The major teaching hospitals of the Alpert Medical School (AMS) and other hospitals in Rhode Island are undergoing important changes. Lifespan and Care New England are aggressively competing in the broad market place. Independent Rhode Island hospitals have gone into or have come close to receivership (Landmark in Woonsocket, Westerly Hospital, and Memorial Hospital of Rhode Island in Pawtucket). Charter Care, consisting of Roger Williams and Fatima, has applied to be acquired by a for-profit company from California. Furthermore, hospitals from other states have formed new affiliations in Rhode Island including Brigham and Women’s Hospital, which has affiliations with Memorial and Kent Hospitals.

Doctors in Rhode Island are joining large groups or are being employed by hospitals. Faculty at the Alpert Medical School are fast aligning into larger groups or are being employed by hospitals (e.g. 30 cardiologists who are AMS faculty and have been independently employed are now employees of the Miriam Hospital). One of the most important developments for the Medical School is the effort at Lifespan to create a unified organization to employ our faculty, support the academic mission, and succeed clinically. It is a critical step towards strengthening our Academic Medical Center. This organization will eventually employ the entire Brown faculty at Lifespan as well as community physicians. I regard this effort as one of the most important efforts for Brown in many years. The process will be long, but the outcome will be positive. I am directly involved and President Paxson and Provost Schlissel are strongly supportive.

In other news, I encourage you to read the fourth Biomed Annual Report which is now available online. The stories focus on our faculty and students who are dedicated to transformative and socially responsible research, education and service in the life sciences. We continue to make great strides in 2013 and I am proud to work with such an outstanding group of individuals.

Our faculty are exceptional teachers and mentors and we honor several each year for their outstanding work. This year’s awardees for the Dean’s Awards in Biology and Public Health are:

•Excellence in Undergraduate Teaching, Advising and Mentoring in the Biological Sciences- David Rand, PhD, Professor of Biology, Department of Ecology and Evolutionary Biology

•Excellence in Graduate and Postdoctoral Teaching and Mentoring in the Biological Sciences- Diane Lipscombe, PhD, Professor of Neuroscience, Department of Neuroscience

•Excellence in Classroom Teaching in Public Health – Kate Carey, PhD, Professor of Behavioral and Social Sciences, Department of Behavioral and Social Sciences and Center for Alcohol and Addiction Studies

•Excellence in Mentoring in Public Health- Suzanne Colby, PhD, Associate Professor of Psychiatry & Human Behavior (Research) and Associate Director of the Center for Alcohol and Addiction Studies

The clinical teaching awards will be announced and celebrated in June at a reception at the Hope Club. I will report on that event in what will probably be my last newsletter to the community as Dean.

Alpert Medical School signed a memorandum of understanding on March 27 with Johnson and Wales University to explore collaborating on the education of our medical students and their physician assistants in a new Physician Assistants program. Physician assistants will be increasingly important in the future world of primary care and team medicine. Starting cooperative educational programs early will be beneficial to both programs. Fortunately, their new physician assistants education building will be just a few blocks from the Medical School building. We will share facilities and have joint educational sessions.

Fitness Center at Alpert Medical School

Finally, the Medical School building has a new fitness center on the fourth floor designed for the students. The center has the newest equipment, a general purpose room, and a terrific view. Students will find the new fitness center a place to take a welcome break from studying and lectures.

credit: Scott Kingsley

The Corporation meeting of Brown University was abbreviated due to a severe winter storm. We were able to have our Medical School Committee meeting Thursday evening, before the blizzard hit. There was a lively discussion on a number of issues including Public Health, our new Primary Care-Population Health Program, and hospital relations.

The Corporation met by phone on February 13 to take action on a range of items, and, historically, approved the proposal to create The Brown University School of Public Health beginning July 1, 2013. This culminates a more than 10-year process of planning, growing, and developing the Program in Public Health in BioMed. There are many people who have worked hard to make this happen, but the most credit should go to inaugural Dean for Public Health Fox Wetle. Additional credit also goes to Vince Mor, professor of Health Services Policy & Practice who aided Dean Wetle throughout the duration. The school’s faculty have created robust research programs and exciting educational initiatives that place it among the most dynamic and productive public health schools in the country. Congratulations to everyone involved and most of all to the faculty and staff of Public Health.

