Dell Medical School

Clay Johnston, dean of the Dell Medical School, has started from scratch in March to build up the staff and partnerships for the school. Johnston’s greatest challenge thus far has been to focus his energy on key functions of the school, such as initial accreditation.

Photo Credit: Ethan Oblak | Daily Texan Staff

Editor’s Note: This is the last in a series of Q-and-A’s with UT’s deans. Dr. Clay Johnston is dean of the Dell Medical School. He was appointed dean in January 2014. The interview has been edited for clarity. The McCombs School of Business declined our requests for an interview.

The Daily Texan: What sorts of things have happened in the medical school since the Texan last spoke to you? 

Clay Johnston: We’ve been hiring a lot of people. Hiring people is one of the most important things we do. We are almost entirely focused on [hiring] leaders. Now we have three department chairs, with another four to recruit. We had a visit from the accrediting body in February. And that visit went really well. We will hear about accreditation for sure in June. If that goes well, we will start accepting applications for July 2016.  

DT: What kind of relationship do you foresee between the medical school and the rest of UT? 

Johnston: We have started the first program that cuts across schools, called the Design Institute for Health. It’s us and the College of Fine Arts. We will announce another program like this that will include LBJ, McCombs and the Law School within a month. In addition we will start programs that reflect how we hope to find solutions to health problems.  

DT: What has the recruiting process been like so far? 

Johnston: For us, the most logical way to recruit is to recruit the leaders and have the leaders recruit their people. There are some urgent needs we have to fill, so we are recruiting a small number of faculty along the way. In terms of staff, we met those needs right away. We did inherit clinical faculty from UT Southwestern. 

DT: Recently, the University announced a partnership between the medical school and Huston-Tillotson University. Can you tell us about that, and what are the things you look at when it comes to working together with other organizations, such as Seton? 

Johnston: We have a bunch of partnerships, and we will always rely on those. As opposed to our own stuff, we are trying to work as a coordination and creativity engine to move other entities forward. Seton is a key one because they are a primary in-patient partner. The other major partner for us is Central Health, the Travis County health care district. They make sure that poor people get health care and they do that through contracting with different providers. A lot of teaching will happen there. ... Huston-Tillotson is brand new. We are focused on how we deal with mental health disparities in Travis County. Huston-Tillotson is great partner to help us think about that. 

DT: How can the medical school address disparities in health care access? How could it work to alleviate some of the problems? 

Johnston: I see that as one of the critical roles for us. Right now, too much money is being spent on the emergency room and stuff that happens in the hospital, whereas if we shift the dollars and spending more to promoting health, creating a better environment for people, encouraging them to make better choices and identifying conditions early, we could save tons of money and people would be happier and healthier.  

That’s particularly true in neighborhoods where there’s more poverty. What we are interested in is shifting the payer model. Our role is to help these populations to identify the things that could be effective, potentially to coordinate different practitioners that are acquired to create those plans, directing payers toward wiser investment to their dollar. It will be more effective by bringing good ideas and promoting smart policies and the infrastructure. 

DT: How do you plan to help with students’ tuition and also increase diversity? 

Johnston: Our goal is to have no tuition for a third of our students and to keep tuition low for the other two-thirds. We have scholarships for people who plan to go into primary care — it’s probably going to be a forgivable loan program as the way to encourage it. 

The diversity issue is complicated, and it’s going to be a long-term issue for us. It is important, ultimately, to have physicians look like the patients they are treating. Unfortunately, we’re nowhere close to that in the U.S. health care system. We, as a single school, cannot solve that problem, but we are trying to look at the entire pipeline to interest students in medicine as early as middle school. 

DT: What role do you think the Dell Medical School will play in relation to the other medical schools in the UT System? 

Johnston: We have some fabulous [medical] schools in the UT System. They have been honed through years of tradition. We have this opportunity, and responsibility, to be more representative of where the health care system is going. So the other schools are looking to us to succeed and fail because we are definitely taking some of the risks so they can learn from both. 

Steven Abrams, chair of the Department of Pediatrics at UT-Austin’s Dell Medical School, speaks to doctors and nurses at Dell Children’s Hospital about his goals for the school’s pediatrics department.
Photo Credit: Rachel Zein | Daily Texan Staff

Steven Abrams, chair of the Department of Pediatrics at UT-Austin’s Dell Medical School, spoke Monday morning to doctors and nurses from Austin about his vision for the department’s future.

