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Just one more question

October 1, 2008
by Gary Tetz
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Like the great TV detective Columbo, Long-Term Living columnist Gary Tetz (Funny You Should Ask) always has one more question. In this bimonthly feature, he talks with long-term care leaders about anything that pops into his mind. He's as surprised as you are that they'll speak to him, and apologizes in advance for whatever inanity he might blurt out in the pressure of the moment.

He has written a long-term care textbook with a very weighty title—Long-Term Care: Managing Across the Continuum. His name is even on the cover, complete with middle initial. And since I have instant respect and admiration for anyone with the knowledge and focus to accomplish such a feat of strength and courage, I knew I had to talk to John R. Pratt.

Besides authoring what has become a standard part of healthcare curriculums nationwide, John is assistant program director for health programs at St. Joseph's College of Maine. After 25 years in hospital administration, including 15 as a CEO, he's spent the past 19 years creating distance learning programs for education-thirsty long-term care administrators.

Once he had reminded me where Maine was and assured me that geography would not be on the test, we moved on to other topics.

So you're helping provide continuing education for administrators?

Yes, we're one of the half dozen or so programs that are accredited by the National Association of Long Term Care Administrator Boards (NAB). What makes us quite different is we're dealing almost exclusively with mid-career working adults, not the traditional college-age student.

And since you're exclusively online, the beautiful thing is you never have to see these people.

(Laugh) Well, actually I do get to see them sometimes. And even though they're online, I still get to know them a lot better than I ever knew that kid in the back of the classroom.

But that kid never showed up for class in his bathrobe. You're not using Web cams, are you?

No, and now that I'm working at home as well, I'm very glad we aren't.

You've been involved in healthcare pretty much your whole life.

Yes, I've been interested in this since I was 18. A lot of the folks I know in healthcare administration got into it by accident, but in my case, it was quite literal. During my freshman year in college, I was in a car crash and spent six months recovering in a hospital. That's when I knew what I wanted to do.

Were you interested in the profession because you had a bad healthcare experience or a good one?

A good one. I was in the hospital a long time and got to know the administrator. I saw the satisfaction he got out of what he did, and decided I'd rather work with people than things. Before that, I had planned to become a mechanical engineer.

You used to be a hospital administrator, but now focus on long-term care. Why?

Unlike being the administrator of a large medical center, I found long-term care brought me a lot closer to the residents. I got to know them much better than I ever did the acute care patients who came and went.

Let's talk about your book, Long-Term Care: Managing Across the Continuum. It's a standard textbook in many programs.

Yes, as near as I know, 30 to 40 colleges are using it, and I get a lot of rewarding feedback. At this moment I'm updating it to a third edition.

What does the title mean? Are you referring to the time/space continuum?

At times when I was writing it, yes.

So you're basically trying to describe the workings of long-term care at both the supergalactic and subatomic levels.

Actually, that says it very well. I found there were some good books out there that were very broad, sort of intergalactic. And there were some good ones that were very nuts and bolts, very subatomic. I wanted something in between, so I said to myself, “Shut up and write it.”

Given the book's widespread use, that has to be a lot of pressure. If an administrator fails, is it your fault?

(Laugh) No, I've got a lot of built-in contingencies there. All I can do is give them the basic administration information. But the rewarding thing is that over the years in teaching and working with a lot of them, very few have failed. I don't know that that has anything to do with me or my book, but it's always gratifying.

Now, I'm not trying to discourage you, but your http://Amazon.com sales rank is 211,133.

Oh really? I'm not a bit surprised. When I wrote the book, I knew I wasn't going to retire on my royalties.

But here's the good news. Under the subheading of “caregiving,” and the descending subcategories of “books—science—medicine—physician and patient,” you're number 58.

(Laugh) Okay, well that helps.

This book reflects your lifetime of experience in healthcare. How are the demands on an administrator different today than when you came into the field?

Oh, it's much, much more complex. I sometimes say half-jokingly to my students that these days it's a lot more fun teaching it than doing it. It's become really difficult out there. The regulations are tougher. The folks who are paying for healthcare, both government and private, are scrounging for money to cover it. And because of that, more restraints are being imposed on the people providing it.

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