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School of Medicine
And then she said it again, “I’m quitting, this place has finally gotten to me.” This was not exactly the message I anticipated hearing from a faculty member a few weeks back. But that’s what she said. And it was later that evening, after we had talked for some time, that I decided on the title of this presentation. Today I’ll talk about “Cultivating a Tradition of Excellence,” what that means for the school, what it means for the State and University and what it means to you as faculty, staff, student, or resident. It is my intent that by the end of this talk you will feel motivated, optimistic, and challenged – with a clear vision of the future. Before I’m done, I’ll give you some follow-up on that faculty member and what she’s decided to do. As Dean, one of the most frequent questions I’m asked is “How are you doing in your new job?” Well, it’s been an exciting, challenging, and very fulfilling time since I became dean, 104 days ago. My sincere thanks to all of you: faculty, chairs, staff, and students for welcoming me into this role. You have truly made the transition a smooth one. A special thanks to the Offices of Student Services, Alumni, Development, Planning and Marketing, and Legal Services – you’ve welcomed me and my office staff with open arms. In particular my thanks to the Vice President’s staff. Carlotta, Carol, Babette, Hazel, and Norma. You’ve been wonderful to me and my staff, which has made the transition and our start-up a great success. Many of you know that we set up the dean’s office and staff with Charlene Gaston as my executive assistant, with whom I worked as President of UHA and Marlene Hogan as my administrative assistant. Both of these ladies certainly keep me on time and on track. When I became dean, I asked Leslie Miele to fill a new position called Director of Project Management. She has helped me plan several detailed initiatives and assure that the proper follow through occurs on both my end and yours. All of these individuals are dedicated to providing assistance, minimizing bureaucratic obstacles, and solving problems. I want to take a few moments to thank my family. My wife Charlotte, and two of my daughters, Amy and Allison, are here this evening. I want to express my sincere appreciation to them, for encouraging me to pursue this role and their ongoing support. Twenty-five years ago, Charlotte and I, as third year medical students were just about to get married. Charlotte, thank you for all you do and all that you are. I’m looking forward to the next 25 years. I also want to thank my daughters, and in doing so I want to let all of you in on a secret. No one else can bring “the dean” back to reality faster than his kids. I am still reminded to take out the garbage! Being in the dean’s chair has given me the opportunity to learn more about what you are doing. This is an amazing school. Almost daily, we are able to make announcements of significant achievements across all of our missions. Here are just a few. Through the work of Drs. Barbara Ducatman, Ann Chester, and a host of others, our Center of Excellence in Women’s Health was nationally recognized and funded. This unique project is the result of the cooperation among Internal Medicine, Family Medicine, OB/GYN, UHA, and the hospital – doing what we do best, working together. Drs. Jim Helmkamp, Jeff Coben, and the staff of The Center for Rural Emergency Medicine were awarded a multi-million dollar grant in injury control. The WVU-BrainLAB Partnership was announced between our neurosciences departments, the hospital, and private industry. The neurosciences continue to grow with programs in epilepsy and stroke. The Department of Medicine continues to bring in new research funding. Just a few years ago research funding totaled hundreds of thousands of dollars, now it’s millions. Dr. Woody Moss and his staff recently received a national award and recognition for their End-of-Life program. Last week, I received three books from SoM faculty authors. Thank you, Drs. Cronin, Mandich, and Zaslau. Dr. Bill Neal and the CARDIAC program seem to win a new award each month. And our recruiting efforts in the surgical specialties continue to pay big dividends with the addition of several new surgeons. In September, the search for a new dean of the Eastern Division campus was successfully completed with Dr. Mitch Jacques now filling that important position. Back in Morgantown, Dr. Jim Arbogast agreed to serve as the interim Chair of Family Medicine and the Chair of our Graduate Medical Education Council. In addition to his role as interim chair of Pediatrics and Associate Dean for Student Services and Alumni, Dr. Norman Ferrari has assumed overall responsibility for GME. And Dr. Anne Cather has been appointed our new Executive Director of the Oman medical program here at WVU. Just this past week I received word about our medical students’ performance on the Step II examination. To date, over half the class has taken this test and we have a 100% pass rate, with