New – and familiar – challenges in academic medicine

By Brooks Jackson / Guest Column

It’s been just a little over two months since I joined University of Iowa Health Care. It’s been an accelerated learning curve getting to know the names and faces and the myriad responsibilities of the many people who collectively represent the day-to-day research, education and patient care operations of this impressive academic medical center.

Over the course of my 40-year career in medicine, I’ve been fortunate to have held leadership and academic roles with other health systems – at the University of Minnesota, Johns Hopkins in Baltimore and Case Western Reserve in Cleveland.

But as anyone who has pursued their career with different organizations in different cities knows, each new situation or setting can seem both foreign and familiar, whether it’s the administrative structure, decision-making process or even the company culture that shapes employee and customer perception and satisfaction. Often with change comes a unique, but not unexpected, set of challenges and opportunities.

I came to UI Health Care from a relatively similar position at Minnesota and I’ve been asked by both former and new colleagues: Why Iowa?

The answer is that UI Health Care has a unique structure. It is a truly integrated academic health system with a highly ranked medical school, patient care enterprise and provider group practice that is well-aligned in terms of strategic priorities. Such a system allows for the alignment of goals and priorities, streamlined decision-making, and a balanced allocation of resources to support the tripartite mission of research, education and patient care.

Navigating change in health care is difficult enough as it is. Trying to navigate change within a paradigm of competing interests and priorities is even harder.

There are other reasons why UI Health Care is a place of great accomplishment and potential. We have premier education, research and patient care programs, with some of the world’s top experts in many areas. One of my goals is to help raise awareness – and our national rankings – in several of these key areas.

We have world-class facilities, including the Pappajohn Biomedical Discovery Building, which houses the new Iowa Neuroscience Institute, and many convenient, off-campus clinic locations such as the one in Coralville’s Iowa River Landing. We are also home to the new UI Stead Family Children’s Hospital, which splashed onto the national stage last fall when football fans and players in the adjacent Kinnick Stadium launched the heartwarming “wave” in support of pediatric patients.

And we have outstanding people. I’ve discovered that Iowans are friendly, hardworking and collaborative. Moreover, Iowans believe in their state and their state institutions. They take pride knowing that our success is their success, too.

UI Health Care has formed partnerships with other health systems and providers in Iowa as well, both for patient referrals and for collaborations in data-sharing and technology, medical education and residency training, and outreach services that provide specialty care in communities inside the Corridor and across the state.

Health care in Iowa – and across the nation – is not without challenges and uncertainty, of course. Federal cuts in reimbursements for prescription drugs and lab tests raise concerns. The impact of the new tax law and the future of federally-funded research is unclear. Iowa continues to have some of the lowest Medicare reimbursement rates in the nation. Private insurance payers have their own challenges in light of the state’s aging population and long-term care issues, conditions such as obesity and diabetes, the opioid crisis and the ever-increasing costs of health care delivery.

As part of a state institution, UI Health Care embraces its responsibility to Iowa: to educate future generations of the state’s health care providers, provide tertiary and quaternary care for complex conditions, and conduct research that leads to new understanding of human health and disease, as well as new treatments for all patients.

It’s our commitment to the state. And I’m glad to be here to help make it happen.

Dr. Brooks Jackson is University of Iowa vice president for medical affairs and dean of the UI Carver College of Medicine.