Abrams addressed several issues important to his goals for the medical school during his talk. One of Abrams’ most pressing challenges will be to connect already-established pediatric care centers and the medical school, according to S. Claiborne Johnston, dean of Dell Medical School.

“There are a lot of great things going on in pediatrics in Austin, and [there are] groups that are established and used to doing things a certain way,” Johnston said. “We need to work with them even if they’re fearful of us. [Abrams is] the perfect person to show them our goal is to make everyone better.”

Abrams said one of his main goals for pediatric care in Austin is to have better communication between facilities.

“I think the medical school stands not as part of hospital competition, but to serve the community,” Abrams said. “We can’t change that there is competition in health care. That’s an inherent part of it.”

Tim George, a neurosurgeon at the Dell Children’s Medical Center, said Abrams only provided a brief framework of his goals, and he would like more depth in the discussion of coordinating the medical school’s work with other pediatric clinics.

“There are tactical things we need to accomplish so we can solve the problems that face us and fulfill the goal of having a unique ecosystem,” George said. “How do we pay for it? These are all open questions. Once we figure that out, we can figure out how to better teach and care.”

Abrams also said he intends to provide more comprehensive health care for children in Austin as well as preventative care to address the growing problem of childhood obesity. 

“The University of Texas at Austin is an amazing place and one of the reasons why I’m so excited to be here,” Abrams said. “We need innovative curriculum, committed to creating not just physicians, but dietitians and nurses who will understand the needs of children. We have to educate all groups in health care providers, such as critical issues like on-time vaccinations. We have an opportunity to think carefully of that and think of the pediatric education, make pediatrics a field [medical students] want to go to and understand the value of a pediatric education.”

Le-Wai Thant, a doctor at the CommUnity Care clinic that aims to help the underserved population of Austin, said she is optimistic about the more well rounded health care children would receive with the medical school and outpatient clinics such as the one she works with.

“This will be the beginning, and we’ll start having a connection,” Thant said. “We haven’t set up an official way of communicating yet. It’s a big population we serve around here, and having the structure and way to communicate among specialists and the community medical school — to double up treatment — would be the best for the whole community.”

Photo Credit: Andy Nguyen | Daily Texan Staff

After 20 years of service as an executive board chair at the Seton Healthcare Family hospital network, Charles Barnett is planning to move to the McCombs School of Business, where he will work to connect the Dell Medical School with UT business students.

In his role as an executive-in-residence at McCombs, Barnett will mentor students and faculty in the field of medical administration.

“The opportunity to use [McCombs] as an innovation engine to integrate the work being done [and] interface that among the colleges, especially the business school, is really important,” Barnett said.

After working as vice president and chief operating officer at a Virginia hospital, Barnett said his work at Seton Healthcare Family required skills beyond what he expected when he started the job.

“When I got here, I thought the job was going to be running a hospital, but it turned out that was only a piece of it,” Barnett said. “It was really about thinking about community building, oddly enough, and how an organization like Seton can become an important and critical asset to the creation of a viable, sustainable community beyond just the healthcare work it does.”

Barnett said his work helping Seton Healthcare Family hospitals to improve the safety of baby delivery is his proudest accomplishment. In 2002, Seton Healthcare Family hospitals saw an average of 31 babies who suffered birth trauma per 10,000 live births, according to Barnett. After new protocol were put in place, that 31 dropped to one baby per 10,000.

“We were able to develop a protocol by which the number of babies which suffered any kind of birth trauma event were reduced dramatically,” Barnett said.

Greg Hartman, president for external affairs, academic medicine and research at the Seton Healthcare Family, said he started work at Seton because of Barnett.

“He has been instrumental in building the excellent healthcare we have here today, from the heart transplant program, to the nationally recognized low birth trauma, to the building of the new medical school,” Hartman said.

Barnett also helped develop new protocols to serve patients in Central Texas, according to a statement released in Aug. 2014.

“Barnett also introduced new ways to care for a growing and diverse population, including the addition of insurance products and the first steps toward a more organized system of care,” the statement said.

Barnett said Seton Healthcare Family helped save hospitals that were in financial trouble, allowing those hospitals to develop other health resources.

“We salvaged a number of things,” Barnett said. “Probably, the most important was Brackenridge Hospital, because without that, none of these other things [would exist] — Dell Children’s Medical Center would not exist; the graduate medical education programs would not be there; the medical school would not be getting ready to take its first class.”

