Greenberg looks at MUSC future
Dr.
Ray Greenberg tackles Catalyst questions on the university's future with
frank answers about research, education and clinical services in a time
of financial crisis
In its search for MUSC’s next president, the search committee described
the candidate as a businessman, a CEO-type administrator, a financial planner
and a fund-raiser. Of these or other roles, which do you see are your strong
points—the characteristics that will leave your imprint on the university?
I see myself as a fairly traditional academic person—a faculty member,
a spokesperson for the faculty and university students, alumni and staff.
I was interested to read in news articles published the past few days in
which they said colleagues described my strengths in management. I’d like
to think that it has to do with being a good listener who embraces and
supports the ideas of others and works effectively with colleagues in a
collaborative way.
In my role as provost, I haven’t had a lot of responsibility in fund raising because my job has been focused on the academic program. In my previous job as dean at Emory’s School of Public Health, I had much more responsibility for fund raising, because it’s a private university and also because we were starting a new school. We had to build buildings, raise an endowment. I had the opportunity to work on the capital campaign.
In the capital campaign, the goal for the our school was to raise $6 million towards the cost of a building. We ended up raising more than $20 million for the campaign for public health. I enjoyed the fund raising part of the job very much. It was an opportunity to meet successful people in other walks of life. An important part of successful fund raising is to communicate well the vision of what you’re asking people to support. Sometimes they’re more skeptical because they’re not part of the system.
You have to sell the idea. That’s a very different type of challenge from internal communications issues. I found it a very rewarding part of the job, so I look forward to that new role.
At 44, you’re perhaps the youngest or among the youngest leaders/
presidents to take the helm of an academic medical center of this size.
Do you believe your age will play a factor in how the university, the local
community, and the state government sees how you will manage and lead your
administration?
The age issue has gotten a lot of the attention. It’s funny to me because
I don’t think of age as an issue. I’ve been young compared to others in
every job I’ve ever had. I was a medical school department chairman at
age 32. I was dean at age 35 and I was provost at age 40. I’m just accustomed
to being young for the job. I really don’t think twice about it.
What does it mean for the institution? In one aspect, I hope to bring to the job a level of energy and enthusiasm, that probably correlates to my age, a willingness to acknowledge that I don’t have all the answers, and a desire to listen to people who have more experience. But I hope it also offers the opportunity to take a long view at this job.
When you look back at Dr. Edwards’ tenure as president, obviously he was successful in many ways, but the fact that there was one person in place in the leadership role for 17 years provided stability. More important than anything else, he allowed the university to move forward. I would hope that I could offer that kind of stability of leadership in my presidency.
MUSC’s progress within the past two decades has been one of enormous
growth. As you assume leadership of this institution, what do you see as
the university/medical center’s theme (Dr. Edwards’ theme was “excellence”)
in the next decade?
Four days ago, I didn’t think I’d be in a position to answer these
questions. It’s all a little early to talk about the future.
In Research?
On the research end of things, there are a number of exciting initiatives
under way, in the very early stages. One is with the recruitment of Dr.
Peter Kalivas, professor and chair of physiology. He’s been asked to help
lead an effort to develop neurosciences on campus. I think the next decade
is going to be a critical decade in advancing the knowledge base of neurosciences.
When you think about the problems that we deal with in Alzheimer’s disease
and other degenerative neurologic conditions, as well as addiction disorders,
that is absolutely a critical area.
Another opportunity is the recruitment of Dr. Yusuf Hannun, who is professor and chair of Biochemistry. Dr. Hannun has been given additional responsibility to help us develop structural biology on campus. This means looking at and understanding in depth the structure of biological molecules and linking that to how they operate. This is absolutely a critical area in the development of new drugs and the understanding of biological processes in general. The kinds of disciplines critical to this are X-ray crystallography and nuclear magnetic resonance spectroscopy (NMR). At the moment, we need to recruit outstanding investigators in both areas. This will serve almost any aspect of research on campus.
Another area of research to maintain our focus on is cancer. I think it will be an important opportunity for us with the expansion of the Hollings Cancer Center. There’s also a fair amount of interest in the development of a children’s research institute. Dr. Charles Darby has spearheaded that effort. I’m very supportive and enthusiastic about that. I hope we will see that in the next few years.
In Clinical Services?
Obviously, we have some immediate challenges. One is the implementation
of the hospital authority. I fully expect that we’ll spend a major part
of the coming year in working through all the many issues in implementing
the authority. It will be very time consuming to a large number of people
on campus. In addition, we’ll need to look at our clinical facilities and
a number of projects underway for renovations. The key renovations are
the OR and ER, and there are discussions that are in the early stages for
new facilities. These plans need to go forward.
