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Colleagues commend CEO's tenure

Outgoing Chancellor for Health Affairs Dr. Ralph Snyderman taught Dr. Sandy Williams more than just the complexities of medical leadership--he also taught the medical school dean how to fish. Williams reminisced about a trip to Canada last summer in which the pair fished for Northern pike, demonstrating the personal side to his 30-year relationship with Snyderman, Duke's health care impresario who will leave his position in June 2004.

Tales from medical administrators testifying to Snyderman's dynamic and far-reaching leadership are common. After assuming the chancellor position in 1989, he personally steered the Medical Center's development into an expansive Health System and has added an undeniable mark to many of Duke's recent initiatives, particularly the Institute for Genome Sciences and Policy and the Duke Clinical Research Institute.

"The high rankings and national stature that we currently enjoy at the Duke Medical Center are attributable, in no small part, to his wise leadership over the past decade," Williams wrote in an e-mail.

Criticism of Snyderman is also common, with many objecting to what they call a harsh leadership style. Ten years ago, several physicians circulated a petition lobbying against Snyderman's continuation to a second five-year term as chancellor.

He has often seen his face put on many of the Medical Center's controversial episodes, such as the conflict between Duke Hospital and its nursing staff when nurses voted on whether to unionize. Snyderman claimed he has worked diligently to improve the Hospital's work culture. "It's been one of the most difficult, frustrating endeavors I've ever been involved with," he said.

Williams defended Snyderman's personal touch. "He has been my friend and mentor, coaching me through the initial period of my deanship with just the right balance of constructive criticism and non-intervention," he wrote.

Snyderman said the final decision on a successor will probably wait until after President Nan Keohane's replacement is chosen, so the new president can weigh in. An official search will likely begin in September.

Since Snyderman plans to remain active for the next 16 months and will return to Duke after a one-year sabbatical, administrators expressed hope that he will remain a central architect of Duke's future.

"I will certainly miss working with him, but aim to make the most of our time together to ensure that the aspects of genomic medicine that are so central to his concept of personalized medicine will continue to develop here," wrote IGSP Director Huntington Willard in an e-mail. "The IGSP owes its very existence to his vision and energy and will stand as his legacy."

Snyderman had a similar role in the founding of the Duke Clinical Research Institute, which has gained wide respect for the study and conduct of clinical trials. Because of his expertise as a physician-scientist in immunology and his experience in research and development at Genentech, a San Francisco-based biotechnology company, Snyderman had the unique foresight to support DCRI, said institute Director Dr. Robert Califf. "He gained an appreciation for where science and medicine are intersecting," he said.

Now, the two institutes are poised to do ground-breaking work together in another of Snyderman's pet projects--prospective medicine--for which he has achieved national prominence. Their methodology would be for IGSP to identify the genetic basis of a disease, and for DCRI to then translate that knowledge into human treatment, hopefully subverting the disease before it can develop, Califf explained.

At the same time, Snyderman plans to remain an outspoken voice for new models of patient care. "He has distinguished himself on the national scene as a bold and innovative leader, calling for necessary changes in our entire medical care system," Williams said.

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