Dean's Letter


Adapted from the Dean's State of the School Address, September 30, 2003

Dean Thomas J. Lawley





 his the beginning of my eighth year as Dean, and my enthusiasm for the School of Medicine (SOM) and my admiration for you, the faculty, have never been greater than they are today. We have accomplished much these past seven years. We have graduated 800 new physicians. We have trained 2,100 residents. We have admitted more than 300 new PhD students. You have written more than 22,000 articles, book chapters, and books. You have recorded nearly 15 million patient visits. We have recruited more than 700 new faculty members at the rank of assistant professor and above. We have appointed 20 new department Chairs, created five new academic departments, and built or remodeled nearly 1 million square feet of research, clinical, and teaching space, excluding the Emory Crawford Long Hospital Redevelopment Project. We have increased our research funding more than threefold, and we have increased the stature of the medical school.
      We clearly have accomplished a great deal, and we should be proud of what we have done. The reasons we have been successful include a combination of comprehensive planning, hard work, cooperation among faculty and between departments and schools, belief in ourselves, and belief in us by our patients, trustees, foundations, and state and federal governments. But most of all, it is because we have developed a compelling vision of who and what we want to become and then displayed the collective leadership to accomplish our goals. Without a doubt, we have many outstanding leaders, at every faculty and administrative level, and those individuals have been key players in shaping our success.
      I will update you on seven key subjects, which include Grady Memorial Hospital, our new strategic plan for research, teaching and education, our clinical enterprise and our affiliates, the faculty, our finances, and philanthropy. So let us begin with Grady Hospital.



 

 



The new Emory Center for Clinical Training and Faculty Building
provides much-needed education
and office
space at Grady Hospital.

















  s you know, we have a huge commitment to indigent care at Grady. Also, Grady is an important venue for the education of our medical students and residents. We provide 306 attending FTEs (full-time equivalents) there. We are partially reimbursed by Grady for about half of those attendings, and the SOM pays for the other half. We also have 378 residents at Grady in 50 fully accredited programs, and this year, our physicians had about 805,000 patient visits. A number of programs at Grady that you know well are among the largest and the finest in the nation—trauma, the neonatal ICU, the burn unit, the HIV/AIDS clinic, emergency medicine, the diabetes unit, the stroke center, the poison control unit, and the sickle cell center. All are programs of which we are very proud.
      In FY02, Grady’s budget totaled $580 million, and $53 million of that was allocated to the SOM. However, state and federal agencies directly reimbursed Grady for approximately $35 million of that $53 million. So the net cost to Grady for Emory attending and resident physicians was approximately $18 million, or 3% of the Grady Health System budget. Without a doubt, we are a great bargain for the citizens of Fulton and DeKalb counties.
      In FY02, through the Emory Medical Care Foundation (EMCF), we provided $24.6 million to help support physicians, staff, and programs in addition to the support Grady was budgeted to provide. Further, in FY02, Emory physicians working at Grady provided indigent care worth approximately $26 million, for which there was no reimbursement because 45% of all patients at Grady are uninsured and do not pay for their services.
      In addition to EMCF support and unreimbursed care, we provide other types of in-kind contributions, including the building that we constructed at Grady to house our faculty, and state and federal grants for patient care (see Figure 1). Thus, the total funds and services that Emory contributes to the Grady Health System exceed $100 million per year over what Grady is budgeted to reimburse. However, it is clear that Grady is in a financial crisis. The number of indigent, uninsured patients continues to rise. Cuts in Medicaid have occurred, and more are on the horizon. Support to Grady from Fulton and DeKalb counties has decreased over the past decade, and malpractice insurance rates and settlement costs have increased. All of these factors and more have contributed to Grady’s plight. But there is hope.
      As we all know, Grady has a new administrative team. It is one that displays effective leadership and planning capabilities. Dr. Andrew Agwunobi, Grady’s new President and CEO, has great energy and enthusiasm and a good track record. And no one knows more about running hospitals than Grady COO John Henry Sr., who recently retired as CEO of Emory Hospitals and Wesley Woods Center. The SOM stands ready to work with Dr. Agwunobi and his team to help enhance the efficiency of hospital operations and maintain and improve the quality of care that is delivered. We look forward to the opportunity to help plan strategically for Grady’s future.
      However, if enhanced operating efficiencies and/or increased funding from county, state, or federal sources do not materialize, Grady may not be able to afford all SOM services and may ask us to decrease them. I have asked all department Chairs to determine how budget cuts would affect their ability to deliver services at Grady and how they would accommodate any cuts in faculty or resident staffing. I hope there is no need to implement any of these plans, but we must be prepared.


















































