The University of Colorado School of Medicine has excelled at its primary missions during the past year, Dean Richard D. Krugman, MD, reported last week in his annual State of the School Address.
The school stands on a solid financial base, offers a national example for community service, is investing in its research program and provides a comprehensive learning environment, Krugman said in a review that covered the past year and reflected on his more than 24-year tenure as Dean.
In a speech titled “Don’t Think It Hasn’t Been Fun!,” Krugman called it “a really good year for our school” and he thanked faculty, staff, hospital partners and executive leadership for their contributions to the successful year.
Financial Base Solid
The financial footing of the School of Medicine continued to strengthen thanks to the robust clinical practice of faculty, stronger charitable contributions from donors and unprecedented unrestricted support from the University of Colorado Health.
“As far as revenues go, we have maintained a fair amount of success,” Krugman said. “We have surpassed $1 billion in revenue.”
The growth of support from University Physicians Inc., (UPI) has been crucial to the school since 1990, when Krugman became interim dean. He noted that the school was a “research-intensive institution” at that time, but that two things happened that changed the face of the school. Colorado General Hospital became University of Colorado Hospital and the Department of Pediatrics moved to Children’s Hospital Colorado, which was known as The Children’s Hospital at the time.
“Since that time, the clinical revenue has grown,” Krugman said. “And when we got to this campus, things have taken off. As you are aware, we significantly subsidize our academic mission with clinical dollars. And UPI, which generates the clinical dollars resulting from the work of our clinical faculty, now represents more than half of the revenues in the school of medicine.”
Contributions from private donors provided more than $63 million for School of Medicine programs last year and are on track to match that level support again this year.
The dean also noted that the newly established annual academic funding support from the University of Colorado Health totaled $10 million last year and is set to provide about $12.4 million to the school this year.
“That gift was a milestone because we had not previously received unrestricted support from our affiliated hospitals for our work,” he said.
Community Service a National Model
Krugman commended the community engagement core of the Colorado Clinical and Translational Sciences Institute (CCTSI) for offering an example for others to emulate.
“This particular part of the CCTSI is looked to as a national model,” Krugman said. “I can’t tell you how many institutions that have CCTSIs, which require community engagement, actually don’t quite know what community engagement means.”
The recently established Community-Campus Partnership and the soon-to-open student faculty primary health care clinic will strengthen the ties with neighbors of the Anschutz Medical Campus.
Research Funding Growing Again
“In the research area, it was a very, very good year,” Krugman said, noting that research funding was rebounding after cutbacks in federal support. The American Recovery and Reinvestment Act of 2009 briefly boosted funding.
In fiscal year 2014, the School of Medicine’s research funding grant awards totaled $358.7 million and represented the second largest source of funding to the school.
“We are back up,” he said. “And there are figures in (the 2014 Facts and Figures) book that show we’re on a path to continue to increase our research funding as a School.”
Krugman discussed investments in two key research initiatives that will continue to boost the school.
The first is the Center for Personalized Medicine and Bioinformatics, which includes COMPASS (Clinical Operational Molecular Predictive Analytic Shared Services). With significant contributions from UPI, the University of Colorado Health and Children’s Hospital, the school is establishing a data warehouse that will have widespread impact.
“COMPASS is the data warehouse for the campus that is going to be absolutely critical to the future of our basic research, our translational research and the move toward personalized medicine, as well its importance in health outcomes and health care effectiveness.”
The second was the planning to invest in infrastructure for cryoelectron microscopy (Cryo-EM), a move that involves at least eight departments in the planning process.
The Dean also recognized the significant contributions of Chip Ridgway, M.D., senior associate dean for academic affairs, who died in July.
“Chip’s loss has been enormous for us and we all feel it,” Krugman said.
Strong Partnerships with Hospitals
Krugman lauded the efforts senior leadership at the school and UPI for building solid relationships with the school’s hospital partners. With improved communication between hospital administration and a united focus on service excellence, the partnership is growing stronger.
“The connection between the hospitals and the clinical vice chairs in the school is better now than it’s ever been before and that is enormously important,” Krugman said. “There was a time when many of us in the school didn’t particularly care about what went on in the hospital and occasionally over the years, we’ve had a hospital that didn’t particularly care what went on with us either. Those days are gone. The relationship with both hospitals is as good as it’s been.”
He specifically noted the efforts of Doug Jones, M.D., senior associate dean of clinical affairs; Jane Schumaker, executive director of UPI; Stefannie Emerson, UPI’s senior director of business development and planning, Christina Finlayson, M.D., associate medical director at UPI; and Michael Narkewicz, M.D., associate medical director at UPI.
Establishing Office of Professionalism
In the Office of Academic Affairs, Krugman said, establishing the Office of Professionalism has been a significant achievement.
“I know there’s been a lot of conversation around this and I’ve had a lot of people say, what are we doing with this and why are we even doing it,” he said. “We started this effort because we’ve recognized since only 1985 that our students have reported mistreatment by faculty, residents and staff. It’s not unique to us, every medical school in the country and I suspect lots of professional schools as well deal with us. It clearly has had an impact as I have talked to graduates from our classes in the 70s and 80s about why they are or are not contributing to the alumni association. Many of them had adverse experience here.”
The goal is to create a better way than the anonymous-reporting programs that failed to curb unprofessional behavior and to include better communication with the hospitals, where some of the behavior occurred.
“Because we’re a place where each of our hospitals has separate governance, we actually have discovered recently that awful encounters that hospital staff or others have had with some of our faculty never came to our attention for a year or more,” Krugman said. “And they never came to our attention because the staff member was employed by the hospital. It was reported to HR at the hospital and the person who was in charge of the faculty member – that is the chair of the department, who is a university employee and works for me – never hears about the problem. One of the reasons that we put this group together was so that we could identify problems early and address them soon.”
Eliminating unprofessional behavior is critical to the mission of the school and the hospitals he said because “there are clear data to show it has adverse effects on patient care, quality and learning.”
The school provides a better curriculum and offers better support to students now than it did when Krugman became interim dean in 1990.
The program now is centralized to avoid duplicative content, requires mentored scholarly activity, provides problem-based learning and offers a supportive learning environment.
“I just want to say this about students,” he said. “I was told early on in my career and most of you have heard this, most faculty’s view of education can be described this way: We talk about my fellow, our residents, your students. And if you think about it, medical students are the only people in the school of medicine who are not linked into or attached to a department.”
As a result, some MD students didn’t get the attention they needed. The updated system ensures that those students now “feel there is someone actively looking after them.”
Krugman concluded his report with a Top 10 list of the reasons for his longevity as Dean. He is now the longest-serving dean in the history of the School of Medicine and is currently the dean of deans among medical school leaders in the U.S.
Krugman announced in January that he would step down as dean when a successor is hired to return to some research that he would like to pursue. He noted in his speech the names of retired faculty, saying “What was a little scary for me was that one of them was my intern when I was on the faculty.”
He said he had the temperament and training that served him well, but it hadn’t been a lifelong ambition to become a dean.
“Unlike some of you who are really focused on getting answers, I’ve got a pretty big tolerance for ambiguity and a presumption that most things will get better on their own, in time, with a little anticipatory guidance.”
His personal remarks gave credit to family and friends, mentors and colleagues. He said Lilly Marks, executive vice chancellor of the Anschutz Medical Campus and the university’s vice president of health affairs, “is an extraordinary colleague who in my view really is most responsible for the success of this school and campus.”
And, finally, he thanked “wonderfully supportive and loving wife,” Mary for more than 51 years of partnership, his immediate family and everyone at the school “for letting me have this job. It really has been fun!”