UT med school aims to innovate
But some fear effects of wave of expansion
The University of Texas at Austin’s new medical school has grand ambitions. It not only wants to train a slice of the next generation of physicians but intends to transform the delivery of health care.
Officials in Austin say the Dell Medical School, which opened this month, presents the rare opportunity to start a medical institution from scratch with its own approach to improving patient care while forging a close connection to the community that is paying the bills to operate the school.
However, the new medical school in Austin is opening at the end of a wave of medical school expansion across the country that some experts fear has oversaturated the market with graduates in need of physician residency spots and other post-medical school education required to actually practice medicine.
UT also is opening a second medical school this year, in the Rio Grande Valley, which will bring the number of medical schools in Texas to 10, with two more slated to open in 2017. In addition, University of Houston officials have expressed interest in a medical school.
The state’s commissioner of higher education, who has pushed back against plans to build more medical schools, has warned that graduates eventually may have to cross state lines to find residencies — a bad sign for Texas, considering most doctors practice
near the location of their last residency.
In Austin, the new medical school leaders say the school is in a position to distinguish itself, though they use the same buzzwords uttered by many across the country: patientcentered, value-based care; technological innovation and entrepreneurship.
UT leaders insist it’s “not just talk.”
“I know it could seem that way,” said Clay Johnston, the school’s inaugural dean. “We’re in a great position to really make a difference. We want to take full advantage of that opportunity and ask big questions like, ‘How should a medical school be designed? What should its relationship to the community be? What is it we want from health care, and what’s the role of academic medicine in getting us closer to a model of health care we can all applaud?’ ”
UT’s long-term vision looks like this: The medical school grows and its leaders can do new things without any “bureaucratic scar tissue” to slow them down, a spokesman for the school said. In the process, the medical school can help revamp health care models so they focus less on pushing patients through clinics and more on actually getting those patients the medical help they need.
The school is opening in a rapidly growing capital city that is quickly diversifying — Austin has grown by 10 to 12 percent a year and is now more than a third Hispanic — and UT medical school leaders are banking on that being the ideal place to develop a health care model that can be extrapolated to the rest of the state and the nation.
Funded by taxpayers
Funding is one of the major areas that leaders say sets apart Austin’s new medical school from its peers across the country.
At a traditional medical school and center, a significant chunk of money comes from clinical fee-for-service work. That’s not the case at UT. The school is not dependent on “filling hospitals” or making sure “MRIs are full” to make ends meet, Johnston said. UT’s school is funded by local taxpayers who agreed to raise their tax bills to send $35 million to the school each year. That means UT has a responsibility to be responsive to the community that helps pay its bills.
UT will have to raise its own revenue beyond that. For that, UT has hired Mellie Price, a longtime leader in Austin’s tech community, to be the school’s executive director of technology innovation. Price is tasked with finding business partners outside of UT who can take the academic work done there to the commercial marketplace. Price also will work to launch companies from within the medical school.
‘Different railroads’
UT-Austin has “an extraordinary commercialization opportunity,” Price said. “When you put the patient at the center of the health care experience, all of the sudden you realize that the software out there, the tools out there really don’t support that business process.”
There could be a natural tension at hand in Austin between the medical school’s intent to develop a new patient-focused health care system while also monetizing the work done there, said Kenneth Ludmerer, an expert on American medical history at the University of Washington in St. Louis.
“Personalized medical care focuses on the person and doing what’s right for the person and not putting financial goals first,” Ludmerer said. “There’s a contradiction in their message, if they’re talking about entrepreneurship and patient-centered care. ... I’m not saying they can’t do both, but those are two different railroads you’re on and they sometimes are in opposition to each other.”
Ludmerer said there are “many, many examples” of schools using “personal care” as “marketing and lip service and the real orientation is entrepreneurship.”
UT, however, is in a much stronger position to succeed with a new medical school than many of the medical schools that have popped up over the last several years, he said.
That is reflected in the faculty UT has been able to recruit.
The school’s chair of surgery and perioperative care, Kevin Bozic, held an endowed chair at the University of California San Francisco. He helped write new Medicare rules and is a national leader in valuebased care, Johnston said. It’s an emerging health care philosophy and payment method that pays providers based on results and quality of patients’ medical treatment instead of the traditional payment according to the volume of patients treated and services rendered.
UT also was able to lure Elizabeth Teisberg, a former Dartmouth College professor, who co-wrote “Redefining Health Care: Creating Value-Based Competition on Results,” a 2006 book that envisioned value-based care.
The school hired Stacy Chang, an engineer who was managing director of the health care practice at IDEO, a global design and consulting firm in California, to head a new Design Institute for Health. The institute is a collaboration between the Dell Medical School and the College of Fine Arts at the University of Texas at Austin.
“It’s a variety of folks from a variety of areas, not all MDs, and all really passionate about taking advantage of this opportunity and trying to get it right,” Johnston said.
‘Where I wanted to be’
UT officials say they can do both — build a new health care delivery system while commercializing the research done at the medical school — because the research they’re looking to monetize will be focused on developing those new health care models.
Classes started this month for the medical school’s first 50 students, some of whom said they were drawn to UT Austin over more established schools because of the opportunity the new school presented.
Francisco Barrios, who grew up in Houston and attended Sharpstown High School, said UT’s vision of creating a “vital and inclusive health system” attracted him.
“It just felt like this was where I had to be,” Barrios said. “This was where I wanted to be.”