 


et us now turn to research. In FY02, Johns Hopkins ranked No. 1 among the top 10 schools of medicine in research funding from the National Institutes of Health. Emory ranked 21st in NIH funding, two slots higher than we did in FY01. I anticipate an increase in NIH funding of up to $20 million for this year, but this may not move us up more than one or two slots in the NIH ranking, since the other schools are not standing still. Although our NIH funding has grown by 160% since 1996, we still have a long way to go.
      As shown in Figure 2, our NIH funding increased from $55 million in 1996 to $143 million in 2002, the latest year for which we have federal data. This is the second-fastest rate of growth among the top 25 medical schools in the nation. As our school NIH rankings have increased, the number of our departments that rank among the top 20 departments in their specialties also has increased. We currently have 11 top-ranked departments in NIH funding. They are Rehabilitation Medicine (3), Microbiology and Immunology (4), Neurology (6), Dermatology (10), Pharmacology (11), Family and Preventive Medicine (12), Neurosurgery (16), Gynecology and Obstetrics (16), Pathology (16), Ophthalmology (18), and Psychiatry and Behavioral Sciences (18). They should all be very proud of what they have accomplished over the past several years, and I anticipate a number of other departments will rise to the top 20 ranks within the next few years.


 

        
      
I would like to congratulate the recipients of this year’s Dean’s Clinical Investigator Awards. They are among our brightest and best faculty. New recipients include Drs. Jack Arbiser (Dermatology), Marc Moss (Medicine), Dominique Musselman (Psychiatry), Andrew Neish (Pathology), Charles Parkos (Pathology), David Rye (Neurology), and Zachary Stowe (Psychiatry). They join 15 other active Dean’s Clinical Investigators who have received awards during the past two years. Through the dollars provided by the Dean’s Office and nominating departments, we help protect research time for faculty with clinical responsibilities.

An Ambitious Plan for Research

    We have been in a research strategic planning mode during the past nine months. We concluded the period covered by our first Research Strategic Plan, from 1997 to 2002, last year. We have fulfilled every major element of the plan, and by any measure it was a smashing success. Our new plan for 2003 to 2008 is now complete, again chaired by Drs. Wright Caughman and Ray Dingledine. Dr. Robert Rich led the Executive Committee, and the Planning Committee included representation from the SOM as well as the Rollins School of Public Health, Yerkes National Primate Research Center, Emory College, and Emory Healthcare.

      As with the first plan, we used a series of benchmark schools for comparison (see Figure 3), all of which have more NIH funding than we do. However, our NIH funding grew at a rate of 17.2% over five years. Only one other school, Baylor, which is ranked No. 5, grew at a faster rate (19.7%) than we did. This accounts for our ability to rise in NIH funding from 31st in 1996 to 21st in 2002. Our faculty deserve great credit for the work that went into this achievement.

