April 17, 2009

Balser looks ahead to role as Medical Center leader

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Jeff Balser, M.D., Ph.D., will become vice chancellor for Health Affairs in June. (photo by Joe Howell)

Vanderbilt's Jeff Balser, M.D., Ph.D., incoming vice chancellor for Health Affairs and dean of the School of Medicine, is an accomplished clinician and researcher.

At 47, Balser is the youngest person ever to lead the Medical Center. He spent the past decade working closely as an apprentice to Harry Jacobson, M.D., current vice chancellor, to prepare for the role. Jacobson hand-selected Balser as his successor and, as a mentor, has placed Balser in a series of roles with ever-increasing responsibility.

With a busy career he doesn't have a lot of hobbies. His two passions are his family and Vanderbilt, where he graduated with dual degrees in 1990.

Balser spends his days leading experts in medicine and science but goes home each night to the life of a typical suburban husband and father, complete with three school-age children.

He has held a number of roles at Vanderbilt — associate dean for physician scientists, professor and chair of Anesthesiology, associate vice chancellor for Research, dean of the School of Medicine — but none are more important than the one he accepts in June.
Balser recently talked with staff writer Craig Boerner about his new role.

You left Vanderbilt after graduating and went to work at Johns Hopkins. Did you think you would come back?

I knew I would come back. I remember standing in Light Hall the day I left, looking around and thinking ‘I will come back here.’ I can tell you where I was standing, right next to the south staircase in Light Hall. And when I got the phone call from Vanderbilt in 1998 I actually remembered that moment.

I didn't know how, or where, or what I'd eventually do, I just knew that I would return someday. I really felt so much like I belonged here it was just hard to imagine that I wouldn't come back.

(photo by Joe Howell)

(photo by Joe Howell)

You will soon be the new vice chancellor for Health Affairs. Has it sunk in yet?

I think it will take a little longer. It's not that I haven't been thinking about what this might be like because it has been discussed. The succession plan was something that Harry and I had worked on together for years. But, that said, when it actually happens the feelings, emotions are not something you can anticipate, how it will really feel.

That Monday night we had a nice dinner and Melinda said, “Wash the dishes.” And I said, “Absolutely.” I think we are all kind of enjoying the press releases and the spots on TV, but it is very important that my family still feels we are who we are … a typical suburban family with kids in school.

How will your experiences working at all levels of the Medical Center help you in your new role?

When there is a problem, or a new opportunity, that comes up … and they come up constantly … my experiences give me context. Is this an emergency or is this something that we can work on over a period of weeks? Is this a great opportunity or something that would distract us from the really important work we are doing? It's harder to prioritize if you don't have context because then you are relying totally on what others say, or guessing.
I am certainly more comfortable in the job because I feel like in some way, shape or form I have touched so much of the Medical Center. I may not know every person but I am familiar with so much of what happens here.

That's a comfort, and it gives me confidence.

How will you grow the legacy of Dr. Jacobson and his predecessors?

Your legacy is, in many ways, shaped by the challenges you confront on your watch. We're in the worst economic crisis since the Great Depression and, by any measure, health care in this country is broken.

So, what a challenge … but what an opportunity for Vanderbilt to lead. And so I think my legacy will be measured by the degree to which Vanderbilt steps forward and really plays a role in solving the big problems in this country. Are we going to be a spectator and ride along or are we going to shape the future?

It is a very simple question and you obviously know what my bias is, very much like Harry's, I want us to be driving. Harry was very much a driver and I also have that gene.
There seems to be a gene for leadership at an age that might be a bit younger than is traditional in my family. My mom's brother was the youngest CEO in the history of Ball Corporation. And my mom's sister married the guy who was the youngest CEO in the history of Indiana Bell.

Talk about your plans for the transition. I know you probably aren't interested in being the dean and the vice chancellor at the same time for very long. Are we moving away from the role of the traditional dean?

My plan right now is to go on a listening tour and take some time to look at what the best model is for the future of an academic medical center.

To assume the structure we had was the right structure, I think, is naïve because it has been that way for 150 years. It may be the right structure but it is hard to know for sure — the fact that typical deans now have more than 50 direct reports in medical schools … as the chancellor said in the Town Hall meeting, it is not like hiring a dean of a Law School. That job description is clear. At medical centers across the country, the role of the dean is in flux and is debated. And we can't hide from that, we have to really look at it and think about what is best for us moving forward, given that the size and scale of the Medical Center has grown so rapidly.

(photo by Joe Howell)

(photo by Joe Howell)

The challenges that the previous deans faced are very different than what we are dealing with here with a research enterprise that is two to three times larger than in 1998. I plan to talk to leaders of other leading academic medical centers about what they are doing in this space before we make a decision about how to proceed.

Discuss the concept of one university — the University and Medical Center together. We already are one university but how do you go about making it very obvious that we are one?

