Q&A with Richard Krugman, M.D., School of Medicine

School of Medicine Dean Richard Krugman, MD, announced in January that he would step down as Dean when a search for his successor is completed. To honor his achievements and to celebrate the School’s history, the School is planning the Bow Tie Ball on Nov. 15.

During more than 24 years leading the school, Krugman has presided over an era of unprecedented growth and prestige, nurturing careers, mentoring colleagues, building a team of physicians and scientists who are training a generation of new leaders in research and medicine and providing world-class care to patients. In the 24 years before he became dean, the School of Medicine had 11 different deans or acting deans and five of those had served in the decade preceding Krugman’s appointment as interim dean in 1990. Since becoming dean, more than 4,000 physicians, physician assistants, physical therapists and medical scientists earned degrees from the School and launched their careers. Krugman has appointed all Department chairs, major center directors and senior leadership at the School, established a workplace that values collaboration, directed the School’s move to the nation’s newest academic medical center campus and strengthened the School’s financial foundation by overseeing the growth of its successful physician practice plan, University Physicians, Inc.

Why did you decide now to step down as Dean and what do you plan to do next?

It was a syzygy. You know what a syzygy is? No? S-y-z-y-g-y. Things came together. A syzygy is an unusual alignment of several things that don’t normally align that way. The first time I learned about the word syzygy was in 1980 when we fired off Voyager 1 and Voyager 2 because it turned out that the planets in the solar system were aligned in such a way that one rocket could pass by every single planet on a single trip. And that normally doesn’t happen. So syzygies are not very common. They are the unusual alignment of normally disparate events.

So, among the syzygies, there were work reasons, there were family reasons, there were personal and  professional reasons and that included No. 1 I have been in the job longer than most and I’m pleased with what we’ve accomplished. Having reached the point that I’ve actually recruited all of the chairs and all the major center directors in the school, I thought it was the right time to move on as I heard a President say once, about 50 years ago, and pass the torch to another generation.

Professionally, I was on my way to do a study and try to make some major changes in the child abuse field in 1990 when I got into this job. I put off a sabbatical at that time to take this job because I thought it would only last a year or two. Interestingly, the problems I was trying to work on in that field are still there 24 years later and I think I’d like to have the next phase of my career be just a professor working in the area that is pretty important for me.

It seems like a long time has passed. The conditions you wanted to study are still the same?

No one has done the study I want to do. The child protection system in the United States is still struggling. The approach that this country has taken to try to help abused children and their parents wasn’t working in 1990 and I don’t see any evidence that it’s working any better now. And the systems I wanted to study in Europe, for the most part, are still there, although they’ve changed some. But neither system has any data to support their assertions that they have good outcomes. And, from my perspective, that’s in part what needs to be done in the field of child abuse.

And, you know, the truth is I’m 71 and I figure I’ve got at least a decade for this next career and I think it will take me a decade, by the way, and if I waited a lot longer, I’m not so sure. I’ve looked at the longevity of males in my family and they range from 84 to 97, so I think the time’s right for another career.

How did it come to be that you were asked to be the interim Dean?

On Monday afternoon, July 2, at 4:30 I got a call from the Chancellor, Bernie Nelson, at the Kempe Center (where Krugman was director), who said the Dean has resigned, I need to talk to you about who should be acting Dean. Could you stop by the house? So I got there and I gave him three names and he said, ‘Well, those are fine, but actually, I need you to do this job.’ And I said, ‘Well, I can’t do this job because I’m going to Belgium.’

He said, ‘You don’t understand. I really need you to do this job.’ And I said, ‘Why?’ And he said, ‘Well, you know, there are warring factions in your school, you know that. I asked the chairs to give me names of who might be acting Dean and you were No. 5 on one list and No. 13 on the other list, but the only one on both lists. I need you do the job.  And I said, ‘That’s not a ringing endorsement. I think I’m going to go to Belgium.’ And he said, ‘Please don’t say no to me. Talk to your family. Let’s have breakfast tomorrow morning and we can talk again.’

Three months into the job, Bernie said, ‘the President, the Regents and I think you’re doing very good job. There’s been a lot of turnover in the School. We would like to give you a three year contract as dean.’ And I said ‘I appreciate the support but I’ve always believed that if your only support is above you, you’re hanging. So, why don’t you start a search and if the chairs and the students and the faculty think I should be in the job after a search, I’m happy to consider the job, but I’m not going to just take the job.’ He and I had this conversation almost monthly and in March of 91 I said, ‘Who’s the next dean? I’m going to Belgium in July.’ And he said, ‘You’re serious?’ And I said I’ve been serious for six months. I said I’m not taking the job without a search. So they started a search and I didn’t apply.

Why? You didn’t want it?

I didn’t apply because I really wanted to go to Belgium to do this study.

Well, in mid-May the chair of the search committee and a number of faculty came to see me and said you know we think you’re doing a good job and we think you should apply. There are some good candidates but we think that you should apply. So I said, OK and I put off my trip to Belgium again and went through the process.

In December, there was a schoolwide retreat to try to get some consensus on how could the school solve the problem of the incredible turnover in the Dean’s job. I missed that retreat because I wound up in the hospital with appendicitis. I had an emergency appendectomy on the night of Dec. 16, 1991, and when I woke up the next morning, among other people at my bed was the chancellor who said he’d gotten my name from the search committee and he wanted to negotiate. And I said, that’s nice, but I don’t negotiate on morphine. I’ll see you after the first of the year.

Sounds like the retreat solved the issue of turnover.

I have no idea. Nobody ever shared with me what the results were.

What are your favorite accomplishments as dean?

The curriculum change we got in place for the medical students in 2005, the move to this campus, having 24, 23 chairs now, and a dozen major center directors who really do work with each other. Those are the big ones.

As Dean, you preside over a faculty that includes neurosurgeons and pediatricians and cardiologists…

And psychiatrists and basic scientists…and every one of them think differently, solve problems differently and communicate differently, if they communicate at all. And that’s why, I’ve said this before and people always sort of laugh or don’t understand it, being in child abuse work for 10 years was really good preparation for this job because in that work you have to work with physicians, lawyers, social workers, law enforcement, criminal and civil judges, educators. They all think differently, they all solve problems differently. They all see life from their own perspective and if you’re going to be successful on behalf of the child and the family, you need to be able to work as a multidisciplinary team. You need to listen and take what they say into effect.

It turns out that schools or universities are not very different. And in this environment, it’s not just all of the faculty and the departments, but it’s five different hospitals, it’s different health systems, it’s alumni, it’s the legislature, it’s everybody who’s got a different perspective on what the job is. They are made up of all these very different groups of people, but the analogue to the child and the family is that if this school and the university are going to be successful, you have to make sure that all of its parts work well together.