Topics, September 15, 2008
The Health Science Center’s “leading indicators”
Economists use the term “leading indicators” to chart the health of the economy at any given moment. An important leading indicator for the Health Science Center is President Machen’s announcement last week naming the Search Committee for the next Sr. Vice President for Health Affairs. That announcement signifies that, after adjusting to state budget cuts and other bumps in the road last spring, the Health Science Center is now back on track for an orderly succession in leadership. A degree of normalcy and stability has returned to the Health Center. All in all, despite being buffeted by significant state budget cuts, and there are almost certainly more to come, I have been pleased with the way deans, department chairs and other leaders have stepped up to manage through those cuts in creative and innovative ways.
All of our colleges are now doing well and are focused on important goals to move each college ahead. The College of Dentistry is aggressively implementing a new clinical education model within its clinical practice, the College of Veterinary Medicine is focused on the planning and construction of the new small animal teaching hospital, the College of Public Health and Health Professions will undergo its public health program accreditation site visit in the next weeks, the College of Pharmacy is leading the planning for collaboration between UF and the Burnham Institute, and the College of Nursing has just completed its first year as one of four nursing schools to participate in the Veterans Affairs Nursing Academy, a national effort by the VA to address the severe shortage of nurses.
Once the new Sr. Vice President for Health Affairs is appointed, that individual will then organize a search to select a permanent Dean for the College of Medicine.
During this extension in service as senior VP that you can think of as my “extra innings,” I am focused on three major priorities: our collaboration with the Moffitt Cancer Center, a re-evaluation of our strategy for the regional campus in Jacksonville, and providing full support to the interim dean of the College of Medicine. I want to give you a brief progress report on each of these areas.
UF/Shands/Moffitt Collaboration
With the change in leadership of the College of Medicine this spring, and a new UF Shands Cancer Center director not in place until just this past July, we were concerned that the momentum created with the Moffitt announcement last January might not be sustained. Through hard work on the part of many people, particularly Cancer Center Director Joe Simone and College of Medicine Interim Dean Mike Good, we are moving ahead on all fronts.
Most notably, with funds from UF’s strategic research investment fund, the UF College of Medicine, and Moffitt, we have created a $3.7 million pool of seed money to fund collaborative research projects that bridge both institutions. These projects will result in discoveries, publications and extramural grants that, in two years’ time, will bolster our joint application with Moffitt for National Cancer Institute designation as a comprehensive cancer center consortium.
Next, we are nearing completion of a contract between Moffitt and Shands HealthCare that will allow our patients to participate in Moffitt’s Total Cancer Care program, or TCC. Under this arrangement, our patients’ clinical data and tissue samples will be entered into the TCC database so that treatments can be optimized for their specific type of tumor. This is a giant step down the path of personalized medicine that is going to be the sine qua non of cancer care.
Lastly, the College of Medicine faculty group practice, clinical department chairs and Cancer Center staff are developing a multidisciplinary care delivery model in the UF and Shands clinical settings where cancer patients are cared for. We already have some good examples of that model at UF on a smaller scale (in neuro-oncology and prostate). But cancer is such a complex set of diseases from the standpoint of providing seamless quality care that this will be a huge challenge for us. We’ve got some early movement in the right direction, but we’re going to have to crawl, walk and run to get to full implementation.
Jacksonville Regional Campus
Twenty-eight of the nation’s 129 accredited academic health centers have a regional or branch clinical campus. I have always said that if you’ve seen one regional campus, you’ve seen one regional campus. That’s because they come in every shape and size, and were established for reasons that are unique to each situation. I have also said that among all the regional campuses with which I am familiar, historically one of the most successful has been our regional campus in Jacksonville. That assessment is largely based on the way Jacksonville complements the medical, nursing, dental and pharmacy educational programs offered in Gainesville. The regional campus has done well under the heady leadership of Regional Campus Dean Dr. Robert Nuss, the support the Jacksonville community provides to the campus and the partnership with Shands Jacksonville.
