Topics, May 28, 2009
Change brings opportunity
My wife, Macky, has always accused me of thriving on change, of being energized by times of insecurity and transition. “When are you going to finally settle down?” she teases.
Those of you who know that I’ve spent all 29 years of my academic career right here at the University of Florida might think I’m actually more a creature of habit. But the fact is I really don’t do well sitting still. Every six or seven years, I’ve found myself wearing a new hat. Professor of pediatrics. Division chief. Department chair. Physician-in-chief of the Shands Childrens Hospital. And of course, for the past seven years, senior vice president for health affairs. But now it’s time to don yet a new one.
Why do I seem to thrive on change? Because I view it as a positive. The insecurity that comes with change helps us see what we otherwise take for granted; it helps us appreciate what is good about the way things are but be impatient to improve that which could be better. It’s about laying strong foundations, then taking our belief in a better tomorrow and acting on it.
The famed composer Gustav Mahler once said the real art of conducting consists in transitions. Together we have worked hard to position the Health Science Center for success and for taking the necessary next steps. Mahler set out to greatly expand the scope of the symphony. We have set out to build on the breadth of the academic medical center, and that brings us to a pivotal transition of our own. The challenge going forward will be to accelerate the integration of various components of the health center system into a more powerful partnership that bridges our missions.
It’s no secret we face serious economic challenges. State support is certainly declining. Patient care reimbursement is falling. The challenges of caring for the underserved are increasing. Grant funding in the past decade has been more difficult than ever to come by. More recently, university endowments are shrinking, along with the hospital’s financial assets and reserves. You might presume these economic realities would force us into self-protectionist silos that turn our constituent colleges’ focus inward. But the truth is, any gap that still exists between our scientific brain trust … our efforts to train, teach and discover… and the actual delivery of health care is more intolerable than ever. Ultimately the kind of parochial thinking these economic challenges might foster is instead going to yield to more integrated thinking and more inclusive partnerships. This approach is our competitive advantage — in patient care, in multidisciplinary research, in interdisciplinary education. This is what the academic health center of tomorrow needs to look like, and we are poised to move in that direction.
That’s not just my opinion. Many analysts are now concluding that the strongest and most successful academic health centers are those that are building integrated organizational structures that align mission, values and finances. We realize more than ever before that the education and research elements of the university cannot be separated from the patient care delivery system. Doctors cannot be separated from nurses, from pharmacists, from other health providers. Researchers at the bench cannot be separated from clinical trial specialists in the clinics. Those who teach physicians will in the future be teaching health-care teams that include nurses, public health workers, pharmacists, and so on.
That vision is more than just a concept. It exists in bricks and mortar. The physical environment of the Health Science Center has evolved in recent years. You only have to glance around campus. We’ve undergone a robust expansion … thousands of square feet … as the Cancer Genetics Research Complex has taken form. The Biomedical Sciences Building, the Emerging Pathogens Institute, the Shands Cancer Hospital — all will soon be completed. And all are concrete examples of the kind of teamwork we will increasingly depend on to integrate our missions. Not one of these new buildings is devoted solely to a single college or a particular department. Rather, they are designed to foster collaborative partnerships. The Biomedical Sciences Building, for example, will house neuroscientists, diabetes researchers, bioengineers and epileptologists, among others.
But it’s the important work and the care provided in those buildings that will help us make our mark. The University of Florida and Shands have long been leaders. While the state is in the process of opening new medical schools, our Health Science Center remains the largest research and clinical enterprise in Florida. Patients come to us from every corner of the state, and our programs reach out across Florida into many communities. As such we are vital part of the prescription for economic recovery. The HSC has led the way in terms of responding to the stimulus opportunities for federal dollars. Consider that we recently submitted more than 300 research grant applications in a single month. Meanwhile, UF is awaiting word on its application for the federally funded Clinical Translational Science Award. This program would help us create the infrastructure necessary to speed the process of translating biomedical research discoveries into improved therapies and health-care delivery through the university’s new Clinical and Translational Science Institute. UF's application, under the direction of Dr. Peter Stacpoole, received the second-highest score in this round. We've learned the NIH will make awards to at least five institutions this year. So we are feeling very confident we’ll receive this five-year award at a total of approximately $5.3 million a year. That’s an example of how the HSC has collaborated with other units within the university, including Liberal Arts and Sciences, Engineering and IFAS. And it’s a great example of the HSC leading the way for the rest of the state.