a mean class score of 228 versus a national mean of 215. Congratulations to the students and the many faculty who prepared them. Of particular importance to many of you, I am pleased to announce four new searches; the Anesthesiology search committee will be lead by Dr. Sandy Emery, the Pediatrics search by Dr. Ann Chinnis, the Family Medicine Search by Dr. Jim Stevenson and the Exercise Physiology search by Dr. Bill Neal. Additional searches that have either begun or will soon start include those for our new thematic research centers and for the UHA President/CEO. I want to use this opportunity to again thank Drs. Ferrari and Arbogast for serving in the interim chair position and for all of the departments for their understanding during these leadership transitions. Dr. Jeff Neely also deserves special recognition for his service as interim President and CEO of UHA. As my long list indicates, we are obviously doing some great things as a school and staying quite busy. But in order for us to discuss Cultivating a Tradition of Excellence, we need to understand the scope of our organization. What exactly is the WVU School of Medicine and who are we? We are: one medical school, with 572 faculty members, working at three distinct campuses, which in turn is part of the HSC, part of the state’s premier University. We have nearly 800 professional program students in Community Medicine, Exercise Physiology, Medical Technology, Occupational Medicine, and Physical Therapy. There are 396 Medical students, 111 Graduate students, 275 Residents, and 30 Fellows. Additionally, we have over 1400 staff supporting our School’s educational, research, and clinical missions. Our budget is nearly $240 million - with funding coming from our practice plans, the state, our teaching hospitals, research, tuition and fees, and donations. Speaking of tuition and fees, I think it is important for all to know what we are asking medical students to pay for their education. For in-state students, the cost is now $15,700 and for out of state $36,102; amounts that are very competitive with our peer institutions and less than many. While we have seen a plateau in new research dollars coming in over the past year, we continue to attract significant grants. Fifty faculty are federally funded for $21 million, 70 faculty are funded with state, industry, and foundation contracts for about another $14 million. Annually, our physicians care for over 362,000 patients in outpatient settings and admit over 28,000 to our inpatient physician services. Last year 20 international patients traveled to Morgantown to receive care. There is a critical interdependence among all of these people and entities. Education serves as the foundation for research and our clinical services. Research brings new therapies to clinicians and opportunities for educators. Service becomes the way we directly touch the lives of hundreds of thousands of West Virginians each year. Departments work with Centers, Chairs with Directors, faculty with staff. These relationships are absolutely critical, and something I will return to later in this talk. While our School is complex and vast, it must maintain significant relationships with other organizations and individuals to successfully complete all of its missions. Within the Health Sciences Center I work closely with Dr. Spratto of the School of Pharmacy, Dr. Martin of the School of Nursing, and Dr. Koelbl of the School of Dentistry. I would like to recognize WVUH and Mr. Bruce McClymonds for their ongoing support of the School. I don’t believe there is any hospital president who is a stronger advocate for medical education, research, and for just “doing the right thing.” I’ve known Bruce for over 14 years and I hope he continues as my partner in clinical care programs for as long as I’m dean. There is also a close relationship with the West Virginia United Health System and Mr. Tom Jones. The System continues to work with the school on contracting, business efficiencies, and exploring new opportunities. Tom brought with him a wealth of knowledge of the state and healthcare. He continues to support many of the programs and activities within the School. Thank you. The School, through our Charleston division, enjoys a solid relationship with Charleston Area Medical Center. Mr. Dave Ramsey, Dr. Glen Crotty, and Ms. Sharon Hall have worked closely with Dr. Clark Hansbarger and his staff to ensure the ongoing success of our clinical campus. Soon, we will talk about the new partnerships that our Eastern Division has with WVUH East. Finally, I must thank University Health Associates and West Virginia University Physicians of Charleston and their boards for their dedication to the School and our missions. Quite simply, we could not exist as a school of medicine without these organizations and these relationships. There is one more individual I will recognize today. I certainly would not be able to talk about these achievements, these relationships, the size and scope of our School if it hadn’t been for the leadership of Bob D’Alessandri. For 