Based on the results of a confidential review of Chancellor for Health Affairs Dr. Victor Dzau's performance, President Richard Brodhead recommended that he be reappointed to a five-year term Tuesday. Dzau, who is also the CEO of Duke University Health System, sat down with The Chronicle's Matt Johnson in March-as the review was being conducted-to talk about the initiatives he has undertaken since coming to Duke in 2004 and his plans for Duke Medicine going forward.
The Chronicle's Matt Johnson: Looking back on the last few years as chancellor for health affairs, what tangible accomplishments are you most proud of?
Dr. Victor Dzau: I don't think you can simply separate tangible versus intangible because a good leader has to have vision and has to inspire people. You can build a building and call that a tangible achievement, but I would say actually changing the culture of a place and inspiring people to have the right values and work for the right mission is actually more important because if you do that, the tangible things will come with time. At the end of the day, it's about what we believe in, so I put that first.
As far as achievements, we are now number two in [National Institutes of Health] funding, and that's a big jump that's very exciting. For the health system, patient-centered care has been very important. When I first came, I wouldn't say that we weren't doing it, but it certainly wasn't a mantra and now it's a mantra. It's not perfect because you always find problems here and there, but I think the patient-safety work we've done is very measurable. We just looked at the [Centers for Medicare and Medicaid Services] measurements for quality of care, and we have by far the best scores in the Triangle and are along with the best in the country.
Importantly, I think we are now transforming this campus. We are talking about a new hospital addition, a new cancer center and a new medical school education building. I think things look very good right now.
C: How do you handle your role and the various responsibilities you have?
D: I think it's important to remind people that as chancellor, I have both an academic role and a health system role. Historically, I think this position has had a little more emphasis on the health side, but I'm working to change that.
We need to adapt our curriculum to the needs and opportunities of the 21st century. Everyone recognizes that the health care environment is changing dramatically, and doctors need to know a lot more than just diseases and diagnoses. I want our students to be great leaders in the future. We created a residency in global health, and I'm thinking about applying that model to a residency for M.D./MBAs that can give contemporaneous experience in clinical work and management. I see students graduating with M.D./MBAs and I say, "Why shouldn't we create a pathway for them and have more leaders retained in health care versus going to consulting or venture work?" I'm an accidental leader; I didn't train to be one, but I think others could be properly trained.
C: What challenges do you see facing DUHS in the future?
D: Within the health system the challenge is going to be to continue integrating all the components. I'd like to see much better alignment with the health system and the Private Diagnostic Clinic. That's going to be difficult, but I'm very encouraged by the leadership of the PDC. There's been a lot of effort on their side. They have gone out and visited other health systems and looked at how that relationship is. It's difficult because there's a long history and we have to put a lot of effort into building trust, but I think we'll get there.
My belief is that reimbursement [from insurance companies and government health programs] has been getting worse and worse, and we expect reimbursement to continue to decline. Everyone knows the cost of health care is going up, and it must come down. I would hope sincerely that our next [national] president is going to take this on. I won't mind if we have to tighten our belt for the good of the country. It would make my job a little more difficult, but maybe more satisfying because we now know we can deliver care to more people who need it.
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