      What conclusions can be drawn from this benchmark analysis? First, Emory investigators are as successful as those in benchmark schools in competing for RO1 grants. But there are differentiating characteristics among our benchmarks. These characteristics include a greater focus on team science, a larger number of productive NIH-funded investigators, a more extensive training environment, a deeper infrastructure with better core facilities and broader administrative support, a culture that demands success in discovery, and greater strategic investment in emerging opportunities.
      As part of our new Research Strategic Plan, the Planning Committee recommends investing in seven emerging areas of biomedical research and health care. We have historic and current investments in all of these areas, especially in cancer, neurobehavioral sciences, immunity and host defense, and vascular and barrier biology. We have not invested as much in the three emerging areas of regenerative and reparative medicine, health services research, and molecular structure and interactions. Our Research Strategic Plan clearly calls for increased emphasis in all seven of these areas.
      The Planning Committee also made seven recommendations, which revolve around three broad principles, as follows:


Culture

  • To strengthen the research culture in the SOM and better align and integrate it with the missions of the Woodruff Health Sciences Center and Emory University.
People
  • To increase the number of NIH-funded investigators by recruitment, but also, very importantly, by retention.
  • To increase the number of research trainees. Currently, we have 331 individuals in PhD programs in the Graduate Division of Biological Sciences (GDBBS). The Planning Committee would like to raise that number to 500 during the next several years.
  • To improve support for investigators in clinical departments.
Programs and Infrastructure
  • To develop new research facilities.
  • To increase programmatic NIH grants, such as Program Project Grants (PPGs), and develop centers of excellence in biomedicine and health. Regarding the value of team science and grant mechanisms, I want to emphasize that being a project director on a PPG will count just as much for promotion as a second RO1 grant.
  • To increase investment in core labs, enabling technologies, and research and administrative support.

    
       The Research Strategic Plan is both ambitious and expensive. We do not have the resources to fully implement this plan, and that is one of the reasons why we need to raise a substantial amount of money, which I will discuss later.
      Finally, let me return to the subject of NIH awards, specifically the market share of NIH awards measured over time. Not only has our NIH funding increased each year, but so has our market share. Individual school rankings change from year to year, but the market share that is captured by the 10th-ranked medical school remains remarkably constant. This represents a good benchmark. If we continue on our present growth rate in NIH research funds, we will reach the 10th-ranked NIH funding position in 2017, which I find completely unacceptable. While it would be delightful to reach our goal in 2008, I do not believe that is possible. However, by increasing our already rapid growth rate by 50%, we can attain the No. 10 position by 2012. That is our goal.

















 


ow let us turn to teaching and education. Despite decreases in the national pool of medical school applicants, we continue to admit high-quality medical students. Last year, we received more than 5,000 applications for 114 positions. The average GPA was about 3.8, and the average MCAT score was 33, an all-time high for us. So it is clear that SOM applicants and matriculants continue to be outstanding. Our students and graduates achieve great results on standardized tests such as the USMLE (US Medical Licensing Examination). Routinely, about 20% of our students score at or above the 99th percentile on Parts 1 and 2 of these exams. Our seniors get outstanding residency positions, and more than 60% of our first-year students have an important and relevant research experience.
      In addition to medical students, we educate graduate and allied health students. Our Allied Health Programs are doing well. Of the 281 faculty members associated with the Graduate Division of Biological and Biomedical Sciences, most are from the SOM. As I indicated previously, total student enrollment is 331, and the Research Strategic Plan calls for that to rise to 500. The entering class of graduate students is very solid, with an average GPA of 3.4 and an average GRE of 1929. The GDBBS has eight different programs ranging from biochemistry, cell biology, and developmental biology to population biology, ecology, and evolution. Many of you are now involved with one or more of these programs. I would like to congratulate Dr. Bryan Noe for what he has done over the years for the GDBBS. He has shepherded and developed our programs within this division. Bryan is now Interim Dean of the Graduate School of Arts and Sciences, where he is doing a very fine job.
      We made a number of advances in our medical education program during the past year. We built an education floor for students and residents in the new Emory Center for Clinical Training and Faculty Building at Grady. I thank the Emory Medical Care Foundation for their support in this regard. We restructured the Executive Curriculum Committee with more power for curriculum supervision and more input from course directors and clerkship directors. And we enhanced the use of simulated patients and OSCEs (Objective Standardized Clinical Exams) for all third-year medical students. We also upgraded the Anatomy and Physiology Connector classrooms and enhanced the small-group rooms in the Woodruff Health Sciences Administration Building. However, we are still in desperate need of a new state-of-the-art Medical Education Building.
       We introduced new courses and improvements in some existing courses and clerkships, and we divided each class into four different societies to provide mentoring and vertical interactions with other classes above and below them. All of these important changes have been made through great effort and time commitment by the Office of Medical Education, led by Dr. Jack Shulman and his colleagues. But even bigger educational changes loom on the horizon.
       As much as we have done until now, and as well as we are doing by many standards, I want our next major educational initiative to be the creation of a new vision for our approach to medical education in the SOM. I want that vision to catapult us to the forefront of medical education in the nation. The time is right for Emory to create a new paradigm for educating medical students and house staff in new subjects, using new techniques and new structures. I want this vision to be novel, compelling, expansive, and differentiating. And we should take the lead in this endeavor nationally.
       There are several steps to consider regarding this medical educational initiative. We should create a strategic plan based on principles that include determination of what the end product of our educational process is now and what it should be in the future. And if they do not link up, we need to pay attention to that. We should decompress and shorten the first two years of the curriculum to allow for the creation of different educational tracks for students and new curriculum approaches. We must build a dedicated state-of-the-art medical education facility to accommodate this vision. And we need to have a timeline and a cost for implementing this. We will begin this planning process this year, and it will surely run into the next year. I believe the outcome will be transforming for the SOM, and perhaps for other schools as well. I cannot wait to get started on this.






























