2007 - Rising to the Challenge

Daniel W. Rahn, MD
President
September 6, 2007

Thank you, Dr. Tingen, Michael, and Bryan... and thank all of you for joining me here in the wellness center for my annual address about the health, well-being, and future of the Medical College of Georgia.

Delivering this address in a gym makes me feel as if I'm leading a high school pep rally, which - the more I think about it - isn't all that incongruent since we have so much to cheer about. One of those things is the reason we've gathered here today instead of in the large auditorium.

Thanks to a generous gift from a longtime cheerleader and supporter, Mrs. Natalie Lee, we are renovating the large auditorium. Mrs. Lee's gift, in honor of her late husband Lansing, will transform the large auditorium into a more modern and attractive facility... for us and for colleagues who visit our campus for continuing education opportunities. Lansing Lee was a great friend of MCG and a long-time member of the MCG Foundation board of directors. His wife's gift pays tribute to the life of a generous man. The change to the auditorium will be impressive - and will include enhancements to the lobby and to the entrance of the building. I hope you'll plan to join me there this time next year when I deliver the 2008 State of the University address.

In addition to the large auditorium renovation, we have nearly 20 other facilities projects underway or in the planning stages. One of which is program planning and facility design for a new building for the School of Dentistry. You'll recall that the State of Georgia allocated five million dollars this year to fund this planning and design effort, a strong and tangible indicator of the state's support of MCG and dental education in Georgia. If all goes according to plan, we'll be cutting the ribbon on that new facility by late 2010 or early 2011.

But beyond our buildings, we have many successes to celebrate today. A growing campus, yes, but also...

• growing interest in MCG health professions programs across all schools, with 4,200 applicants for less than 900 slots in our incoming class
• a growing student body, approximately 2,400 this fall
• a growing faculty and growing faculty success in securing educational grants and research grants from the highly competitive National Institutes of Health
• and plans for future growth of our clinical, research, and educational programs

I won't use our time here today to review all the numbers. I'm trying hard to keep my talk under 30 minutes this year. I came in at about 45 minutes in 2006 and was subsequently advised by my staff that if I went much longer we'd need an intermission. The verb of the day is "inspire"... not "expire." With that in mind, I'll simply remind you that, for the quantitative-minded among you, please remember that you have access to a significant amount of institutional data on IRIS, MCG's online data and information system - that's available directly from the MCG home page - and in Scope, our mini-fact book - that's available from the Office of Decision Support. And I encourage all of you to continue to read the MCG home page, the Beeper, MCG Today, and MCG Tomorrow to keep up with our good work in moving the ball down the field.

I assumed the presidency of MCG a little more than six years ago and, like most new presidents, was served a plateful of institutional challenges...

• a campus population greatly reduced and challenged by the early retirement program... we lost 729 administrators, faculty, and staff as a result of this initiative... that's a lot of institutional memory
• a research enterprise that had posted only minimal growth from year to year in the late 1990s
• decreasing applications and student enrollment
• a health system in significant transition to reverse several years of decreasing inpatient volume and deteriorating financial performance

We - all of us, I believe - recognized the difficult job ahead of us if we were to truly transform this university from (say it with me; we've all read the book)... good to great.

Why was MCG at this turning point? Was it that those who preceded us were asleep at the switch? Were they not as good as we are? I don't think so. I believe it was because the structure that had been successful in the past could not function optimally in a changing environment. MCG simply had to change, to adapt to changing circumstances if the institution was to continue to deliver on its mission. And over the past six years, we've done an exceptional job. We have populated our campus with faculty, staff, students, and, yes, even administrators, who work hard and with focus to advance our singular mission - to improve health. But, we are noting several trends that may threaten some of the advances of recent years.

We are experiencing unacceptably high and costly faculty and staff turnover rates, largely due to the highly competitive market in which we operate.

Our research productivity has greatly increased, particularly in the area of NIH awards... but while we're hauling in more fish, the actual size of the catch is not growing proportionately. Over the past six years, we increased the number of research awards, from 316 to 500. But, after a few years of large increases, our research funding grew only two percent from 2006 to 2007 for a total of 65.2 million dollars in research grants. Two percent may not sound impressive, but this small gain represents advancement in a research environment in which NIH funding is not keeping pace with inflation.

We've expanded our educational mission in both volume and diversity of academic programs... and we must continue that growth to reverse (or at least temper) current and projected workforce shortages in many areas of the health professions. The costs associated with expanding health professions programs are significant, however. And these costs strain our financial capacity and that of the University System of Georgia at a time when the demand for public higher education in Georgia is at an all-time high. At present, the University System of Georgia is working to create capacity to meet the needs of an additional 100,000 students by 2020. How much of that demand will be in the health professions? Will MCG be ready to provide state leadership for growth in these critical areas?

