The following is an abridged and edited transcript of the October 16, 2025, Quarterly Department Update. To view the entire presentation, click here (hawkid login required).
We’ve done a number of these over the last year and so we’re going to talk a little bit about where we’ve been for the last year because my one-year anniversary has happened. And then where we are and where we’re going to go.
So we’ve been here for one year together, and I really want to test how well you know me. So this is the quiz portion. It’s interactive. So I’m going to have three lies and a truth up there, and I’m going to have you vote.
So when I’m traveling, what is my go-to guilty treat? A Subway sandwich, double meat, A Twix bar, double size, a vodka martini, or a venti skinny vanilla latte. Who votes for Subway sandwich? Twix? Vodka martini. That’s what you guys want. The vanilla latte. All right, you’re wrong. It’s Twix Bar. I only buy it when I’m traveling. It’s weird. And I have to get a double. I don’t understand why, but I eat it all. Okay, Twix.
My first job was working at Subway or TCBY, The Country’s Best Yogurt, tutoring football players at Ohio State, or Burger King. Who votes for Subway? TCBY? Tutoring football players at Ohio State. Burger King. Burger King is the answer.
These are all jobs I’ve had. My first job, we lived in grad student housing. We didn’t have a car. My dad was a grad student, so I had to work where I could walk to. And so Burger King, TCBY, and Subway were within 20 minutes of walking. I did tutor football players at Ohio State. Had to tutor them in Swahili and math. It was an experience. It was an experience.
The last question, my favorite thing about Iowa so far, spring and fall seasons. Sweet corn. The Pella Tulip Festival or all of you. Who votes for spring and fall? Sweet corn? Very good. I tried sweet corn for the first time this summer. It was delicious. Pella Tulip? All of you? OK, this is a gimme: all of you. All right.
I do want people to get know a little bit about me as we go over the years. So I’m going to do these question & answers every once in a while.
So let’s recap our first year together. I want to start by obviously acknowledging one of the great accomplishments that happened for our Carver College of Medicine, which is that we’re all really living on the shoulders of a giant Mike Welsh. So just to remind everybody, Mike actually did his MD here in 1974. He was a resident here as well and has been a faculty member here since 1981 and he’s been the director of the Pappajohn Biomedical Institute since 2013.
His most recent accomplishment is getting the Lasker-DeBakey Award, which I think many people know of is considered like the American Nobel. And then a number of other awards are listed there that he’s also recently gotten. It’s a great accomplishment for Mike and for his team. I know he always acknowledges the team. I think it’s also a great accomplishment for the patients who have CF, for the division, the department, and the institution. We’re very proud of him.
An example of another individual who’s recently been honored and who’s an example of Dr. Walsh’s legacy is JP Clancy, who recently got the award for achievement for the 2025 Carver College of Medicine Distinguished Alumni Award. He is an Iowa alumnus and now he’s currently senior VP for clinical research at the CF Foundation. He’s a physician scientist who’s dedicated his career to the hope for a cure for CF, and he became involved in CF research as a medical student under the direction of Dr. Welsh.
So Dr. Welsh and his legacy continues. We’ll be having a celebration to honor Dr. Welsh’s achievements at an event this fall and more details will be provided soon for that.
I want to talk a little bit about what we’ve collectively accomplished. And none of these are what I’ve done. This is what everybody’s done, and I do want to thank the entire team that helps put together these slides because again, all the information is not with me. So I want to talk about different categories of things. So we’ve had really good improved financials and clinical productivity, and I’ll show you some data.
So we’ve had year-over-year improvement in departmental finances, year-over-year growth in productivity and clinical RVUs, and then year-over-year improvement in physician productivity. And so we’re at about the 62nd percentile as a collective department, which is all great. We’ve created a new Division of Hospital Medicine beginning in FY 26. And with that we’ve also created a separate Division of General Internal Medicine. The idea here is that these are two busy, busy divisions with clinical research, operational portfolios, and now we’ll have leaders in each one that are able to focus on it more.
We’ve also had clinical growth and expansion as all of continued integration to Medical Center Downtown (MCD) and successful opening of Medical Center North Liberty (MCNL). We’re also expanding into Cedar Rapids and Quad Cities markets. Starting Monday, we’re expanding electrophysiology services to the MCD campus and we’ve gotten support, and we’re grateful for it, for Anesthesia-supported procedures, GI at MCD and then also expanded ERCP services at Medical Center University.
I want you guys to hear about all this. It may or may not impact necessarily your patients or your service, but these are big efforts that the department and the health system are working on to, again, improve access for our patients and for people in Iowa. And then we’ve also had growth in cancer services through partnership with Holden Comprehensive Cancer Center.
