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Archive for Saturday, June 4, 2011

KU medical school should match hospital’s excellence

June 4, 2011

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Several weeks ago, Gov. Sam Brownback made it clear he wants the Kansas University School of Medicine to improve its national ranking. This was one of his concerns when campaigning for the governorship, and it continues to be one of his priorities.

In past years, the KU school received national attention and praise for its training of primary care physicians and its innovative program to encourage these doctors to start their practices in rural, less populated and underserved areas of the state.

In 1948, when he was 32 years old, Dr. Franklin Murphy became dean of the KU medical school. He moved to Lawrence three years later to become the university’s ninth chancellor. Murphy compiled a superior record in leading the medical school as well as the university. He served as an excellent example of how one person with vision, courage and the ability to inspire individuals can make a tremendous and powerful impact.

Murphy eventually left Lawrence to become chancellor of the University of California, Los Angeles. Dr. Clarke Wescoe, at the age of 32, followed in Murphy’s footsteps as dean of the KU medical school then succeeded Murphy as chancellor from 1960 to 1969. He, too, served with distinction and helped the university move to higher academic achievements.

During these years, the KU medical school was recognized as an outstanding, forward-looking institution.

Unfortunately, in recent years, the school has not maintained the national rankings it once enjoyed, and the high faculty morale and enthusiasm is missing.

The plight of the medical school comes at a time when its neighbor, KU Hospital, has risen from the depths of teaching hospitals to its present ranking as one of the nation’s best. One part of the Kansas City, Kan., medical complex is struggling while the other is reaching new heights and national recognition in many areas.

What’s the difference? Why the difference?

A dynamic young leader, Irene Cumming, was named chief operating officer of KU Hospital in 1995 and president and chief executive officer of the hospital in 1996. Positive changes were spectacular. There was a vision and a goal, and employee morale was revitalized. The entire staff, from the most junior janitor to the most senior surgeon, all bought into a commitment to make the hospital a leader in every respect.

Cumming resigned in 2007 after Gov. Kathleen Sebelius attempted to load the hospital’s board with individuals who would follow her instructions and when KU Executive Vice Chancellor and School of Medicine Dean Barbara Atkinson and Chancellor Robert Hemenway favored weakening the KU Hospital and medical school in order to strengthen its cross-town competitor, St. Luke’s Hospital.

Fortunately, this effort was defeated, and Bob Page succeeded Cumming as the hospital’s president and CEO after Cumming moved to Chicago to take a senior national medical position.

Page has sustained the hospital’s upward momentum, and the hospital is doing well. The physical plant is growing, and it clearly is the No. 1 hospital in Kansas City and the region. Morale and quality of care are excellent, patient satisfaction is high, and patient counts and revenue numbers continue to grow. Also, the hospital is contributing more than $86 million a year to the medical school, many millions more than was the case only a few years ago.

What’s the difference? Leadership, vision, commitment and the desire and ability to instill excitement, excellence, enthusiasm and pride throughout the operation.

The hospital’s mission statement is “To lead the nation in caring, healing, teaching and learning.” This goal permeates the entire hospital family from the board of directors, headed by Bob Honse, to every hospital employee.

Unfortunately, this spirit and leadership are lacking at the medical school.

Atkinson came to KU in 2000 after a troublesome period at the Hahnemann School of Medicine in Pennsylvania. She was named KU executive dean in 2002, leading the school’s Kansas City and Wichita operations. In 2005, she was named executive vice chancellor of the KU Medical Center. She was the first woman in the country to hold both positions at a medical center.

A few years ago, a national study reported that the average tenure for deans at U.S. medical schools was three years and eight months. Authors of the report noted there is a danger of deans staying too long; they suggested eight to 10 years should be the maximum.

Being a dean of a medical school is a demanding, tough job because the place is filled with individuals with tremendous egos who often are temperamental and difficult to work with. Nevertheless, many schools have exciting and visionary deans.

Atkinson has been the executive dean for nine years and executive vice chancellor for six years. Her time as dean far exceeds the national average of three years and eight months. It is reported she has never had a review of her performance, as is the policy for other chairs and administrators.