Barnett said he hopes the Dell Medical School will provide medicine industry leaders that can work to resolve pressing issues.

“We’re going to have to figure out how to help people stay healthier if they’ve got a chronic condition, so they can stay out of the hospital and out of the emergency room,” Barnett said. “The medical school will provide us with thoughtful leaders in medicine to do two things — to help us solve these kinds of problems and really change the way we think about what a physician needs to do going forward.”

Because of Dell Medical School construction, the University removed hundreds of “C” parking spots in lots near the Frank Erwin Center and School of Social Work, causing frustration among some commuting students as they returned to campus for the spring semester.

According to UTPD spokeswoman Cindy Posey, Lot 108, south of the Erwin Center, lost approximately 290 spots at the end of the fall semester. All of Lot 80, near the social work building, is being used to construct a chilling station for the Dell Medical School complex, Posey said.

“About 200 spaces will be returned to this lot at the completion of the project,” Posey said. “The parking needs when these spaces return will dictate the designation for these spaces, but I am certain that student parking will be a part of the mix.”

Austin Hill, mechanical engineering senior, said students who commute to campus often have difficulty finding a place to park.

“Today, I drove around for almost 10 minutes in circles waiting for a spot to open up — along with about five other cars,” Hill said. “And, sometimes when you find a spot, it’s a carpool spot, which I didn’t know was a thing until I got a ticket for it last Thursday.”

Hill said he used to park in Lot 80, but, because of the closure, he now tries to park mainly in Lot 70, just north of the closed-off area. Hill said he does not park in the lots east of I-35 because of how far they are from his classes. If he can’t find an open spot, Hill said he just pays to park on the streets around campus.

Dennis Delaney, operations manager for Parking and Transportation Services, said there are a sufficient number of empty parking spaces east of I-35.

“Before Lot E was closed on any given day, we had anywhere from 200 to 300 empty spaces on the other side of I-35,” Delaney said. “We’re still finding those locations empty — not as many as before, but there are still empty spaces that can accommodate people with a ‘C’ permit.”

Delaney said the parking services department has sold 2,264 “C” permits and 1,635 “C+” permits over the course of this academic year.

“Basically, we sell as the demand is there, so, if people are asking for them, we’ll sell them,” Delaney said.

English senior Heather French said she does not regret purchasing her “C+” permit, but she is still frustrated with her
parking situation.

“The PTS site makes it sound like parking across 35 is an easy option, when, in reality, the bus system is so unreliable that one has to plan a ton of time for taking the bus, which is not a viable alternative,” French said. 

The University is building a new parking garage near the site of the new medical school in order to make up for lost spaces, Posey said.

“The garage will have 100-plus spaces, and it will serve the medical school district, including students,” Posey said. “The overall net gain for parking spaces on campus because of the Dell Medical School will be about 600-plus spaces.”

Delaney said the new parking spaces at the medical school garage will be accessible to all students.

“At the medical school, the only people who are probably going to want to park over there are the nursing school students and medical school students, so the demand that’s there from them is what’s going to drive how popular that garage is,” Delaney said.

The Dell Foundation promised a $25 million matching donation to the Seton Healthcare Family’s teaching hospital Tuesday.
Photo Credit: Griffin Smith | Daily Texan Staff

The Dell Foundation promised Tuesday to match donations, dollar for dollar, up to $25 millions for the Seton Healthcare Family’s teaching hospital to help cover the remaining costs.

The hospital will be located next to the under-construction Dell Medical School, to which the Foundation donated $50 million in 2013. The 211-bed teaching hospital is slated to open in 2017 and will cost an estimated $295 million. 

The new hospital will work in affiliation with the medical school, according to a legal agreement between UT, the UT System Board of Regents and Seton Healthcare Family. 

“UT Austin and Seton will also work to expand the healthcare infrastructure, workforce, and services available to all residents of Central Texas,” the agreement states.

Sen. Kirk Watson (D-Austin) released a statement shortly after the announcement in support of the donation.

“Our community’s goal of transforming health care in Austin and beyond requires a modern, 21st century teaching hospital,” Watson said. “This generous donation from the Dell Foundation helps us reach that goal.”

Watson said the hospital and the medical school are vital to completing his “10 Goals in 10 Years” plan to improve health care in Central Texas.