These highlights are just the tip of the iceberg. The HSC colleges are rife with other examples.
The College of Public Health and Health Professions has successfully evolved from offering a very strong collection of traditional health professions programs to an integrated platform that focuses on the public health issues affecting populations, while maintaining quality programs that target individual patient needs. These approaches are creatively complementary. The college’s recent accreditation was a home run ball. Achieving an almost unblemished accreditation visit on the very first try is really astounding, and that speaks to the creativity and the uniqueness of what they’ve put together.
Construction of the College of Veterinary Medicine’s new Small Animal Hospital, the cornerstone of the Veterinary Education and Clinical Research Center, continues, and the associated expansion of clinical services is positioning us to be the best on the planet. In early May, the first part of the concrete vault that will house a new linear accelerator was formed in a single pour of 180 cubic yards of concrete. The accelerator will enable stereotactic radiosurgery planning and treatment for oncology patients to take place on-site at the vet school, currently the only veterinary practice in the Southeast to offer comprehensive oncologic care, integrating oncologic surgery, medical oncology and radiation therapy. What that will mean for education and resident programs going forward is almost immeasureable.
The College of Pharmacy is leading the nation in the development of distance delivery education programs to really impact workforce needs in terms of pharmacists. Several new graduate opportunities will broaden career paths to graduating pharmacists and other health professions competing in a declining economic marketplace. The programs come through unique collaborations with strong education and research partners who share a common vision of patient-centered health care. For example, this fall, the Food & Drug Administration’s Center for Drug Evaluation and Research will partner with UF to recruit individuals to become research scientists trained in safety and regulatory decision-making.
The College of Dentistry has emerged as one of the top five dental schools in the country, whether you consider US News & World Report or NIH rankings. The oral biology department is No. 1 in the nation.
The college is now the second-highest NIH-funded dental school in the country. The college also has a vibrant and growing program in behavioral science and oral epidemiology.
The College of Nursing has grown to be a statewide and a national leader. The Bachelor of Science in Nursing program is widely regarded as the best in Florida and one of the strongest in the Southeast. The college’s professional graduate programs are consistently ranked in the top 10 percent of US News & World Report graduate nursing programs. The college also is a leader in transitioning from a focus on advanced specialty programs to the new professional D.N.P. degree. The Doctor of Nursing Practice will ultimately be the terminal degree of choice for independent practitioners with nursing degrees. Out of that will come an even better trained and more highly skilled nursing workforce. The college also is producing the nursing faculty of the future. An astounding 70 percent of graduates of the baccalaureate nursing program go on to obtain advanced degrees.
The College of Medicine clearly continues to be an innovator in medical education. The research arena is also poised for great expansion, especially as the Cancer Center continues to grow and the new hospital comes on line this November. And the Institute on Aging has achieved remarkable success under Dr. Marco Pahor and his team, garnering serious national recognition through achievements such as the Claude D. Pepper Older Americans Independence Center and the coordinating center for a $40 million disability prevention program.
So it’s a great time to hand off the baton to my successor, Dr. David Guzick. Clearly the next months will be times of additional transition. The permanent dean positions in the colleges of Medicine and Public Health and Health Professions will be filled. And in another year or so Dr. Joe Simone will have completed his term as director of the UF Shands Cancer Center, and a search will kick off for that position as well. These and other key leadership positions at the HSC and within our research enterprise will be among the first orders of business for the new senior vice president. Dr. Guzick is very well-equipped to lead the next phase of HSC growth and integration. His experiences at Pittsburgh and Rochester have taught him well what a truly integrated academic health center looks like, and he has the personal leadership skills and character required for success.
This is a time of both challenge and opportunity. A focus on broader integration and closing the gaps between research discoveries and application to patient care on the one hand and between student education and safe quality health care delivery on the other are vital. Doing so isn’t only good for us. It’s good for Florida. It’s good for our students. And it’s good for our patients.
Finally, a personal note of thanks to each of you. Thanks for your dedication to our mission. Thanks for doing what you do so well each and every day. And thanks for your continued commitment to making the Health Science Center a great place.
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