As I have noted before, Associate Dean for Medical Education, Dr. Phil Gruppuso, has initiated a planning process to develop a new program at the Alpert Medical School to train students in Primary Care and Population Health. Assistant Dean, Jeff Borkan, MD, PhD, is charged with the development of the planning process. Twenty-four students per class will be admitted beginning in the summer of 2015. Students will be educated in both primary care and population health resulting in an MD degree and a master’s degree. The program is designed to train a cohort of leaders who will work in primary care; lead primary care practice groups; serve as primary care educators in medical schools; become advocates for primary care; and more. They will also lead the new era of health care reform in both Rhode Island and the country. (Read more in this op-ed recently published in Brown Medicine and The Providence Journal written by Jeffrey Borkan, MD, PhD; Philip Gruppuso, MD; Paul George, MD and me.)

President Paxson asked me to form an advisory committee for the program consisting of representatives from state government, our sister colleges and universities in Rhode Island, practicing physicians, practice organizations, the major health insurer, and our teaching hospitals. Our first meeting on January 8th was an amazing success. The group of approximately 28 leaders gave their opinions and advice regarding our Program. They enthusiastically endorsed, and considered it the context of the future of health care in Rhode Island. The gathering was like a very lively New England town meeting with the key stake holders discussing solutions to the challenges of health care in the future. Leaders, exchanged ideas and proposals. Of note, Stephanie Chafee, a registered nurse and First Lady of Rhode Island, gave us the benefit of her extensive experience in the health care arena. Subcommittee meetings have occurred or have been scheduled and a second meeting of the entire group occurred February 12th. President Paxson and Provost Schlissel attended and provided valuable input and support. Overall the process has produced much needed advice and backing for the incipient program. Perhaps as important, the process has brought Rhode Island leaders in many areas of health care together in a series of forums that permit the exchange of ideas and that provide an important vehicle for planning the future of health care in our state.

And finally the search for my replacement, led by Provost Schlissel, is proceeding well. I am not involved for obvious reasons, but understand that the prospects for attracting an outstanding dean of medicine and biological sciences are excellent.

The work has been very satisfying but, of course, at times stressful. Since the first day in 1990 that I began administrative work as Physician-in-Chief of Montefiore Hospital at the University of Pittsburgh, my jobs have been all-encompassing. Balancing the needs of individuals and units with the needs of the overall organizations and keeping your integrity has not always been easy. Thus I will be returning to my roots on the Infectious Diseases faculty at the ripe old age of 68. I look forward to work that I have not been able to focus on− writing, teaching, clinical care, and our international programs−on July 1, 2013. Provost Mark Schlissel will chair a national search for a new dean. Both Provost Schlissel and President Paxson have made clear that the momentum and upward trajectory of the Division of Biology and Medicine is an important priority for Brown University.

Another important update from the Division since the last newsletter is that we are in the early stages of developing a new Primary Care – Population Health (PCPH) program. This program will be aimed at creating the next generation of practitioners and leaders in primary care and population health. This plan was originally proposed by Associate Dean for Medical Education Philip Gruppuso and the planning process is being led by newly appointed Assistant Dean and Chair of Family Medicine Jeff Borkan. As envisioned, the program will have 24 students per class. This is in addition to the 120 students per class that are now in the Alpert Medical School. There will be a separate admission process and a separate curriculum designed to focus on both primary care/population health, as well as traditionally required medical science content. Students will graduate with a medical degree but with additional expertise in topics such as health care reform and policy, prevention and end-of-life care, management of provider systems, and health care economics. There will be the opportunity and perhaps the requirement for a master’s degree. The educational methods will emphasize active learning, case-based material, and small group sessions. The clinical experience will be a longitudinal third-year experience instead of the traditional specialty clerkships. In the longitudinal experience, students will follow a panel of patients. They will see children being born, people diagnosed with a variety of disorders and treated with medication, surgery, and other procedures. By following individuals and families, students come away with the same content as traditional clerkships but a much better understanding of health and disease prevention. We hope to admit our first students in 2015. I will report more on the program’s development in subsequent newsletters.