“We’re well on our way to accomplishing the 10 goals in 10 years that I laid out in 2011, and the Dell Foundation has proved an invaluable partner,” Watson said. “It’s exciting to see this much momentum and progress.”

Clay Johnston spoke at the AT&T Conference Center Friday about building a new health care “ecosystem.” Dr. Johnston is the inaugural dean of the Dell Medical School and will begin his tenure March 1.
Photo Credit: Xintong Guo | Daily Texan Staff

Clay Johnston, dean of the Dell Medical School, called for a health care revolution in a speech Friday at the AT&T Executive Education and Conference Center.

Johnston said he hoped to build a new health care “ecosystem” by shifting the industry’s focus to developing innovations in education and information processing. He said the health care industry should adopt the Lean Startup model, a plan that emphasizes preventative health care measures.

“We need experts in health care redesign and people who understand population health,” Johnston said “We can be much more influential by coordinating not just with the physician community, but with the broader community to get it to move forward.”

Johnston said the health care system is outdated, with discrepancies between modern technology and the technology used in the health care field. 

“Health care accounts for 18 percent of the U.S. economy, and, yet, it’s powered by technology that’s really 50 years old,” Johnston said.

The McCombs Healthcare Initiative sponsored the event. Edward Anderson, director of the Initiative and professor at the McCombs School of Business, said Johnston’s vision of coordinating health care with the community could lead to a technology boom in Austin similar to that of the 1960s. 

“We have the potential for doing, here in Austin, what was done back in the late ‘60s with high-tech manufacturing,” Johnston said. “It did great things for Austin and put Austin on the map. I think we’ve got a good shot, particularly with this mandate and this team, for making that happen again here in health care.”

Ahmed Riaz, creative director at Frog Design Inc., said Johnston had a positive message that applied to a variety of Austin professionals, including those outside the health care industry.

“He’s in a position to actually change things in the medical world and has a plan to create a system that involves the community,” Riaz said. “It really engaged Austin as a community and the society at large.” 

Johnston, who begins his tenure at the Dell Medical School in March 2014, encouraged future medical students to facilitate health care innovation.

“We want the medical schools here to enable the entire community to start thinking about being partners, envisioning better solutions and moving health forward,” Johnston said. “One of the best places to start that is here on campus.” 

Correction: This story has been edited since its original publication. In his quote about a potential health-care boom in Austin, Johnston referred to a mandate, not a man. Further, he began his tenure in March of last year.

The University hired its first two department chairs for the upcoming Dell Medical School earlier this week.

Kevin Bozic will be the new chair of the medical school’s surgery department, and Amy Young was hired as the new chair of the obstetrics and gynecology department. Bozic said he plans to build his departments in such a way as to help make the Dell Medical School a nationally recognized institution.

“I am very excited about the opportunity,” Bozic said. “Austin has a very vibrant community who embraces innovation and change. I am looking forward into capitalizing the entrepreneurial, innovating spirit and improving the value of health care.”

Bozic said he has held leadership positions at institutions across the nation. He previously worked with Clay Johnston, Dell Medical School dean, at the University of California-San Francisco, where he is a professor and vice chair of the Department of Orthopaedic Surgery. He is also a visiting scholar at Harvard Business School. He graduated from the University of California-San Francisco School of Medicine and the Harvard Combined Orthopaedic Residency Program. 

“A new way of teaching medicine in the new Dell school is to first understand the needs of the patient and organize a system to optimize the help to the patient,” Bozic said. 

According to the University, Young has an experience in initiating and leading programs and collaborative partnerships in obstetrics. Young now works as the chair of the Department of Obstetrics and Gynecology at Louisiana State University Health Sciences Center-New Orleans. She has also served as the District XI chair of the American College of Obstetricians and Gynecologists.

“Improving women’s health is an essential part of the Dell Medical School’s mission,” Young said in a statement. “We can reshape health and health care delivery that improves outcomes for women here and helps catalyze positive change across the country.”

Johnston said the school is founded on a partnership that will help resolve the evolvement of health care.

“This is an exciting time,” Johnston said in a statement. “The decisions we make now will help make Austin a healthier place and a model for the world. The vital, inclusive health ecosystem we want to create is starting to shape.”

