This month I have the pleasure of introducing our CEO, Gary Merchant. His experience, ideas, and philosophies are the catalyst for our phenomenal growth. His passion is hospice. He is constantly on-the-go for Alamo Hospice, but I recently sat down with him to ask a few questions about hospice and about himself.

Gary, welcome to the pages of NSIDE MD. I have been telling our readers they would get to meet you. Tell us how you got into hospice:

I started working with older people through my church. As part of that ministry, I was privileged to attend a seminar where Dame Cicily Saunders was speaking on caring for the dying. There were only about 12 people in attendance, so I basically spent two days with the founder of the modern hospice movement. She introduced me to the concept of working with the terminally ill and caring for them.

I was the pastor of a rural church and volunteering as a hospital chaplain at the time, and so I counseled a lot of people facing a poor prognosis. I then moved to Fort Worth to attend seminary, and began volunteering with St. Joseph Hospital where I got more deeply involved in hospice.

Around 1990 I decided to become a full-time hospice chaplain. My interest in hospice led to a seat on the management board where I really began to learn how hospice operates. My interest grew beyond chaplaincy, and I accepted a position with another program in Fort Worth as the psycho-social supervisor.

I was promoted to program administrator and oversaw a growth in census from around 30 to 250 patients. I was then promoted to the vice president of operations, running about 400 patients in three programs. We grew that to about 750 patients and when we were purchased by a larger organization, I became the chief operational officer of a much larger company with programs in several states.

Tell us about your philosophy of hospice:

My philosophy is that dying is a natural part of living. Although that statement is absolutely true, it is also a traumatic experience for many people in our society. We have moved away from death being a natural part of life, to viewing death as a failure of the physicians and the health care system. I know that is not true. Hospice gives us the opportunity to help people accept the reality of death and to make the last season of life more productive.

Is there a secret to leading a great hospice organization:

My experience is that hospice attracts great professionals who really believe that hospice is what I will call a mission. I try very hard to identify how each person views that mission for themselves, and then I work to create an environment that allows the individual mission to become assimilated into the greater team concept of our company’s mission. That environment fosters individual success, which in turn becomes the primary catalyst for our company’s success.

How do you describe the role of hospice to physicians, nursing homes, assisted living facilities and others in health care:

I always describe hospice as providing a supporting role to the physician, the facility and the family. Engaging hospice is often the very best shot we have at creating a win-win situation, in a circumstance where it is easy to focus on only what is being lost.

How do you view the role of hospice in the continuum of health care:

Hospice naturally fits into the continuum of health care. Caring for those who are terminally ill has always been a part of the continuum of health care. Hospice has fine tuned that process to make it more compassionate, more comfortable, and less stressful.

What does the future of hospice look like:

Hospice will grow tremendously. Our challenge is to adapt to an increasingly educated and demanding consumer. As is true in all of health care, our clients are better informed and educated, and their expectations of how we respond to their needs will continue to multiply.

Having been a part of so many hospice programs, what makes Alamo unique:

I can truly say that the focus here is, and always has been, to create a hospice that is focused on patient care and team work. While the bottom line gets the attention that it must have, the patient and the team always come first here. That, I can tell you, is pretty unique.