It has been seven years since MCG Health, Inc., assumed responsibility for the management of MCG's clinical facilities. The MCG Health System is well-established, and we have made extraordinary gains in clinical and financial performance. But, we struggle today with inadequate resources to meet the needs of the uninsured and to fund trauma services while at the same time supporting education and our continuous and pressing need for new technology and new clinical facilities.

Six years ago, our task was daunting. But we faced our challenges, advanced our mission, and increased our value to the citizens of this state. We... the members of the MCG community and our partner organizations.

But just as I don't have the time today to discuss every institutional data point, I can't cover every positive accomplishment we have noted. But here are a few...

Applications to MCG academic programs have increased 38 percent since fall 2001, up five percent from last year to this year. The lowest point occurred in fall 2002 when we noted less than 2,700 applications to MCG programs. If you gauge our success from that point, we have posted a 56 percent increase.

Enrollment has increased 24 percent since fall of 2001. And the academic performance of our students continues to be exemplary.

We have been recognized for innovative educational programs... like the Doctor of Nursing Practice and the Clinical Nurse Leader programs... both the 10th such programs in the nation... now being emulated by hundreds of other institutions across the United States.

Our NIH funding has increased by 85 percent (23.7 million to 44 million) since the close of 2001.

We've developed a strategic vision for the MCG Cancer Center, under the direction of Dr. Kapil Bhalla - a vision that links multidisciplinary clinical care with clinical trials and translational and basic research.

We've begun enrolling patients in phase I and II clinical trials making cutting edge care available to patients right here in Augusta.

We - actually Dr. Rick McIndoe - received the largest grant in MCG history... 15 million dollars... to serve as the coordinating and bioinformatics unit for the NIH animal models of diabetic complications consortium, a multi-institutional study into the cause of diabetic complications.

We - Dr. David Hess and his colleagues - have developed a telemedicine system (ReachMD) to bring state of the art care to stroke patients in remote areas, removing geographic barriers to care of individuals suffering thrombotic strokes.

And... we have been nationally recognized as a leader in patient- and family-centered care... the active and continuous engagement of patients and families in all aspects of their care.

I could go on but the tempting aroma of Firehouse subs reminds me of my 30 minute commitment to you. So let me re-emphasize... over the past six years, we - as an institutional community - looked change and challenge and sometimes even chaos right in the eyes... and we not only survived; we thrived. But, even as we celebrate our success, we are being served another plateful of destabilizing forces. You've heard the expression... this ain't your pop's station wagon? Well, this isn't the same environment we operated in over the past six years. Disruptive change is afoot. And, once again, we must adapt.

If we keep doing the same things we have always done, we will get what we already have. To address the new challenges and new opportunities, we will have to approach our work, our professional lives, and our mission with new strategies. We must develop new institutional skills to survive and thrive in this new world.

Change is both constant and universal. Thousands of miles from where we stand today, the Inuit people, an indigenous population living on the edge of and within the Arctic, are struggling with disruptive change of a magnitude unknown to most other people on the face of the earth.

A report released in February by the Intergovernmental Panel on Climate Change describes how dramatic changes in climate have impacted the poles of the earth much more significantly than elsewhere. Temperatures have risen at twice the rate of the rest of the world. Scientists predict that large areas of the Arctic could be completely ice free by the end of the century.

What impact does this have on a population that, for thousands of years, has survived and thrived in this icy and remote region of the world? Earlier this year, National Geographic News reported on an expedition led by U.S. polar explorer, Will Steger - a 1,200 mile, four month journey by dogsled across Baffin Island in the Canadian province of Nunavut. Steger, who has been exploring polar regions for more than 40 years, noted several alarming shifts in the traditional world of native Inuit hunters. Many older Inuit hunters, for example, no longer venture onto the ice because what they know about their world - wisdom passed down through the generations - no longer works. Hunters are falling through thinning and retreating ice and drowning. One small village on the expedition's journey lost seven hunters over an 18 month period. Those who continue to hunt are seeing dolphins for the first time in their lives but have to travel farther and farther to find seals - animals that depend on the Arctic ice for their breeding grounds.

In the September 2006 issue of Arctic, scientists reported that the breakup of Arctic ice occurs earlier and earlier each year - seven to eight days earlier each decade. The increasingly navigable waters of the Arctic have not only brought dolphins but also tourists. This August and September, eight cruise ships visited a remote Arctic region of southeast Greenland for the first time in history.

Imagine that you've lived your entire life in one of the outmost regions on the globe and you find yourself - on a seal hunt - being photographed by a group of tourists from Boise, Idaho.

That... is disruptive change.

The Inuit, who have 50 expressions for snow and ice, have no words to describe the warm weather birds - the finches and robins - that now wing their way across remote Arctic lands. They certainly don't have words to describe what cruise ships full of tourists will bring to their world.

