Welcome to the new year! In December, in preparation for the State of the Department address, I reviewed oodles of tables and numbers and pie charts. And it became immediately clear that despite many surprises and challenges we faced together, we did really well in 2022 in meeting the department’s mission: to provide superior health care and to inspire and educate world-class clinicians, for the people of Iowa and the global community. With that mission restated and in mind, where do we go from here in 2023 and beyond? After the stress and uncertainty of the last three years, how can we continue to create a community of people that finds joy at work and who are unleashed to find creative ways of delivering care and education, of conducting research that paves our path into the future? We all want to be a part of something bigger than ourselves and we are. My vision is that this department is a place where the contributions from each of you matter and matter to you.

I heard from you in many conversations over this last year that what matters to you and gives you purpose and joy is taking the best care of patients, educating students, residents, and fellows, and doing any kind of research, whether it is outcomes-based or bench research. So, how do we best position the department to help young and established faculty be those kinds of clinicians, educators, and scientists, how do we help promote and advance new research ideas, and how we do support educational activities? Or more specifically and practically, how can we all contribute to a financial environment where the full range of these activities are supported? The State of Iowa contributes less than 3% of its total budget to the three Regents universities and that percentage is not likely to change anytime soon. (For comparison, it’s nearly 9% in Texas.) And our chances of getting Hollywood stars or dot.com billionaires to drop big checks at our doorsteps are small.

Despite the relatively unglamorous nature of day-to-day clinical work, it remains the one source of revenue that we do have under our control. And one step we can take to help ourselves is to optimize the way we capture our clinical activities. In my discussions about the new compensation plan with divisional leaders, I have learned that, in the past, we have missed out on some opportunities to bill for the services we have provided, for example, by using notes that do not result in billable labor. You may have already started these conversations in your division. The new compensation model is meant to reward you for your efforts, and we want to support understanding and practices to make you more mindful of ensuring you receive (and the department receives!) the full reward—financial and otherwise—for the vitally important work we actually do. The more we can maximize that reward, the more we can support the other activities we are interested in: academic medicine, research, and education. As important as it is for us to build our community with a shared vision and mission, a “work smarter” shared strategy can be a foundation for our ongoing success. As we share the “work smarter, not harder” meme, please know this should not be interpreted as leadership asking you to do more or to accept less; we want you to receive the full reward for the hard work you already do.

Finally, in thinking about community, it is important to recognize the comings and goings of some noteworthy members of our department. Dr. Paari Swaminathan joined us in late-December to lead the electrophysiology group in cardiology. Paari trained with us about a decade ago as a cardiology fellow.  He remained in our memory as a competent and hard-working cardiology fellow and a wonderful person. Welcome back! Dr. Richard Hoffman and Dr. Nicole Nisly both recently had their last days in Iowa  and I am grateful for the opportunity to say good-bye and offer them a token of my appreciation for their impact on the department.

Today, two different recognitions will take place celebrating contributions to the department. Dr. Mary Beth Fasano has led the Allergy/Immunology fellowship for many years and her impact on the national stage in this subspecialty will be felt for many years to come, both in terms of policy and in her trainees who have since gone to greatness. And, although she may have grabbed fewer headlines, Ellen Struzyinski has also had a transformative effect on this department. Today she begins her retirement today after more than 22 years of service, not just in running our successful Copy Center, but also making sure our offices are painted, carpeted, and comfortably furnished. It is hard to imagine what life will be like in our department without her. She leaves with our deep gratitude and our best wishes for the next, exciting and hopefully relaxing chapter of her life.