UNC and Wake County Physician Partnerships

Last week, I had the opportunity to speak about the future of academic medicine to the Wake County Medical Society alongside Dr. William J. Fulkerson, executive vice president of Duke University Health System. I have included my remarks below.

A lot is happening in medicine and health care, in the nation, in North Carolina and in Wake County. I am pleased to join with my Duke colleague, Bill Fulkerson (Executive Vice President, Duke University Health System), on this program tonight, to discuss issues of common interest. All that we do has to be done in a way that meets the health needs of our fellow North Carolinians, and improves the care that they receive.

We at UNC Medicine and UNC Health Care are leaders in research, teaching and clinical care. We have much to celebrate. The recent 2011 USN&WR rankings of the nation’s medical schools put us #2 for primary care and #20 for research. More than half of all UNC research dollars were awarded to School of Medicine investigators.

And we are working to provide even more research opportunities. We, like Duke, are one of 55 institutions nationwide who have received an important, large NIH grant that enables us to speed the implementation of new ideas and technology into clinical practice, and to collaborate with new partners.

We are currently collaborating with more than 600 community members across the state in all areas of medicine, and we invite you to partner with us in these new research opportunities. They are specifically designed to move us out of our traditional university research environments, to be much more engaged with the community. You can find more information about this on our website: http://www.tracs.unc.edu.

At UNC we take our educational mission very seriously. We have long partnered with others across the state to train our medical students and our residents and fellows. A full 40 percent of the clinical experiences of UNC med students occur outside of Chapel Hill – WakeMed is an important educational site for us here in Raleigh. And our residency programs are much intertwined with WakeMed’s clinical activities here, too.

We have recently announced the formation of two branch clinical campuses of the UNC School of Medicine, in Charlotte and Asheville, which will allow us an even more focused way to educate medical students there, and to expand the size of our med school class.

UNC Health Care Now and in the Future
UNC Health Care, including Rex Healthcare, employs more than 12,800 people, and last year we saw more than 270,000 patients. We provided almost $300 million in uncompensated care – an important part of our mission to serve the state, a substantial portion of which was to residents of Wake County.

Rex Healthcare expands our reach to the people of Wake County. The NC Cancer Hospital at Rex, set to open in 2014, will be a dedicated cancer center here in Wake County. It will provide patients access to the resources of UNC’s NC Cancer Hospital, which opened last year.

New Opportunities for Partnership
We believe academic institutions, local health care providers and physician groups will work even more closely together in the future, as we together face pressure to serve patients better and more cost effectively.

It is about more than just payment rates. Success in the future will require physicians and hospitals to become true partners in the delivery of coordinated, quality, lower-cost care.

We think academic health centers like ours are a good starting point. For the most part we are already integrated within our organizations – and now we are reaching out to partner with others across our communities. We have no cookie cutter approach to physician relationships – we have created partnerships that include employment, joint ventures and academic affiliations.

Rex and UNC have a decade-long track record of successful collaboration with physicians. We are always happy to have you speak directly with those physicians to learn more about how they view UNC/Rex and how they view our approach as a partner. Our guiding philosophy has been to partner with the best physicians in a community, and to help ensure that we get patients to the right care at the right time. In particular, this means that if the needed care can be provided locally, it should be provided locally, by our partner physicians. Certainly we want to be available at UNC for your patients, as we are to all of the people of North Carolina, for tertiary or quaternary medical care. But we have no intention of siphoning patients from your market. Again, our partners at Rex and in the community can validate our success with this model.

Leading organizations will be the ones that understand how to work collaboratively and effectively with physicians. We recently launched Triangle Physician Network (TPN), a joint effort of UNC and Rex to operate a regional network of leading physician practices. There are currently more than 130 physicians in TPN. It is led by physicians, for physicians.

Our strategy for affiliation is simple – we listen to and work with quality doctors to develop mutually beneficial relationships. We want and need physician help with making this strategy work well over the long haul – to improve what we are doing today and to develop innovations for the future. Improving communication and care coordination is an important aspect of this effort – I am on the board of the new NC Health Information Exchange, and we are fully committed to providing our primary care and specialty physician practices the ability to coordinate with the latest in electronic medical records and other technology.

The Road Ahead
There are many challenges ahead. There is an urgent need for more primary care providers, especially in rural and other under-served areas. Health reform is a big unknown, especially with the political turmoil around us – though I remain a firm advocate for thoroughgoing health reform. I am very much aware, as a former school of public health dean, that we need to make major progress in improving the health of the population – issues like smoking cessation, physical activity and the obesity epidemic.

I appreciate the work that all of our colleagues do to meet the challenges before us. As I said earlier, all we do has to be done in a way that meets the health needs of our fellow North Carolinians, and improves the care that they receive.

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