We’ve had continued success in intramural research, a number of new funding from NIH, AHA, CDC, and many other sources. A number of new KO8s, KO1s, and VA CDAs. So successful mentoring and a lot of work by individuals to provide, apply for those. And then we have an ongoing and successful collaboration with the VA. We’ve also had ongoing excellence in medical education, year-over-year increase in small group teaching. In FY 25, the departmental providers had more than 2,400 hours of small group teaching, and that’s an increase from FY 24.
So thank you for those individuals who do that. Our faculty are routinely regarded as effective teachers and we’ve had fellowship expansions for positions in EP, in renal genetics and liver, and then in rheumatology as well. So I think in all our missions, clinical care, research, and in education, we’ve had substantial accomplishments that we’ve collectively done over the last year.
I also always talk about building community, and so I want to show you a little bit about some of the things I’ve done to integrate myself and my family into Iowa. So some of these are personal photos. I took a trip to Yellowstone with my husband and some friends we’ve known for 25 years, and that was really fun. My husband and daughter and I went to an Indian wedding. We had some friends visit from out of town, so we were able to show them around Iowa City.
My dad, who also lives with us is currently in India, but before he left, he planted in a big garden. So I have to go every other night to water it and to pick veggies. And you think it’s not that hard, but picking the okra. So this is okra. These are Indian zucchinis. They’re out of control. And the okra is like 10 feet tall and it grows at the tip. So I have to grab a stalk, walk it back, lean over and cut it. And then it really makes your hands itch a lot. I didn’t know this anyway, but I do it. I do it to keep him happy. I send him photos of it every other day because his answer to me is always, “Who says love does not make things grow?” So it’s very sweet actually.
Let’s see, what are other pictures? This is with the residency class. This is one of our first yellow pictures. It was the day before homecoming game. I have been to a football game, as you see with my little tattoos. This was at Brad Manning’s going-away party. And this is in Philadelphia. I’m doing the ELAM program, Executive Leadership in Academic Medicine, and Rachel Maassen and I are the two representatives from Iowa. So it’s been a good summer. We’ve been busy and good.
Oh, and then this photo I’m super proud of. This is my daughter and what you might notice is we both have UIHC badges. So she applied for a job as a pharmacy tech intern at MCNL and really enjoyed her time there, learned how hard working is. So it was good for us, but she was excited to both be employees here. She’s back in school now.
We’ve also had a number of events to celebrate community. This I think is a photo with a number of the hospitalists on the first day. These are photos from different divisions, cardiology and others as they’re having a welcome to the new year parties. So I think it’s important that we continue to celebrate community and build community as we all work through.
So where are we in terms of current opportunities and challenges? I just want to start by saying that we do recognize how hard everybody is working to take care of patients and we do continue to expand. We had expansion into MCD, we’re now at almost two years, about 1.75 years. And expanded to MCNL about six months ago. All of these efforts are to make sure we have access for patients in Iowa, to make sure that our expertise, our excellence can be given to them, but it is a ton of work operationally. And then for all of you as clinicians, and it comes with challenges, there’s no doubt that some of the staffing and other things are being stretched thinner than we’d like.
I wanted to show people again, in the spirit of transparency, what’s been the clinical productivity of the department year over year? This is fiscal year 18 through fiscal year 25. These are all the clinical work, RVU productivity, including hospitalists. And you can see that in FY 25 we were at 1.2 million. This is out of about six and a half, 7 million total for the entire institution. So that tells you our impact as a department for the institution.
And then I wanted to acknowledge that people are doing clinical work and taking care of patients and their colleagues and friends and neighbors in many, many different settings. So what we’ve done here is show you the productivity and the work that’s happening in the outpatient setting. That’s a lot of outpatient work. That’s all the clinics, the procedure rooms here, consults and inpatient, and then outreach and offsite. So people are working in many different domains, very, very hard with the goal of providing great care for our patients. So thank you for all you do and for all the work that we’ve done.
I want to also talk about research data. So we are showing something similar. So this is looking at FY 2021 all the way to 24/25. This is a total number of dollars in these categories. So different associations, drug research, federal pass through, other, and the VA. This is total dollars. So direct and indirects combined. And you can see a nice large number, and I’ll show you again in a few minutes how this compares to the rest of the college of medicine and where we fit into the ecosystem. We had some decrease here in drug research dollars, but one of the things that we are very proud of is that our federal funding numbers have stayed steady. We’ll talk a little bit about the substantial challenges that we’re all facing right now and how we’re going to have to mitigate those challenges.
