Health, academic institutions must affiliate to compete

Dr. Edward J. Wing heads the department of medicine and biological sciences at Brown University that includes the $45 million Warren Alpert Medical School, which opened in August in Providence. He is in charge of an annual budget of $142 million; 500 division employees; 1,056 students – including 416 currently at the medical school – and more than 2,000 faculty members on campus, in the hospitals and in the community.
As an example of how the medical school benefits the state, Wing says that 38 percent of the doctors in the state were trained at the Brown medical school or in its residency programs, and 13 percent of the state’s doctors graduated from it.
Wing, who still sees patients once a week at The Miriam Hospital, discusses the importance of the new medical school and challenges the state faces in reforming health care.

PBN: You were a champion of locating Brown’s Warren Alpert Medical School in Providence’s Knowledge District? Why was that so important to you?
WING: The medical-school building itself [which opened in August 2011] is extremely important for Brown University and for the medical school. We did not have an identified home for the medical students. They were in buildings on the main campus. So, just the fact of having a medical-school building has been transformative for our students and our faculty. It’s made a huge difference.
Placing it in the Knowledge District was a very important strategic decision for Brown. It was one of the first major educational buildings that was not on the College Hill campus. We were really saying that Brown University is committed to the Knowledge District area – not just to the research facilities that Brown already had there, at 70 Ship St. – but this is Brown committing to that area for all of its functions. It’s also close to some of the hospitals.

PBN: What kind of difference does having a medical-school building make?
WING: It’s allowed us to have adequate space for the medical students. We had barely adequate space up on the campus, but now we have new anatomy suites, for example, where they learn anatomy. We had an anatomy suite on the campus in the basement of a building and it was just not ideal, to say the least. Now we have an anatomy suite that is three times as large, it’s on the third floor, it has natural lighting, great ventilation. … It also has allowed us to increase the size of the medical-school class, from 96 to 120 per class. So we went from a total of below 400 students to 480 students.

PBN: What do you see as the single biggest problem facing health care reform in Rhode Island?
WING: I went on a trip with [Gov. Lincoln D. Chafee] and Mayor [Angel Taveras] to Pittsburgh [in October to the University of Pittsburgh Medical Center on a health care fact-finding tour]. That’s where I spent most of my career, actually, I was there for 22 years and then came to Providence 14 years ago.
In Pittsburgh, like most other medical centers, the hospitals and the faculty and the medical school are all aligned. They are integrated into an academic medical center … either merged or affiliated into a single unit. They have their faculty and a single practice plan and all of those are closely integrated with the medical school and they can strategically plan to provide the best medical care for the citizens of their area. They can provide the best education and then they can also be the drivers for innovation and research.
In Rhode Island, we’re fractionated. We have separate hospital systems. We have physicians in a variety of employment models and we don’t have a close link like other institutions with the medical school. Despite that, we’re very good, we’ve grown and we have outstanding research and education. We could be much better. So that’s one aspect. The second is that we are in a regional marketplace with Boston. So our competition is not each other, it’s not with the hospitals in Rhode Island, from my point of view, it’s with the Boston institutions. They’re knocking on our door. They’re actually in Rhode Island and competing with us. As you know, we have for-profits potentially in this system … and that would be more competition as well.
The only way we’re going to succeed in the marketplace providing clinical care, education and research is to be in a single academic medical center. … We need to integrate and, from my point of view, quickly. We need to have our hospitals much more closely aligned, as well as our faculty and a practice plan closely aligned with the medical school.

PBN: There was an attempt to merge Lifespan and Care New England systems and it didn’t work out. What do you think of that?
WING: The merger to me would be ideal, but if they’re not merged – and there may be reasons not to do that – they at least have to be closely affiliated and not competing with each other. The competition locally doesn’t make sense to me.
I think we’re at a time of opportunity. We have changes in leadership at all the major hospitals and at Brown [including changes that have or are scheduled to take place at Pawtucket Memorial Hospital, Care New England, the Lifespan board, Rhode Island Hospital and the Brown presidency, as well as appointment of Dr. Mark Schlissel as Brown provost last year.] So all of those are changes and, I think, opportunities to start being more closely affiliated, bringing together the various aspects of the system I described and having a true academic medical center. •INTERVIEW
Dr. Edward J. Wing
POSITION: Dean of medicine and biological sciences at Brown University
BACKGROUND: He began his career in academic medicine at the University of Pittsburgh, where in his 21-year tenure at the university’s medical center he rose through the ranks to serve as chief of infectious diseases and interim chief of medicine. He became chair of Brown’s Department of Medicine in 1998 and dean in 2008.
EDUCATION: Bachelor’s degree in chemistry, Williams College, Williamstown, Mass., 1967; medical degree, Harvard Medical School, 1971; internship and residency, Peter Bent Brigham Hospital, Boston, 1971-1973; infectious-disease fellow, Stanford University, 1975-1977
FIRST JOB: Worked in a printer’s shop in New York City, handling menial chores such as stuffing envelopes
RESIDENCE: Providence
AGE: 66

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