it. Exactly.
SF: So, seeing as you’re from Albany…where did you go to school at?”
JD: I attended Albany High School. I received my undergraduate from Harvard.
JD: Then I moved back to Missouri — Kansas City, specifically.
SF: You don’t talk like an ol’ boy that went to Harvard.
JD: Well good.
SF: You may have broke my streak. I always said I’d never met a boy from the Ivy Leagues that I ever liked, you sure you went to Harvard?
JD: I did.
SF: Now, how many Albany High School graduates have been to Harvard?
JD: I think I was the first one to go to Harvard College, there was an Albany graduate that went to Harvard Law School.
SF: My assumption is, there wasn’t a Harvard recruiter driving 136, looking for folks to come to Harvard.
JD: That is accurate. My dad grew up in Kansas City, Kansas; Strawberry Hill. My mom grew up in Albany. One of his buddies was a doctor. He went back east, and practices today as an Orthopedic specialist in North Carolina.
SF: Healthcare’s in your blood then?
JD: A little bit. I mean, that was my Dad’s friend. Every year on the 4th of July, I was at the Doolittle 4th of July celebration in Kansas City, Kansas. My dad had his friend living in North Carolina, call it grandma’s house. There were no cell phones at this point, so you had to call grandma’s house. The phone rang in the kitchen and somebody came and got me; I was playing basketball outside and he said, “John you don’t know me, but I’m a friend of your dad’s, and he said you did well on your boards, where are you going to college?’ I told him a few places I was thinking about going and he said, ‘You haven’t done your homework have ya?’ I said, “Tell me what you mean.” He said, “Well you didn’t say anything about any Ivy League schools.” I said, “Well there’s no way I could afford that.” He said, “See, you haven’t done your homework. Those places have more free money to offer ya than any of the places you just told me about.’ I said, “Okay, well thank you for that bit of input.” Mom and Dad divorced when I was 14. Money was kind of a big deal.
SF: I reckon there are a whole bunch of folks in Albany living comfortably, but without a lot of money to throw around.
JD: Yes. And so that opened things up for me. I applied to a couple places. I had also had the great privilege and pleasure of attending Missouri Scholars Academy for three weeks between my sophomore and junior year, and that’s where they had the big college night.
JD: Two years later, I applied. Came home from school one day in the spring, and had a letter of acceptance. Went back in east in April for a visit.
SF: What was it like? To get home from school — from Albany High School — To Come in the house, and you have a letter from Harvard, and you open that thing up, and that’s a hell of a story.
JD: It was a thick packet instead of a skinny envelope, and that was a good sign.
SF: Your momma just had to be beaming. Is there anybody in church that Sunday didn’t know you were going to Harvard by the time she left?
JD: I think even before the days of social media that word traveled pretty fast.
SF: Yea, that’s awesome. Tell me what that’s like, for your parents to take you out there, and leave ya in Massachusetts?
JD: It was very interesting. Actually, neither of them came out until pretty far into my freshman year; they put me on a plane.
SF: It kinda feels like you’d be like, in ‘It’s a ‘Wonderful Life’ ya know, when he was leaving for school and going on this trip or whatever, Mr. Gower bought him a suitcase. It kinda feels like in Albany if you were going to Harvard, it’d be- the town would be proud.
JD: I had a lot of great support in Albany. I was valedictorian of my class and I got to thank everybody in town. People were very generous in supporting me and let me know they were excited. I had two things I spent money on before I went out there. One was a really good winter coat. Which was a good idea because we broke the all-time snow record my freshman year, then broke that my junior year. I had a real nice coat to get me through. Other than that I had a lot of good directions, where we researched, ‘Okay you fly into Logan, take the #33 bus to T station, get on the subway, you change to Park Street, and I came out of the ground and I was at Harvard square.
JD: That was in April. I had a great time there — it was “okay, let’s do this.” And in the fall, similarly, grandma and grandpa drove me to the airport, and at least this time I knew what was going to happen when I came out of the subway station at Harvard Square.
SF: So, what did you study at Harvard?
SF: What did you do after that?
JD: I came back to Kansas City. I worked for the Federal Reserve for a short time — a very short time. My boss left the Fed after I had worked for him for about six months, then he went to work for Cerner. He had three people reporting to him at the Fed; when the first two turned him down, he called me, and I went to work for him at Cerner. I was there for 11 years; I stayed there until I had the opportunity to move home to Albany. That opportunity was at my hometown hospital — where I was born. Albany had the same CEO for 29 years, John Richmond. And I became Mr. Richmond’s idea of a succession plan. And so, fortunately, he and I were able to convince the independent board there in Albany that a non-traditional candidate, who was an Albany kid, who’d kinda been working in healthcare for a decade at Cerner, was somebody that’d be okay to hand the reins to at the local hospital.”