 


et us now look at our clinical enterprise and our affiliates, beginning with Emory Healthcare. First of all, I would like to congratulate Mr. John Fox, Dr. Rein Saral, Mr. Donald Brunn, Ms. Sarah Dekutowski, and their colleagues, who have done a remarkable job with Emory Healthcare (EHC) and The Emory Clinic this past year. Their major accomplishments include finishing FY03 better than budget with a positive net operating income. That is tremendous. They consolidated all EHC employees into one benefits structure under one employer. They completed redevelopment of the Emory Crawford Long Hospital campus, moved the Winship Cancer Institute clinical operations into a wonderful new facility, successfully installed PACS (Picture Archiving and Communication System) at EHC locations, developed the foundation applications required for further implementation of EeMR (Emory Electronic Medical Record), and continued to improve management processes, both in the Clinic and in Emory Hospitals. Future initiatives throughout our health care system follow.

Emory Healthcare (FY04)

  • Increase EHC net patient service revenue by 7%.
  • Decrease medical malpractice loss exposure for the health system.
  • Develop a detailed, Clinic-based operational plan for the implementation of EeMR.
  • Implement an improved and consolidated performance management system for EHC managers and staff.
  • Continue to promote a high-performance, patient-focused service culture through ongoing service initiatives across EHC.

Emory Hospitals (FY04)
  • Increase volumes at Emory Crawford Long Hospital.
  • Manage expenses to meet budget targets in agency labor use, malpractice insurance, new technology, and pharmaceuticals and implantables.
  • Initiate a strategic review of facility plans for Emory University to improve efficiencies and ensure that the hospital’s needs are met.

The Emory Clinic (FY03)
      Emory Clinic administrators have greatly improved the revenue cycle through financial clearance, denial management, charge capture, and payment variance. They have improved patient and referring physician experience, and Press Ganey patient satisfaction scores have increased significantly over the past three years. I have played a significant role in many long meetings to boost the financial performance of specific targeted Clinic Sections, many of which have improved. The Clinic has developed and implemented new space for the Orthopaedic Surgery Program and developed section-specific operational plans for the implementation of EeMR and PACS. Additionally, the Clinic has addressed program planning needs for strategic programs, including the Heart Center Program, the Breast Program, and the Winship Cancer Institute Program. And, very importantly, the Clinic has continued to develop section and department middle management.