Obviously, we need to focus on the financial pressures in the medical center and continue to explore ways of keeping costs down and work at the federal and state levels to improve the financial resource base available to support patient care. We need to be targeted in new technologies and services that are distinctive and distinguish MUSC from other health care providers.
In Education?
I do not expect to greatly expand the numbers of students or degree
programs. I think we need to be very strategic in any new offerings based
upon a real demonstrated need in the workforce. An example of a good program
that I’m very excited about is a master's program in clinical research,
which is right now under review at the Commission for Higher Education.
I see this as a way of training the next generation of clinical investigators.
We have a diminishing pool of research-oriented physicians so this is a
very important issue. That’s an example of a clearly targeted program that
I think we can develop that will fit an unfilled niche.
I hope we’ll continue to look at distance education as a vehicle for reaching statewide, in which the Charleston campus is only one of multiple locations providing educational outreach to students across the state.
Related to that, I hope we’ll stay on the cutting edge of educational technology. We have a wonderful educational technology laboratory here. We have many web-based courses, using new media for educational purposes. We have an extraordinary library under the leadership of Dr. Tom Basler.
Finally on education, there’s been some focus on the need and value of more interdisciplinary education for the students of our health disciplines. Early in their careers, they need to be exposed to the team concept and recognize the value that each health care provider brings to patient care. It’s been difficult to make progress in this area but I think we’re making some headway. One of the things we’ve talked about with the deans is creating an interdisciplinary honors program in which we bring students together from various colleges for joint educational experiences.
MUSC’s expansion plans have been set in place. Will you continue
to follow established plans for Value 2000 and the MUSC Strategic Plan?
The Value 2000 effort is important. It looks at how we can be more
efficient in our operations. There is a continuing need to explore those
efforts, but they’ve already produced some dividends such as developing
a policy on electronic signatures so that we can move more to a paperless
means of operations. We absolutely have to continue those efforts.
In terms of strategic planning, we’re now two years out from our first campus-wide strategic plan. And it may be a little premature to jump into a completely new strategic planning effort. I’m looking forward to working with the faculty, staff and students not to revisit the strategic plan, but we need to identify high priority areas of focus that we can use as rallying points for the MUSC family.
An immediate concern for me is morale of the institution. I think that morale among faculty is lower than a year or two ago. For many of the reasons that we’ve already talked about — the financial pressures and how that translates into their work environment and pressures that are placed on individual faculty.
The uncertainty regarding the next president of the institution also contributed to a loss of focus. I think we needed to address the concerns on people’s minds, taking a proactive stance and assuring them that we’re taking these concerns seriously.
How will programs like Value 2000 and the Strategic Plan affect students?
I think it depends upon the program the students are involved in. We
do regular surveys with students, and overall feedback is very positive.
There are some programs that have experienced dramatic curricular changes
recently, and while we’re sorting through all the issues involved in that,
it has created some concern for students. When I met with representatives
from the Student Government Association, I think, by and large, they’re
very happy. They feel well-respected and well-treated on campus. There
are tremendous learning opportunities. That’s not to say that there aren’t
some issues to be concerned about, such as improving financial services,
health services and parking.
In your new role, you’ll have oversight of the Medical Center. As
a physician and academician how will you relate to the clinical side of
this institution?
My role model for this job has been Dr. Edwards, who is an oral surgeon
but has not been in practice for some time. I think he was very capable
of dealing with the clinical side of the operation, even though he was
no longer clinically active. In order for that to happen, you need to have
very good people on that side of the organization whose judgment you trust
and who are effective problem solvers. I think we have extraordinary people
in place. I’ve worked closely with most of these people for four years;
people like Dr. Layton McCurdy, vice president for medical affairs; Dr.
Joanne Conroy, associate vice president for medical affairs; Stuart Smith,
vice president for clinical operations and executive director, MUSC Medical
Center; and Marion Woodbury, CEO of UMA—these people are close associates
of mine and we work very well together. I’m going to rely on their continuing
leadership.
Let’s address the issue of money. It’s been no secret among staff
that MUSC is experiencing financial problems. Some people have ventured
to say that we’re broke—bills aren’t being paid, there’s a hiring freeze
with staff, etc. Just how bad is the situation? Can you tell us how you
plan to work through this? When will we become “green” again?
Let me say a few things about the financial situation: It’s all very
relative. Although we’re experiencing some challenges here, compared to
our peer institutions around the country, our problems our modest.
Just this weekend I saw a release that projected a $200 million deficit at the University of Pennsylvania Medical Center. The latest numbers I saw from the University of California-San Francisco/Standard was an $85 million deficit in their joint operations. These are the premiere academic health centers in the country and they’re experiencing a greater magnitude of financial crisis than MUSC is experiencing.
