August 14, 2014

Rounds: A message from the Vice Chancellor for Health Affairs

The rapid change in the economics of health care delivery has challenged us all — financially, operationally and culturally. But through it all, our organization of 20,000 people is not just reacting. We are also learning.

The rapid change in the economics of health care delivery has challenged us all — financially, operationally and culturally. But through it all, our organization of 20,000 people is not just reacting. We are also learning. And as we do, we become ever more adept at innovating and adapting, positioning us strongly for whatever challenge the future holds.

Jeff Balser, M.D., Ph.D.
Jeff Balser, M.D., Ph.D.

Yes, we are still recovering in some areas, and we will spend the coming year focusing on those areas.

We will do so in a way that exceeds the high standards and expectations of our people. But as the summer winds down and new students and residents return to campus, I believe it is just as important for us to reflect on what has not changed — what has not only been preserved, but has become even more visible and extraordinary.

While we struggle with tough economic times in health care, it is helpful to think about why we are here — what gets us up in the morning, and brings us to work every day. For most of us, this is not just a job. It can’t be.

We are here to do something special, something that is a both a privilege and a calling. We build hope — hope that is real for people. Hope that is built upon the extraordinary care we deliver to millions, the world-class research advancing that care and the education and specialized training only Vanderbilt provides for this entire region.

While concerns over continued reductions in federal funding for biomedical research are ever present, our research facilities are brimming with activity.

VUMC funding from the National Institutes of Health, already ninth in the nation in fiscal year 2013, increased by an astonishing 5 percent in fiscal year 2014. And when we include support from industry and foundations, research grew by 10 percent, pushing our total annual funding well beyond $0.5 billion.

When I talk with our scientists, they are clear it is not about the money, but why it matters. Growth in grant dollars truly hastens the pace at which they can make the discoveries that give hope to millions of patients — in some cases translating their results to care in “real time,” impacting patients coming here for their care.

Just within the past few weeks Vanderbilt-led research teams: identified molecular signatures with promise for earlier detection of colorectal cancer; discovered triggers for a rare and fatal diarrheal disease in newborns; unveiled a new study of East Asian women that identifies genes with higher risk for breast cancer; and even showed that it may be possible to create new types of bacteria that treat obesity and other chronic diseases.

While pushing the envelope of discovery, we gave hope to 2 million patients in our hospitals and our clinics, breaking all records from prior years. Your extraordinary efforts to care for so many patients, at all hours, despite the challenges we faced is truly awe-inspiring. It reflects a commitment by Vanderbilt’s people so profound and compelling it is difficult to capture with words. Fortunately, the many stories speak for themselves.

Steve Taylor suffers from advanced heart failure and traveled from Holly Springs, Mississippi, to Vanderbilt. Over the past year the Vanderbilt Heart and Vascular Institute has grown to become the largest center in the U.S. to implant minimally invasive left ventricular assist devices (LVADs). More than 20 years ago, VUMC was a pioneer in using LVADs as bridges to heart transplantation.

In those days, patients lived in an ICU for weeks and even months waiting on the right match for a donor heart. Today, we implant an LVAD through an opening in the side of a patient’s chest only 2.5 inches wide. The difference for Mr. Taylor is game changing; keeping him not just alive, but enjoying life and family while waiting for a new heart.

All ages are impacted by the advanced care that only Vanderbilt can provide in this region of the United States. Emily and Jason Reaves traveled from Florence, Alabama, to the Monroe Carell Jr. Children’s Hospital at Vanderbilt so their son Luke, who was 1 year old at the time, could be treated for Barth syndrome, an extremely rare genetic disease that affects the heart.

Barth syndrome is so rare that only about 200 cases have been reported so far worldwide. While other institutions treat childhood heart disease, few centers in the nation have physicians and nurses with the special expertise to treat such rare conditions.

As his condition deteriorated, Luke was also placed on a ventricular assist device until a new heart could be found. He was transplanted in January to have a second chance at life.

Two weeks ago, the School of Medicine held its White Coat Ceremony, a celebration marking the official entrance into medical school, where 89 new students were welcomed to a rich history and tradition dating back to 1874. From an applicant pool of nearly 7,000, these students come with the most impressive MCAT scores, GPAs and prior leadership credentials in our history.

Last week in the School of Nursing, nearly 350 advanced practice nurses completing their degrees were welcomed to their profession during the annual Pinning Ceremony. And in July, 306 new resident physicians and 124 nurse residents joined VUMC.

And soon, nearly 100 young scientists in pursuit of their doctoral degrees will begin their training in Medical Center research facilities. These students and trainees, with a heart to serve humanity, are a pillar of our culture. Their enthusiasm, questioning and eagerness to challenge the status quo are inspiring.

As we welcome all of these young people into our family, we should all be conscious of what they experience in their first weeks and months on campus. They are likely to hear stories about the economic challenges we’ve faced. But more importantly, they will be inspired by the commitment they see as we do what only we can do. And over time they will come to understand that the “why” for the nearly 20,000 people of Vanderbilt University Medical Center transcends everything.

We create hope — hope that is real for people. Through selfless and generous works performed by each of you every day, their lives, and our lives, are forever changed. It’s who we are.


Jeff Balser, M.D., Ph.D.
Vice Chancellor for Health Affairs
Dean, Vanderbilt University School of Medicine