This is to show you that within the entire College of Medicine, total research dollars about 266 million, we’re about 98 million. So a good 37% of it. So all of you who are involved in research, all of you who are admin, support research, all of those who are clinicians who are participating in clinical research, et cetera, should be proud of this.
We are about a third of the Carver College of Medicine in terms of faculty on a given day. We take care of about 40 to 50% of the patients in the hospital. And as you can see over several years, we’re contributing about a third of the research portfolio. So you all collectively are doing a tremendous amount of work and have a tremendous amount of talent focused on our three missions.
In terms of education, we all know it’s an essential part of our academic mission. I want to remind everyone that recruitment season is underway. This is our big effort every year to bring in great candidates for our residency program. Many from the team have identified a great number of candidates. Please be available to interview them if the residency office reaches out to you. And the goal is to match applicants to faculty from their special area of interest. So if you’re reached out, if you’re in cardiology, GI, ID, nephrology, et cetera, please make yourself available.
I just want to remind people that we have a couple of different distinction tracks, Point of Care Ultrasound run by Sydney Bowmaster, Population Health run by Krista Johnson, and Medical Education run by Jenny Strouse. And so again, if you need more talking points for the residentcy applicants that you meet, we can provide that. But it’s important to see all of these areas of distinction succeed in the residency program.
And to talk a little bit about all the scholarly activity that the residents were doing. I think you all saw the recent ACP clinical vignette competition. We had 31 participants. We had a really productive, very highly sought after internal medicine research day with a great outside speaker. And then I think over 80 posters. We had two award winners from our residency for that. The Society of Hospital Medicine, a lot of submissions for their posters. About 25 publications in FY 25 from residents and a lot of presentations at national and local meetings. And this is really where we’re educating, training, supporting, mentoring our next generation of colleagues. So it’s really important that we continue to do that.
I want to call Dr. Smock up. He’s going to talk a little bit about the Division of General Internal Medicine. Last time we talked, Dr. Gutierrez gave you an update on Hospital Medicine.
Dr. Smock: Thank you for giving me the time. I hope it only take more than maybe eight to 10 minutes. I certainly appreciate the support of Upi and Grant and Kristen and the entire departmental team and I’m sort of humbled in this role and hope to be a steward for this division and put us in the best position to eventually recruit a permanent director of the division.
So I’m going to talk a little bit about who we are, what we do and our team. We’ll give some fun facts along the way so we’ll have some audience participation sort of similar to what Upi did earlier and we’ll take on a little journey of who General Medicine is.
So we are not a new division, we’re really an old division. It’s a division I joined as a faculty member 15 years ago, but we are a bit new. We’re narrowed, we’re more focused. We’ve lost our hospitalist colleagues, but we are now laser-focused on what we really do in general medicine, which is primary care, geriatrics, supportive and palliative care, and research.
We’re still a large division. We’re no longer the largest division in the department, but we’re still a big division with 45 faculty members, many of whom are clinicians and a lot who are both clinicians and researchers and then PhDs and APPs, and our administrative staff. I’ve told our division, and I think this is true, that we are the bedrock of our department. We are where patients enter our system. We are oftentimes the last touchpoint of the system for patients at the end of their life, be that in palliative care or geriatrics, and our researchers do the work to take innovative new evidence-based and then get that to our patients in the middle of their life.
And so I’m sharing this picture here of some exposed limestone. Does anybody know where this picture is from? It’s in the state of Iowa. Yeah, Dr. Klein got it. So this is a picture of the exposed limestone bluffs along the Upper Iowa River north of Decorah, which is where I’m from, where I grew up. And if you’ve never been up there on a canoe trip or a kayak, I would highly recommend it. It’s absolutely gorgeous. I call it God’s country and that little corner of the state is very different geographically, geologically than the rest of the state of Iowa. So it’s pretty cool. Anyway, that’s my pitch for Decorah.
This is General Medicine. You know what we do? I’m not going to read all of the words on this slide, but we do primary care over the longitudinal of a patient’s adult life, usually with a focus on those patients with chronic multiple chronic conditions. We provide supportive and palliative care to families when they have life-threatening illness or life-limiting illness. We deliver comprehensive geriatric care to their patients and families.
We do a whole ton of research, whether it’s health care, delivery, science, implementation science, rural health science, quality improvement projects that brings that knowledge to the patient’s bedside into our practices, into our clinics. And we do a lot of education as well in our department, not only only with the majority if not all the medical students, all of our residents spend time learning their primary care with our faculty members and we have fellows and other health professionals in their education.