Why have we been better off than some of our peers? One is because we did some things a few years ago that have positioned us well. The change in management process produced staffing ratios that are much more favorable than you find at other academic institutions. Second, we have proportionally less capitated health care in the local marketplace. Our institution is well recognized and is placed strategically in this market where patients perceive that we are the best provider of care in the Lowcountry area, sometimes faring better than our competing sister institutions.
We will attempt to reduce our costs through efficiencies gained in the
new hospital authority. We will also try to encourage the state to allocate
some of the tobacco settlement funds toward health care and biomedical
research. We will also attempt to get some changes to the federal balanced
budget act to stave off reductions in graduate medical education and disproportionate
share payments.
Prior to the authority legislation, a great deal of effort was put
into forming a fully integrated health care network of which MUSC would
be a part. Will the fact that we still are “outside” a network hurt MUSC
in the future in containing costs? (Which in turn would affect clinical
research and education.)
Conventional wisdom about a few years ago was that hospitals absolutely
had to connect with a fully integrated health care delivery system. These
trends and popular fads come and go. Now, people who’ve invested a huge
amount of money in creating these networks are actually suffering financially.
MUSC is reasonably well-positioned in respect to that issue. That’s not
to say that there may not be times when it may be appropriate for our institution
to make strategic alliances with outside parties for particular needs.
What obstacles are faced by MUSC that would possibly slow research
growth?
Obviously, one of the key things is what will happen to research funding.
Of course, the principal source of funding for our research is federal
support (about 60 percent), which is mostly from the National Institutes
of Health (NIH). At the moment and during the next few years, federal funding
in research from the NIH is expected to be strong. I hope there will be
considerable growth opportunities in terms of NIH funding.
Recently, we’ve placed some emphasis on corporate or private funding. We’ve put into place some structures that I hope will make us more competitive for private funding. The Foundation for Research Development facilitates technology transfer and the Clinical Innovation Group, which is our clinical trials coordinating center. They are two examples of resources that will help us compete for private funding.
My projection is that we’ll see continued growth in research funding due to key investments that we’ve made in the past few years which will start paying their dividends in the next few years. When we’re successful in recruiting a new basic science department chair and make resources available for that individual, he or she will be able to recruit additional faculty, who in turn, bring and write new grants.
I’m very proud of the College of Nursing’s growth from about number 70 in terms of NIH funding among nursing schools in 1997 to making it to the top 25 in 1998. It is conceivable that they can make the top 10 nursing schools if they continue in this direction.
Our new dean of the College of Health Professions, Dr. Danielle Ripich, comes from a very strong research background herself. We’ve made resources available to help expand the research program at the College of Health Professions. They’re ranked 18th among allied health schools and NIH funding, they have also made lots of progress. I have similar aspirations for Dental Medicine and Pharmacy, as well. I hope it’s a campuswide phenomenon.
As the presidential search narrowed down to the top three candidates
during the past several months, how difficult was it to compete among two
well-respected colleagues and staff members?
Since last week’s announcement, I’ve had the opportunity to speak with
both Drs. McCurdy and Darby. We respect each other on both a professional
and personal level. Dr. Darby has improved the health and well-being of
more children in South Carolina than anyone else that I know. Dr. McCurdy,
after Dr. Edwards, probably has had the most influence in raising the stature
of this institution within the past 10 years. I really look forward to
continuing our work together. I will draw upon their knowledge, expertise
and talents within the coming months. I hope that the MUSC community can
come together and share our collective goal to help guide this institution.
How do you propose to fill the position of provost and vice president
for academic affairs? Will you conduct the search internally or recruit
from outside the university?
Four days ago, I certainly didn’t think that we’d be looking for a
new provost. The truth of the matter is that I haven’t thought through
it in great depth. Clearly given the time frame, we might have to make
an appointment on an interim basis before we can conduct a national search.
I’ll be talking with a number of people to get their sense of who they
feel would be appropriate in that position. In my opinion, there are a
number of people who are qualified. Ultimately, we will conduct a thorough
external search for the best possible candidate on the national scene.
We will look for someone who can work effectively with a broad range of constituents. Each of the six colleges has its own needs and issues. The successful candidate must have strong interpersonal skills and possess high academic values and standards. We want an effective spokesperson for the educational and research missions of this institution. Finally, that individual must be someone in whom faculty and staff can have a lot of confidence.
Is there a final message you’d like to convey to the MUSC community
about yourself?
It’s very important for me to know what’s on people’s minds—what their
concerns are. I personally read and respond to my e-mails. I hope people
will feel comfortable in sharing with me what they think we’re doing well,
as well as the things we need to improve upon.