Attempting to fill the impressive shoes of the past chairs of obstetrics and gynecology at Duke University Medical Center is no small challenge. But Dr. Haywood Brown, nabbed from the Indiana University School of Medicine last year to replace Dr. Charles Hammond as chair of the OB-GYN department, has been making big strides in those large shoes.
Brown assumed duties as chair last October when Hammond stepped down after 22 years to spend a year as president of the American College of Obstetricians and Gynecologists.
"[Brown has] re-energized the department considerably," said Hammond approvingly. "He brings a real initiative and enthusiasm."
In a statement last October, Brown highlighted improving research, education and patient care as the first objectives on his agenda and has since done exactly that, proving himself to be "a first class 'gyno' doing a first class job," Hammond said.
To Brown, the number-one priority for the department is re-directing the residency curriculum to be more attentive to "rounding and maximizing the learning and teaching opportunities" as an OB-GYN resident at Duke.
Although Brown acknowledges that there is a "serious pull on residents' time," particularly in light of the fact that medical residents are restricted to work less than 80 hours a week, he said he is adamant about not letting his residents "work at the expense of their education." The department's weekly Wednesday meetings, for example, have since become "protected education time," that are mandatory for residents to attend.
In addition, there is a national trend of OB-GYN becoming a decreasingly popular clinical specialty.
"This is a significant concern to [OB-GYN] as a discipline. It is a physically demanding and consuming discipline and [the] rising cost of medical liability is pricing some practitioners out of practice," Hammond said. "Put these two things together, and it begins to reduce [the number of] those interested in the discipline."
To combat this national phenomenon, Brown is encouraging changes in the length of medical student rotations in the OB-GYN department, spearheading efforts to raise awareness of the specialty through medical student interest groups and recruiting quality residents.
"The current first year residents here now are the first ones selected by Brown," said Dr. Stanley Filip, the division chief of Duke Women's Health Associates who is currently involved in the selection of next year's residents coming to Duke's OB-GYN department. "We're seeing the same level or higher quality of applicants since last year and we certainly haven't seen any decreases."
In addition to Brown's attention to residents, he is also aiming to boost the OB-GYN department's national rankings.
"We have been good at a lot of things, but now we want to be great," Brown said.
Brown now has laid out a five-year plan to make OB-GYN a top-10 department in research, education and training in addition to improving the department's mediocre ability to bring in National Institutes of Health research funding. "We're now 40th in the nation for NIH funded research--that's not bad but we can be better," Brown said.
The department's renewed emphasis on research is exciting to OB-GYN division chiefs like Dr. David Walmer.
"[Brown] has been making internal strides to make it easier for the faculty to compete for federal dollars," said Walmer, who assumed the position of division chief of Reproductive Endocrinology and Infertility shortly after Brown arrived. "When I came here 16 years ago, the focus was on research. But then managed care came in and the focus was on survival--we are in an environment of shortened resources. [But] now it's time to shift back toward research again."
Patient safety is also very much at the top of Brown's agenda and the Medical Center as a whole. Every department at Duke has been charged with having monitoring tools for patient safety, said Brown. In the OB-GYN department they have "time-outs" in the operating rooms, where everyone looks around to make sure that everything is in order.
"Nobody comes to work and says, 'I want to hurt somebody today,'" Brown said.
Sandy Williams, vice chancellor and dean of the medical school, further notes that he has found Brown successful in making Duke a friendlier environment for patients.
"I recently took an afternoon to observe the functioning of our OB-GYN clinic at Duke South and found it to be a model for good management," he said. "Also, just last week, a member of our Board of Visitors stopped by my office to express gratitude for the care his daughter received by Dr. Brown."
In the meantime, Brown appears to be filling in those large shoes as chair of the OB-GYN department pretty well. Williams said faculty morale is very good and among the best in the Medical Center.
"I think the faculty here has uniformly respected Brown," Filip added. "In the past year, three new chairs have been appointed and we think we've got the best one."
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