Photo Credit: Photo courtesy of the Shivers Cancer Foundation | Daily Texan Staff

The Dell Medical School established a faculty chair to honor Austin physician Dr. Robert Askew, who graduated from UT and completed his residency at UT Medical Branch-Galveston in 1959.

The Shivers Cancer Foundation contributed $1 million to establish the Askew Chair in Oncology. The foundation commemorated the donation Friday, after Askew passed away in July. The gift represents one of the largest contributions associated with the foundation.

According to Clay Johnston, dean of the Dell Medical School, the chair will help the school maintain qualitative standards in treating patients and training doctors.  

“The gift will help ensure that the Dell Medical School has a top-flight physician providing cancer care to Travis County residents and training the next generation of doctors,” Johnston said in a statement.

Johnston also said the chair will be in charge of recruiting top faculty members to help maintain a high standard for the school.

“The Askew Chair in Oncology will also be a model for how we recruit and retain the best faculty members and shape the Dell Medical School into a world-class institution,” Johnston said.

This is the second chair to be established within the school — the first being the Chair for the Department of Medical Education, which Susan Cox currently holds. 

Photo Credit: Griffin Smith | Daily Texan Staff

Clay Johnston, dean of the Dell Medical School, emphasized in a lecture Monday the importance of not accepting the status quo when looking for new solutions in the health care system.

Johnston was hired as the inaugural dean of the Dell Medical School in January. Currently under construction, the school is scheduled to open in fall 2016.

Johnston said medical schools have become multibillion dollar enterprises that see any new business models as threats to their structure.

“They get stuck,” Johnston said. “And promoting health isn’t the priority — but helping the sick.” 

During the lecture in Burdine Hall for a freshmen signature course speaker series, Johnston said, as a researcher focusing on stroke prevention, he was frustrated with the process of executing research studies. He felt the procedure took too long and did not effectively reach
the patients.

“There were few people saying, ‘How do we make research faster? How can we reorganize the structure in order to accelerate studies to reach patients? [It’s] horribly inefficient and everyone is suffering from this,’” Johnston said.

His criticism of the standard method for conducting research studies influenced his concern with other areas in the medical field.

“A new issue comes up,” Johnston said. “Not only is it inefficient, but, with new innovation, it increases the cost of health care. … People are not benefitting from the new technology. The cost of banking and telecommunication has gone way down, so it’s changed the way we live our life, but that’s not true in health. Drugs are not getting cheaper with technology. It’s actually gotten more and more expensive.”

Johnston identified several issues he saw within the health care system and urged students to think critically about those issues, including the requirement to visit the doctor’s office when patients have the flu or that hospital gowns exposing a patient’s rear are still used.

Johnston also evaluated the gap insurance companies create between patients and the value of their care, as well as the “lone cowboy” physician who underplays team and community efforts.

“Just accepting that they should be that way means we’re not looking for solutions,” Johnston said. “It’s not something to be sad about, but it’s an
opportunity for things to be addressed and solutions to be proposed.”

John Daigre, Dell Medical School spokesman, said the presentation was aimed to help students envision themselves in the school and see their work in the medical field go beyond UT.

“It’s about understanding that … creating a medical school of the future … includes a lot of things that people may not recognize,” Daigre said. “It’s all about new models of care — using data and technologies [in a] new way.”

UT released its affiliation agreement Monday between the UT System Board of Regents, the University and the Seton Healthcare Family regarding the Dell Medical School.  

“UT Austin and Seton will also work to expand the healthcare infrastructure, workforce, and services available to all residents of Central Texas,” the agreement states.

Seton will replace the University Medical Center-Brackenridge with a new teaching hospital on UT-owned land across from the medical school. The initial term of the agreement is for 25 years, effective Jan. 1, 2015.

The agreement — which Chancellor Francisco Cigarroa, President William Powers Jr. and Jesús Garza, Seton Healthcare Family president and CEO, signed last week — also gives the medical school complete control over its education. As Seton abides by the Ethical and Religious Directives for Catholic Health Care, it prohibits certain medical procedures related to areas such as family planning, women’s health and end-of-life care. In accordance with the agreement, medical school students will receive training for these procedures at a separate facility,

In May 2012, the Board of Regents approved a minimum of $25 million per year to support the development of the Dell Medical School, according to the agreement. The regents also agreed to pay up to $5 million per year for eight years to be used for faculty recruitment for the medical school.

The Dell Medical School is scheduled to open in fall 2016.