Today at BSOM

With these blogs, I have made a clear association between my personal and professional experiences. Each influences the other in significant ways.

This Jamaica shop shows a unique way of working together.

The last few days have offered the opportunity to learn in support of leadership. For me, sometimes, it takes a distracting set of personal real-world experiences to gain insight on the journey to clarity.

First came the visit from the Liaison Committee for Medical Education and the accreditation review of our school. We have received their draft report and have responded. There were no surprises. The snapshot of our educational programs revealed that our purposes and goals align with the “purple and gold.” Our faculty members are dedicated to the success of our students, and we remain steadfast in support of our tripartite mission. Bottom line is that we have done well, and now we must do better!

The last couple of days have been spent at the Council of Deans spring meeting in Florida. This was a very useful meeting as there was the opportunity to explore the boundaries of medical education and health care with the other deans from across the nation. Linking our health system to the real social and economic needs of the communities that we serve was one of the major themes. As you know, the Brody School of Medicine has ranked seventh in the nation in this regard, so we had something to contribute to the conversation.

Florida is about an hour and 50 minutes from my mother in Jamaica, so I decided to stop in for a couple of days before returning home to Greenville. She lives in the center of the island in the mountains.

So, having come from Miami where the hotels and services are “over the top” to a county town in Jamaica where a hotel upgrade means air conditioning and hot running water on demand, there was sufficient contrast for some reality-checking. (Add spring break in full swing in Miami for additional distraction!)

As you may have recognized, we have been seriously engaged in talks with our partners at Vidant Health with regard to clinical integration. Not so obvious is the fact that the complexity in creating a full strategic alignment comes from the fact that we often duplicate services and functions. Almost invariably, we are both proud and satisfied of the quality and value of these services. Double helpings of motherhood and apple pie!

During a customary walk at dawn in Jamaica, I was thinking about “the Brody” and happened by Kenneth OR Ben’s upholstery shop, just down the road from “Lane” in Mandeville. Back engineering the thought process could offer insight into the decision-making for the wording of the sign. The sign on the wall of the establishment perhaps signaled a complex process of negotiation between Kenneth and Ben.

Rent and costs are expensive, and in a micro-economy where survival depends on meager margins, the most efficient deployment would necessitate sharing of the costs. Further, for efficiency, one telephone number, with an efficient “back-office” triage system would be optimal. For customer retention, the product must be of high quality and competitive in a very dynamic marketplace.

Kenneth and Ben are very smart people. Whenever I visit next, I’ll look for the next evolution in the business relationship. I am predicting that the sign will say Kenneth AND/or Ben’s upholstery.

Can you make the connections? How efficient do we need to be with health care reform in full implementation? What are the plausible scenarios in the future for Kenneth and Ben? What do you think?

Paul

Our stories say a lot about us, and they can also teach us a lot from them ourselves. Consider this example about one of our colleagues, summarized by a volunteer interviewer:

 She was at mass one day and heard the priest repeat a few lines very slowly and oddly. In thinking that he was having a stroke, she approached the pulpit. As a diabetic educator and research nurse, she quickly realized that he was hypoglycemic. In caring for him and talking with him, she noticed severe symptoms such as a potential deep vein thrombosis and indication of infection. They negotiated that he would go to the hospital immediately following mass, as he had come up for the first communion ceremony and was determined to finish it for the children. Afterward, he went to the hospital and was admitted for immediate antibiotic treatment and therapy for the clot.

Although he asked for no visitors, he requested that she come and see him. Together they talked about what she knew best: diabetes. She helped him understand the disease and the problematic symptoms. It was through her ability to identify a problem, follow her gut and demand that the priest, an obvious authority figure, trust her and seek treatment that she was able to change and potentially save a life.

This was a great example of a “Just do it!” story. It is one of more than 400 stories of peak experiences heard late last year by a team of 60 staff, faculty, M2s and senior administrators who interviewed their peers in the school’s community. Their goal: to discern what gives life to BSOM when we are “creating possibility.” On Friday, Jan. 20, these interviewers came together in energetic fashion to make sense of what they had heard.

Together they identified enduring factors that appeared again and again in the interviews: unconditional respect; “get your ego out of the way;” feeding the fire; “persistaverance.” Metaphors were created to more deeply describe the medical school when it is at its best in creating possibility: a team of rowers with a common goal; balloons of many kinds rising together; a tree with strong roots and many possibilities for the spring; a single family of healers embracing our community.

What will be done with so much work? First, a group of six will refine the afternoon’s outcomes into a white paper that will be shared with the Brody community. We’ll then begin imagining together a future BSOM that gives life to those peak experiences and the positive core of the Brody School of Medicine.

Stay tuned.

Paul

Perhaps trips of any type need to have a beginning and an end for us to really feel as if we have accomplished something of purpose. Milestones are there for a reason.

Not being able to leave well enough alone, I have given this idea some thought and have recognized that there may be exceptions.

