October 17, 1997

New leader well prepared to guide VUMC’s next era

New leader well prepared to guide VUMC's next era

Dr. Harry R. Jacobson's mentor at the University of Texas Health Science Center recalls Jacobson as the ideal academic physician: a discriminating investigator, enthusiastic educator, meticulous and dedicated clinician.

This balanced background in the three missions of an academic medical center, combined with an important business savvy, prepares Jacobson well to lead Vanderbilt University Medical Center into a new era of academic medicine, his colleagues say.

"I considered him to be one of our finest faculty members, and I tried to do everything I could to keep him here, but he obviously had a wonderful opportunity at Vanderbilt," recalled Dr. Donald W. Seldin, William Buchanan and Systems Professor of Internal Medicine at the University of Texas Health Science Center in Dallas.

Seldin was chairman of the department of Internal Medicine when Jacobson ‹ who had been recently promoted to the rank of professor of Internal Medicine ‹ was successfully recruited in 1985 to head VUMC's division of Nephrology.

"I'm delighted to hear of his appointment as vice chancellor, and I believe that Vanderbilt is extremely fortunate to have Dr. Jacobson as its leader," Seldin said.

Preserving each of VUMC's three missions ‹ the finest patient care, a vibrant quest for new knowledge and the training of tomorrow's health care professionals ‹ is critical to the future of VUMC, as it is for other academic health centers across the country, Jacobson said.

"Patient care, research and education each have, at various times in my career, been a major focus for me," Jacobson said in a recent interview. "I understand these three missions, and I appreciate how equally important they are. Nowadays, academic medical centers really need to work very hard at making sure that each of their missions is strong, that a critical mass of top-quality faculty and a critical amount of resources are dedicated to each one.

"It is important that we recognize that each of these missions must be of equal priority."

Jacobson has served as interim vice chancellor for Health Affairs since Dr. Roscoe R. Robinson stepped down from the post July 1 after leading the medical center during 16 years of exponential growth and important preparation for turbulent changes in health care delivery. As deputy vice chancellor for Health Affairs for the past two years, Jacobson worked closely with Robinson as VUMC initiated a number of changes to put the institution in a position of strength in the current and coming health care marketplace.

"I believe I'm much better prepared for this job because I spent the past two years working with Ike Robinson," Jacobson said. "That experience gave me a first-hand understanding of the medical center, how it operates and its strengths and weaknesses."

Among those strengths, he says, are the continued quality of the faculty and the collegiality across clinical and basic science departments, as well as the steps taken over the past few years to reduce costs, increase efficiency, establish important networking relationships with other providers and build the medical center's base of primary care.

Jacobson said his goals and vision for VUMC are very much like Robinson's: to maintain and enhance VUMC's position as the leading health care provider in the region and among the very finest academic health centers in the world.

If there is a difference in management style, Jacobson said, it will be a greater delegation of responsibility, accountability and authority to a larger management team, which he says is essential to meet the new challenges facing academic health centers today and in the coming years.

"We need top people in charge of various components of the medical center who really have the flexibility and authority to act when it's needed."

The physical growth seen during the Robinson years is an important foundation for future development, Jacobson said. He predicted that the growth in new buildings and facilities will continue.

"We need to develop some new programs in important areas of science, and that will require more research space in the future," he said. "We need to grow our efforts in human genetics, in neuroscience, in developmental biology, in geriatrics.

"We also want to consolidate some of our clinical programs into new space. A prime example would be the recently merged Wilkerson Speech and Hearing Center with the Department of Otolaryngology. We very much want to develop a building for communication disorders to house those two entities. We also have a high priority on bringing orthopaedics, neurosurgery and neurology together into a neuro-musculoskeletal institute, and that will require new space.

"So I think there will definitely be more bricks and mortar."

Whether the existing Children's Hospital optimally meets the region's needs is also being evaluated, Jacobson said.

"The current Vanderbilt Children's Hospital is 15 year old. It's the same size it was back in 1982, but the region it serves has grown tremendously. We haven't made a final decision, but we're taking a look at whether a new Children's Hospital is in our future."

In addition to further enhancements in the medical center's facilities, Jacobson's goals include making sure more people outside VUMC know about the medical center's achievements in patient care, research and education, and working to be an even stronger asset to the community.

"We're a world-class medical center, but our own community needs to see some of that world-class effort focused on it," he said. "We want to look at ways the medical center can help the community, look at new programs that we might develop that would be a high priority for our community."

