Category Archives: UNC School of Medicine

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.

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.

Fall Address to Faculty

Recently, I spoke at the Fall Faculty meeting of the UNC School of Medicine. I discussed the progress our School has made to fulfill our missions of education, research and patient care.

I am very proud to be a part of such a leading organization.

Our school is working hard to improve health around the globe. In Malawi, for example, we work to provide HIV testing and counseling, conduct research projects to reduce adult and mother-to-child transmission of HIV, and teach classes in epidemiology, pediatrics and HIV care.

Nationally, our research efforts and hard work have again enabled our school to be counted among some of the best medical schools. U.S. News & World Report's 2011 graduate school rankings placed our school 20th overall for research and second in primary care.

To meet our mission to educate the next generation of care providers, we announced the expansion of our school to Carolinas HealthCare System in Charlotte and Mission Hospitals in Asheville. We will be accepting more students into our program and we will send some students to spend most of their 3rd and 4th years in Charlotte and Asheville. This effort would not have been possible without the great support from our partners in these cities and our faculty and staff.

There will, no doubt, be challenges ahead. But as we enter the final months of 2010, I am pleased to look back on all we have accomplished so far and I look forward to the many future successes for our school and for our system.

Medical Education Expansion

For the past almost three years we have been working on a plan to expand medical education at the UNC School of Medicine.

In the spring of 2008, the UNC Board of Governors approved this plan — which will eventually see our class size go from the current 160 to a new size of 230 students per year. We will do that in partnership with colleagues at Carolinas Medical Center in Charlotte and Mission Health in Asheville.

We had asked for and much hoped for new state funding for this expansion — but the recession and the state’s fiscal problems have prevented that.

Nonetheless, we have now decided to proceed with the expansion, albeit on a slower timetable.

This Saturday I will be in Charlotte and Asheville to do ribbon cuttings for the new branch campuses of our med school in each of those cities. This is truly a landmark set of events, and we will be celebrating this progress toward meeting the health care needs of our state.