One of our sister schools at ECU, the Thomas Harriot College of Arts and Sciences, sponsors a lecture series called the Voyages of Discovery. These “voyages” take place in Wright Auditorium in the center of campus.

The two most recent guest lecturers have been Sir Salman Rushdie and Henry Louis Gates Jr. In the past, our own Dr. W. Randolph Chitwood Jr. has transported us on his own personal journey.

To hear these impassioned life-interpreters has been a tremendous privilege. The whole voyage experience has been so convenient, since I have not needed to travel farther than across town. This has caused me to ask questions about the meaning of “journey.”

The winter solstice will be Dec. 22 at about 12:30 a.m. That’s when Earth, due to its position in its orbit around the sun, is tilted away from the sun by about 23.5 degrees. Here in the northern hemisphere, the result is the sun makes its lowest arc across the sky, giving us the shortest period of daylight of the year. In times gone by, that led to dire predictions of continued slippage into total darkness and the end of the world.

Having grown up relatively close to the equator, the seasonal changes were hardly noticeable, and so the predictions of impending doom were clearly not as popular as has been customary in the antipodes of the world. In Jamaica, folks have no personal concept of seasonal affective disorder.

What is also very clear is that while we “up here” are experiencing less daylight, the folks living “down there” in the southern hemisphere are experiencing the longest day of light in the year. Happy, happy, happy, I am thinking! We don’t really have to go to South America, however, to appreciate all of this happiness. The journey can be accomplished right here in Greenville. And if that is not enough, remember, our day will come. Just wait until summer!

Those old doomsday stories remind me of my youth in Jamaica. My brother and I would hand-carve spinning tops and fling them to the ground on a string as hard as we could throw. The smaller the top, the faster it would spin and the more rapid would be the precession, or wobble on its axis, until it fell over, inanimate, on the ground. The more substantial the top, the slower would be the wobble and the longer it would spin.

Like those tops, the earth precesses, but it takes about 26,000 years to complete one cycle. With such a deliberate wobble, I am expecting that it will continue spinning for a very long time. Those ancient end-of-the-world predictions are little to be worried about.

For me, at this time of the year, the reality that it’s summer somewhere and one day will be summer up here is an additional reason to fearlessly celebrate and really appreciate the season of giving that we welcome perennially.

May I suggest that we take the opportunity to go on our own personal journeys during this temporary period of external darkness. In so many ways, the Brody School of Medicine has come a very long way this year, and we are only half-way there.

I am looking forward to as many worthwhile challenges as possible in the New Year. The possibilities are bright and welcoming, and I look forward to us continuing to meet the needs of our mission during the New Year.

On behalf of our family, may I wish you the best gift of all, good health!

Best,

Paul

The rest of the world tends to count down to the end of the year. We in academic medicine have just reached our stride by now and are accelerating.

There is a constant flow of good news that permeates our school at this time of the year. Here are the elements of just a couple of communications that came across my view this week:

–Dr. Pete Pancoast of the Department of Internal Medicine was just informed that the pulmonary disease and critical care medicine program was fully accredited for five years. The review committee provided commendation for the program and found no citations. None! This is quite remarkable.

–Dr. W. Randolph Chitwood was informed that one of our medical students, Amber Melvin, was selected as one of 20 – from 100 applicants – to receive a 2012 Society of Thoracic Surgeons Looking to the Future Scholarship.

This may seem to you as two minor announcements. On their own merit, they are not trivial by any means. In full context, this dean’s mailbox is privileged to receive 20 or more of these sorts of positive messages of accomplishment every month.

As I have repeated in the past, we live in a miraculous environment with the opportunity to positively affect the lives of all of the citizens in eastern North Carolina. That is a privilege that is truly humbling.

May we reflect on all of the opportunities that we have been given over the last year and look forward to our continued individual and collective successes.

Thank you for all that you do for the citizens of our region on behalf of the Brody School of Medicine at ECU.

Paul

I am certain that those of us who have raised kids will immediately understand what “button-pushing” really means. It seems that even as babies, our children learn very rapidly how to win a concession by pushing all of the right buttons. This skill is brought to a fine level of development if one is fortunate enough to have a predominance of girls. At least, that is my own personal experience.

How many shoes and purses does one human being really need? Please don’t ask me to answer this question, as my answer is apparently very wrong. My kids are all grown, but I am still learning.

Button-pushing can become a very important part of adult life as well. Sometimes this activity can take on sinister and destructive forms.

Fortunately, there are many “good buttons” to push. They all embrace some elements of caring, courtesy, selflessness and service to others.

A most recent example of good button possibility that has presented itself to us here at work is the State Employees Combined Campaign. On Friday, Chancellor Ballard announced the following:

“I am writing to ask for your financial support of the 2011 State Employees Combined Campaign (SECC) which will begin Monday, October 3. Through your contributions, the SECC is able to assist thousands of people in North Carolina and across the nation who need a helping hand. Last year, our faculty and staff contributed $191,743 that was distributed to hundreds of SECC recognized agencies. During the 2010 campaign, 1,036 individuals from across the University participated. Our goal is to have a 5% increase in participation this year. That is only 52 additional participants and we need your participation to meet our goal.”