SF: Now, the hospital in Albany is a different kind of hospital? If you’re not from Rolla or somewhere it might be like a foreign concept, explain the hospital in Albany.
JD: The hospital in Albany has this designation, a federal designation, as a critical access hospital. There’s quite a few of those in the country, about 1350, and there’s 35 of them in Missouri. Critical access hospitals are limited to 25 in-patient beds, and can have all sorts of services. However, they must provide acute care, and have an emergency department. They generally have a, fair bit of outpatient services, and can do some post-acute care in what are called swing beds. So, if somebody’s discharged from an acute care stay, and not quite ready to go home yet, you can provide some post-acute care there in the hospital.
SF: “So, if you were in St. Joseph in the hospital, but you lived in Albany and wanted to come home, to be closer to home, you might transfer them there and they could stay a little while before they were ready to head home?
JD: Correct. It doesn’t always happen that way. Through good partnerships with a number of other hospitals, sometimes a patient will come to our have, have an acute care stay, then move to a swing bed.
SF: Tell me how the hospital started.
JD: That’s a great story. Post World War 2, things were going relatively well. There was some federal funding to build hospital infrastructure— the Hill-Burton Act — that made money available to communities who could get their act together and start a hospital. In Albany, there was a group of citizens who decided the town needed a hospital. They incorporated what became known as Gentry County Memorial Hospital. It was a great name — except it wasn’t a county hospital and wasn’t a memorial to anything. So we ended up changing the name a few years later.
SF: What’s the name of it today? If somebody wants to Google it.
JD: It became Northwest Medical Center, which it was until we became part of Mosaic Life Care in Saint Joseph. It is now Mosaic Medical Center —Albany.
SF: If y’all hadn’t done it that way, a public way, there probably wouldn’t have been a hospital there today, right?
JD: No. I mean literally they went around, sold memberships in the local hospital association for $10 a piece. If you were a member of the association, you could show up to the annual meeting. If you showed up to the annual meeting, you voted on who the board members were. And that’s who ran the hospital.
SF: That’s awesome. You know, you look around the state and Phelps County is so proud and so protective of their hospital. And I mean it’s a tremendous hospital, and it’s got a, not exactly the same, but similar story of how it came to be. I mean, you look around this state, I think you can raise a serious question about if Albany would have that, if they had that foresight back then.
JD: I don’t think it would. I went home in 2010, and the hospital had been well managed, didn’t have any debt, and it had a great reputation and community support. I walked into a really good situation.
SF: That’s the interesting thing, you know. Looks like folks of Gentry County, I know are Republicans. You know, the party voting can change with the time, but they were always conservative. Conservative folks in how they dress, in what they drive, they’re just conservative folks. It’s interesting you know, you go on the internet. With social media, and everybody’s so harsh it’s harder and harder to do anything together.
I’m all for doing something for yourself, but the harshness is sad to see, and really people forget that in rural Missouri, some of the best things we’ve ever done for ourselves was accomplished by coming together. Now there were a few done through government, or maybe it was through a co-op, and some through a hospital. Some of the best things we’ve done for ourselves had been things where it was not just one guy doing it- it was a group of folks. I almost feel like in some ways even us rural folks are losing some of that. That Albany story is a great story, and you look at other places that didn’t have the foresight to do that, and they don’t have hospitals today.
JD: Yes. I was advantaged — and I’m biased because I grew up there, and my family is there. And, I’m super proud of what’s happened there over the years. My grandpa was the banker in town. His obituary hangs on the wall in my office.
A little aside. A guy came to me right after I started at the hospital in Albany. He is a great guy — a successful small businessman in northwest Missouri. He was a self-made man. He came in and he told me a story about my grandpa that I’d never heard. I said ‘Okay lay it on me.’ and he said ‘I was a pilot and I wanted to buy a little twin-engine airplane. I didn’t have the money, I was just starting a business, all this other stuff. And I went and I sat in your grandpa’s office. And I told him I wanted to borrow money so I could buy an airplane, maybe start a flying club, share it with some other people. And he said, ‘And your grandpa looked at me and he said, ‘I’m going to loan you the money for this airplane. And you know why?’ He said, ‘No, tell me why.’ He says, ‘Because someday somebody around here is going to need to fly somewhere. There’s going to be a medical emergency, or a flood — there’s going to be something. And I’m going to know a guy that’s got an airplane.’ That’s the way my grandpa thought about being a steward for the area.
SF: Well I tell ya, I could almost tear up. There’s a man in my life, a man named Jim Belnap from back home, he has since passed away, but Jim Belmap was that guy in our town. That highway- you can drive down from St. Louis all the way to Poplar Bluff on a four lane highway is his doing. Jim Belmap was that guy that said, “You know what, this doesn’t make me any money today, we’re gonna do this. This is the right thing to do, at some point it’s gonna help us out, and I’ll maybe benefit on the back end.” A rising tide. He-Jim Belmap was the rising tide for Poplar Bluff. We miss those guys when they’re gone.