The LCME site survey team visit took place from October 9-11, 2012. Phil Gruppuso led over 120 faculty members, administrators and hospitals executives in a self-study process over the past year. The survey team reported initial findings in a verbal report to President Paxson, Provost Schlissel, and me. We are cautiously optimistic and a full report of the findings will be sent from the LCME in February 2013.

The Brown approval process for the School of Public Health is nearing the end. The final vote before approval by the Corporation was taken this month by the faculty. It passed without a dissenting vote. Associate Dean for Public Health Fox Wetle actually gave me a hug, my first, right after the vote.

Students at Orientation being sized for their white coats

On August 8th, one year after the opening of the new Medical School building, 120 students of the class of 2016 began their medical school orientation. This class is the largest in our school’s history and includes 64 women and 56 men. The students bring a wide diversity of past experiences to Alpert Medical School. The class includes musicians, scholars in the humanities and sciences, a graduate of Annapolis who served two tours of duty in Afghanistan and one in Iraq with the Marines, and an author and host of cooking shows on television. As usual, we held a reception for them in our backyard, where they did a number on the sushi. Our dog Snicky is a particularly enthusiastic host for all such events.

This week we will have the first-year graduate students entering PhD and master’s programs in the biological sciences and public health over for a similar reception. The Division welcomes 56 new students into 11 PhD programs and 83 new students into nine master’s programs. They join 261 graduate students already in their training.

Graduate students are the life blood of the sciences. After initial classroom study, the students select laboratories to do their doctoral projects leading to a thesis. The students learn by doing–they design their projects with their mentor’s guidance, work for years on their experiments, and then prepare and publish their findings, culminating in their final thesis. During their years in the lab they learn the rigor, frustration, and exultation of science. As significantly, they contribute to knowledge and form a vital part of the research teams in our laboratories. When I tour the labs in BioMed, I inevitably see graduate students, post docs, as well as undergraduates, all working in teams. The scholarship from our laboratories, in large part driven by our graduate students, is the basis for the outstanding scientific reputation of Brown University. The trainers in our graduate programs come from departments in the Division, including our hospital faculty, as well as departments outside of BioMed including, for example, Chemistry and Engineering. The students also form an important part of our educational programs, serving as teaching assistants in the major undergraduate courses taught by our faculty. I can’t emphasize enough the importance of our graduate students to BioMed and the University.

Important changes are occurring in the Rhode Island health care marketplace. Care New England (CNE), parent company to Women & Infants, Butler, and Kent Hospitals, has agreed to explore an affiliation with Memorial Hospital of Rhode Island. Memorial Hospital has had significant financial problems in the past few years and viewed an affiliation with a strong hospital partner as essential to its survival. Fortunately for Brown, the association will most likely be CNE. As many of you know, Memorial is the home for our Family Medicine department as well as an important training site for the departments of Medicine, Psychiatry, and others.

Steward Health Care, a for-profit health care system with 11 affiliated hospitals in Massachusetts, is considering taking over Landmark Medical Center in Woonsocket. Landmark has been in receivership for the past two years and risks closure if an agreement with Steward is not reached. Westerly Hospital declared bankruptcy in the spring and has recently agreed to be purchased by Lawrence & Memorial Hospital (L&M). Other independent hospital systems in the state including CharterCare Health Partners (Roger Williams Hospital and St. Joseph’s Hospital) are stressed financially and may also be looking for a partner.

In summary, independent hospitals are under severe financial pressure in Rhode Island. The Brown teaching hospitals for the most part are in relatively good shape financially, but the winds of health care change will cause a radical reorientation of our delivery system in the next few years. Our teaching hospitals and clinical faculty will need to be prepared for changes such as bundled payments, tiered delivery, an emphasis on primary care networks and prevention. Alpert Medical School should be at the forefront of these changes as well, helping our clinical faculty and institutions work toward a new landscape.

My final note is about Brown’s 249th Convocation, which occurred on Wednesday during a major Rhode Island deluge. President Paxson gave an inspiring talk titled “Constructive Irreverence.” She encouraged Brown students to think anew, take up the challenge of exploring the fascinating intellectual life at the University, and make a difference in the world. I urge you all to view her speech.