15 years Bob served as Dean and through his actions helped build the school we all call home today. Shortly after he became Dean, I had my first visit and interview at WVU. It was Bob who first talked to me about the mission of the school. A mission to serve. And from that day forward, I was convinced that WVU was the right place to be. On a personal note, before, during, and after our July transition, Bob and Elaine have been an on-going source of kindness, critical information, and support. Charlotte and I both want to thank you. Bob is recognized by his colleagues and leaders from around the state and nation as a “leader among leaders.” He is known for his unrelenting focus on mission, insistence on high standards and selflessness. Please join me in thanking Dr. Bob D’Alessandri, and Elaine, for their many years of outstanding service and ongoing contributions to the SoM. We have talked about who we are, and now we need to talk about what we want to become – what is our vision for the future and what are the challenges we face. When I started in my new role as dean, I had to do what each of you has done when you’ve taken on a new job. I had to set some priorities for myself and those working with me. In spite of having been here 14 years, I will tell you that the view changes when you move to the Dean’s office. There is much to learn - even it if is just looking at the same issues from a different perspective. It was critical to get a thorough understanding of the questions and concerns facing our faculty, staff, and students. I couldn’t do that by sitting in my office waiting for the phone to ring or an email to appear. So, I decided to make some visits. Over the last three months I’ve been to the Charleston and Eastern Division campuses. I’ve met with all of the Associate Deans and Chairs. I’ve sought input from within and from outside of the School, from students, alumni, supporters, and donors. But the most important thing I’ve done is to meet with the faculty. In over 30 hours of direct, face-to-face meetings, I was very encouraged that, by and large, our faculty understands our mission. They know that it is “To improve the health of West Virginians through the education of health professionals, through basic/clinical scientific research and research in rural health care delivery, through the provision of continuing education, and through participation in the provision of direct and supportive clinical care”. Although it is clear that the faculty appreciate the mission of the school, there were also common issues that I heard repeatedly during these meetings. Concerns were voiced about resources and productivity - the ongoing expectations to do more with less (less financial resources and less human resources). There were mission support issues - increased financial pressures that resulted in less teaching time and little to no dedicated scholarship time. Morale issues - faculty are tired and feel that they are running as fast as they can but are not making any forward progress. Facility issues were also cited – there is inadequate space for all of our research and teaching needs. Concerns were repeatedly expressed that our relationships with WVUH, CAMC, and WVUHS need to be stronger. Finally, there were operational issues – concerns exist about the roles of centers vs. departments, the implementation of the Strategic Research Plan, and inefficient business processes that could be traced back everywhere from the Dean’s office to the Office of Sponsored Programs. I learned a great deal at these meetings and yet the real learning took place just about a month ago. It was after one such a meeting that I talked with the faculty member who I quoted at the beginning of this speech. She was clearly distressed, but her plea was less about the facility, less about salary, and more about what she perceived as lost opportunity. Facilities can be updated, salaries improved, but as she explained, “opportunity lost is gone forever”. And she believed that opportunity was slipping out of WVU’s grasp. Even while the faculty understood the mission they remained uncertain of the School’s vision. They complained that there was no overarching goal, no unifying concept. Chairs wrote about this in their departmental assessments and faculty pointed to this in our joint meetings. As a wise philosopher once wrote, “Listen carefully, more is often said than heard.” With quiet reflection, a common vision for the School became clearer and clearer to me. Imagine you are looking across a pond and the glare is preventing you from looking underneath. Change your position and what was once hidden, suddenly opens up. Just below the surface of our day-to-day lives as faculty, students, and staff, there exists a bubbling, vibrant desire to be and do more. Listening carefully, beneath the complaints about facilities, workload, and budgets, one word kept creeping back into the discussions. EXCELLENCE. EXCELLENCE. Faculty, staff, and students kept stating that they wanted to do the best possible job and then some. Excellence. They