Two ways: how we work and how we message. One really nice example of messaging is that the chancellor came over to the Medical Center to talk about the leadership transition. He did what he would do if there was another major leadership transition elsewhere in the University. That's meaningful.

The degree to which we are including leadership from the University in meetings that go on in the Medical Center is ever increasing. The Provost attends our executive faculty meetings now. I attend his dean's meetings.

The best way to bring people together is to actually have them working together — doing real work that is day-to-day. Provost McCarty and I are increasingly developing programs and platforms where people in the Medical Center and in other schools in the University are interwoven, so we naturally become one. As we work together more and more, people tend to forget about “separation,” as we are literally bumping into each other all the time.

What do you mean when you say trans-institutional?

A good example would be the way the Chemistry Department, in the College of Arts and Sciences, and the Pharmacology Department and the Biochemistry Department in the Medical School, work together in the new discipline of chemical biology. Faculty are co-located on the same floor of a research building in the Medical Center. Chemistry students are working with School of Medicine faculty and vice-versa. That's complete integration. We are very much a part of the University just like the law school or the business school — not separate but a critical part of the whole. I think of it that way already.

I would also say that a huge strategic advantage — perhaps our greatest one — as a medical center is that we are part of Vanderbilt University. The fact is, new scientific disciplines tend to emerge at the interstices between programs and schools. The fact that we are not isolated, but part of a thriving university assures we can not only respond to the evolution of science, but lead in those changes.

Right now we are in a period of restricted operating capital due to global economic forces. When the economy improves, in terms of growth for the Medical Center, do you expect the same emphasis on building and expansion that we have historically experienced?

While we are experiencing economic recovery, we must become smarter about ways to assure we deliver the best health care, education and science to ever-expanding populations in a less capital-intensive way.

For example, our extraordinary informatics capabilities let us consider how we might influence and support health care, in all different kinds of venues outside our walls, around the state and across the globe. For example, we can support a large group of practitioners by providing our health care IT platforms in their practice sites. That doesn't require bricks and mortar, but is a powerful way to spread our knowledge and resources.

Yes, when the economy recovers we will continue to build and grow but our strategy will continue to be one that considers all options to influence the healthcare and science, as we need to continue to put more and more resources into programs and people. So I would say intelligent expansion is our strategy for the future — expansion that is central to core mission, and is designed to leverage all of our assets to improve and influence health locally and nationally. It might be buildings, but sometimes it will be other kinds of growth, through partnerships and other vehicles.

You said your two passions are Vanderbilt and family — tell us a little more about family life.

I have thee children — Jimmy, 18; Jillian, 17; and Maddie is a seventh grader. My son is getting ready to go to college and so we have been spending a lot of time thinking about his options and talking about his plans. My older daughter is a gymnast who is very accomplished and competes regionally and nationally, and my younger daughter is a soccer player. So we have done a great deal of travel soccer and gymnastics with our daughters… it has been a great way to stay involved in their lives.

(photo by Joe Howell)

(photo by Joe Howell)

I was always an average athlete. Very average. Melinda, on the other hand, has been a marathoner, and she still forces me to run with her on occasion. Our anniversary is July 20, and we were married in 1985 at the end of my first year of medical school. And we have known each other since we were 18, when we met as freshmen in college at Tulane. She refused to go out with me at first, but relented during my sophomore year.

Talk about the new administration in Washington, D.C., as it relates to science and our opportunities.

The whole atmosphere around biomedical science is warming rapidly. There is a huge increase in funding available for biomedical science in the federal stimulus package, and that plays to our strengths. It is a very exciting development and is just a huge opportunity.

For example, I believe we will lead the country in developing the vision for what personalized medicine really looks like. That includes genomics-driven diagnosis and therapy with our DNA databank, as well as looking at the entire context of the individual — their social situation, their age, their resources and how to tailor care specifically to the individual. It is all personalized medicine, not just the DNA sequence. And that comprehensive view really plays to our strengths. Personalized medicine, at one extreme, is this very clinical molecular vision; but at the other extreme and just as important is the warmth and caring we have for each other as individuals and for our patients. What is very special about Vanderbilt and speaks to our ability to lead that, is that we have both.

What does it mean when you tell us we need to “keep our eye on the ball?”

It means that we have huge challenges and opportunities in front of us and we shouldn't be distracted by the noise. And by noise I mean the economy or health care reform or even the fact that there has been a leadership change at Vanderbilt. We will succeed through it all — because of our resources, our character, and our ability to remain focused on getting the hard work done.

I will only be as successful as the people here and my job and my joy is supporting them in their work — we must accept nothing but excellence and keep our expectations for what we can accomplish very, very high. As a leading medical center with extraordinary resources and capabilities, in one of the world's leading research universities, our responsibility to society is tremendous and is something we should always keep in front of us — people in the local community, and throughout the nation and the world really are depending on us.