Paul Rothman started his "dream job" on July 1, the day he stepped into the role of dean of the Johns Hopkins University School of Medicine and CEO of Johns Hopkins Medicine.
Rothman—a distinguished physician, scientist, educator, and academic health care leader—took charge of a $6.5 billion academic medical center and a health system with a global reach. It's a storied institution, he says, and one he has long admired.
His new position, he says, presented a daunting challenge professionally, but one he embraced.
As dean, Rothman leads an academic division with more than 2,500 full-time faculty members, nearly 1,300 part-time faculty, more than 1,400 medical and graduate students, and more federal research support than any other U.S. medical school.
He also governs—in partnership with Ronald R. Peterson, executive vice president of Johns Hopkins Medicine and president of The Johns Hopkins Hospital and Health System—a system of six hospitals in Maryland, Washington, D.C., and Florida. Johns Hopkins Medicine also comprises several suburban health care and surgery centers, more than 30 outpatient primary health care sites, a full-service home care provider, managed care plans, and hospital management, consulting, and clinical education services in the Americas, Europe, the Middle East, and Asia.
A rheumatologist and molecular immunologist by training, Rothman previously served as dean of the Carver College of Medicine at the University of Iowa and leader of that university's clinical practice plan. At Iowa, Rothman led an ambitious transformation that included recruiting new leadership for nine departments and building a new branch campus. He also oversaw an overhaul of the medical curriculum and the establishment of a strategic new administrative structure for University of Iowa Healthcare.
Rothman—who will give the first State of Johns Hopkins Medicine address at 5 p.m. on Tuesday, Dec. 11, in Turner Auditorium—recently took time with the Gazette to discuss his first months on the job, and to look inside the foreseeable future of Johns Hopkins Medicine.
Q: What were you focused on your first few weeks and months here?
A: Meeting people. I've tried to get to know the place. As you know, Johns Hopkins is a huge enterprise. We have more than 2,500 faculty, thousands of employees, and all our residents and students. I wanted to meet them.
So once a month I've had lunch with professors. I have dinner once a month with medical students. I have regular lunches with department directors. I meet with community leaders. I've reached out to those at the Johns Hopkins Urban Health Institute, gotten to meet trustees. I just try to get out as much as I can to understand this institution so that when decisions come up, I'm as informed as I can be.
I also want to get the pulse of the day, find out what people are thinking, and learn how I can make them be successful. I want to put people in positions where they can succeed.
Q: How forthcoming are students?
A: The students are great. Medical students are not shy, I'll tell you. I've had two dinners with them to date. You'll hear things from students you won't hear from faculty, and vice versa. They've been very productive conversations.
Q: In what venues do you meet people?
A: The students I've been meeting at area restaurants. I want to give them a good meal. I have lunches with professors right here on campus. I want people to be comfortable.
Q: After many years of looking at Johns Hopkins from afar, you're an insider now. What has surprised you most about Johns Hopkins?
A: Johns Hopkins has such a rich tradition, and for so many years has been the top institution of its kind in the country. So what surprised me is that people here are amazingly down-to-earth. I don't see any arrogance. I see people who really want to do the right thing, and work together. People have also been amazingly friendly. They are forthcoming and just very welcoming. I'm not sure if that part is a surprise, but it's been a positive.
Q: Must make your job a bit easier.
A: Yes. I'll also tell you that I've been trying to meet the scientists who work here, and they are doing such outstanding work. I'm not surprised to find this, but it's something that energizes me, the outstanding level of science that people are doing. I'm driven to help them be successful.
Q: What is the greatest challenge to medical education and what we do?
A: When there are threats to federal funding levels, that impacts everything. Academic medical centers must wake up to how dependent we are on the federal government. I'm not just talking about NIH [National Institutes of Health] and NSF [National Science Foundation] funding but the funding we get from the Department of Defense, Medicare, Medicaid, and other sources. We are just so dependent on the federal government.
So at a time when we may be under long and large fiscal restraints, and maybe decreases in funding, academic medical centers like Johns Hopkins are vulnerable.
Q: Does that keep you up at night?
A: [Laughs]. I sleep well at night. Is it a concern, yes, but do I think [federal dollars are] going to dry up? No. I think when you talk to people in Congress, you understand there is a fundamental commitment to medical research among our legislators, our government, and the American people. Long term, the dollars are not going to dry up. Is it going to be tight for several years? Absolutely. But from what I see, Johns Hopkins has the potential to thrive. That is because we have the most outstanding faculty, and even if we're flat in terms of funding, there is still a $30 billion NIH fund that we can compete for. And we've been competing for these dollars successfully for years, and we will continue to do that. It just might mean that we all have to work harder.
Q: You have mentioned your plans to unveil a strategic vision for the future of Johns Hopkins Medicine. Where does that planning stand?
A: This process started before I arrived here, and that is the dominant thing I'm working on now, finishing up that strategic plan. We are hoping to present a preliminary one this month. We are actively working on our priorities. The reason this is so important is, like I said, this will be a turbulent time in health care in general and academic medical centers in particular because of these funding issues. Efforts will be made to stem the rising costs of health care, so a strategic plan can ensure that we will be able to stay true to our mission and that when these tough decisions need to be made, it's done in an informed way and in line with the goal of the institution.
Q: What will this plan look like, generally speaking?
A: Right now there are six mission imperatives. They are not fully formed, but they include human capital, financial structures, building an integrated health system, clinical excellence and patient care, discovery, and education. Overall, we are looking at how we structure ourselves.
Q: The field of medicine has taken extraordinary leaps in the past few decades. Will medical education also evolve at a rapid rate?
A: Somewhat. We have our new Genes to Society curriculum that really focuses on the role of the individual patient, and how we use that information to guide prevention and treatment. It's a pretty unique and advanced curriculum. We have a whole new education paradigm here, and we will continue to refine our approach.
Q: What fields are changing?
A: The big changes are the expansion to this field of precision medicine, which is guiding what we know about the individual patient so we don't look at patients in general terms or at everyone who has a certain disease. We will find ways, based on genetics and personal health history, to engineer direct therapies for that individual patient.
Another growth area will be on trying to keep people well, getting the health care system from a position where it's focused on the sick and the illness to a system more focused on wellness and keeping people from getting sick. I'm talking about a focus on preventive care. We are really taking that on as a mission.
We also have to keep in mind that we have an aging population, so we need to continue to focus on chronic illnesses.
Q: Last question. Have you familiarized yourself with Baltimore yet?
A: I'm getting there. I'm starting to learn my away around. It's a lot different from Iowa.