Chancellor's Tale

Snyderman Ralph Snyderman

Description

During his fifteen years as chancellor, Dr. Ralph Snyderman helped create new paradigms for academic medicine while guiding the Duke University Medical Center through periods of great challenge and transformation. Under his leadership, the medical center became internationally known for its innovations in medicine, including the creation of the Duke University Health System-which became a model for integrated health care delivery-and the development of personalized health care based on a rational and compassionate model of care. In A Chancellor's Tale Snyderman reflects on his role in developing and instituting these changes. Beginning his faculty career at Duke in 1972, Snyderman made major contributions to inflammation research while leading the Division of Rheumatology and Immunology. When he became chancellor in 1989, he learned that Duke's medical center required bold new capabilities to survive the advent of managed care and HMOs. The need to change spurred creativity, but it also generated strong resistance.  Among his many achievements, Snyderman led ambitious institutional growth in research and clinical care, broadened clinical research and collaborations between academics and industry, and spurred the fields of integrative and personalized medicine. Snyderman describes how he immersed himself in all aspects of Duke's medical enterprise as evidenced by his exercise in "following the sheet" from the patient's room to the laundry facilities and back, which allowed him to meet staff throughout the hospital. Upon discovering that temperatures in the laundry facilities were over 110 degrees he had air conditioning installed. He also implemented programs to help employees gain needed skills to advance. Snyderman discusses the necessity for strategic planning, fund-raising, and media relations and the relationship between the medical center and Duke University. He concludes with advice for current and future academic medical center administrators. The fascinating story of Snyderman's career shines a bright light on the importance of leadership, organization, planning, and innovation in a medical and academic environment while highlighting the systemic changes in academic medicine and American health care over the last half century. A Chancellor's Tale will be required reading for those interested in academic medicine, health care, administrative and leadership positions, and the history of Duke University.

Sujets

• Philosophie et théologie
• Memoir

Informations

• Publié par: Duke University Press
• Date de parution: 13 octobre 2016
• Nombre de lectures: 0
• EAN13: 9780822373933
• Langue: English
• Poids de l'ouvrage: 65 Mo

Extrait

A Chancellor’s Tale

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A Chancellor’s Tale T R A N S F O R M I N G A C A D E M I C M E D I C I N E r a l p h s n y d e r m a n, md

oreword by Darre G. Kîrch,md

d u k e u n i v e r s i t y p r e s s Durham and London 

© 0 Duke Unîversîty Press A rîghts reserved Prînted în the Unîted States o Amerîca on acîd-ree paper∞ Typeset în Whîtman by Westchester Pubîshîng Servîces

Lîbrary o Congress Cataogîng-în-Pubîcatîon Data Names: Snyderman, Raph, author. Tîte: A chanceors tae : transormîng academîc medîcîne / Raph Snyderman,md; oreword by Darre G. Kîrch,md. Descrîptîon: Durham : Duke Unîversîty Press, 0. | ïncudes bîbîographîca reerences and îndex. | Descrîptîon based on prînt versîon record andcipdata provîded by pubîsher; resource not vîewed. ïdentîfiers:lccn009 (prînt) |lccn0089 (ebook) isbn98088 (hardcover : ak. paper) isbn98089 (e-book) Subjects:lcsh: Snyderman, Raph. | Heath servîces admînîstrators—North Caroîna—Bîography. | Coege admînîstrators—North Caroîna—Bîography. | Duke Unîversîty. Medîca Center. | Duke Unîversîty Heath System. Cassîficatîon:lcc ra982.d842(prînt)| lcc ra982.d842 d857 0 (ebook) |ddc0./—dc lcrecord avaîabe at https://ccn.oc.gov/009

Cover art: Raph Snyderman în ront o Davîson Buîdîng, 99. Photo by Wî and Denî Mcïntyre.

C O N T E N T S

oreword – vîî darrell g. kirch, md Acknowedgments – xî

ïntroductîon – 

part i  –yneuroJehT c h a p t e r 1 rom Brookyn to Duke – 9 c h a p t e r 2 Hîstory o the Academîc Medîca Center – 

c h a p t e r 3 Evoutîon o the Duke Unîversîty Medîca Center – 

c h a p t e r 4 Learnîng the Busîness –  c h a p t e r 5 Gettîng Down to Busîness –  c h a p t e r 6 Reconstructîon –  c h a p t e r 7 îghtîng or Renewa – 

c h a p t e r 8 A New Begînnîng – 99

part ii  –vîseîttaMInîajor c h apter 9 Enhancîng Dîversîty, ïncusîon, and Communîty Reatîons –  c h a p t e r 1 0 Duke Cînîca Research ïnstîtute – 0 c h a p t e r 1 1 Duke Unîversîty Heath System – 8 c h a p t e r 1 2 ïntegratîve Medîcîne –  c h a p t e r 1 3 Personaîzîng Heath Care – 

part iii  – Relatîonshîps, Leadershîp, and Lessons c h apter 14 Phîanthropy and Reatîonshîps – 89 c h a p t e r 1 5 Reputatîon and Crîsîs – 0 c h a p t e r 1 6 Steppîng Down and Lessons Learned – 