It will be interesting to observe the reaction of KU Chancellor Bernadette Gray-Little to Brownback’s desire to see improvements at the KU medical school. The chancellor is responsible for determining the leadership of the school and making changes when necessary. Usually, the executive vice chancellor is responsible for hiring the medical school dean. The current situation is unique because Atkinson holds both of those positions.

Brownback wants to see the KU medical school rise to new levels of excellence. That also should be the goal of the chancellor, all Kansans and certainly those who serve on the Kansas Board of Regents.

There’s no magic or single answer for how to achieve this goal, but, clearly, there must be outstanding leadership, vision and enthusiasm exhibited by the school’s leader if there is to be any chance of significant improvement.

Comments

Lawrence Morgan 3 years, 6 months ago

I do not agree with you that Dr. Wescoe provided leadership. To my mind, he did just the opposite.

However, you have a strong feeling that there is a need for change at the Medical School, and I strongly agree with that. The Medical School needs to be just as highly accepted as the Hospital! Your article on this was well appreciated.

Jack Martin 3 years, 6 months ago

Readers of this column would benefit from having some facts about the progress of the KU Medical Center in recent years.

For example, KUMC's National Institutes of Health ranking has risen 15 places in five years, reaching 60th nationally in the latest rankings. The faculty has more than doubled in size over the past decade and medical school enrollment - critical to meeting Kansas' physician shortage - is on track to rise from 175 today to 211 in 2012, thanks in part to the expansions in Wichita and Salina. This is on top of the #5 national ranking for meeting the school's social mission.

Additionally, KUMC's private fundraising has nearly doubled in the past four years, while the external research funding earned has increased from $69 million in 2005 to $100.7 million today.

With the KU Cancer Center set to make its NCI application in September and the creation of the School of Public Health underway, KUMC's progress is set to continue.

yourworstnightmare 3 years, 6 months ago

I cannot speak to the leadership at KUMC in the past. However, I can speak to the result.

While other medical school were actively building basic biomedical research as a cornerstone in the 70s, 80s, and 90s, KUMC was not. KUMC seemed content to coast, and by and large missed the "molecular revolution" in basic research beginning in the 70s. Now KUMC is trying to play catch-up.

I can't say for sure, but my guess is KUMC was not provided with the motivation or the funding to build basic biomedical research, representing a failure at KUMC as well as at the state level, as the verve for tax cuts ouptaced all else in tjhe state, including building a topo-ntch medical school, which requires money.

yourworstnightmare 3 years, 6 months ago

If it isn't absolutely clear by now:

Research = ranking.

This is true at KUMC as well as KU-Lawrence. Teaching, training students, outreach, and other activities are important. But to move up in the rankings, it is research that is most important.

Research, research, research and more research is a message that Brownback as well as university leaders should heed. NCI designation and support of research in the cancer center is a good step. More of this needs to happen.

JayHawke 3 years, 6 months ago

As usual, Mr. Simons either does not have or care to report the facts. The so-called $86 million "contribution" to the school of medicine by the KU hospital is almost entirely compensation to the KU faculty physicians who practice medicine there (hospital CEO Bob Page, who with his staff is undoubtedly the source of this information, consistently omits this inconvenient but critical fact). This is the KU faculty doctors' payment for the superb medical care they provide to the hospital's patients. It is not support to the KU School of Medicine. Unrestricted support from the KU Hospital to the School itself is minimal, about $ 5 million or so. While the hospital's "vision" statement has a nice ring to it, Mr. Simons should sometimes review the statutory mission the Kansas legislature actually gave the hospital when it allowed the hospital to split from KU—it in fact is to support the medical school, provide specialized medical services, and to provide care to the indigent. In practice, the first and most important of these missions, which is essentially monetary support to the medical school itself, is given short shrift by the KU hospital and its board of directors. It takes money for a medical school to move up in the rankings, and frankly this should be part of the KU Hospital's vision, since it exists to support the School of Medicine.

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