This will be a part of an ongoing conversation that I will be having with you. Yesterday, the Chancellor distributed a memorandum to the Brody faculty and staff. I most certainly echo all that he has said. I also wanted to let you know a bit about how we are working to sustain our missions of education and service to the region.
First thing – we must continue to recognize that we have been very successful in creating primary care doctors for North Carolina and supporting a mission of service over the years.
We contribute mightily to the research efforts of the university. We provide quality health services to an increasing number of patients who do not have the ability to pay for their health care, and are recognized as a transformational force in the region.
These facts have been heralded by others at local, regional and national levels.
At the same time, we are all aware that health care is undergoing a transformation and, as a result, we must also change.
In recent years, we have been significantly challenged to continue to provide excellence in education and clinical service to all people of our region.
In the last five years, Brody has absorbed a cumulative, permanent state budget cut of $9.2 million, or nearly 19 percent of our state funding. These cuts mean we have had to teach our students and take care of our patients with fewer resources. Losses in funding for support staff and operations has made it more difficult and costly to hire and retain qualified employees, to keep essential basic functions operating smoothly, and to keep needed medical equipment up-to-date.
Much of the shortfall resulting from these legislative cuts was able to be “back-filled” with money from the ECU Physicians practice. More recently, our ability to continue to backfill through our faculty practice has been further compromised seriously by legislative actions, which have effectively eliminated millions of dollars from our previous and future practice revenue.
We are working very diligently on efforts to convince policymakers and payers to alter actions they have already taken, and to change or abandon consideration of additional actions that are harmful to Brody’s financial sustainability. Proactively, and on a daily basis, we are informing and educating key leaders about the impacts of their decisions on Brody. Although that work will continue very aggressively, we must concentrate most of our efforts on those things we can impact directly – the Brody School of Medicine and ECU Physicians practice.
Realizing that this compounding series of factors were coming together to fundamentally alter the historical environment in which Brody has operated, I and members of my senior leadership team have been working with department chairs and external consultants to conduct a comprehensive analysis of the school’s operations and funding sources, and those of the ECU Physicians practice. Our goal was to develop a detailed understanding of our current situation and the factors that contributed to today’s reality, as well as a very clear vision of where we need to go as an institution in order to secure a bright future for the school while becoming more self-reliant in the process.
Early in 2013, we hired Hunter Partners, a consulting group specializing in the issues we face, to help us conduct an extensive evaluation of the ECU practice plan and make recommendations for how we might best position ourselves to continue our success.
We have some outstanding and extraordinarily productive faculty. That productivity is in clinical practice, in education and in research. I intend to publicly recognize and celebrate these most vital individuals. What we have also found is that these super-performers are often not just under-appreciated, but they are also under-compensated for what they do. Once firmly underway, the transformation and restructuring of Brody and ECUP will allow us to include appropriate increases in compensation to reflect the disproportionate contribution these high-achievers make. To these high-performers, I ask that you continue your great work and actively engage your colleagues to encourage them to emulate you.
We also have found that the majority of people are solid performers who consistently contribute to the Brody mission. To you, I say thank you! You are the sturdy backbone of our school and practice plan. Please continue your good work. I appreciate everything you do. Additionally, I ask you to identify ways – big and small; personally or systemically – that will help improve what we do and how we do it. If your insights can help us find ways to mentor and inspire one more student, care for one more patient in a day, seek another opportunity to secure a research grant, or implement myriad other enhancements, you will be helping to meet the challenge we all face.
There are also a small number of under productive faculty, and these will need to be coached, and monitored. Compensation will be adjusted accordingly.
Change for Brody provides an opportunity for all of us – faculty and staff, as well as our extended university family and the community – to imagine and build our future together.
The Brody School of Medicine is neither alone nor the first medical school to undergo transformational change. Emory University School of Medicine, Wake Forest Baptist Medical Center and a peer community-based medical school, University of South Carolina School of Medicine, have all begun significant restructuring in order to position themselves for the changes affecting all of us. Mergers, acquisitions, integration of clinical practices, “right-sizing” and new management arrangements are everywhere one turns.
Four decades ago, when the ECU School of Medicine was created, a tripartite mission was clearly established and has become deeply rooted within our values and our daily work.
Today, in the midst of tectonic shifts in health care and medical education, and increasing pressure on state funding and practice revenue, our vision remains clear and our mission remains constant. Brody is and will remain dedicated to training our doctors and treating our citizens.
While we remain dedicated to our mission, we must adjust how we are organized and how we operate to accommodate today’s realities.
It is important to know that in every way possible, the decision to take an action is objective – based on analysis of our own data, as well as review of the evidence and peer-based benchmarks. I ask your full support to implement them.
We will continue working very hard to educate leaders in Raleigh about the value and critical nature of retaining the Medicaid Upper Payment Limit, or UPL, and SODCA, for ECUP’s financial stability.
Concurrently, chairs and senior leaders in my office are working to determine how best to operate ECUP practices to improve patient access to care, effectiveness and efficiency, patient satisfaction, and revenue optimization, along with anything else within our control.
We are carefully reviewing positions funded by the practice plan, and considering where this funding is appropriate, and in some cases, looking for other funding arrangements or opportunities to right size our clinical enterprise.
This work is being done thoughtfully, and with attention to medical school and residency accreditation requirements, the most prevalent medical conditions in our region, and the historical profitability of the unit. We have established principles that help us define what is core to the function of our school.
Our clinical operations must become more efficient and consistent. So, we have brought in Ms. Deb Brown to serve as Interim Clinical Operations Director. Ms. Brown has experience in working with academic practice plans all over the country to successfully make the same kinds of changes and improvements she is beginning to implement here.
The changes and actions we are implementing are designed to improve patient satisfaction and health outcomes. We believe that the changes, when implemented, will lead to increased productivity and enhanced revenues that are important to support the missions of our school. We also are focusing on measures that are aimed at assuring a high level of faculty and staff vitality and satisfaction.
More information is available by visiting “Preserving the Mission” on the Brody Web page. If you have questions or comments – either specific to your personal situation or more general in nature – you will have an opportunity to privately submit your question or comment to be addressed.
My colleagues and friends, there is no way to be less than fully transparent about the challenges we face and the concerted actions we must take. We do these things to prepare for the future of health care in eastern North Carolina. The Brody School of Medicine will remain the leader for improving the health of our population and for increasing access to care for our fellow eastern North Carolinians.
I ask you to join me in shaping an exciting future for our school and practice, so we can continue to serve the citizens of this state through excellence in education and clinical care!