The Atlanta Veterans Affairs Medical Center
      The SOM would not be what it is today without the strong partnerships we have with our affiliates. The Atlanta Veterans Affairs Medical Center (VAMC) is of major importance to our teaching program. We have 160 full- and part-time medical faculty there, and 118 residents and fellows. We have a close relationship with the new director, Mr. Thomas Cappello. Direct cost research support, generated by our faculty at the VAMC, increased by 15% last year to nearly $22 million. As a result, the VAMC ranks No. 11 in research awards nationwide. Clinical services continue to grow at a remarkable rate, up 7.4% this year. More than 480,000 outpatient visits by more than 52,000 unique veterans are projected for FY03.
      The VAMC is heavily involved in planning for a project known as Capital Asset Realignment for Enhanced Services (CARES). This is a national effort to expand VAMC services and resources to better serve some areas of the country and reduce them in others where the veteran population is falling. Because we are in Atlanta, CARES will have a positive net effect on our VAMC. Community-based outpatient clinics will grow to handle the outpatient load, as will facility-based specialty care. In addition, a new research building, between 40,000 to 60,000 square feet in size, at the VAMC campus has been proposed, with the go-ahead planned for FY04.

Children’s Healthcare of Atlanta
      We continue to enjoy a strong relationship with Children’s Healthcare of Atlanta. Children’s has outstanding leadership in Dr. James Tally, the CEO, and Dr. Jay Berkelhamer, Senior Vice President for Medical Affairs. We have done extensive joint planning with them. One outcome has been the development of our Pediatrics Building, currently under construction. This much-needed facility has been made possible through significant philanthropy from several sources. We continue to collaborate in philanthropic planning with Children’s. We also have done joint program planning for a number of services that are delivered by our faculty. There is joint research funding through the Children’s Research Center and joint recruitment, most importantly of the Chair of the Department of Pediatrics, who will also be Medical Director for the Egleston campus of Children’s. Our relationship with Children’s is close and productive, and we look forward to even more progress in a number of areas.
 






Dr. Allan Levey





Dr. Larry McIntire






 


would like to focus now on our wonderful faculty and their many achievements. This past year was an important one as we recruited four new department Chairs. We recruited Dr. Sarah Berga from the University of Pittsburgh as Chair of the Department of Gynecology and Obstetrics. Dr. Allan Levey, one of our own, is now Chair of the Department of Neurology. Dr. Larry McIntire of Rice University joined the SOM as Chair of the Department of Biomedical Engineering. And Dr. Tris Parslow came to us from the University of California–San Francisco to become Chair of the Department of Pathology and Laboratory Medicine. In addition to recruiting these outstanding individuals, Chair searches are under way in Biochemistry, Pediatrics, and Radiology. I will share the results of those searches with you just as soon as I can.
      The Dean’s Office has set several important goals for faculty development throughout the SOM. We want to recruit an individual into the Dean’s Office who is focused on faculty development. We want to seek approval of a nine-year tenure clock. We want to increase diversity among faculty and increase the number of women and minorities at senior faculty ranks. And we want to ensure that all departments have implemented the Faculty Development Policy and are addressing mentoring of junior faculty. Dr. Claudia Adkison, Executive Associate Dean, Administration and Faculty Affairs, is taking the lead in a number of these initiatives.
      In 2002-2003, the SOM had 1,499 full-time faculty members in the clinical and basic science departments, of which 32% are female. Additionally, 471 faculty members are at the senior rank, which includes associate and full professors, but only 16% of these are female. Our Chairs, Division Directors, and faculty need to help us retain, recruit, and mentor our female faculty to move more of them into senior ranks where they can serve as role models and leaders for all of us. There is good news to report regarding our progress. Effective September 1, 2003, 70 faculty were promoted or appointed to the senior ranks. Of those, 26% were female. That is encouraging, but we have to make sure that this is more than a one-time phenomenon. We also need to pay more attention to increasing the racial diversity of our faculty, particularly among our senior faculty.
      In proposing to extend the tenure clock, it is worth noting that 38 of the 126 medical schools in the United States have changed their tenure clock to more than seven years. Our proposal would extend the tenure clock, only in the SOM and nowhere else in the university, from seven to nine years. However, faculty could be nominated for promotion with tenure at any time during the fifth to seventh academic year. The tenure clock extension would allow candidates time to establish independent research funding and to publish. It also would allow clinical faculty time to establish a practice, begin a research program, and do some teaching. And it would allow faculty who have primary child care responsibility the time to achieve both professional and personal goals. A number of our peer institutions have done this successfully, and we should too.
      Now a word about our Faculty Development Policy. This policy calls for periodic evaluation of professional development by the Chair and the faculty member, working together. The process recognizes accomplishments and sets goals for the faculty member, and it requires a mechanism for formal faculty mentoring in the department or in a division when the faculty member requests it. A number of departments promote faculty development well. One is the Department of Pharmacology, led by Dr. Ray Dingledine. The Chair discusses appointment and promotion guidelines and expectations with all new faculty and assists them with grant applications to federal agencies and private foundations. Faculty receive a comprehensive progress review and a plan to address their needs during their third year on staff, and the Chair meets informally with faculty periodically to assist them with problems and needs. It is an excellent program.
      I also would like to mention the Department of Medicine, led by Dr. Wayne Alexander. Wayne has established a formal Faculty Development Committee to provide oversight and establish guidelines for mentoring and development, to review all appointments and promotions at the associate professor and full professor levels and then advise the Chair, to develop and implement a plan for periodic evaluation, to identify candidates for internal and external awards, and to develop tools for mentoring faculty. Both departments serve as excellent models for demonstrating leadership in the area of faculty development. I urge and expect all Chairs in all departments to develop similar programs if they have not already done so. Our faculty are our most valuable asset. We have invested resources in them, and we must be sure that Chairs and senior faculty invest their time and expertise to help junior faculty learn the academic ropes and maximize their chances for success.