VUMC also will continue the evolution of its corporate culture, begun under Robinson's leadership, to become a more welcoming place to patients, their families, referring physicians and others, he said.

"We need to become a friendlier place, a place that's easier for patients to come to and receive their care, a place that's easier for referring physicians to send their patients, and a place where more physicians in the community can come and practice."

Jacobson, 50, was born near Munich, Germany, and was a preschooler when his family immigrated to the United States, settling on the south side of Chicago. Because he came to the United States at such a young age, Jacobson escaped some of the ridicule faced by his older brothers, who spoke no English when they began school.

A product of the Chicago public school system, Jacobson went on to attend the University of Illinois, earning a bachelor's of science degree in 1969. He also attended medical school at the University of Illinois Abraham Lincoln School of Medicine, where he was a member of Alpha Omega Alpha.

After his graduation from medical school in 1972, Jacobson served his internship and residency in Medicine at Johns Hopkins Hospital in Baltimore, followed by a fellowship in Nephrology at the University of Texas Health Science Center in Dallas.

Jacobson then served two years as chief of the Renal section for the U.S. Army Surgical Research Center at Brooke Army Medical Center in San Antonio. In 1978, his military service completed, Jacobson returned to Dallas as assistant professor of Internal Medicine at the University of Texas Health Science Center. He was promoted to associate professor in 1982.

Seldin recalls Jacobson as a "grave, serious fellow" and minces no words when asked about Jacobson's work in Dallas. "He was intellectually brilliant," Seldin said. "As an investigator, Dr. Jacobson did first-rate work. He was imaginative and extremely dedicated. He also held a marvelous sense of taste and discrimination; his work went straight to core questions and he never wasted time on marginal issues."

As a physician, Jacobson was responsible and conscientious, following his patients meticulously and never complaining about his heavy clinical load, Seldin said.

"He always wedded basic knowledge to clinical application, which made him an ideal academic physician," Seldin said. "He also exhibited the capacity to face critical, practical problems in the practical realm in which they presented themselves. They might involve financial problems, administrative problems, an abrasive interaction with someone ‹ but he always approached them in a rational and thoughtful manner."

In 1985, Jacobson left Dallas to accept a position as professor of Medicine and director of the Nephrology division at Vanderbilt. By that time, Jacobson had also distinguished himself in the field of nephrology research, where he had interests in kidney physiology and the mechanisms underlying kidney disease. His productive research continued at VUMC, where he held more than $1.5 million in active grant support before his growing management responsibilities necessitated turning his research over to other principal investigators.

Since joining the Vanderbilt faculty, Jacobson has served in a number of roles, including as staff physician and nephrologist at the Nashville Department of Veterans' Affairs Medical Center.

But his impact in medicine, and the field of nephrology in particular, reaches far beyond VUMC. Jacobson has chaired two National Institutes of Health committees on issues in nephrology, has contributed sections or chapters to 10 medical textbooks, has published more than 100 peer-reviewed original publications, maintains editorial duties with a half dozen medical and scientific journals, and is the co-editor of a major textbook on kidney disease, The Principles and Practice of Nephrology, now in its second edition.

In 1993, Robinson created seven task forces to address specific issues as VUMC prepared for the coming changes in health care. He chose Jacobson as his co-chair to oversee and coordinate the task forces' work.

Jacobson is also a successful entrepreneur. He helped found Contact Software International Inc., which merged with software giant Symantec in 1993. He is also the co-founder of Renal Care Group Inc., a national nephrology practice and dialysis company. Jacobson stepped down this week as the company's chairman, but he remains a member of its board of directors.

Jacobson acknowledges that letting go of his hands-on research ‹ although unavoidable in the face of growing management responsibilities ‹ wasn't easy. But he adds that giving up his clinical duties would be even harder.

"Right now, my plans are to continue to see patients," he said. "Last year, when I gave up my grants to other people, I did that. But I haven't yet been able to stop seeing patients. That would be the hardest thing for me to do."

Jacobson and his wife, Jan, have three children, Marli, 25, who practices law in Washington, D.C.; Nicholas, 17, a senior at Brentwood High School; and Andrew, an 8th-grader at Franklin Road Academy. His brothers still live in Chicago and his sister lives in Dallas.

If there is any bittersweetness to his latest accomplishment, Jacobson said, it is that his parents, who died last year, will not be able to share it with him.

"It would have been nice to have them around to celebrate," he said. "They were my biggest fans."