The chancellor asks us to showcase our community leadership” and give “a bit more this year.” Our own ECU Medical & Health Sciences Foundation is one of the potential beneficiaries of the campaign. Please remember that charity can start at home!

We here at Brody are generous people and have ample opportunity every day to “push the right buttons.” We are in the right “business.” Please be careful then to be a disciplined and caring button-pusher, as you share your capacity, love and kindness with others. I think that this will mean even more this year.

Hope to see you soon. And Go Pirates!!!

Paul

When I ask how she is doing, my 89-year-old mother always says that she is “holding on.” This response has not changed for decades.

As we have come through the last natural disaster, weathered the statewide economic recession and struggled with the day-to-day demands of providing education and service, it is tempting for me to say to others that we are “holding on.” This response, however, is less than satisfying for me.

“Holding on” seems to signal that there is nothing else that can be done. This is a maintenance of the status quo response.  OK, but not good enough.

Our real world asks more from us. How can we serve the people of eastern North Carolina in the best way that we can imagine? How can we better serve our families? What can we do to improve personally? Holding on is not the best approach, I would say.

The swirling rhetoric at the national level has been informative. Job, jobs, jobs is the chant. What sort of jobs shall we create? It is the creating – the inventing – of new products and processes that has made our economy strong. The inventiveness of a society seems to be the one seminal index of a thriving national economy.

The Triangle Business Journal just published the 2011 Best Places to Work. The companies are all highly successful and encompass health care, high technology and high-end service industries (see list below).

In reflection, yesterday, I reviewed a report from the Fiscal Research Division of the North Carolina General Assembly. The report indicated that higher education is responsible for 18 percent of the state budget, amounting to just over $3.5 billion.

(click to enlarge)

Having endured painful cuts at our institution of advanced learning, I wondered if this investment by our state is sufficient or may fall short of the need. I presume that if we are to be successful in the future, it will require that we have the smartest and most highly educated individuals here in North Carolina. We should have already recognized that we need to be competitive – not just with other states but on the world stage.

If I believed that eastern North Carolina were already fully provisioned with all of the highly skilled workers that will allow us to compete with just the rest of the state, I’d be very satisfied. But it’s clear we have much work to do to continue to educate a competitive workforce in our region.

So, for me, it’s not about “holding on;” it’s more like “keep driving forward.”

Have a great, and safe, Labor Day!

Paul

2011 Best Places to Work (Triangle Business Journal)

Giant companies category (1,000+ employees)
Duke Raleigh Hospital, Raleigh
NetApp, Research Triangle Park
Rex Healthcare, Raleigh
Time Warner Cable , Morrisville
WakeMed Health & Hospitals, Raleigh

Large companies category (151- 999 employees)
Accenture, Raleigh
ChannelAdvisor, Morrisville
EMC Corporation, Durham
SciQuest Inc., Cary
Ernst & Young LLP, Raleigh
Eye Care Associates, Raleigh
Nationwide Insurance, Raleigh
Red Hat, Raleigh
Railinc Corp., Cary
Workplace Options, Raleigh

Medium companies category (51-150 employees)
Bronto Software, Durham
Bulk TV and Internet, Raleigh
Camden, Raleigh/Apex/Morrisville/Chapel Hill
Cherry, Bekaert & Holland LLP, Raleigh
Clark Nexsen Architecture & Engineering, Raleigh
Clarkston Consulting, Durham
Highmark Companies, Cary
SchoolDude.com, Cary
ShareFile, Raleigh
TowerCo, Cary

Small companies category (fewer than 50 employees)
Alston & Bird LLP , Durham
BioAgilytix Labs, Research Triangle Park
The e-NC Authority, Raleigh
Evoapp Inc., Durham
FGI Research, Chapel Hill
HireNetworks, Raleigh
Langdon & Co., Garner
MMI Public Relations, Cary
Relevance Inc., Durham
The Select Group, Raleigh

My dear colleagues,

You have been in my thoughts. Most certainly, there has been significant property loss and personal injury all along the East Coast. We are aware that more than 200,000 people in eastern North Carolina are still without power, and there is still an aftermath of disaster that is being addressed as we speak. It is the Brody professional family that remains foremost in my mind.

At a minimum, there is clear evidence of water infiltration on the north side of our building. It will take some time to assess all of the damage that has occurred.

I know that in times like these, the Best of Brody comes to the fore, and we literally weather the storm together. This response is representative in all sectors of our team –- from facilities maintenance, our staff, our students, our  educators, our researchers and our clinicians.  We are also fortunate also to have a group of seasoned administrators who have planned and prepared for the worst, season after season.

Now, on the “leeward side,” I am interested to know how everyone fared.

Please let us know how you have been. Your security is important to us all.

Thanks for all that you do for the BSOM.

Best,

Paul