Epîogue – 9

Appendîxes –  Notes –  Addîtîona Resources –  ïndex – 

Gallerîes appear ater pages 120 and 186

vî — Contents

F O R E W O R D

When Raph Snyderman,md, was eected chaîr o the Assocîatîon o Amerîcan Medîca Coeges (aamc) în 00, he was at the ore- ront o eaders în academîc medîcîne who were thînkîng about the changes oomîng în heath care. ïn hîs chaîrs address at the aamc annua meetîng the next year, Dr. Snyderman dîscussed the great strîdes that medîcîne had made sînce Word War ïï as a resut o our countrys învestment în bîomedîca research and deveopment. He descrîbed the sequentîa emergence o the fieds o genomîcs, proteomîcs, and metaboomîcs—areas o study that woud aow us to better understand, dîagnose, and treat compex dîseases. He aso outîned a practîce o medîcîne based în these dîscoverîes—one that was proactîve, predîctîve, team based, and customîzed or the îndîvîdua. At that tîme, these concepts had not yet attaîned the broad ac- ceptance we see today. Perhaps most împortant, Dr. Snyderman then caed on a those în academîc medîcîne to ead the transor- matîon o Amerîcan heath care în the twenty-first century, as our predecessors dîd în the twentîeth century. Thîs ca to actîon has resonated wîth the communîty în the ensuîng years. As changes acceerate în heath care, academîc medîca centers have been ceary posîtîoned on the cuttîng edge o change.

Leadîng în a tîme o transormatîon îs not a mînor task. Successu eader- shîp în our rapîdy evovîng heath care envîronment requîres îndîvîduas wîth both vîsîon and flexîbîîty, ones who can mobîîze hîgh-perormîng teams to find customîzed soutîons to the unîque chaenges our înstîtu- tîons ace. We need eaders who recognîze and extend the taents o those around them rather than dîctate a prescrîbed set o one-sîze-fits-a answers. As Dr. Snyderman wrîtes, hîgh energy, drîve, a wîîngness to îsten and to earn, and a very hîgh standard or success produce the most successu and înnovatîve eaders. You wî see these quaîtîes îustrated throughout the journey descrîbed în thîs book. More than ever, Amerîcan heath care wrît arge and the academîc medîca centers that drîve îts înnovatîons need orward-ookîng eaders to achîeve the cuture o personaîzed and patîent-centered care that Dr. Sny- derman caed or în hîs address. ïn the years sînce he outîned hîs vîsîon, we have made sîgnîficant progress. The pace o scîentîfic dîscovery has ac- ceerated, brîngîng new toos that aow hîghy targeted dîagnostîcs and therapeutîcs. Heath care deîvery systems have sharpened theîr ocus on quaîty and saety programs to împrove outcomes or both îndîvîduas and popuatîons. And because o the eadershîp o înstîtutîons îke Duke Unî- versîty în advancîng personaîzed medîcîne, patîents across the country are more actîvey engaged în theîr own care. ïn addîtîon, we have a greater abîîty than ever to determîne the îkeî- hood o a patîent deveopîng a certaîn dîsease, oFer guîdance on manag- îng rîsks, and mînîmîze the damage o dîsease through eary dîagnosîs and înterventîon. We have enhanced and extended our partnershîps wîth co- eagues across the heath care proessîons so that înterdîscîpînary teams o proessîonas ensure contînuîty o care or patîents. Technoogîca advances have împroved patîents access to medîca înormatîon, as we as to theîr own bîoogîca data, hepîng them make better-înormed heath care decî- sîons to achîeve theîr desîred outcomes. Hospîtas across the country aso are pîotîng new payment modes to ensure that patîents pay or vaue-based care rather than or îndîvîdua servîces on a ragmented, ee-or-servîce basîs. A these changes are beîng embedded în new deîvery modes such as the patîent-centered medîca home and are supported by toos such as teeheath to enhance patîent autonomy and transorm care. The resut îs unprecedented flexîbîîty în

vîîî — Foreword

how, when, and where patîents can access and communîcate wîth theîr physîcîans. Thesedeîverymodesnotonyarehavîngaposîtîveîmpactonîndîvîd- ua patîents but aso are provîdîng better heath care access to entîre com- munîtîes, even those that hîstorîcay have been underserved. Advancîng personaîzed and hoîstîc care requîres enhanced, bîdîrectîona communîty engagement to achîeve greater heath equîty, a more dîverse workorce, and care that truy meets the needs o each patîent în our dîverse and growîng popuatîon. Patîent-centered care requîres cutura competence to engage în eFectîve communîcatîon wîth patîents and amîîes, data to document and understand patîents backgrounds and preerences, and partnershîps to connect patîents wîth communîty resources, socîa servîces, and heath care specîaîsts so that care îs hoîstîc, înked to oca assets, and responsîve to patîent needs. Despîte a these advances, the heath needs o too many patîents go unmet. As Dr. Snyderman noted în hîsaamcchaîrs address în 00, the growth o proactîve and predîctîve care was the resut o a ha century o edera învestment în cuttîng-edge research that vasty încreased our body o medîca knowedge. But more than a decade o dîvîsîve poîtîcs has put our government în a state o grîdock, wîth serîous împîcatîons or aca- demîc medîca centers. The Great Recessîon o 008 resuted în decînîng state support or hîgher educatîon, încreasîng the debt burden o those pur- suîng careers în the heath proessîons. Stagnant edera undîng or medî- ca research has put hope on hod or mîîons o patîents and theîr amîîes suFerîng rom chronîc or îe-threatenîng dîseases. Stabe edera undîng or medîca research îs vîta—not ony to find new cures and treatments or înesses today but aso to generate groundbreak- îng dîscoverîes that wî contînue to transorm how we practîce medîcîne în the uture. Utîmatey, the ony way to achîeve better care or îndîvîduas, create heathîer communîtîes, and reduce heath care costs îs to învest în the educatîon and research that wî make these goas possîbe and wî pro- vîde a patorm or the next great transormatîon o medîcîne. Physîcîans take an oath to respect a patîents autonomy and rîght to se- determînatîon. Thîs undamenta need to respect the outcomes that matter most to a patîent îs at the heart o many o the changes we see across heath care. When theaamcpresented Dr. Snyderman wîth the Davîd E. Rogers

Foreword — îx