Category Archives: The Practice of Medicine

UNC School of Medicine Recognized by AAMC

The Association of American Medical Colleges (AAMC) recently delivered its annual report, and the UNC School of Medicine ranked highly. The report said that at UNC, we are:

  • Providing graduates that meet priority needs
  • Delivering a diverse physician workforce
  • Advancing medical discoveries
  • Producing very satisfied graduates
  • Meeting community needs
  • Offering an affordable education

The report is evidence that the school continues to strive toward our mission, but also shows us where there are opportunities for improvement. For example, our school was ranked in the 17th percentile for Hispanic graduates, but in the 94th percentile for African-American graduates. We must continue working to recruit, train and graduate a more diverse workforce, as well as maintain and improve upon our success in all other areas.

To view the AAMC’s full report, click here: UNC AAMC Rankings.

Two passionate surgeons

Today the UNC medical family is learning about and dealing with the loss of two of our most committed colleagues.

Dr. Keith Amos, assistant professor of surgery, and outstanding surgical oncologist, died very unexpectedly while in Edinburgh, Scotland, as a visiting scholar. He was one of our best and brightest young physician leaders, with a special passion for treating breast diseases and for eliminating health disparities.

Dr. George Sheldon, who chaired the UNC Department of Surgery from 1984 to 2001, died after an illness at UNC Hospitals. He was an internationally renowned leader in medicine and surgery, having served as president or chair of practically every surgical society in the country, and as chair of the Association of American Medical Colleges.

In the days and weeks ahead, we will each look for ways to remember and celebrate the work of Keith Amos and George Sheldon.

But today as I remember them both – I am struck by the remarkable gift we have in medicine – to make a difference in the lives of others – and in each of their cases, in the lives of many others.

George and Keith were very different people in many ways, and they were at very different places in their careers – one near the end his, the other in the most productive period of his.

But they both were passionate surgeons, dedicated to serving others.

We will miss them very, very much.

Health care: a desire to help others

Completing a marathon is an incredible accomplishment. And, completing the Boston Marathon is an even greater achievement. That is what makes the events that unfolded at the finish line yesterday even more tragic. It is difficult to comprehend something so terrible, but I am heartened by the outpouring of support.

Runners found the strength to continue running from the finish line to the nearest hospital to give blood. Spectators rushed over barricades to help the injured. And, first responders jumped into action.

I am thankful for the medical and emergency personnel, the medical staff at local hospitals, law enforcement and the everyday citizens who answered the call for help. An inspiring desire to aid others was evident during yesterday’s event, and it was a great reminder of why we do what we do each day – to help others. My thoughts and prayers go out to the runners, the families and the city.

School of Medicine ranks highly

U.S. News & World Report announced this week that the UNC School of Medicine ranked 1st in Primary Care. The improved health of our country and state will depend on innovation in the delivery of primary care, and I am very pleased that our program is leading among all medical schools.

The School also ranked 22nd in Research overall and several specialty areas were named in the top 20: Family Medicine (2nd), Rural Medicine (5th), Audiology (3rd), Occupational Therapy (10th), AIDS (9th), Physical Therapy (9th) and Speech-Language Pathology (11th).

As we work to be the nation’s leading public school of medicine, these rankings speak volumes for the dedication of our faculty, staff, students and alumni. Thank you all for your dedication to excellence in medical education, research and clinical service. These rankings place our School among the top institutions in the country, and demonstrate our commitment to our mission and vision. You can read more about the rankings and how other programs performed at UNC here.

Leading at the School of Medicine

At the UNC School of Medicine, we constantly strive to be the nation’s leading public school of medicine. We believe that partnership and collaboration are the key to advancing our mission, and our most recent partnership with Blue Cross and Blue Shield of North Carolina (BCBSNC) demonstrates our commitment to lead.

Approximately one million North Carolinians are either active or retired military. Many organizations across our state and country work to support these men and women, and now, the School is proud to be a part of this effort. In partnership with BCBSNC, the School is starting a new two-year physician assistant master’s degree program for military medics. This program provides an unprecedented opportunity for these veterans to put their hard-earned skills to work once they return home. BCBSNC pledged $1.2 million over the next four years to help establish the program. We expect to enroll our first class in 2015.

In North Carolina, almost one million people live in areas that do not have adequate access to primary care physicians and services. And, as our state continues to grow in size, access to physicians and quality medical services will be more limited – particularly in rural areas. We anticipate that this program will help increase the number of medical professionals who choose to deliver care in our state. We also hope that other institutions across our state and country will follow our example implement similar programs to support these men and women as they enter the next chapter of service to our country.