During the week I went to two talks, one given by Art Horwich, a graduate of the first medical school class in 1975, and the second by Nick Carter, a student who will graduate next year. Art Horwich spoke at the annual Ruth B. Sauber Distinguished Medical Alumni Lecture. Art graduated first in his class and described his time at Brown as very exciting and in fact transformative. He described reading in the musty, decrepit original medical school library on the first floor of Arnold Laboratory and being thrilled by the classic articles on genetics. Next door was Ruth Sauber’s office leading to Dean Stan Aronson’s office. Both individuals were always available and important in their own ways for the students. Art went on to a career in pediatrics and research in genetics and cell biology. He has made one of the truly fundamental discoveries on the mechanism of protein folding within a cell. His work has potential importance to such diseases as Alzhiemer’s disease. His many awards include the Lasker Award in 2011, one of the most prestigious in biomedical science and for some a prelude to a Nobel Prize.

The second talk was given by Nick Carter, a fourth-year medical student. Nick took a year off to work with Patrick Moynihan ’87 in Port-au-Prince, Haiti, at St. Luc’s Hospital. Patrick is president of the Louverture Cleary School, a secondary school for poor Haitian students who would otherwise not be able to get an education. More than 90% of the students go on to University, and many become doctors. Nick Carter, a graduate of Williams College (my alma mater), was mentored by Patrick. Nick plans to go into surgery and practice in Haiti. During the past year he worked in the wound clinic and the intensive care unit in St Luc’s Hospital. Unlike many who have worked for a short time in Haiti, Nick talked about the most important health problems facing that country. They are not what you expect, i.e. cholera, HIV, tuberculosis. The real and long term problems for the country include nutrition for children. Much of the food consumed in Haiti is imported (ironic for a potentially rich agricultural country). It consists of processed food, hot dogs, and food rich in fats and carbohydrates. Obesity and hypertension are significant problems with the resultant diabetes and cardio/cerebral vascular disease being major growing scourges. Care that we take for granted, such as the availability of insulin, is lacking. On the other hand, many children from the countryside don’t have enough to eat and are malnourished which comprises the end of the spectrum. When I was in Haiti I went to a ward in St. Damien’s Pediatric Hospital where I heard the constant cry of children with kwashiorkor, a form of malnutrition resulting from a lack of protein in the diet. Women’s and maternal health are significant issues. Pre- and peri-natal care is lacking. There are not enough doctors to perform life-saving Caesarean sections. Injuries resulting from automobile, industrial, and cooking accidents are common. Again there are insufficient resources to care for people adequately. Nick is the first person I have heard coming back from Haiti to correctly identify the most significant problems that need to be addressed. I predict that Nick will be one of the leaders in health care in Haiti in the future. Art and Nick are two Brown medical alumni, the earliest and the latest, making their marks in two entirely different areas but both showing the creativity and the special spark that characterizes our students.

We are planning for a School of Public Health and a formal proposal will be brought forth in the fall. The process entails approval by the Biomedical Faculty Council, the Academic Priorities Committee, the Faculty Executive Committee, the full Faculty and the Corporation. At points in the approval process, the Provost and the President will review and approve the proposal. Provost Schlissel and I have had lengthy discussions concerning the structure of BioMed and the administrative and financial plan going forward. We are working hard with the Provost and President-elect Paxson to mitigate any negative effects on Alpert Medical School of separating a School of Public Health from BioMed.

This week Phil Gruppuso, Associate Dean for Education, held the Sixth Annual Dean’s Excellence in Teaching Awards reception at the Hope Club. More than 115 people attended the event to honor our faculty who teach and mentor our students and residents. Two medical students, Sheela Krishnan, MD ’14 and Tom Anderson, MD ’13 gave moving testimonials to the truly outstanding teachers at the Alpert Medical School. As Sheela said “They are our almost like rock stars for us.” Both students noted that the faculty are their role models as well as their teachers. The future patients of our students will benefit from how our superb faculty teach and mentor our students. The acknowledgment by the school and the students of our faculty, plus pretty good food and drink, gave the whole affair a wonderful feeling.

