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Chris Larsen  
Christian Larsen  
August 14, 2013

Addressing our changing landscape

In the past week, Dr. Wright Caughman, John Fox, and I have been reaching out to everyone in the Woodruff Health Sciences family to provide you information regarding the changing landscape in academic medicine and Emory's response to position us for success.

Over the past year, the effects of the sequester, the Affordable Care Act, and intense market competition have created significant financial challenges for all academic medical centers, including ours. For several years prior to the sequester, NIH funding had been steadily declining. Our investigators have felt these effects through single-digit pay lines and reduced budgets on NIH grants. Despite these challenges, our investigators have been remarkably successful—publishing important work in top journals and competing for funding. And yet we project that NIH awards to Emory Medicine faculty for FY13 may fall by more than $12 million compared with FY12. We are not alone. Data from the NIH Reporter indicates that some of our peer institutions are experiencing even greater declines.

From neonatal care to comprehensive cancer, cardiac, and neurosciences programs, trauma care, burn care, and end-of-life care, our clinical teams provide the most advanced, compassionate, patient-centered care for our community and beyond. We provide this care in a rapidly changing health care landscape that has led to challenges for Emory Healthcare, with more on the horizon. Grady Memorial Hospital has made remarkable strides in recent years, but the lack of Medicaid expansion poses a particularly acute threat for Grady and for Children's Healthcare of Atlanta.

Across the Woodruff Health Sciences Center, Emory Healthcare, and the School of Medicine, we are taking steps to reduce our cost structure and position Emory for future success. The Departments of Surgery, Urology, and Otolaryngology have entered into a shared-service agreement to decrease redundancy and improve service. Similarly, the Departments of Emergency Medicine and Family Medicine are now under the leadership of Kate Heilpern. Helen McLaughlin and Malik Smith recently led a performance-improvement effort that simplified the process for faculty appointments and promotions and greatly reduced cost. While targeted faculty recruitment continues, we are focusing a greater proportion of our resources on support of our existing faculty and programs.

Currently, we have several initiatives looking at opportunities to reduce our cost structure. An internal labor management action team is reviewing open positions and evaluating the use of shared-resource models in other areas across the system to streamline and simplify operations. We have also engaged Chartis, a consulting firm that has worked extensively at academic medical centers, to assist us in interviewing chairs, faculty, and staff; in collecting and analyzing data; and in identifying other opportunities.

Dr. Caughman asked for input from faculty and staff throughout the WHSC and has received a tremendous response. These ideas are being compiled and divided into categories for review and implementation. We continue to seek ideas for cost savings and efficiencies. We have two ways in which you can contribute:

1. Email: evphafeedback@emory.edu
2. A website has been set up to capture and implement ideas from throughout WHSC. Please log on to: http://whsc.emory.edu/home/improvementideas/ to share your thoughts and ideas.

Our primary purpose is improving the health of those we serve through patient care, educating future health care providers and leaders, and making and translating discoveries to advance health. I am confident that by working together our clinicians, researchers, educators, staff, trainees, and students will define the solutions and models that will allow us to lead the way for Emory and for American academic medicine.
Christian P. Larsen, MD, DPhil
Dean, Emory School of Medicine

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