So the rest of this talk, I’m going to give you a little something you may not know about General Medicine and then use that to introduce members of our team. So first audience response question and please just shout out some answers.
Any idea how many primary care visits our faculty members in General Medicine did in the last fiscal year? This doesn’t include VA, this is university -only clinics. Any idea? Ballpark? 40,000 – it’s higher, not quite that high. I like it though. So almost 54,000 unique clinic visits to around 15.5 or so, 15,000 unique patients. It’s a lot of patient visits and our faculty are doing a great job, and these are the folks that are doing it.
All these facts that I’m giving you, I had nothing to do with any of these achievements. This is from our faculty members that are doing it. I’m just merely the spokesperson. So this is our team at Iowa River Landing. Dr. Donelson, Dr. Klein, our medical directors out there. They do a great job and really a strong team of people who have dedicated their lives to doing really good primary care, which is a challenge every day, but it’s also very rewarding, and I think these people would tell you the same. Okay, next fact.
How many practice locations do General Internal Medicine providers provide clinical care?
This is a single digit, so I already told you Iowa River Landing. Eight? Little bit lower but close. Six. So we’re at six locations. IRL, the university, the VA, Heartland Clinic, which is a private practice primary care clinic that was absorbed as a part of the merger with the former Mercy Hospital. We have a provider that works at the Woodward Resource Center, which is a state-run facility in Woodward, Iowa. And then we actually have a provider who works with Iowa City Hospice as well.
So these are some of our other practice sites. I’ll get to Hospice or Palliative Care in a second. But we have a core group of VA primary care, which I’m also a part of. I didn’t put my picture in there. And then our Heartland Clinic, Dr. Moonjely and Dr. Ovrom, who’ve been primary care providers for many, many years in the community. Dr. Ovrom’s actually retiring soon after, I don’t know, 35 years or something like that, doing primary care and Dr. Wu as well. Margo is a legend in geriatrics, not only clinical service but education across the state and the country. Dr. Angel is our provider at Woodward and then we have a couple other faculty members with OCRME.
Okay, next. Now we’ll go palliative care. How many others? So our palliative care program is certified or accredited by the Joint Commission. So the question is how many other palliative care programs nationwide received Joint Commission accreditation before us? It’s actually four. So we were the fifth. Our palliative care program was the fifth program in the country to receive Joint Commission accreditation. Our palliative care program just celebrated their 25th anniversary as a program at our institution. So they have been national leaders.
This is our team in Supportive and Palliative Care. Dr. Struck directs the service. Dr. Hagiwara and Dr. Clark have been our leaders of our fellowship program. Dr. Kirkpatrick I mentioned earlier is the medical director for Iowa City Hospice. a strong team, they’re all over the hospital and in the clinics and in the cancer center, et cetera. They’re a strong team.
Number four, total amount of grant funding. So total dollars, indirect, direct and indirect dollars to our General Medicine faculty over the last fiscal year. Upi told you, what was it, 98 million for the department. How much of that is General Medicine? So $25 million is credited to General Medicine. Actually the majority of that is actually from the VA. So we have a big VA resource funding research in our division and led by these people.
Dr. Perencevich leads CADRE at the VA, multiple other researchers, very involved at the VA in rural health. Dr. Reisinger is involved with the clinical and translational science center here at the university and many other faculty that I know you’re aware of and do great work and have done so for a long time. These folks are a powerhouse. I was going to tell you how many papers they published in the last year, but it’s so many. It’s impossible to figure out how many papers these folks publish on a yearly basis.
This is my administrative team other than me, this is everybody else that gets it done every day in General Medicine. They’re a great team. I’ve known Jennie for a long, long time. Jamie as well, a long time. These others I’m meeting and starting to work with them are really good. So they’re a great team and I’m humbled to get to work with them every day and they’re teaching me a ton on a daily basis.
Okay, number five. What percentage of this is going to for more of an Iowa focus, what percentage of our faculty, both our faculty and APPs that receive some sort of their training at the University of Iowa, be that their residency, medical school, MPH, PhD, whatever. About 69% of our faculty received some percent of their training at Iowa. We recruit people who come here and want to stay. I think this is an impressive number in our division. Certainly we want to recruit the best from everywhere else, but we also want to keep our own people.
My sixth need-to-know slide was how many clinical FTE have we lost in the last three or two years? We lost about seven clinical FTE, mostly at IRL. In the last two years there was about 7,500 patients that had to be absorbed into other panels. Some went to geriatrics, some went to family medicine. Our departures were mostly retirements. Dr. Beck, Dr. Davis who were longtime primary care providers here and had big, big panels.