Why were there pigs’ feet on the third floor of the Alpert Medical School building? For the answer, read on! Last week more than 300 health care professional students in the building participated in an inter-professional team training workshop that is one component of AMS’s inaugural Clinical Skills Clerkship, a three-week non-specialty specific clerkship designed to prepare AMS students for their specialty clerkships that begin early next month. One hundred Alpert students from the MD Class of 2014 worked alongside 200 nursing students and pharmacy students from the University of Rhode Island. They were practicing team medicine, in which doctors, nurses, pharmacists and other health professionals provide integrated, expert care for patients…together.

Course leaders Julie Taylor, Paul George, and Dana Zink are building on previous sessions to expand and further develop team training curriculum at the medical school. It was great to see nurses in blue scrubs as well as medical and pharmacy students in their white coats interacting with our standardized patients in the Clinical Skills Suite. Outside the rooms I saw pigs’ feet! The medical students were practicing suturing pig feet lacerations in a session on trauma. Incidentally, we had ordered 400 pigs’ feet from a local butcher to provide tissue for the sessions.

This wonderful development in the nascent collaborations among health care professional training programs in Rhode Island was possible for two reasons. First, the new building provided the necessary space and facilities. Second, collaboration is increasing among all of the professional schools in Rhode Island. I predict that there will be much more integrated education between health schools in the future.

We value teaching at all levels in the Division. When I took over as Dean four years ago, I knew that we had a variety of teaching awards for faculty in the clinical departments and that they were an important way of recognizing teaching commitment and excellence. As a consequence we established four Dean’s Teaching Awards in the departments on the campus, two for faculty in the Program in Biology and two for the Public Health Program. The awards are made in recognition of the faculty in the Division who demonstrate a commitment to teaching that goes above and beyond the call of duty. The selection process includes a review of nominations by several rigorous committees. The winners are recognized at Brown University’s Annual Faculty Award Event in May. Each awardee receives an engraved piece of crystal and a check. This year’s winners are listed below:

Donald Jackson, PhD – Dean’s Award for Excellence in Undergraduate Teaching, Advising and Mentoring in the Biological Sciences

Susan Gerbi, PhD – Dean’s Award for Excellence in Graduate and Postdoctoral Teaching and Mentoring in the Biological Sciences

Don Operario, PhD – Dean’s Award for Excellence in Classroom Teaching in Public Health

Amal Trivedi, MD – Dean’s Award for Excellence in Mentoring in Public Health

Next month I will highlight our teaching awards for the Medical School.

A proposal has come before the Rhode Island Legislature to create a new for-profit osteopathic medical school in the state. One of the stated reasons is to provide primary care doctors for Rhode Island. I have sent a letter to key legislators stating my concerns about such a school. I will also meet with Governor Chafee and the President of the Rhode Island Senate, Senator Paiva-Weed, to outline some of the issues. I will point out that Alpert Medical School is rated highly for primary care and that many of our students (including several native Rhode Islanders) go into primary care. One of the principal problems with primary care in this country and in Rhode Island is that the reimbursement rate is quite low compared to other specialties. Additionally, reimbursement in Rhode Island compares unfavorably to Connecticut and Massachusetts. Our residents in training can move just 15 to 20 miles away to either of those states and make 15 percent more in revenues. That is where some set up their practices. Having said that, I want to work with the leaders in the state to help solve the issue of primary care physicians. I’ll describe some of the new initiatives that Alpert Medical School is undertaking in subsequent communications.

Two weeks ago I went to China with Julianne Ip, associate dean of medicine for the Program in Liberal Medical Education and International Programs, to visit medical schools affiliated with Brown: Zhejiang University in Hangzhou and the Chinese University of Hong Kong (CUHK). Both offered fascinating insights into the changes in China and the rapidly evolving clinical, educational, and research aspects of these schools. The size and volumes of the hospitals are astounding. At the First Affiliated Hospital of Zhejiang University, there are almost 3000 inpatient beds and over 2 million outpatient visits per year. The research in some areas, such as infectious diseases, is growing rapidly with new resources and equipment. The leaders of the medical school are very interested in new and innovative approaches to medical education. We have a popular medical student exchange program with Zhejiang. The CUHK is more western, but also very interested in collaborative relationships. There are already research collaborations between their school and our program of public health.