New infographic from the AAMC

The Association of American Medical Colleges (AAMC) recently released a new infographic that demonstrates how the country’s medical schools and teaching hospitals work to improve patient care. The graphic can be downloaded and viewed here.

The graphic demonstrates how vital medical schools and teaching hospitals are to our country’s health care system. For instance, the nation’s nearly 400 major teaching hospitals train 80,000 residents in primary care and specialty areas each year. Nearly half of all external research funded by the National Institutes of Health is conducted at medical schools. And, AAMC teaching hospitals provide nearly 40 percent of hospital charity care.

UNC Health Care’s status as a teaching hospital allows us to better train the next generation of doctors and better serve the patients we see each day. We are proud to be a part of a nationwide effort to improve care and better train medical students.

Training medical school graduates outside of Chapel Hill

I was pleased to see the Raleigh News & Observer’s recent coverage of the UNC Family Medicine’s medical training program at Prospect Hill Community Health Center in Caswell County. In the story, Dr. Evan Ashkin points out that the average physician to patient ratio in North Carolina is low – nine physicians per 10,000 patients. This ratio becomes even more skewed in rural and economically vulnerable areas.

The UNC School of Medicine and UNC Health Care are working together to mitigate the health care challenges in the rural areas of our state. One of the ways we do this is by providing residents with opportunities to train in underserved areas across North Carolina – like Prospect Hill.

North Carolina is expected to grow by four million people in the next 18 years, and our state’s health care challenges will grow along with it. Coupled with this growth is an aging physician population. Within 20 years, our state will have 25 percent fewer primary care physicians than we need – particularly in rural areas.

By encouraging residents to train in locations like Prospect Hill, the School hopes to better serve patients in communities that need more physicians and increased access to care. This is an important part of our mission, and I look forward to continuing this commitment to the people of North Carolina.

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.

New Leaders for UNC Medicine and UNC Health Care

A new academic year has just begun, with a new group of students.

And we have a new group of leaders for the UNC School of Medicine and UNC Health Care.

Not everyone is new, to be sure, but we’ve tapped some new leaders and moved others into new roles and new titles.

¢ Marschall Runge, MD, PhD, is Executive Dean, my principal deputy for the School of Medicine, and his focus is the academic affairs of the school. He is leading the effort to create a new strategic plan for the School. In addition, he will be the director of the NC TraCS Institute and PI for UNC’s CTSA grant. He remains chair of the Department of Medicine.

¢ Kevin FitzGerald, MPA, is Vice Dean for Finance and Administration, the principal leader of the School focusing on management and operations across all our missions. He continues to be our liaison to the NC General Assembly.

¢ Terry Magnuson, PhD, is Vice Dean for Research, the principal research leader for the School. He remains chair of the Department of Genetics. He oversees graduate education in the basic medical sciences, working closely with Warren Newton. He is leading the effort to create a new research plan for the School.

¢ Warren Newton, MD, MPH, is Vice Dean for Education, the principal education leader for the School. His primary focus is medical student education, but is also charged with integrating all our medical school activities, including allied health education, continuing medical education, graduate medical education and graduate education in the basic medical sciences. He remains chair of the Department of Family Medicine.

¢ Allen Daugird, MD, MBA, is President of UNC Physicians and Associates, the principal leader of the School’s faculty practice plan.

¢ Rick Pillsbury, MD, is Chair of the Executive Committee of UNC P&A, the new group of chairs who are Al Daugird’s principal advisory group. He remains chair of the Department of Otolaryngology / Head and Neck Surgery.

¢ Paul Godley, MD, PhD, is Executive Associate Dean for Faculty Affairs, the principal leader in the dean’s office focused on developing our faculty and working with them to assure their success.

¢ Amelia Drake, MD, is Executive Associate Dean for Academic Programs, directly assisting Marschall Runge, Kevin FitzGerald and me with key tasks in leading the School’s academic initiatives.

¢ Tony Lindsey, MD, is Executive Associate Dean for Clinical Affairs and Chief of Staff of UNC Hospitals, working with Marschall Runge, Gary Park and others to advance our clinical and quality activities.

¢ Chris Ellington, MBA, is Executive Vice President and Chief Financial Officer of UNC Hospitals, the principal financial leader of the Hospitals.

¢ Brian Goldstein, MD, MBA, is Executive Vice President and Chief Operating Officer of UNC Hospitals, the principal operations leader of the Hospitals.

We have a very good team in place — with these leaders and the others who continue in their important roles.

And we are off to a good and fast start to the new academic year.