Two things have happened over the last few years that compel us to take a step back and review our strategy in Jacksonville. First, after a number of years of attempting to unify College of Medicine clinical departments that spanned Gainesville and Jacksonville, with the chair on the main campus and an associate chair on the regional campus, we made the decision a couple of years ago to develop distinct clinical departments with their own leadership in Jacksonville. That change provided the regional campus with more autonomy and dexterity in managing local issues. Perhaps inevitably, it has also made it more difficult to maintain a coordinated system-wide approach to developing and deploying tertiary-level clinical programs. So a question is, how do we structure our extended patient-care system in a way that optimizes UF and Shands’ resources, reputation and opportunities?
Second, just a few years ago, with an impending shortage of physicians in Florida, the College of Medicine made the commitment to sequentially ramp up its class size from about 110 to 180 students. Jacksonville, and the diverse clinical settings it provides, has been a crucial part of those plans. But now, the state is building new medical schools at universities in Tallahassee (FSU), Orlando (UCF), Miami (FIU), and Boca Raton (FAU). By 2011, this added capacity will result in over 30 percent expansion in first-year medical student slots in the state! Given this added capacity in the medical education system, as well as the current challenges with state budget cuts, further class size expansion at the University of Florida beyond the present 135 medical students appears unlikely. So the question arises, how do we best utilize the Jacksonville campus for the medical education program beyond the current clerkship experience for our third-year students?
These questions have taken on a greater sense of urgency in light of what has been a challenging year financially in Jacksonville. Already in an extremely competitive market, the physician group practice and Shands Jacksonville teaching hospital have sailed into a perfect storm of an economic downturn and an adverse payer mix just at the time they were bringing new programs online, thereby incurring expense but not yet fully realizing the anticipated revenue. Although the campus has acted aggressively to limit the damage, the underlying economic conditions may persist for some time.
To get fresh perspective on the situation, we have engaged a consultant with considerable stature and experience in academic health care. Peter Kohler, M.D., was the president of Oregon Health and Science University for 18 years, compiling an impressive record of accomplishment. Since retiring from OHSU in 2006, he has been leading an effort to establish a satellite health education campus for the University of Arkansas. Dr. Kohler will be meeting with leaders on the Gainesville and Jacksonville campuses later this month. I’m hopeful that he can bring insights and perspective that help us make the most of this critically important relationship.
The UF College of Medicine Transition
The third major focus for me at this point is to support College of Medicine Interim Dean Mike Good in every way I can. Although Mike was thrust into this role rather suddenly, the senior leadership positions he held under Deans Tisher and Kone and the mentoring they provided gave Mike valuable experience and perspective on the challenges of running a medical school. By the same token, the college’s department chairs and the other Health Center deans know who Mike is, what his values are and the way he communicates. In the three months he’s been in the position, Mike has demonstrated a real ability to listen to people’s concerns and to work through lots of complex problems in a collaborative fashion. That open and consensus-building style has been particularly important for the college given Mike’s transitional role.
Still, because the search for a new senior vice president will play out this academic year, and the recruitment of the next permanent dean may take another 8 to 12 months after that, I expect Mike to function just like the permanent dean for the foreseeable future. He is fully empowered to make the decisions that any permanent dean would make. And there are plenty of them, relating to recruitment of key leaders, setting priorities for the college, dealing with curriculum reform and working with Shands and our other partners in the clinical arena.
To date, Mike and I are remarkably in tune in terms of our vision for the college. In our weekly meetings, each of us comes with an agenda, and it’s extraordinary how much my agenda is the mirror image of his. Mike is not afraid to ask for advice, but he’s also strong enough to graciously go another direction when he feels it’s in the best interest of the college.
In short, Mike Good is turning out to be just the right person, at just the right time. And that’s but one more leading indicator that the Health Science Center at large, and each of our colleges, have collectively turned full attention to the critically important work at hand.
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