On a final note, I recently visited the annual poster session for research by undergraduate seniors concentrating in the Biology program (Public Health had their session one week before). I spoke to one student, Zoe Weiss, a PLME student from Lincoln, RI, who studied the anthropology of Inuit Native Americans in Northwest Alaska in the 1700s. Her analysis included work with tools and bones from animals that served as a source of food. Among other things, she said that it prepared her for anatomy in medical school, which she starts in August. This is an area of particular interest to me and I was fascinated. There were many other excellent posters across a wide range of biology disciplines. I was impressed by the enthusiasm and achievements and once again reminded of the excellence of Brown students.

Match Day, on March 16, was terrific (see full list). Our students matched to outstanding residencies—it seemed to me the best overall that I have seen. We held the event in the new medical school building for the first time…balloon drop and all. Many families were able to attend with their students. Several babies were there to cheer on their parents. Phil Gruppuso, associate dean for medical education, played with his band as usual. At noon sharp, students ripped open their envelopes, let out a yell, and immediately did one of several of the following: 1) hugged friends, 2) hugged family members, 3) phoned their friends, 4) texted their friends, and 5) had a drink of Champagne. Of interest, 44.1% of our students matched to primary care programs (family medicine, internal medicine, pediatrics, or med/peds), an increasing trend over the past few years. A smaller number of students graduated this year (79) compared to previous years, primarily because many students have taken time off to do research, work overseas, or get master’s degrees. Next year we anticipate close to 120 graduates. Incidentally, I have learned from experience that absolutely no one has any interest in hearing what the dean has to say on Match Day, so I wisely said nothing. As you can imagine, a great time was had by all.

Brown President-elect Christina Paxson came to campus last week. She officially begins her duties July 1. As you may know, she is currently professor of economics and dean of the Woodrow Wilson School at Princeton University. Her scholarship in part has dealt with health care and the effect of poverty on health, including that of children. She has also been funded by the NIH. I attended a dinner honoring her given by the Provost and I also had a one-on-one meeting with her. My impressions, like everyone else’s, I have talked to, have been very positive. Christina is quite interested in both the Medical School and the future school of public health. By extension, she asked many questions about the health care system in Rhode Island, our hospitals and our physicians. Furthermore, she expressed an interest in meeting faculty and health care leaders in our community. I for one am very excited to have her as our new president and look forward to her active involvement in BioMed.

Medical schools rankings were published recently in US News and World Report. Our ranking in primary care rose from 28 to 24, but in research dropped from 29 to 35. We have seen this type of variability from year to year previously. Research funding dropped for practically all schools because of the decrease in ARRA funding. We believe, however, that the drop in our research ranking resulted from a fall in NIH funding compared to our close competitors. There is a cluster of schools close to our ranking, and the change in even one of the eight factors used to determine ranking can rearrange the order of this cluster. You should keep in mind that our drop in NIH funding was actually lower than the average drop for all schools. Nevertheless, our NIH funding remains strong and our funding per investigator is among the highest of all medical schools. In all I am pleased with the rankings, and Alpert Medical School remains among the very best institutions in the country.

We have been working on some strategic new academic initiatives in the Division of Biology and Medicine over the past six months. We have made major commitments to the area of Structural Biology by purchasing new equipment to analyze the structure of molecules and hiring new faculty. As you may know, scientists working in this area of biology discovered the structure of DNA that has proven so vital to all of biology and the health sciences. More recently, similar techniques were used to determine the structure of the HIV virus that in turn resulted in the development of effective drugs to battle this infection. We have also committed to new space and recruits in our Department of Molecular Microbiology and Immunology. Thanks to this and to the leadership of Laurent Brossay, MMI will become an even stronger department.

Support of Brain Science is another major commitment by Brown University. The University is investing in new faculty, infrastructure, and eventually new space for this exciting area. Three recruits are being hired this year alone. The overall Brain Science Initiative is multi-institutional and includes our hospital partners, who are also committing major resources by hiring new chairs of Neurosurgery, Neurology, and Psychiatry.

