Leader hopes to continue sharing
As new chief clinical officer of UMMC, Marcozzi says he’ll champion systemness
Dr. David Marcozzi, who has lived in Davidsonville since 2016, is assuming the role of Chief Clinical Officer of the University of Maryland Medical Center in Baltimore. He is also the COVID-19 incident commander for the University of Maryland Medical System and a medical adviser to Gov. Larry Hogan.
We talked with him about his role over the last year and his reflections on health care and the pandemic. When the pandemic started, Marcozzi was a practicing emergency medicine physician inside the University of Maryland Medical Center and an associate professor within the School of Medicine. He also was assistant chief medical officer, meaning he balanced both seeing patients and handling administrative business.
This conversation was edited for length and clarity.
When the pandemic started, was it an immediate shift into your role as incident commander, or was it a gradual realization that we really need someone in charge of all of this?
I don’t know if you know, I used to be in federal government for a decade or longer, and I used to work on emergency preparedness, health care delivery, and the intersection of both things like a pandemic, things like mass shootings, things like hurricanes, and how are we ready to help our nation’s health care delivery system to respond to events like that. And, you know, as I transitioned into my medical center roles, you never leave your roots, right?
When the pandemic occurred, I kept eyes on concerns that I was hearing, and I continued to do that for any essential threat. But I knew I had genuine concerns early on that this would be something that was not just a China-focused emergency; this would likely be a world situation, and we would all be grappling with it here in the United States.
And as the incident commander, you’re now overseeing 13 hospitals. Was that daunting?
You’re using the right word. Did it give
me mild chest pain? Sure it did.
Did you have any regrets? Looking back over the last year, was there anything you decided was a mistake you would have done differently?
Yeah, there are many.
In every disaster, you always have a list of lessons learned. And I always challenge them as lessons learned because are they truly learned or are they just documented but never learned? It has always been my charge to make sure the errors that we made through this response, we won’t make again.
But there were specific issues that I can identify.
I didn’t focus on the resilience of our team members early enough. I don’t think I directly supported them enough.
Because our nurses and doctors weren’t just nurses and doctors, right, they were clergymen; they were family members. They were brothers and sisters to those patients because we stopped visitation. The stress, the unbelievable stress, not only from the response but to take on those additional roles — I should have done a better job. I should have provided more support to those individuals because they really demonstrated just unbelievable resilience.
Fundamentally, the issue is, you know, we still lost a lot of lives. I think through how in my leadership role, how I could have
— you know, one preventable death is too many. Could I have been better at that job to prevent even some of those individuals from dying from COVID-19?
That’s the problem. I should have been better. The question is, what are the steps I should have taken to mitigate some of those deaths?
In your new role, as you’re thinking about these things, what are you hoping to bring to the clinical staff and the quality of care that you’ve taken from this last harrowing year?
I hope to be able to continue to champion systemness.
Are you saying S-Y-S-T-E-M-N-E-S-S? Can you define systemness for me? I don’t think I’ve ever heard that term.
Classically, hospitals operate in their entities, right? Even if you’re part of a University of Maryland Medical System or another hospital system, they still operate primarily as an entity amongst themselves.
And I think what happened was we created a structure with authority, responsibility and accountability to the system and structure.
We would have never done this before, from one hospital that was short that one mask, another hospital in our system, had we created this systemwide approach, they probably wouldn’t even know that they were short, nor would they have shared. So we move people, people being patients. We moved personnel; we moved equipment across our entire system to assure that we never had shortfalls, or we mitigated shortfalls as much as we could.
That is the concept of systemness. Previously we’ve written quite a bit about how University of Maryland Baltimore Washington Medical Center, part of the university system, and Anne Arundel Medical Center are competitors. But this year, they coordinated, cooperated quite a bit on vaccination, I think, like kind of sharing data and best practices. Is that something you know, under your leadership, you would like to continue?
Oh, absolutely. There’s a fine balance. And we’re in a competitive market, no question about it, but I truly feel that despite the competitiveness, the collaboration we realized as a result of the stress of the pandemic is something that I feel is a success story.