Our folks are working hard, but we are hiring, whether that’s clinical people, MDs or APPs, both at IRL and Heartland, we’re going to be hiring in Palliative Care and we’re certainly involved in the cluster hires and other strategic hires within the research divisions. We have challenges for hiring. We’re aware of that, but our demand for our services are too great. We want to be in the primary care business and in other things that we do, and we have to grow. So please help us recruit for us, support us, and we’re here for you. We’re here for the department, here for the institution.
This is a collage of pictures of me through the years and then my family and my boys. So this is my October Halloween picture there. I think I was trying to be a surgeon at that point in my life. I’ve seen the light and came to medicine, but then I think that was my medical school graduation. My picture becoming a chief resident, my current picture and then my family. We took a trip to Rocky Mountain National Park this summer and we’re standing by gorgeous waterfall there. And then my sons are involved in athletics amongst other things. So I don’t know how they do that over the hurdles. There’s no way I could put my body in that position. But anyway, thank you.
Dr. Singh: Wonderful. Thank you so much. The goal is to have somebody from a division or a program sort of talk a little bit about what they’re doing every year. I think I’m guessing that even for those of you who’ve been here for a long time, some of what you heard is new and it’s great to have that.
So in terms of where we’re going both short- and long-term goals, I want to add, there’s a couple of requests I have for all of you. You’re going to get emails for completing a number of things, the Working at Iowa Survey and for those of you who are in specialties that are eligible for Doximity, please do. And then we’ll talk about annual reviews.
This is the Working at Iowa Survey, I think you got it a few weeks ago and will be sent a reminder. We need, the institution needs, to hear from you, so please do submit this. I don’t think everything is perfect here. I don’t think everything is perfect anywhere, but I do think this is an important way for us to have our voices heard, and I do think the leadership works hard on working towards improvement. So if we don’t speak up, our voices won’t be heard. So please do submit that. You can look at that link or you can scan the survey here.
Then also for those who are on subspecialties that are registered for Doximity, please register so that we can participate in the Best Hospitals and Best Children’s Hospital surveys. It’s a good way to show our support for UI Health Care and improve our national recognition. You have to claim your profile by October 31st to be able to vote next year. So again, the list is here as well as to register. This applies to many subspecialties, not all, but I see somebody scanning. Pulmonary. Good for you.
And then I want to talk a little bit about annual reviews. So I don’t know what the culture has been here about meeting with your division director and getting mentoring. I don’t know what it’s been, but it is going to be a more formal expectation, because I actually think on a weekly, daily basis, you see somebody in the hallway, you have a conversation and you get formally and informally mentored and guided. But I think this is really, really important.
So it’s a collegiate requirement, but I actually think beyond that, it is the reason we’re all here. We’re all here to grow. I came here to grow. I came here to learn new leadership skills from all of you to grow in my journey. And everybody, including me, deserves a chance to get feedback on a regular basis and to grow from that. So this really is an opportunity for faculty to meet one-on-one with your division director not in the hallway but a 30-minute meeting or something that’s assigned, to get feedback and to outline and discuss goals, including plans for success or to mitigate challenges that have arisen.
In my opinion, nothing should come up in a promotion or reappointment package that hasn’t been discussed multiple times in an annual review. So maybe that hasn’t been the culture here that we do it regularly, but it is a culture moving forward. And that takes two, right? So that will mean the faculty submit their paperwork, that you expect a good meeting with your DD and then you go from there. So we’ve tried to move up the timeline a little bit so that we give everybody enough time. So forms are going to be available for faculty completion beginning in mid-November. We’re going to ask the division directors to start the process earlier. The deadlines are listed here. We haven’t been very good at this in the past and to me it’s not that it’s a collegiate requirement to me. This is a growth requirement. This is what we all should and expect and need from a place that we’re working.
So we’re going to really do some emphasis on research. We’ve had some substantial recent successes. I’m just showing some examples. This is Anil’s lab, I think this is Rebecca Dodd’s lab and this is Song’s lab. I couldn’t list all of them and I also didn’t want to miss somebody, but we’ve had multiple new and renewed grants in FY 26, wide variety of types across many divisions. There’ve been two large program project wins in oncology and pulmonary. A lot of trainees are publishing very widely and in very high journals.