Public Health has some very exciting news. Last week, three faculty members from Tufts University were recruited to form a new Center for Evidence Based Medicine in Public Health at Brown. This highly successful, internationally known group, including Dr. Joseph Lau (see recent profile in The Lancet), Thomas Trikalinos and Christopher Schmid, uses meta-analysis to evaluate large numbers of studies in determining the effectiveness of medical treatments. Comparative effectiveness research is at the forefront of our country’s efforts to determine what works and what doesn’t work in medicine. The implications for quality medical care and reducing costs are enormous. Our hospital partners and clinical faculty will be working closely with this group to bring the best medical care to Rhode Island.

On campus, the Division is recruiting a total of 14 tenure-track faculty this year. This surge of initiatives and hiring has occurred in part because of the vision and support of our new provost, Mark Schlissel. Mark, I and others have worked hard to clarify our priorities and craft a plan for expansion in the Division. Using resources from the Provost’s office as well as Biomed will allow us to continue to grow strategically in our areas of strengths.

AAAS fellows in BioMed

I want to note some important honors and appointments from Division faculty. First, three faculty on the campus were elected to fellowship in the American Association for the Advancement of Science, one of the highest honors given to scientists in the country. They are Barry Connors and Diane Lipscombe in the Department of Neuroscience and David Rand in the Department of Ecology and Evolutionary Biology. In addition, Dr. Sharon Rounds received the Dean’s Award for the Advancement of Women. Sharon has been a strong advocate for and mentor to women throughout the Brown community. Finally Fox Wetle has been appointed to serve on the Health Care Planning and Accountability Advisory Council, for the State of Rhode Island. The Council is empowered by the RI legislature to make recommendations to the Governor, General Assembly, and other state agencies related to a comprehensive health care delivery and financing system for Rhode Island. This Committee will be very important as we move toward better integration throughout our systems.

I recently wrote an Op-ed for the Providence Journal in which I described my concerns for the future of health care and the medical school because of the historic lack of integration across our faculty and hospitals. This problem was emphasized by Dr. Darrell Kirch, president and CEO of the Association of American Medical Colleges, in his visit here in October. In fact he said he was shocked at our antiquated fractionated structure. He pointed out to all of us the risk we face unless we integrate our medical school, hospitals and faculty, as almost all other academic medical centers in the United States have done.

Better integration makes educating our medical students, residents and fellows more effective and efficient. By better integration I mean a more cohesive and unified academic medical center. It also makes research more cost effective and streamlined to carry out. Perhaps most important, better integration allows us to provide the most inclusive, coordinated, low cost – high quality care for the citizens of Rhode Island. However unlike integrated systems like the Mayo Clinic or Kaiser-Permanente in California, we do not have a single organization that employs our physicians, manages the hospitals and relates closely to the Medical School. In Boston there are several models of integration where costs are lowered across the system and quality is addressed more directly. Massachusetts as you know ensures that every citizen has access to a primary care physician. Although they are not perfect, their health care system and their academic medical centers are far ahead of us in Rhode Island.

Alpert Medical School, its faculty and teaching partners have heard the call and are beginning to take steps toward better integration. First, several clinical departments are working hard to create a unified faculty practice plan called University Physician’s Group, Inc. As they work more closely with the Medical School and our teaching partners they will strengthen education, research and provide more coordinated care for patients. The Brown-Lifespan affiliation agreement is one year young. We have worked diligently together on many issues including the recruitment of faculty and strategic planning in research and education. Furthermore we are in the final stages of our affiliation negotiation with Care New England. Care New England is a very important partner to the Medical School providing specialized cutting-edge research and training at Women & Infants and Butler Hospitals. The Providence VA Medical Center continues to serve a vital role in our education and research. Finally we have begun meeting with Memorial Hospital of Rhode Island to strengthen our existing agreement.

We have the opportunity to work closer together, to provide even better care than we do now to ensure we educate the next generation of physicians in the best possible way and improve our health care through research. Alpert Medical School is committed to this goal and I will be working closely with our teaching hospitals and faculty on these important issues.