JD: My grandpa was Carl O. Smith, and if you can find anybody near Gentry County that has anything bad to say about Carl O. Smith, you’ve done something because I’ve never found one.
SF: MHA has been around a long time. I’m sure the hospital in Albany is involved as a member.
SF: So you were very familiar with the association?
JD: Yes. Served on the board for seven years.
SF: Okay. Then took this job as running it?
SF: Interesting, did you go from the board to this job, or you were on the- Or were you on the board at the time that you took this job?
JD: I was on the board. I was actually serving as the MHA Board Chair in 2021. That’s when Herb Kuhn announced his retirement.
SF: How is Herb doing by the way? What’s he up to these days?
JD: He’s doing great. He’s still in town. He and Becky are traveling a fair bit. As he said “Now that I’m retired, I don’t go on vacation, I go on trips’ and they’re going on trips. Herb’s doing great.
SF: Well good! It’s an interesting thing. I watched Steve Hobbs at the Missouri Association of Counties. He went from the board to running the association. Tell me about that dynamic. That’s a little bit different dynamic than a lot of associations coming in and somebody takes the job; there’s a bit of a different wrinkle to doing that, explain that if you will.
JD: I made the decision, rather than just continuing on the board and as a member of the search committee, to recused myself from the search committee. At that point I threw my hat in. The search committee and the broader board were all folks that I had known for some time.
SF: So when you go about that do you tell some board members, ‘This Is what I wanna do’ and kinda ya know I don’t wanna influence things, I mean it is a delicate situation right?
JD: Very much so. What I had to do was make sure that I made a decision relatively early, so nobody could say that I had access to any information relative to the search. Somebody else was already slated to chair the search committee, so I wasn’t stepping away from that. I Didn’t step away from the board, because if I wasn’t selected, I would’ve continued in my role at the hospital in Albany and as a member of the board of trustees. But, I walked totally away from anything having to do with the search committee. The board had retained a consultant to lead the search. My communications were with the consultant.
SF: I watched Dave and your team and folks, well they carried a heavy burden in the capitol the last few years. From the day Medicaid, whatever you wanna call it, when the federal government under President Obama gave folks a chance to increase Medicaid, they carried a heavy yoke around that capitol. And took a lot, a lot of bullets fair, not fair they took them. It’s almost- it felt to me as an observer like, he knew whatever was gonna happen- I mean I think everybody that really watched the government knew that Missouri was expanding Medicaid it was just a matter of how. It took a little longer than I would have necessarily pegged that when it had started, but it was a vote that was up to the public, the public was gonna pass it. And they did. It almost felt like Herb knew he needed to drag that plow, until however this was gonna shake out, shook out, and give somebody a fresh shot, without having to carry that around all the time.
JD: I think Herb was extraordinarily dedicated and dutiful. And I think Herb really wanted to get Medicaid expansion/reform done while he was still with the association Herb can speak for himself, but I think he felt very good about the timing of his well-earned retirement, and surely he left us in a good spot.
SF: It just felt to me like he- it would’ve been a tough move to leave before- and you know kinda had to vote and you know the whole chaos afterwards for a little bit, but it kinda felt like he knew what he was doing at that point. So you come in, tell me when you hit this place what you’re thinking of and what do you want to make happen: for the hospitals in this state, the association, over at the Capitol.
JD: There are a few things, I mean number 1, to be- I’ve now committed the next decade or more of my life to supporting the hospitals and health systems in the state of Missouri, and I’m happy about that; I’m happy about that because I think they’re the good guys, and I think the last couple of years show that. When the public needs something — when there’s an emergency, a disaster, somebody going hungry, somebody needs clothes, whatever it is — people know that you can go to the hospital and the hospital will take care of you.
Healthcare is a huge industry, it’s a complex industry, there will be all sorts of competitors, moving in, trying to peel off certain profitable parts of the industry. At the end of the day hospitals are there providing a bit of a safety net, utility-type function, although necessarily funded or regulated that way. So what am I here to do? I’m here to advantage the good guys. I need to build relationships, have thoughts, make proposals — to always be for something. Right? People get tired of when you’re just against something all the time. I’m no protectionist, I’m no preservationist. The world is changing. We made the change at the hospital in Albany. We took an organization that had been independent for 60 years and led it down the path of becoming part of something larger. I gave up a fair bit of control and took a personal and professional risk becoming — like now I have a boss that has a boss. But if you think about things at the macro level, the world’s changing and moving. How are we going to help hospitals and health systems continue to provide incredible service to people in the state of Missouri and transform as necessary? A huge part of that is how we interact with partners — other associations, the business community and state government. I need all those folks to feel really good about the work that we’re doing. I think in part that is by helping them understand us better and building relationships.