believed in sustained superior performance that could surpass others. Excellence. They reported that when they compared themselves to their colleagues at their national meetings and conferences not only could they stand toe-to-toe, but we at WVU often offered novel approaches or techniques years ahead of others. Excellence. In 1990, a book was published called, “Generation of Growth.” Many of our more “experienced” faculty remember it. It catalogued the beginning and flourishing of medical education here on the hill. Since that time, the HSC, School of Medicine, and in fact medicine itself has changed dramatically. A new, Generation of Challenges followed our Generation of Growth. Challenges included new and significant State demands, budget cuts, falling reimbursement, budget cuts, rising federal regulations, and budget cuts. The Generation of Challenges left its mark on the School of Medicine. We are tired, but like the athlete who has been rigorously training for the triathlon, we are ready. Now it’s time for a new generation to emerge. The Generation of Excellence. Excellence means we cross the chasm from potential to reality, from dreams to discovery. None of us can settle for anything less than excellence - to do so is selling our selves short. The vision is clear and today I am reflecting back to you that vision. WVU faculty, staff, and students want to be a Top 25 (T25) medical school. And I believe WVU can become a T25 medical school by Cultivating a Tradition of Excellence. What does it mean? What are the tangible benefits? Becoming a T25 medical school will be a source of tremendous pride for the University and State. And the reality is that West Virginia needs more things to be proud of. A T25 designation will serve as a source of empowerment for faculty, staff, students, and residents. Our success will attract new resources and serve as a powerful tool in retaining our best faculty. This new designation can pull all of WVU to a higher level. A T25 status does not have to be the exclusive domain of our football team! What will we look like? A T25 medical school educates the best and the brightest that America has to offer. A T25 medical school impacts the health of the state by serving as an anchor for its health care system. A T25 medical school is one where intellectual curiosity is valued. Where curiosity leads to questions and hypotheses. These in turn lead to funded research. And the funded research leads not only to health advancement but to economic impact and opportunity. A T25 medical school has figured out how to have sustainable and renewable financial resources. A T25 medical school attracts the best and the brightest faculty, staff, and students. When T25 faculty leave to assume new positions within other schools, they leave as colleagues with the WVU imprint and they forever serve as a source of goodwill, references, and collaboration. A T25 medical school has a National Cancer Institute designated cancer center and an American College of Surgeons designated Level I trauma center. A T25 medical school knows how to bring the joy of academic excitement and fun to students, faculty, and staff. A T25 medical school has figured out how to balance the demands and resources across each of its missions. A T25 medical school realizes that it cannot be in the T25 by every measure. But I am certain that when we achieve T25 status, the “common lot” will be much improved. There are some of you who are now saying, “Prescott’s lost it! We don’t have enough money, resources, time, ability, or skill to make this a reality.” But I believe those individuals underestimate our potential. And I think many of you quietly agree with me. So, how do we go head-to-head against Michigan, Alabama, and, dare I say, Pitt, when we don’t have the capital or the resources they can bring to bear? The answer is we don’t go head to head. We simply play a better game, our game. We must capitalize on what we have and what they don’t. We must play to our strengths, our people, our relationships, and our values. When needed, we must exploit their weaknesses, their size, their bureaucracy, and their blinding pride. You can count the number of rural academic health sciences centers on one hand. We must use that to move ahead. As a school of medicine, we tie our work directly to the health needs of our state. Use that to move ahead. Our school, teaching hospitals, and our practice plans all talk together. Use that to move ahead. We are inspired by tradition but not bound by it. Use that to move ahead. I know this won’t be easy and in some parts of the School there seems to be a belief that we are just WVU - we don’t excel, we just get by. Yet since I’ve been here, I’ve seen countless examples of just the opposite. We excel in West Virginia and at the WVU School of Medicine through our willingness to partner and collaborate. We focus on interpersonal trust rather than personal ego; we emphasize service to others rather than gain to oneself; and we are innovative in the face of scarce resources and external threats. We