But I think we have to say there’s a lot of challenges here currently. All the issues with the H1-B visas that affects our ability to hire physicians. It also is going to have an impact on research labs as you’re looking at hiring trainees and grad students and postdocs. I mean I’ve heard, I know the same thing you do, which is that there’s sort of murmurings nationally that there will be carve-out exemptions for health care workers, but the government is shut down, which is our second big challenge. And so we haven’t heard anything further. I don’t know if that will also include research colleagues.
I think we should keep hoping for the right thing. I know that the college, the university is very involved with advocating for some changes to that. And I think you know what I know at this point. So right now it’s really quite a little bit of a standstill and uncertain. And then of course on top of that we have the government shutdown. So it seems like they vote every day, every other day in the Senate. Nothing seems to move forward and it does feel like very much of a blame game. Everybody’s pointing to the other team. I don’t know what the answer is. I don’t know if I don’t have any insights about when this will happen or change.
I do think these are substantial, real practical limitations to where all of us are at. I’m going to cross my fingers and my toes and hope that cooler, calmer heads are going to prevail at every level and that some of these things, all of these things will get mitigated. And so we do need to keep our eye on the ball, which is that we continue expanding our research faculty. And so we’re going to talk a little bit about that.
So I’ve said this over the year that we talk a lot about clinical care, we talk a lot about education, but our commitment to the research mission continues. And sort of the most practical way to show that is that we are going to continue with supporting the people who are already here as well as expanding through cluster hires. Though we’ve talked before, we have two cluster hires that we’ve initiated. One for basic and translational research to fund up to four to five positions. Josalyn Cho and Chad Grueter are the co-chairs. One for outcomes research and health services. Again to fund four to five positions. Diana Jalal and Phil Polgreen are the co-chairs and they’re here and they can help answer questions.
We’ve made this to be all levels, assistant, associate and professor. And we’ve included tenure and clinical track because we know that some people who are doing clinical translational research may fit into that category. We really want to increase cross-disciplinary research. We really want all of you to help advertise for best candidates and let us know what you think we should prioritize during screening.
I just want to list the areas for the two things. So for research areas, for basic and translational, everything from stem cell biology, metabolism, inflammation, autoimmunity, tissue remodeling, fibrosis and cardiac and vascular biology and even projects and programs that cross multiple of those. The committee is very broad and is listed here. Again led by Drs. Grueter and Cho. And you can see Song, Yumi, Eli, Mark Burkard, Amy Ryan, Jennifer Bermick, and Sara Zimmerman is the admin supporting them.
And then for health services research, cross-disciplinary research, implementation science, clinical trials, health systems research, data science, informatics and AI. Drs. Jalal and Polgreen are co-leading, and you can see the talent that’s assembled for that. I want to just stop for a second and see if Josalyn, Phil, if either of you have any comments, I’ll say one thing or two things. We need all of you to help us get people to apply for these. This is a time where there’s uncertainty across the country, so there may be concern about moving, but these are tenure track or other positions that will come with institutional support and great new colleagues. And so I think we want to encourage people to apply. So we’ll send you out the links, but I think the more outreach that people can do, the better.
Dr. Polgreen: Absolutely. And so if you have any form of trainees or colleagues, please encourage them to apply. It’s really easy. We’ve been intentionally broad both of these. There aren’t a lot of hoops to jump through, so please share the word early on.
Dr. Cho: This is great for early career PhD candidates or MD PhD candidates, mid-career people. So if there’s someone in your field and you feel comfortable reaching out, please do so. If you’d be more comfortable with the search chair reaching out, please just email us to do that.
Dr. Polgreen: Reach out to the division directors. So feel free to talk to them. But also just like Josalyn said, just encourage people to apply, reach out or scan the code.
Dr. Singh: The way I would say it is and Dr. Welsh is an example of what the institution and people here have achieved and it’s a wonderful honor, but what we need is to develop the next generation. Dr. Welsh’s career is going to continue for a long time, but we have to sort of plant the seeds for the next generation of people. So we do need everybody’s help. It is an uncertain time. It’s not easy to recruit.
We have one of my first recruits. Ryan, you want to raise your hand? So Ryan Peterson is a PhD faculty member that joined July, June 30th, end of July. You got your PhD here in Biostats, and then were in Colorado for six years and then has recently come back. And so he’s in Biostats, has a joint appointment at the Department of Biostats, is working with ID and pulmonary and a number of groups. So I do think we want to sort of recruit more people. So if you’ve trained at other places, if you have colleagues at other places, please do reach out.
