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Dean's town hall focuses on space planning, research

Etta Pisano, M.D., College of Medicine (COM) dean and vice president for medical affairs, hosted the first in a series of COM town hall meetings with faculty, employees and students on Dec. 6.

Dr. Etta Pisano

Since her arrival in July, Pisano has communicated regularly with COM members to share and discuss ideas, concerns and issues pertaining to the College of Medicine. Below is an excerpt of questions and answers from the meeting. Pisano’s next town hall meeting is 8 - 9 a.m., Thursday, Jan. 6, Room 302, Basic Science Building.

What are COM’s plans for academic and clinical space?
Two consultant reports were submitted to the college regarding space planning. The consultants were the current and immediate past national chairs of the Group on Institutional Planning of the American Association of Medical Colleges (AAMC). The reports, addressing academic and clinical space, were submitted in October and were shared with members of the COM for review and comments. Both consultants were invited back to answer specific questions by COM chairs, center directors, faculty and staff.

The academic space plan recommended creation of a space committee to advise the dean with respect to allocation of space within the college. This committee would be managed by a “space dean,” would determine specific space needs, and would make recommendations to the dean for assigning and reassigning space in COM. The dean would make the final decisions regarding space allocation. I’m very inclined to implement a policy like this because it allows an organization to reallocate space dependent upon need.

Up until now, the COM’s academic space was managed through the Office of the Provost using a somewhat data-driven process. To keep the process as transparent and data-driven as possible, we need someone in the COM who can collect the data and help manage how we’ll distribute space. The dean’s office has posted a position, associate dean for planning, implementation and assessment, so we can begin the process of responsibly managing our academic space. It would be this person’s job to conduct an assessment of what space currently exists and how it is allocated and utilized, help with the transition to the new management plan, and create new policy. This process won’t happen overnight but could occur during the course of a few months.

At some point, someone’s going to need to take the heat for a change in the policy. I’m willing to take the heat because it’s better for the organization to have a data-driven and transparent process versus a process that is difficult to understand and isn’t able to accommodate the needs of the college. I’m very enthused about this plan but also realize we still need more conversations about it before something’s implemented.

How will reductions in NIH funding and other issues factor into the college’s formula for allocating space?
You can’t take space away from people the moment they lose one grant. We have to be able to work with the chair of the department and the faculty member to help them through a short-term gap. If a faculty member has reduced funding over a longer term, we’ll have to shrink their footprint. As many of you know, we’ve posted a position for a senior associate dean for research —part of that person’s job will be to oversee a bridge funding program within the COM. It’s very important for bridge funding to exist for our scientists, especially during funding downturns. The new research dean, along with other scientists, will manage this process. A reduction in lab space for a particular faculty member is the kind of thing the chair, the space committee, and I will be able to manage. The chair, center director and/or faculty member involved will be able to let us know whether that faculty member’s research is likely to be funded and that will help us make these assessments.

How much input have you had in MUSC’s recruitment of the new provost?
Dr. Greenberg, myself and others are working together in this process. The provost serves as the chief academic officer of the institution. I’ve shared my opinion about the candidates with Dr. Greenberg. I expect to work closely with whomever is selected to this position. As you all may know, the financial situation of the university is challenging; leadership will be called upon to make hard decisions in the next six to nine months. In the last two years, the institution has taken a total of more than 53 percent cuts in our state funding, and we anticipate additional cuts are likely in the next year. It forces leadership to make tough decisions about what we do. I hope to work closely with the new provost especially in these challenging times.

What’s the next step for research within the college and what is the status of the research strategic plan?
I’ve interviewed candidates and announced the names of people vying for the senior associate dean for research position. One person did withdraw from the list. I’m in the midst of narrowing this list and will be announcing the names of the finalists later this week. I plan to have several individuals in leadership positions within the COM interview the finalists. Part of the job of this new research dean will be to help me implement the research strategic plan. Working with the senior associate dean for research, I intend to organize operation committees that will address the recommendations contained within the strategic plan— topics like infrastructure, genetics, etc. I’m hoping that the new research dean also can work with the vice provost for research to discuss what’s working well and address other research needs that should be considered and supported. The operation committees will consider ideas, proposals and recommendations submitted by chairs and center directors, and will also make their own recommendations. For example, the chair of the Department of OB/GYN may want to hire a geneticist, perhaps collaborating with the Hollings Cancer Center to identify a faculty member to conduct research on ovarian cancer. That idea will be proposed to the COM’s genetics operation committee, which will be chaired by the new research dean, and may result in funding from the dean’s office to assist with that recruitment. Funding for approved proposals will be shared by the sponsoring and collaborating departments and the COM dean’s office. This is a way to strategically think about research so that the entire COM is involved in collaborating in future research projects. We have to put the infrastructure in place to get these investments done in a careful way. It will take us most of this fiscal year and some of the next year to develop these plans.