 

 

 

 

 

 

 







 





 

 


 

 


  hat about the state of our finances? All-source revenue for the SOM in FY03 totals $631.9 million. Income generated from all clinical sources is 33.7% of all revenue; this pays for physician salaries. The vast majority of all income, about 85%, is pass-through money. The dollars that I have some discretion over include the Academic Enrichment Fund (2.2%), Tuition and Fees (3%), Research Indirect Cost Recovery (9.2%), and a portion of Endowment and Gifts (11%).
      Regarding clinical revenues, the income generated by physicians to pay physician salaries totals approximately $213 million. Let me point out some important factors. Physicians in The Emory Clinic generate 50.2% of all clinical income. An additional 30.7% comes from Grady Hospital, which includes income from Grady (17.2%) and from the EMCF (13.5%).
      The All-Source Expense Budget, which totals approximately $636.2 million, is the flip side of the revenue budget. Our expenditures correlate with our income sources, such as Clinical (33.5%), House Staff (7%), etc.
However, our expenses exceeded our income by approximately $4.3 million. We had to draw down on our reserves to make up the difference, which we have done for several years running. We cannot continue to do this indefinitely, and we hope to end it this year.
      As mentioned previously, the Dean’s Office has discretion over the Basic Academic Support Budget (Ledger I), projected to be $108.3 million in FY04. This budget has four main revenue sources—Tuition and Fees ($19.8 million), Endowment and Gifts ($27.1 million), the Academic Enrichment Fund ($14.1 million), and Research Indirect Cost Recovery ($45.3 million). Over time, we have experienced a tremendous increase in the actual dollar amount and the percentage of income from Research Indirects.
      How will we spend our Ledger I budget in FY04? The two largest expenditures will be $35.8 million for Academic Departments, the funds that we allocate to departments, and $42.4 million for University Overhead, the largest single expense. The other significantly large portion of the budget will be Commitments and Enhancements ($12.3 million). This portion of the budget provides funds to department Chairs for faculty start-up packages. These have been given to a number of Chairs over the past several years, and we now have more than 15 Chair packages in evolution.
      Let me briefly describe our four streams of income since 1995. Research Indirect Cost Recovery has trended upward nicely, and a slow increase has occurred in Tuition and Fees. The Academic Enrichment Fund was flat for a period of time and then decreased. Endowment and Gifts, which increased nicely for several years, has reached a plateau. We need to be realistic about what our budgets will be for the next couple of years. While we anticipate some increase in Research Indirects and a modest increase in Tuition and Fees (approximately 3% to 4%), we need a major increase in the Academic Enrichment Fund. We also expect a large decrease in Endowment and Gifts.       Consequently, we will be forced to manage tight budgets, and there simply is no way around it for the next couple of years. I wish that were not the case, but we must be realistic about the financial situation we are facing. On that note, let me talk about development.