With that, I’ll just end and I do want to thank the team who gathered all the data for me to share with all of you. I just get the privilege of coming up here and talking, but there’s a big team in the divisions and in the department that are doing all the work. So I’m happy to help answer questions. I do know there were three questions online. So what I’ll do is I’ll answer one question that was online first and then we’ll go to questions here. Let me see if I can find it.
Online question: How will the department ensure faculty are informed and consulted before program or clinical assignment changes? Faculty often learn of major decisions only after they occur.
Dr. Singh: So I’m not sure exactly what this refers to, but there have been two decisions that have been made in the last year where division directors and faculty were not involved. Every other decision that’s been made over the year, the division administrators are aware or are consulted, and the division directors are consulted. So I don’t think there’s anything that we’re doing that hasn’t had a ton of input. So I’m not sure about clinical assignment changes or program changes, what that necessarily refers to. But I would encourage people, if obviously somebody feels this way, to reach out to talk a little bit more and to understand maybe what the rationale was for some of those changes. And if there are issues with sort of communication, we are encouraging our DDs and DAs to communicate with all of you.
Audience question: What can we do from a departmental side of things to modernize our IRB to make our research more efficient?
Dr. Singh: Yeah, that’s a great question. And for those who may or may not have heard it on Zoom, the question was that maybe our IRB and our practices around it need to be a little more integrated. So I think it’s a good question. The timing of it is good. We recently had at an institution level at a Carver College of Medicine, four external reviewers who came and looked at the research program in whole and have given advice to the dean’s office. I haven’t seen that paperwork as to what they’ve advised, but we will. And I think some of it, I do know some of the themes around it were to modernize, update and expand all the support services that go with research. For example, if NIH funding is more unstable, more siloed, we should be doing more clinical, translational, we should be reaching out. But then you need all the abilities to do that. So that’s a great question. I’ve written it down and I’ll take it forward to Pat Winokur and others.
I’m guessing that nobody will be surprised when I bring that up. I can’t imagine that you’re the only one who’s noticed it. Some of this it feels like we’re just getting in our own way. At the same time we’re a state institution and there’s going to be some rules and regulations. When I was at Stanford, I felt Stanford was so conservative, so conservative, so careful and other places just weren’t. But that I never was going to get that to change. We just learned how to sort of navigate through it a little bit more efficiently. Good question. Any other questions before I go to the question online?
Online question: Can you clarify how the Holden Cancer Center and the Hem-Onc/BMT division coordinates strategy and accountability? Their structures appear poorly aligned and confusing to faculty.
Dr. Singh: Okay, so let’s go to the second thing first that their structures appear poorly aligned. So the goals of the HOBMT division and the Holden Cancer Center are to take care of cancer patients and through the state of Iowa. So pretty aligned. The administrative structure in the Hem-Onc division is that it’s a division within the Department of Medicine. The division director reports to me, I report to the dean. The Holden Cancer Center director is Mark Burkard, who also happens to be a faculty member in HOBMT, but he reports to the dean.
So to me, I think of these as two overlapping Venn diagrams. There’s a lot of overlap, but there are aspects of the Holden Cancer Center that are not part of HOBMT. So rad-onc, surg-onc, etc, are part of the cancer center. I think you can’t have a successful cancer center without the HOBMT division, we’re a large portion of the cancer center. You can’t have, in my opinion, a HOBMT division that doesn’t have a really successful cancer center associated. So we’re lucky that we have a comprehensive cancer center. I think we’re at year 25 with the supplement. Yeah. And it’s great that we have a comprehensive cancer center.
The grant renewal will be submitted in the next year, and so I think they’re synergistic and they’re both together. And so I think those would be, and then in terms of strategy and accountability, I’ve given the two different individuals and who they report to for strategy. I would say so there’s two states in the country where cancer rates are going up. Iowa is one of them. Do you know the other? Texas? Nope, not Texas. Huh? Not Kentucky. Utah. So there’s two. See, you learned something. There’s two states in the country where cancer rates are going up. Iowa and Utah, not clear why.
So thankfully because of the HOBMT division, because of the cancer center, our rates of death are not going up because of detection. But so certainly those, our goal has to be provide cancer care for the state of Iowa and to innovate new treatments, you’re going to need the cancer center for a lot of clinical trials, innovation and to partner with rad-onc and others, and you’re going to need the HOBMT division for providers.
Online question: Would you support creating a regular open forum for tenure track faculty to discuss academic priorities directly with leadership separate from administrative meetings?
Dr. Singh: So I’m all for having regular open forums for tenure track or clinical faculty or trainees. I don’t think one or the other is more important than another, but I’m happy to do that to discuss academic priorities directly with leadership separate from administrative. So I don’t know if that means separate from the division, but if this is something of interest, I’ll take a quick poll. If we should have some open forum.