How do you assess MUSC’s clinical operation?
MUSC is in pretty good shape clinically in terms of what has been built in the last 10 years. The organization deserves kudos for having responded to a real financial crisis 10 years ago. If we don’t continue to grow, however, especially in the face of reduced state revenues, we’ll be in trouble. Because of the reduction in state support, we’re more akin to a private medical school and institution than a public institution because there’s so little state funding. Looking at three successful private medical schools in the Southeast—Duke, Emory and Vanderbilt—they all have enormous clinical enterprises. MUSC needs to continue growth of its clinical enterprise to survive and thrive.

In terms of health care reform, MUSC needs to be responsive to the pressures that we’ll be facing. One focus is on increased volume. We’re going to be primary care providers for many, many more people because more people will need and have access to care, because they’ll be linked to federal dollars. It’s coming, so we need to be ready for it. That means developing a structure and mechanism to have a medical home for low acuity, primary care patients. We also need to develop outreach and have affiliated practices for specialty services (higher acuity, more complicated patients). There’s a lot of conversation about what will happen. For example, what does an accountable care organization look like? How will it be structured? What are our responsibilities? We need to work together as one health care system to implement these types of care decisions. It’s a lot of work for all of us in the next two to five years, but I believe we’re well positioned to do this. I’m impressed, not only with how big our clinical enterprise has grown and so quickly, but how well everyone works together.

How can we change MUSC’s campus culture to be more entrepreneurial?
I’m an entrepreneur myself, and am involved in a company that I founded several years ago. It’s been observed that the campus isn’t supportive of faculty interested in entrepreneurial activity. The good news is that entrepreneurialism is highlighted in the University’s Strategic Plan. I think it’s highly likely that the COM will invest some resources in the next few years through the CTSA/SCTR (National Institutes of Health’s Clinical and Translational Science Award/South Carolina Clinical and Translational Research Institute) grant to provide services to assist faculty in their entrepreneurial activities. The institution as a whole appears to be very interested in entrepreneurialism as well. I look at entrepreneurialism as being part of our duty as faculty to make sure our discoveries can help our patients. This is not something we should be ashamed or embarrassed about; it’s what we should do. It’s our responsibility to make this happen. I believe the organization plans to try and place tools and resources in place to make this a reality.

There are investors who want to help us develop our ideas into products and serve patients. If we don’t do this we’ll bypass a potential revenue stream for our faculty and institution. Faculty’s ideas deserve to be developed. I think we’ll end up making an investment in this area in the next year.

MUSC hosts the Foundation for Research Development and Office of Industry Partnerships (OIP). The foundation is essentially our tech transfer office where patents are filed, how intellectual property is managed, etc. OIP is committed to bringing more clinical trials from industry inside the walls of our institution. I have some ideas about how we can make more of what we do user friendly, and we’re starting to talk more about this. I’m very optimistic.

Do you see clinical space in the medical center as fragmented?
We’re lucky to have a beautiful facility in Ashley River Tower, but we have space inside that building that’s being used for non-clinical purposes and can perhaps be converted to clinical purposes. Hospital leadership is considering plans to build in nearby space to relocate people and convert these areas for potential bed space in the coming years. Leadership also has been looking at our physical plant and working with consultants on how our space can better serve our patients. This is all part of a long-term strategic plan. This is a challenge that will not be resolved very quickly.

Friday, Dec. 17 , 2010

The Catalyst Online is published weekly by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. The Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, Editorial copy can be submitted to The Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to To place an ad in The Catalyst hardcopy, call Island Publications at 849-1778, ext. 201.