Members of University Orthopaedics in the Michael G. Ehrlich, MD case study room

On Saturday evening, October 15, we held a special event to express Brown’s thanks to all of the donors who made it possible to construct the new building. Donors were thanked officially, given tours of the building by medical students and had their photographs taken with Ruth Simmons and me. As usual, the students outshined everything. Shreyus Kulkarni MD’14 gave a terrific talk about the importance of the building to the students and their education. He finished by making a very effective plea for a donor to fund the future fitness center, showing how important the building is for the students. Jonathan Fain and I had planned to have our photograph taken in a seminar room on the third floor. When we opened the door, we saw a picture of a microscopic view of a nephron, the working part of our kidneys, on the flat screen. Five second-year students were seated around the table studying for an exam coming up on Monday. We shut the door quietly and had the photo taken outside of the room. Needless to say, students are working hard almost around the clock in the building.

The following Friday, Brown University officially dedicated the building during the Corporation meeting. The speakers were in academic regalia. Chancellor Tom Tisch accepted the building for Brown and thanked all those who made it possible. Ruth Simmons noted that for the first time, the mace of Brown University had crossed the Providence River.

Kenneth Breuer carries the mace as it crosses the Providence River

Herb Kaplan, President of The Warren Alpert Foundation, was given an honorary degree in recognition of his role in making this building possible. Our student speaker, Marina MacNamara MD’12, had a touch of laryngitis but gave testimony to the School, the building, and its importance to her and other students.

(left to right) Marina MacNamara MD'12, Provost Schlissel, Chancellor Tisch

Dr. Darrell Kirsch, president of the Association of American Medical Colleges, gave the keynote talk. He praised Brown’s vision in investing in the future doctors of America, and in particular placing the building in the Knowledge District of Providence, the future economic engine of the city and the state. The food at this event, supplied by Brown Catering, was outstanding. I can attest to the mango desserts but not the sushi. We also realized how well the space in the atrium on all three floors works for social events. People could easily move up and down the stairs to all parts of the building and enjoy this exceptionally designed building. At the end of the evening, the students scooped up the extra food and stored it in refrigerators in the academies for future snacks.

A meeting of the President’s Leadership Council was held on Friday October 28th. The Council is a distinguished body of select alumni, parents, and friends of the University. They are informed of issues and challenges facing Brown and have an opportunity to discuss with the president and senior officers the future direction and activities of the University. During the afternoon, a panel of six medical students from all four years (Amanda Westlake MD’12, Thomas Anderson MD’13, Jenna Lester MD’14, Grayson Armstrong MD’14, Greg Elia MD’15, and Erica Alexander MD’15) told the group of their background, their plans for their future careers, and why they came to Brown. These students enthusiastically described the uniqueness of the School. They spoke of the culture of support by their fellow students and the faculty, the sense of empowerment that the students have, and the mission of the School that includes a strong sense of social responsibility. They expressed better than anyone else can how excited they are about their education, their optimism for the future, and the importance of the building. It made me realize again that all the work we do as faculty, alumni, supporters, and administrators is for the students, a truly remarkable group who will be the future physician leaders of our country.

In a separate development, George Vecchione, president and CEO of Lifespan, has announced that he will step down in December 2012 after 15 years in his position. George has been a highly successful leader. He took over a system that was losing tens of millions of dollars each year and had not invested in its infrastructure appropriately for years. During his early years he had to deal with deficits on operations approaching $50 million/year, power outages in Rhode Island Hospital, labor strife, and tension with physicians. Under his direction, Lifespan invested heavily in its infrastructure, and increased its revenues significantly through such programs as the outpatient laboratory testing system and contract negotiations with health insurers. He centralized back office functions of the system and invested heavily in IT. Perhaps most importantly for Brown, he supported the educational programs including supervising the training of over 500 Brown residents and fellows each year. These trainees are critical to the education of our medical students during the clinical years. Lifespan also invested heavily in its research programs, growing the research profile over time to $80 million each year. Moreover, the system helped Brown recruit hundreds of faculty in all areas. Finally, he negotiated an amendment to the affiliation agreement with Brown that supported the Medical School financially, defined a trademark agreement, and helped develop a strategic planning process with the School. He leaves a strong hospital system to his successors.