Does anybody think that that should be separate from your division meetings? I’m trying to understand what this might get to. So I’ll say for anybody on Zoom or here, if you sent this question, feel free to reach out to me or reach out to Sherry if you don’t want to reach out to me directly and tell me what this is. But in general, my answer is always going to be okay. Yes, to having open forums for faculty and trainees of all sections to talk about things.
Audience question: There was a plan at one time to have you come more regularly to division meetings. Is that still?
Dr. Singh: Yeah, so I think I have four more to do. So I’ve done my second round. I think I did some coloring with you. Did I not, did, yes. I got some crayons and some nice color. It was very soothing actually at the last Immunology meeting, so I’m happy to keep doing that right now. I think we’re in a six-month cadence, but if it needs to be more frequent, I’m happy to do that. There are some division meetings where they’re always with one of my overlapping things, so it’s been a little bit harder and I’ve been traveling quite a bit. But yeah, right now I’m doing every six months. But if it needs to be more frequent, I’m happy to do that. I do realize that every division within the department is going to have some very specific challenges or opportunities and very specific either operational or other considerations. And I’m happy to hear those.
Audience question: There was a period of time where we were hearing a lot about quality and if possible I missed an update, but I’m just wondering if we have things heading in the right direction or new initiatives that are working.
Dr. Singh: Yeah, good question. So the question is that for a while we were hearing a lot about quality. How are things going? Are we going in the right direction? Are we going in the wrong direction? And what are new initiatives? So I talked a lot about it when I first came, despite the great care we provide that we didn’t do well on Vizient metrics. So the good news is that this year’s Vizient metrics came out, we’re doing substantially better than last year.
It has taken a lot of work from all of you as well as the quality team and attention to details. I think it’s good. It’s a promising sign. What I would love to see is for it to get better and to be sustained. So it becomes a part of our culture. So I know it’s great to say we are Iowa and we’re going to have our own way and that’s great for many, many, many things, but for some of these things around delivery of care, coordination of care, quality, standardization actually helps. So we’re doing better. We want to sustain it. I think it’s going to take a lot of work.
Audience comment: Yeah, everything you said is true in safety. We have improved greatly. That was the driver of our improvement in rankings. Mortality improved in the last six months of the prior year. Some of that was due to changes in the way we improved our clinical documentation. We just weren’t scoring the patients correctly. It was leading to us losing credit for how sick our patients really are. The area where we continue to struggle as an institution, particularly the adult inpatient hospital, is on what Vizient calls patient-centric and that is our Press-Ganey surveys, the reported patient experience of the people we take care of, we are struggling not just in doctor and nursing communication, but in the restfulness of the environment and our ability to explain to patients what we’re doing to treat their conditions and what their conditions actually are that we are treating.
Dr. Singh: The other thing we’re struggling with is length of stay. It is going in the wrong direction. We just really need to work on this. So I think that the safety and mortality numbers have gotten much, much better. So I mean, even when I first came and I saw the scores, I was like, wow. But I was never worried that care here by any one of you or anybody on Zoom or anybody of our providers, people are always doing the best they can for that patient. But somehow using these metrics that are used nationwide across all hospitals, we are not representing ourselves the way we want to. Whether that’s our documentation, whether that’s the fact that we complain about our colleagues and say, this department’s not great, and that department’s not great. Patients hear it. Their families hear it. Whether it’s that we don’t have single beds, rooms, right?
That’s something you and I can’t change. Whether that’s that we don’t circle back at the end of the day and tell the patient that of the 10 consultants have come through what the plans are, whether that’s the fact that we have delays in or time or in procedures or in imaging. Whether that’s because patients sit in the ED for 36 hours because we don’t have a bed.
But some of those are better than before. What I would love and I think you would love, and the whole team that works on this is to see it sustained, and then some of these things I think should become part of the culture so that it isn’t, a ton of repetitive stuff to keep. If it becomes a part of our culture, then that’s something that say we say, oh, that’s now sustained improvement. Let’s work on the next two or three things because a lot of this is hard, hard work by individuals. Thanks for asking the question. Any other questions? We have five more minutes together. Any questions online?
Audience question: What is a venti skinny?
Dr. Singh: I don’t know. That was the coffee that Kim Staffey was drinking. I think venti is an extra large size, and skinny I think means non-fat.
Any other questions? Can I do my usual, take a selfie? Yeah. I appreciate all of you coming. Thank you all so much. Thank you.
