Vice Chancellor for Health Affairs and Dean of the School of Medicine
What are the major changes that you think will come to Vanderbilt and the Medical Center over the next 10 years?
This is such an exciting time, in my opinion the most exciting time, to be at Vanderbilt. True, we have significant challenges with a national debt crisis driving radical changes in health care reimbursement and challenging times for research funding. But challenging times also create fertile ground for innovation, and I remain relentlessly optimistic. I believe the next few years will be the most innovative and transformative periods in the history of medicine. And I believe Vanderbilt is extraordinarily well positioned to meet the challenge and play a leading role, showing others the way forward.
At Vanderbilt, we are moving rapidly to personalize the delivery of health care. We are expanding the ability to identify fundamental differences between patients that impact their health, and we are increasingly seen as the world leaders in using this information to make the most informed decisions at the bedside. Through a unique and cohesive set of advancements combining innovations in biomedical informatics, genomics, and nearly all of our research disciplines, we are already delivering on the promise of personalized medicine. For example, heart and cancer patients are already benefiting from our ability to prescribe the most effective drug in an optimal dose for them, based on their genome.
Where do you see the seeds of those changes now?
They are already around us. These seeds of change are within our students, who are graduating and assuming leadership roles in medicine and nursing all over the country. The dynamic and energetic leadership enjoyed by the School of Medicine and the School of Nursing continue to assure that our graduates are among the best prepared and most creative thinkers.
These seeds of change are also present within our laboratories and research programs, where, thanks to the work of our talented investigators and their research teams, we continue to be among the nation’s leaders as measured by either the citation impact of our discoveries or peer-review funding. Enough cannot be said about the impact our scientific discoveries and advancements play in our institution’s success, creating knowledge that has both immediate and longer-term impact, while advancing our national and international reputation. As we become even better known, Vanderbilt harkens as that “place you want to be,” allowing us to recruit ever more promising students and faculty.
When I came here as an M.D./Ph.D. student I found a nurturing place to learn and grow. So I see one of my primary responsibilities as helping us recruit the next generation—a group of faculty, staff and students even stronger and more diverse than those of us here now. We were successful in appointing six department chairs this year who will play a huge role in mapping the future of this enterprise through their recruiting. The benefits of focusing on the quality of our people are tremendous, allowing us to learn more from each other and to dream even bigger.
I would also point out that in recent years our School of Medicine has become a national model for diversity in medical education. We should all take great pride in this as it benefits our institution and medicine in myriad ways. As we nurture and grow this new generation of leaders, we are changing the face of medicine and biomedical science, while assuring the legacy of our Medical Center.
And I never tire of pointing out that this year Vanderbilt was the only academic medical center named to both the Thompson Reuters Top Hospitals list, a distinction entirely based on publicly-reported quality measures and clear patient-care outcomes, and the U.S. News & World Report’s Best Hospitals “Honor Roll,” a reputational ranking. This suggests we are getting the nation’s attention through substantive accomplishments and innovations, while keeping our “eye on the ball” when it comes assuring Vanderbilt patients receive the best care anywhere in the world. And our academic reputation continues to soar, with both our schools of Medicine and Nursing ranking in the top 15 nationally by U.S. News & World Report.
Alongside the opening of new space in our Critical Care Tower and the Monroe Carell Jr. Children’s Hospital at Vanderbilt this spring, we are creating the technical advances in information technology and real-time monitoring and decision support to deliver a renaissance in inpatient care. With accompanying advancements in outpatient care delivery, in part driven by the world’s largest and most distinguished Department of Biomedical Informatics, we are making it possible to care for even more patients safely and cost-effectively. These advances are providing game-changing solutions to the nation’s growing health care workforce crisis.
What is happening now at Vanderbilt that has a chance to have impact all over the world?
There would be many examples, but let me briefly offer you two: The Vanderbilt Kennedy Center is a true crossroads of the University, one of the most interdisciplinary efforts you’ll find at any university anywhere. There are researchers from Peabody College, Medical Center neuroscientists and geneticists, along with faculty and staff from many other schools, including the College of Arts and Science, the School of Law and elsewhere across the entire campus all represented, working together and toward a common goal: understanding and solving the mysteries of human development to help people with disabilities. The Kennedy Center is internationally known for its research into autism. This is but one area of its strength.