have much to be proud of and I firmly believe excellence is not only part of the vocabulary of everyone in this auditorium but it is at the core of who we are. There are places where the commitment to excellence has brought about significant change - think of New York City in the 1970’s versus now. Within the HSC a commitment to excellence brought about: the regional campuses, the development of Department of Emergency Medicine and Center for Rural Emergency Medicine, the Eye Institute, the revitalization of orthopaedics and neurosurgery, and the new construction on the hilltop. Each of these was the direct result of a dream, careful planning, focused resources, leadership, and the belief that we “can do it.” Just remember, it is one thing for others to defeat us; however, it is far worse for us to resign ourselves to lose because we defeat ourselves. For those of you who love football, even for those who do not, I want you to think back to those Maryland football games over the past several years. Did they really have better teams or did Coach Rodriguez get it right when he referenced “the gorilla on our back,” that is, the collective mind set that we couldn’t win, that ultimately determined our level of play. A mind set that never allowed for victory or achieving full potential. West Virginia University School of Medicine get rid of the gorilla! Throw the monkey out the window! It’s time to believe in ourselves - it’s time to reach our potential! I believe I have outlined what we want our vision to be. But the big question is, how do we get there? How do we achieve T25 status? We have to ask ourselves, “What must we stop?” Quite simply there are things we must stop doing now and others we need to begin. We must stop wasting resources and time on infighting. We must decide that it is simply not going to be the way this school works. We must stop arguing and looking over our shoulder or across the table and thinking, “I’m working harder than they are!” By the way, who is working the hardest? Does one organ in your body work harder than others? We are at a critical junction. We can choose to make our relationships stronger with all of our partners by going down an agreed upon path or we can go our separate ways. The latter strategy is one that I believe will result in failure for all. We either work together as a team to move all organizations forward or we will become competitors as each organization struggles to move ahead. All sides have to give. All sides have to benefit or we will not succeed as a school, a hospital, or as a practice plan. What must we do? Our relationships within and outside of the School must be given the highest priority possible. I’d like to say that this is the current situation but it is not. That is why we go round and round on issues ranging from who pays for what space to who is overseeing quality issues. We have to get over these smaller issues and look at the bigger picture. I believe organizations are much like families. I see many parallels to the relationship issues I just described. I came from a big family, there were seven kids – four boys and three girls – and I can tell you that growing up we fought like banshees – especially me and my brother who was younger by a year. We fought over where we sat at the dinner table, we fought when we thought one of us had more chores than the other, and sometimes we fought just to fight. But times change and we changed. We’ve grown out of our adolescence and have become close friends. And most importantly I know, and he knows also, that when the chips are down, I’ll be there for him and he’ll be there for me. Our relationships with our partners need to mature in a similar manner. We must stop our arguing and move forward together. The medical school must work side-by-side with its teaching hospitals and practice plans and we must be able to always count on each other. As dean, I will make these relationships a priority in all that I do. And I am counting on all of our other leaders to do the same. What else can we do to achieve T25 status? In addition to relationship building and joint planning, we must make time, money, space, and personnel available to those who can best utilize them. This will mean we will invest in success and when necessary cut our losses. We must also educate external decision makers and those whose opinions carry significant weight about our school. We must be part of the state, regional, national, and international press. As an institution, we need our faculty and staff to hold prominent positions in national organizations and government panels. They must be part of the National Science Foundation, Institute of Medicine and participate in NIH study sections. We must also promote those activities that lie at the core of any T25 medical school. There must be clarity of our vision and mission. Goals must be set and timelines met. There must be accountability, with both positive and negative consequences for all. There must be transparency in our business practices. We cannot judge or achieve success