I'd like to begin with sincere thanks to all who responded directly to my original e-mail and post. This seems to prove the adage that you are seeking to engage on issues of import, but so far only our colleague Dr. Gleason seems to enjoy the comment opportunity on-line.
We'll see how this progresses -
Today, I want to share with you a set of documents I discussed with the department chairs concerning University investments in the Medical School and its programs. This is all part of the work we're doing to better understand the context for the shared decision-making that takes place at the University of Minnesota.
I've found that many of us operate within our own disciplines - and in the Medical School, that can be sub-disciplines or specialties - and rarely are we exposed to the big picture of what's driving investment decisions.
At the University level, there were a series of decisions made in the late 1990s and early 2000s that focused attention and investments on the health sciences and the biomedical enterprise in particular. Beginning with President Yudof, whose five priorities included a focus on biomedicine, this University has planned for and invested state and University dollars in the programs that benefit the health sciences to the tune of $194 million in the last five years alone. When combined with the capital investment in research building construction of more than $535 million, this represents a strong vote of confidence in our work.
Let's start with research buildings - since 2002, we've added 906,000 gross square feet to the pursuit of new knowledge.
- We occupied the Molecular Cellular Biology Building, MCB, in 2002, providing proximity to many of the basic science departments and programs at the core of the Medical School.
- In 2005, the McGuire Translational Research Building opened, supporting the Stem Cell Institute as well as important infectious disease and immunology work.
- Two years later, we completed renovations to the former state health department building, 717 Delaware Street that now houses important clinical research activities.
- In 2009, we completed the Medical Biosciences Building that houses the Center for Immunology and the N. Bud Grossman Center for Memory Research and Care.
- Also in 2009, we accepted delivery of the 16.4 Tesla magnet that is already producing significant research impact at the Center for Magnetic Resonance Research (CMRR).
- This year, we've begun the 56,000 sq. ft. expansion of the CMRR, providing capacity for many of the Medical School programs, and finally,
- In 2012, we plan to move into the other cornerstone of the Biomedical Discovery District in a building to be discussed in more detail next month - the Cancer/Cardio/Research Commons.
Each of these represents a strategic investment in the core strengths of the health sciences and Medical School.
Among the documents posted are a chart of the Strategic Compact Investments in the AHC - these are state dollars that have been directed to health science programs and projects. And, as the largest school of the AHC, a majority of these projects and programs benefit the Medical School.
But wait - you might say - this doesn't represent money that has come directly to departments of the Medical School - we didn't get to decide how this money was spent.
To that I would respond that each of these investments grew from the education and research strengths of our faculty, as supported by department chairs, and agreed upon by the AHC Deans' Council over the past six to eight years. When we agreed, for example, that we would all benefit from the building and support of clinical skills labs for our students, we developed that program jointly and sought University support that now benefits all AHC schools - while eliminating duplication of effort and cost - an efficient, effective, and targeted use of increasingly scarce resources.
And to Bill, who has posted his conversation on-line, it's important to point out that the Center for Spirituality and Healing is an AHC Center, accountable to all of the AHC deans for its performance and outcomes, with more than 90 percent of its budget coming through its tuition, fees, philanthropy, and sponsored research, including the National Institutes of Health.
More to come.
Thanks for your response, Frank. But you seem to have dodged the issue which was:
An operation that espouses homeopathy has no place in an evidence-based medical school.
Please see the posting - on the U's website - about homeopathy:
http://takingcharge.csh.umn.edu/explore-healing-practices/homeopathy/how-do-i-select-qualified-practitioner
And then please see the posting over the defense of homeopathy by the Director of CSH at:
http://ptable.blogspot.com/2010/02/director-of-university-of-minnesota.html
Regardless of the source of funding, homeopathy and its encouragement has no place in the AHC. And as you have admitted the Center for Spirituality and Healing DOES cost money.
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But at least you made SOME kind of a response and are already far ahead of the provost on the other side of Washington Avenue.
Best regards,
Bill
Despite these investments in the AHC using State funds, I have recently heard leaders in the Medical School state publicly that the percentage of its funding received from the State is so small (and shrinking) that it may not be an obligation of the Medical School to meet the workforce requirements of Minnesota health care system. For example, the need to train students and physicians-in-training in geriatric medicine (in primary care or specialities) is considered outside the current responsiblities of any department in the Medical School.