Not only does the Kennedy Center reach into nearly every school of the University, but the Center also reaches across the country. We are part of a national network of research centers on intellectual and developmental disabilities created by the Kennedy administration in 1963. Children come from all over the country with their parents to receive our care and participate in clinical trials, through summer camps that engage the broad strengths of the University, such as the Blair School of Music.
Another example is that we have an amazing network of shared core research facilities that are networked and managed better than any other in the world. At Vanderbilt, large-scale resources are truly at our researchers’ fingertips—from the world’s largest mass spectrometry research center with more than 45 instruments, to the nation’s most comprehensive DNA databank-BioVU, to the Vanderbilt Institute for Imaging Sciences, housing the largest array of imaging capabilities and faculty scientists in the country. These amazing resources are available for collaborative efforts for Medical Center faculty as well as faculty from all areas of University Central, including Engineering, Arts & Sciences and Peabody.
Beyond the cutting-edge work, cooperation among our faculty and staff plays a fundamental role in allowing us to achieve worldwide impact—from our core labs, to our use of informatics to create a culture of patient safety; to the way we have embraced personalized medicine as a way to improve the quality of patient care. These programs are all possible because our people consider it a priority to work together.
I could describe so many other programs that have this far-reaching impact and are equally compelling. We possess extraordinary capabilities to drive change in patient care at the same time we are driving scientific discovery. We have established a national and international reputation as the leader in emerging areas not traditionally housed in medical schools, such as drug discovery and public health. It is never difficult for me to talk about how Vanderbilt is changing the world.
What are the biggest obstacles or challenges Vanderbilt and the Medical Center will face in the next 10 years?
As we’ve seen during the past few years, none of us can predict how events in the world around us will impact our work at home. Our global economy is now so interconnected—a financial crisis in Greece significantly influences the economy of the United States, and this, of course, affects us.
We have publicly expressed concerns regarding potential reductions to federal funding currently supporting biomedical research and graduate medical education. Through our efforts to improve operational efficiency, we are working to address coming reductions for the reimbursement we receive to treat patients who are insured by Medicare and Medicaid, a cohort currently comprising nearly one-half of all the patients we treat.
Our proactive efforts to grow our savings, to realize greater operational efficiencies and to prudently plan for the future have placed us on firm footing, especially when compared to many peer institutions.
While the world continues to spin, we will continue to be Vanderbilt. This year we will provide more than $400 million in uncompensated health care services to the citizens of Middle Tennessee. This absolutely affects our ability to accomplish many other worthwhile goals, yet our commitment to provide health care services for all people is steadfast.
Through it all, Vanderbilt will not retrench, but will continue to grow in strategic ways. We will seek new and innovative uses for existing physical space, while creating new spaces that allow greater synergy for faculty across the university. A new “TEAM” (The Engineering and Medicine) building is being designed to allow engineering and physical sciences and biomedical science faculty to work together in collaborative spaces, accelerating our progress in fusing technology and biology to solve problems as diverse as limb prosthetics to computational genomics. Our health care programs are rapidly expanding across the region, with three new affiliate hospitals joining Vanderbilt this year, and other partners yet to come. And our educational programs must be ever-evolving to stay ahead of the trends in information science and online learning. “Curriculum 2.0” is a tremendously exciting initiative that leverages our leadership in biomedical informatics and our commitment to team-based multidisciplinary learning to create an entirely new approach to educating students in medicine and other health care disciplines.
What are your hopes for Vanderbilt and the Medical Center in the next 10 years?
We have a unique culture, one based on civility and mutual respect. It is an “us” culture, unambiguously different than the “me” culture seen in many university medical centers. Not only do we experience this culture in our daily work, but there is nationwide discourse that Vanderbilt is “different” in this way.
Moving forward, I believe we will become even more collaborative, leveraging our collective strengths, and building on our collegiality. To me, this remains our secret weapon, our X-factor where other institutions try but fail to accomplish extraordinary things. The future belongs to those who can not only think in new ways, but can actually work together in new ways across disciplines. We must continue to build upon this cultural scaffold to bring amazing discoveries to the world.
The genius of Vanderbilt is that we combine our rich and historic culture with the best of what’s new. My hope is that culture will allow the Medical Center to increasingly collaborate with disciplines and programs throughout the University. I believe that as we realize our full potential for one-university collaboration, we will achieve even greater worldwide impact. In the mind of the public, I hope Vanderbilt will become synonymous with “impact,” as our finest work is exported, publicized and used productively by others. We should be recognized around the world as the intelligence behind health care and biomedical science.