 

 


  e have very high aspirations in the SOM. You are aware of that—they are your aspirations. We have ambitious plans for our clinical, teaching, and research enterprises. Once we have met our financial obligations, we do not have enough money to accomplish our aspirations without philanthropy. I believe that philanthropy is key to our future. And the future is now.
      There is a sense throughout the school, in fact throughout the university, that the time is right to begin a fundraising campaign. Potential donors hold the SOM in high regard, and we have compelling stories to tell. The economy seems to be reviving, and we have a large number of prospects. We have an excellent Institutional Advancement (IA) team, led by Mr. Phil Hills. And, very importantly, we are not starting from ground zero.
      Beginning in 2001, there has been a tremendous upturn in the money we have raised in the form of cash gifts from a variety of different donors (see Figure 4). We also have increased the number of individuals working in Institutional Advancement. It is not a coincidence that both the money and the number of individuals who helped us raise it increased simultaneously. We have gone up from seven FTEs in IA to approximately 20 FTEs. The good news is that if one looks at the direct cost of raising a dollar in the Woodruff Health Sciences Center, it actually has gone down (from 12.7 cents in 1999 to 5.3 cents in 2003). These new fundraisers are high quality, they know what they are doing, and it costs less to raise a dollar over time. This cost probably will not go down much more, but it is an attractive trend.
      In case you are wondering where expendable SOM donations go, most go to our departments, and a tiny portion goes to the Dean’s Office for scholarships and general support (see Figure 5). Most of the money we plan to raise will go to departments and will be targeted. Those of you who oversee department budgets must pay attention to what that means. It may mean that no large increases in discretionary money will be available from the Dean’s Office as we go forward. But you will have increased amounts of money that you can use to move your programs forward, and you must spend every dollar wisely.

 

       I like raising money. It is fun, particularly when somebody does give it to you. I want to mention some basic tenets of fund raising, because the faculty must be heavily involved in this campaign to move it forward. When one factors out buildings, donations tend to be given to individuals, not institutions. Money almost always is given to faculty members who have a cause. Faculty members must be able to articulate their cause in a compelling fashion and tell potential donors why their gift will make a difference. An important element in a successful fund-raising campaign is the ongoing relationship between the donor and the recipient. It is a rare event, if you ask somebody for money on the first or second meeting, that you are received warmly. It almost never happens. So you have to develop ongoing relationships with potential donors.
      Faculty must participate in fund raising by developing their stories, by helping IA staff identify potential donors, and by helping the staff present those stories. In some cases, faculty can take the lead in fund raising. For example, faculty or graduates of the SOM could organize class-specific endowed scholarship programs, much like Dr. Bill Eley, in the Office of Admissions, has done. There are opportunities for individuals who want to take the lead in fund raising.
      The timeline for the Woodruff Health Sciences Center fund-raising campaign is not yet carved in stone, but the fund-raising goal will be $600 million to $800 million, depending on the length of the campaign. So our work is cut out for us, but I am convinced that we can raise that much money and perhaps even more.













