We live in a world where we are inundated by data. It is easy for data to become background noise, but a few recent pieces of data confirm our department’s remarkable growth. The first number is 30,000. Our clinical faculty and other providers will tell you that more people are coming through their clinics every week. Here is the data to prove it. In fiscal year 2018, Internal Medicine logged 253,000 patient encounters at the main campus hospital and in all of our ambulatory sites, including Iowa River Landing. That number rose to nearly 265,000 in the following fiscal year. And now, as of this halfway mark in fiscal year 2020, we are already at more than 175,000. By this date in FY19, Internal Medicine providers across all divisions had about 30,000 fewer patient encounters compared to this year. This is stunning expansion and I know that many reading those numbers are probably nodding their heads. You feel this growth. Your dedication to increase access and to put the interests of all our patients first has made this growth happen.

This growth has particularly occurred in our ambulatory sites and managing it has not been without its challenges. But before I comment on some of those, it is important to acknowledge the faculty, nurses, front-line and administrative staff, and leadership, who have worked diligently, increasing communication and coordination to manage this workload. I know that many of you are spending many hours outside of the clinic triaging patients to ensure timely and appropriate access to care. I know that many are using e-consults to ensure that valuable clinic slots remain available for those who need to see us. I know that many of you are contacting patients prior to their visits to ensure appropriate preparations are made on both sides of the encounter. We have increased our efficiency in slot utilization and have decreased our no-show rates. However, it is important to acknowledge that to sustain this growth, our health care enterprise must focus on identifying and addressing barriers that could impede our remarkable progress. This includes developing plans to increase available clinic space onsite or offsite, optimizing scheduling practices, recruiting support staff to ensure optimal faculty productivity, while maintaining quality and patient satisfaction and limiting provider burnout. I have heard many of these concerns and invite you to keep me informed. My commitment to you is to vigorously advocate for your needs with institutional leadership, who are also aware of many of these challenges and with whom we will work collaboratively to find solutions as we seek to strengthen our health system. Our services throughout University of Iowa Health Care are in great demand from the patients of Iowa and the region. This is a great problem to have when one considers the inverse, however we must be proactive to ensure that we can continue to provide these mission-critical services to patients in our community and state. I am impressed by the commitment and compassion that you exhibit daily. We expect a lot from you and you always exceed our expectations. This motivates me to work even harder to ensure that you have the resources with which to continue to excel. Thank you for your continuous and herculean efforts to provide compassionate care to so many.

The next number is 18. That is the ranking our Iowa City VA Medical Center has achieved out of nearly 100 research-focused VAMCs in the country when it comes to funding. Dr. Brad Dixon, professor of Nephrology and Chief of Medicine at our VAMC, tells me that 41 individual Internal Medicine faculty currently hold active research grants through the VA, and if we count grants coming through the Office of Rural Health that number increases to 44. All told, our VA-supported investigators are managing more than $14M in total research grant funding. Twenty of these awards are VA Merit grants, the equivalent of an NIH R01. Three new VA Merits were awarded as of the first of this year and another was awarded in the latter part of last year. To say that our department has a strong and productive relationship with the VA would be an understatement. The breadth of this work is as expansive as it is on the university side of the street. One of the unique aspects of the VA that has been effectively leveraged by our investigators is its electronic medical record. This represents a national resource, which has enabled us to access large amounts of de-identified patient data from every corner of the country, enabling us to ask pertinent questions about outcomes, risk factors, effective treatment, and knowledge gaps that impact the care of the veteran population. I addressed in my first post this year how leveraging these large data sets will provide opportunity for many of our faculty to engage in scholarly research not only at the VA but at UI Health Care as well.

The final numbers are 340 and 53. The first is the total number of candidate interviews conducted during the recently concluded residency interview season. From October through January, every Monday and Friday, prospective interns and “prelim” candidates met with our faculty and existing trainees to discuss their current work and future plans. That second number, 53, is the number of Internal Medicine faculty members who took time to sit down with those 340 candidates. That 53, listed below, is a true cross-section of our department, including faculty at every rank, our Chief Residents, our education leadership team, and faculty across all divisions. And Dr. Manish Suneja and Dr. Katie Harris somehow and impressively interviewed every single one of those 340! Each Monday or Friday, whether in person or via video link, no matter the time zone difference, I enjoyed welcoming house staff applicants and prospective future colleagues to Iowa to ensure they knew my door was open to questions. To those 53, my deepest thanks for showing these potential new Hawkeyes what opportunities are available to them here. Only about 8 more weeks till Match Day 2020!

I would be remiss in not mentioning one more number, which is numero uno, and offer a hearty congratulations to one of our education leadership team members, Dr. Brian Gehlbach, on his well-deserved receipt of a Collegiate Teaching Award.