But they will.

The earth is changing around them... and they will adapt.

And so shall we. But the change to which we must adapt is not incremental - it is not something that evolves over decades. The change that confronts us is acute and escalating and moving much more rapidly than the slow retreat of a glacier.

Our challenge, our opportunity, our responsibility is to not simply to adapt but to lead in a changing environment. To find a way not simply to survive... but to excel. To do this, we must be focused and intentional and nimble... we will not drift toward greater levels of excellence.

Last week, the MCG leadership team gathered off campus for two days of visioning and strategizing about MCG's future. We spent a significant amount of time talking about societal and environmental shifts that impact our work as Georgia's health sciences university.

We talked a lot about our mission... to improve health and reduce the burden of illness in society.

And we talked about our values... leadership, social responsibility, compassion, diversity, professionalism, partnership, and excellence.

But we also talked about concepts and practices that we must embrace to thrive in this evolving environment.

Expansion of educational programs...

Diversification of funding streams...

Efficiency and new models of business for our academic and research enterprises...

Improving access to MCG academic programs, particularly for individuals historically underrepresented in the health professions...

Integration across disciplines and campus locations...

We talked about new structures for collaboration, new sources of support, new partnerships, and new patterns of performance.

At a very practical level, MCG's greatest contribution to society is through the preparation of the next generation of health professionals. As an institution, we make our greatest impact on the health and well-being of the nation through the careers of our graduates. It is not just what we do but what they do that results in improved societal health.

Georgia, indeed the entire nation, faces significant shortages of health professionals across most, if not all, of the disciplines represented by academic programs at MCG. As we look at our work strategically, we must focus on how to increase our academic capacity-in nursing, medical student education, dental student education, residency programs, and the allied health disciplines. Our primary focus for the immediate future must in increasing our primary value - the production of health professionals to meet the health care needs of society.

On a more tactical level, these are some of the major issues that we must address this academic year...

• We must complete the planning, design, and development of the funding plan for the new facility for the MCG School of Dentistry to accommodate increased dental student and resident enrollment.
• We must partner with the other 24 nursing programs throughout the University System of Georgia to create a true consortium and assure that MCG plays its role in increasing the number of license-eligible nurses in Georgia. We have to not only advance our programs but assist other programs in enhancing their effectiveness.
• We must develop a strategy, an actionable plan, for the growth of MCG's physical footprint to accommodate updated student housing, parking, expansion of the School of Medicine, and future research enhancements. We appreciate the efforts of the local community, the Augusta Housing Authority, our legislative delegation, and the county commission to seek a win-win solution for all in this regard.
• We must develop the best strategy for expansion of medical student education in conjunction with a statewide strategy for expansion of residency education. What can and should be done here in Augusta through increased partnership in this community? And what can and should be done through partnerships in Athens, in Savannah, and in Albany?
• We must expand our own clinical system and partner with others to support increased clinical education needs across many disciplines.
• We must proceed with capital investments through MCGHI to support the work of our clinical faculty and clinical education.
• We must focus our research investments to ensure that our research infrastructure keeps pace with the demands of conducting "big" science so that we can achieve national preeminence in our areas of strength.

All this in addition to providing high quality education to those who have entrusted us with their health professions training, completing the multiple facility projects currently underway, recruiting and retaining the highest caliber faculty and staff, and creating an environment that supports excellence in education and research today while also focusing on the future. This is central to our mission and to our societal value. How will we do it all? I don't have all of the answers, but I do know that, if we stay focused on our institutional purpose, we will find the best way to advance our mission.

Clearly, we've got some work to do, but I'll make a few predictions.

By the end of this year, we will have updated our master facilities plan, clarified our institutional vision, and identified new strategic directions and partnerships to guide our future efforts to expand our academic and research programs. If we execute with focus and commitment, we WILL improve the health and well-being of the people we serve AND we will position MCG as a leading academic health center among the nation's leading academic health centers. This work - our strategic planning - arms us with a renewed sense of the most important institutional priorities as we enter a new budget cycle... and a new environment rife with new challenges.

As I look back and reflect on the challenges we have faced together, I hear Maya Angelou's melodious voice... "I wouldn't take nothing for my journey now." I hope you feel the same way.

MCG needs the committed, focused, creative energy, and talent of every member of this academic community to advance our shared mission. We are stewards of one of the most important missions - perhaps the most important mission - in this state. Collectively, we have the responsibility and the opportunity to develop the new strategies to keep our efforts and resources focused on advancing the societal purpose of Georgia's public health sciences university with increasing levels of transparency and partnership.

As I say every year, I am honored to serve as your president. Thank you for standing shoulder to shoulder with me and the members of MCG's senior leadership team as we chart a course to better health... today and into the future.