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Dzau looks to catapult Duke medicine

Since he was appointed chancellor in 2004, Dr. Victor Dzau has set his sights on a top ranking for Duke's health system and medical school-and this year could be the year.

But Dzau, chancellor for health affairs and president and CEO of the Duke University Health System, will have his work cut out for him.

For 14 straight years, Johns Hopkins University has held the coveted top spot in U.S. News and World Report magazine's annual rankings.

The chancellor, however, is not intimidated by the competition.

"Duke has such potential," Dzau said. "We should be up there in the top three-among the best of the very best. I think Johns Hopkins should worry."

During the past few months, he has implemented a number of major changes that have many people thinking that DUHS and the medical center could rise a few spots when the 2007 U.S. News rankings are released next summer.

Two weeks ago, Dzau announced that DUHS would transfer $280 million to Duke's medical and nursing schools in order to support research and education programs. But major developments began long before the boost in funding.

Within the past year, Duke has seen the birth of several new buildings and institutes, including the graduate medical school in Singapore, the Global Health Institute, a new building for the University's School of Nursing and the DUSON Translational Institute.

In addition, Dzau has revitalized DUHS's focus on health-care disparities on both the local and global levels. Emphasizing the importance to "practice what you preach," he helped establish DUHS and DUMC as smoke-free environments by July 2007.

DUHS's $280 million gift

DUHS announced Sept. 26 that instead of donating its average yearly gift of about $20 million to the University, it would give a lump sum of $280 million to support the medical school-arguably one of the biggest moves in Dzau's time as chancellor.

The funding, which University officials said they believe to be the largest of its kind, will be divided up over the next ten years, Dzau said.

"It's very important to me that I emphasize the academic enterprise-scientists may feel the chancellor is just running the health system and that's not true," Dzau said. "The key issue we said was, 'Let's give this tremendous investment as a statement of support.'"

The funding came as the medical center was approving its new strategic plan-the structural outline for the medical center's development during the next several years-an ideal moment for DUMC, explained Dzau.

Dzau said the money, which came from DUHS's reserve fund and not from direct operational dollars, will not detract from any programs or progress in the health system. He added that he and the Board of Trustees did a "very careful financial analysis" prior to the contribution.

"It's time for the next phase of the next era for Duke medicine preparing itself for the rest of 21st century," Dzau said. "To have the right people, the right environments, the right investments-we have to be bold and not timid."

The money will make many of the strategic plan's goals a reality by constructing new facilities and revamping old ones, recruiting top-tier researchers and scientists from around the world and emphasizing community outreach through Durham-based programs that address health disparities, Dzau said.

In addition, the money will allow the medical school to further its Medical Scientist Training Program, which helps to foster students' careers as physician-scientists.

Dzau also pointed to projects such as increasing the size of operating rooms, creating cancer, cardiology and musculoskeletal centers and an extension of the pediatric hospital.

A part of the donation will also go toward the creation of the School of Nursing's Translational Institute, said Catherine Gilliss, dean of the School of Nursing.

"[The Translational Institute] will facilitate the knowledge development and new knowledge application cycle in nursing care delivery, bring more advanced technology to our educational programs and establish some financially viable and innovative models of nursing service delivery," Gilliss wrote in an e-mail.

The institute will also be funded by the $52.7 million grant it received from the National Institutes of Health last week.

Serving the local, global community

Although he is one of the most powerful administrators on campus, Dzau said he works for everybody.

"People always say, 'No, the Chancellor is the boss'-quite frankly it's the opposite. I serve the community, patients and staff, and I serve faculty," he said.

Dr. Sanders Williams, dean of the School of Medicine, highlighted Dzau's commitment to service and enthusiasm as two reasons why DUHS and DUMC have been able to accomplish so much since 2004.

"Dr. Dzau has amazing energy-the word 'indefatigable' leaps to mind," Sanders wrote in an e-mail. "He is tireless and relentless in the pursuit of excellence."

Sanders, who also worked closely with Dzau's predecessor Dr. Ralph Snyderman, added that the two men have distinct approaches to the job.

Snyderman focused heavily on the creation of new institutions such as DUHS and the Duke Clinical Research Institute, Sanders explained, while Dzau has focused on "system integration," or the fusion of all of the elements of Duke Medicine.

Despite his attention on system integration and creating a positive culture within DUHS-which Dzau calls the main task he has yet to accomplish-Dzau has also focused on the creation of institutions, such as Duke's Global Health Institute.

The institute will unite the efforts of faculty, administrators and students across all campuses and centers to promote education, research and service in health care to underserved populations locally, regionally and around the world, Dzau explained.

Dzau has also emphasized the need for faculty diversity during his tenure as chancellor, and has recruited a multitude of minority and women leaders for the health system.

"I hope we're leading by example-I walk in the room and it's almost like second nature now for me to say, 'Gee, there's not enough women and minorities in this room!'" Dzau said. "One woman and all white men just doesn't reflect society and its diversity in people and opinion."

Pushing toward the 'top three'

With such dramatic changes to DUHS in such a short span of time, conflict inevitably arises.

Dzau said he commonly receives "hate mail" regarding unpopular decisions he makes, but explained that he remains committed to doing what he thinks is best for DUHS and DUMC.

"My number one job is service, number two is to lead, to inspire, to create vision [and] to be able to be bold enough to make certain decisions to move the institution in the right direction," Dzau said. "I feel if I'm successful, people know what it's about-they say, 'Oh wait, it's not about Dr. Dzau, it's about the institution.'"

Even critics of certain policies have said that, on the whole, there is a lot to praise about "the institution"-especially this year. "With the exception of [Johns] Hopkins, we're probably one of the few institutions that is top-ranked as both [a school and a hospital] and I'm very proud of it," Dzau said when this year's rankings were released in July. "We obviously can do even better."

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