 


ust recently, some of you may have seen the cornerstone of the original Emory School of Medicine building that used to be at Grady. It now sits on the lawn just outside WHSCAB. We found it next to a dumpster on Fraternity Row about a year ago. The stone weighs thousands of pounds, and I cannot imagine how it got to the dumpster site. It comes from our precedent institution, the Atlanta Medical College, which was founded in 1854. That means we mark our 150th anniversary in 2004, and we plan to celebrate it. We also plan to use our anniversary as a focus for fund raising, and I have appointed a committee chaired by Mr. Hills to recommend ways to celebrate this anniversary. If you have ideas about how to mark this anniversary, please share them with Phil or me via e-mail. You will hear more about this celebration in the coming months.
      So that is where we are. Clearly, we are strong and on the move. But we do face financial challenges if we are going to fulfill our dreams and emerge as an elite school with a top 10 research program, as an innovator in medical education with first-rate facilities, and as a strong clinical enterprise with an outstanding, well-supported, and diverse faculty. That is what we want to be, and that is what we will be—a destination institution in every way.
      In addition to resources, our goals and aspirations require something else. They require leadership. Let me use department Chairs as an example. They are appointed for many reasons, but one very important one is their ability or potential to lead faculty. Faculty members are bright, high-energy, high-achieving individuals with complicated needs and complicated jobs. Most of our Chairs have no experience in that role when they are first appointed. In order to succeed, they have to acquire a series of technical skills and become politically savvy in the microenvironment of their departments and in the macroenvironment of the school. But most of all, they must inspire loyalty and respect from the faculty. Loyalty and respect usually derive in part from the ability to bring resources to the department from the Dean or the hospital CEO. But they also derive, more importantly, from the personal attributes of the Chair.
      Intelligence, imagination, creativity, honesty, loyalty, a strong work ethnic, and a sense of humor are important characteristics for a leader. Outstanding schools have outstanding Chairs who, in turn, recruit and develop an outstanding faculty. Successful Chairs are values-oriented, embrace innovative ideas, and have the energy to implement them. They also tend to be excellent teachers. They make teaching a priority, and they recognize that their success lies in the success of others—the faculty. Chairs must always put themselves last in line at the buffet table of academics. The attributes of successful Chairs are attributes all of us should acquire and nurture. They are, of course, the key elements of leadership.
      Intelligence, imagination, creativity, honesty, and loyalty abound in our school. All of you are leaders—of faculty, residents, postdocs, medical students, doctoral students, or laboratory, office, or hospital staff. All of us should conduct ourselves with a view toward leading by example and toward learning more every day about how to be better, how to do a better job. Try to ask yourself every evening, “How did I do today?” Then listen to the answer.
      Last year, Dr. Michael Johns took an important step in promoting leadership at Emory by creating the Woodruff Leadership Academy. He took a diverse group of University and Emory Healthcare employees, faculty members, administrators, nurses, hospital staff, and others, and exposed them to an innovative curriculum focused on the attributes of leadership—especially in the Woodruff Health Sciences Center. The Academy has proven to be a great success, with many people wanting to take the course this year. And while only a small fraction of our faculty and staff will ever get a chance to attend the Academy, it does indicate how hungry and enthusiastic many people are about developing their leadership skills. Leadership has an impact on all that we do—whether it is displaying professionalism at all times when we interact with patients, medical students, and residents, so that no hidden curriculum is taught, or whether it is treating each other with respect in our daily interactions. We should always display leadership. Others, especially students, residents, junior faculty, and staff, watch us for clues on how to behave. And they surely form opinions about us based on our behavior.
      I would like to end this address with a quote from Mr. Robert Woodruff, the Atlanta business leader and philanthropist for whom the Health Sciences Center is named. He said, “Again and again, we see both individuals and organizations perform only to a small degree of their potential success or fail entirely, simply because of their neglect of the human element in business and life. They take people and their reactions for granted. Yet it is these people and their responses that make or break them.”
      We clearly have our challenges cut out for us next year. But if we display leadership in all that we do, we cannot fail. We will succeed.
      Thanks a million for another great year!


Thomas J. Lawley, MD
Dean, School of Medicine