without knowing and believing in the fairness of the basic operations of our school. We have to set up systems such that doing the right thing is the easy thing. The entire school must always work at optimal efficiency. This means the clinics, contracting, legal, administration, student services, sponsored programs, human resources, you name it, have to be engaged. Some of these changes have already been instituted and others will soon follow. But you have to help in this process. You have to become engaged. To guide us along the road to excellence, I will call for a major strategic planning and implementation process within the school. We will not only strategically plan but we will teach ourselves to execute flawlessly. We’ll work with the Vice President, the other schools, the hospital, and system and we will set clear goals and objectives. This will enable us to move from a reactive mode, where we are always responding to a developing crisis, to one of proactive planning and execution. You can see I left out two very critical factors, people and money. I’m sure some of you are asking, where’s the money to Cultivate this Tradition of Excellence? As I mentioned before, our operational budget is nearly a quarter of a billion dollars. The Investment in Excellence is not a question of why, but of how much? The funds that we receive from our revenue sources are not only for day-to-day operations but for an investment in the future. In the coming months, I am going to be working with the SoM leadership to utilize the resources we have already accumulated to invest in our future - to invest in excellence. To be sure, we will need additional support from our development efforts - people, corporations, and even the government want to invest in a T25 school. We must redeploy these saved resources to the people, facilities, and programs that not only meet our mission but will allow us to achieve our vision. In the departmental assessments prepared by the chairs, each of them mentioned as a core departmental and School strength the quality and skills of the individuals working throughout the school. Words like “dedicated”, “selfless”, and “hard-working” were repeatedly used - traits that all of us can be proud of. However, the reality is that our faculty and staff are tired and morale is not where it needs to be. We need to and we will invest in our people to make sure all of them enjoy this tradition of excellence. I’ve often said I’ll take the right people in the right job any day over money. Just yesterday I was questioned about what I meant by that. My response was that I’d take 20 true leaders any day over $20 million. Yes, money allows you to do some things, but it is people who bring hope; people who bring ideas; people who bring joy, and people who see possibilities. Dollars are consumed and quickly forgotten but the good works of our talented people go on and on and on. We must attract, recruit, and retain the very best people in the world to our school and then tap into West Virginia’s and WVU’s greatest resource, its people. We can cultivate a Tradition of Excellence and become a T25 school if we utilize our own resources, our own strengths, and our own potential. Yes, we have some issues. But, more importantly, we have people who believe, people who care. And they, you, are our most important asset within the school. Finally, we will have to do what some consider is the most important yet most difficult thing to ask any organization to do. We must change our culture to one of excellence. To Cultivate a Tradition of Excellence we must reignite the flame of academic passion that led us to our careers and to WVU - and that’s where all of you come in. You must be at the heart and soul of this effort. Live your values; try new things, take deep breaths, quicken your pace, forgive others; have fun; and dream of a School where Greatness is not only Learned but Earned. You are the soul of the School of Medicine. In closing, I want all of you to know how pleased I am to be here. How proud I am to be the Dean of the WVU School of Medicine. And how committed I am to helping the school cultivate a tradition of excellence. I am ready to lead this Drive to Excellence. I pledge to you that I will give it my best effort. I, in turn, expect no less from you. A trusted friend once said to me, “WVU is small town, not small time.” Rarely does such a simple statement contain such a profound truth. That’s what the faculty member I mentioned to you earlier came to realize. By the way, she’s sticking around. She has decided that she wants to be part of what’s to come. So please join me in cultivating this tradition of excellence; a tradition that lies deep in the values we hold most precious, a tradition that needs to rise to a more prominent position in all of our actions. If we expect excellence in all that we do we will do, we will become a T25 medical school. I know that becoming a T25 school right now is a dream. But it’s our dream and it is clearly within our grasp.
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