Should not the AHC align its investments using State funds with the needs of the communities served by our graduates (as well as the research interests of the faculty)?
Despite all that I have seen in recent years, I am struck by a major disparity: The AHC/Medical School seems focused on what I will list as the "long-term diseases" to the exclusion of infectious diseases, that is, illnesses that can be managed immediately. It seems that administrative structure is set up to benefit those five, with hardly any recognition of the potential impact that can be made immediately in infectious diseases. The big five, including heart disease, cancer, diabetes, neurological, and applications of stem cell research are all excellent endeavors, and they will no doubt help people now, but major cures and benefits are likely to be well in the future. At the same time, however, the AHC/Medical School has an excellent opportunity to tell people of the State (and World) that we are doing great things in infectious diseases. These things can impact their lives now!
Based on the above, I believe infectious diseases researchers are often made to appear as second tier scientists at UMN. I should point out Frank, that in your recent comments, I don't think there was mention of infectious diseases, despite mentioning just about everything else.
Professor Shlievert is absolutely right!
As Atul Gawande has written (in the Checklist Manifesto):
"After a century of incredible discovery, most diseases have proved to be far more particular and difficult to treat. This is true even for the infections doctors once treated with penicillin: not all bacterial strains were susceptible and those that were soon developed resistance. Infections today require highly individualized treatment, sometimes with multiple therapies, based on a given strain's pattern of anti biotic susceptibility, the condition of the patient, and which organ systems are affected."
As many of you know Dr. Gawande is one of the leading writer-practitioners of medicine today, a MacArthur fellow, and Harvard surgeon. He has written in the most laudatory terms about our outstanding colleague Warren Warick both in the New Yorker and in at least one of his books.
In addition to Dr. Schlievert and his colleagues in the Microbiology Department, outstanding work in this area at our university has been done by other outstanding scientists (e.g. Professor Wells and the late Professor Erlandsen.) Since hospital infection and its prevention is such an incredibly important topic for the practice of medicine, we would be well advised to keep up our strengths in this area and advertise them.
I am somewhat surprised by this exchange. The importance of infectious disease is recognized at all levels with a long list of examples of investments: Institute of Virology, CDRAP, funding to develop CFAR, global health investments, e.g. HIV, malaria, parasitic disease in Uganda, and so on.
Also, lead by Department Head of Microbiology Ashley Haas, an Infectious Disease Corridor was established several months ago and will receive funding in FY11, even in these difficult times.
On a final note, the "adversing" efforts on behalf of the faculty in infectious disease go beyond the limits of this space.
So, I assure you that your are notice, your accomplishments are appreciated, and that this area is of great importance to basic, translational, clinical and outcomes research and clinical practice
The answer to the alignment of resources to community need is clearly yes. And, there is a long track record of doing so. As examples: the expansion of the nursing program and its focus on professional degrees, the expansion of the clinical pharmacy program, the increase in enrollment in the Medical School, and the substantive increase in enrollment in public health. In addition, we revitalized the programs in Occupational Therapy and Clinical Laboratory Science, as the State of Minnesota only real major producer of these health professionals.
We do have a strong grooup of faculty who have taken additional training in geriatrics in the Medical School, as well as nurses and pharmacists, and dentists who focus in these areas. Family Medicine and Community Health and General Medicine both have faculty with added expertise in care of the aged, and practice it in their clinics
We are also strong in the research arena in diseases of aging.
True, we do not have a department or division of geriatrics in the Medical School, but we shore do have a lot of faculty in the health professional schools with advanced training care of the aged who do practice it on a daily basis.
Frank,
Are the previous two comments yours? They are marked as anonymous, which is fine if it is someone else. But if it is you responding, it would be nice to acknowledge this.
I must admit that when I saw geriatrics mentioned here, I went up in flames. I've got a piece up that quotes an earlier Gawande article in the NYT:
Friday, May 4, 2007
How Do We Reward the Great Work of Geriatricians at BigU?
(We close the geriatrics division and they move to Johns Hopkins...)
http://ptable.blogspot.com/2007/05/how-do-we-reward-geriatricians-at-bigu.html
There seems to be a little bit of denial going on here. And how about that homeopathy?