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IOWA CITY - This country's health care industry is in a state of unrest, creating turbulence that's reached the University of Iowa Hospitals and Clinics, and all that uncertainly gave Brooks Jackson pause when a UI faculty member called.
Bruce Gantz - head of the UI Department of Otolaryngology and co-chair of a committee charged with finding a new vice president for medical affairs and medical college dean - was the first person to alert Jackson to the job opening.
'All new positions do take some persuading,” Jackson told The Gazette on Tuesday during one of his first interviews since starting Nov. 30. 'In this day and age, health care is changing so rapidly that one really wants to get a sense of what the stability of the system is. What are the opportunities? You really do look pretty hard before you make a commitment to move or even just interview.”
The more Jackson learned about the post overseeing both the UI's $1.4 billion-a-year health care enterprise and its Carver College of Medicine, though, the more interested he became.
'This was an opportunity where there is a fully integrated system, where leadership - my position in particular - is over both the medical school and the practice plan and the hospital health system so that the academic mission of research, patient care, and education can be balanced,” he said. 'Where it's not fully integrated like that in the leadership at the top, those competing missions can be very difficult to achieve.”
As vice president for health sciences and dean of the medical school at Minnesota since 2014, Jackson said he experienced some of those challenges. In that role, he led the university's academic health center and coordinated learning across six schools and colleges - medicine, dentistry, nursing, pharmacy, public health and veterinary medicine.
'But I was not over anything of the hospitals or the clinics,” he said.
Minnesota more than 20 years ago sold its hospital and clinics to Fairview Health Services, a private, nonprofit enterprise. The two entities last year, according to media reports, were working toward a merger aimed at producing a top-tier research medical center - like at the UI.
But the deal fell apart 'after Fairview executives claimed the U wanted too much control,” according to the Minneapolis Star Tribune.
Jackson told The Gazette the system separation was 'very very difficult.” Before his leap to Minnesota, Jackson led the pathology department at the Johns Hopkins School of Medicine for 12 years, and he said that was a fully-integrated health system.
'So the contrast really was quite evident that that is really important,” he said. 'Those fully-integrated health systems…they really have a big advantage, and so that's what really appealed to me.”
Before applying for the Iowa post, the 64-year-old Cincinnati native never had stepped foot in the state. In his exploration of the campus and culture surrounding it, Jackson said, he was struck by the widespread stronghold of support for the university and its health care enterprise.
'It is the state's medical school,” he said. 'If you go to Ohio, there are like six medical schools, or seven.”
But Iowa is not immune to the grand challenges facing health care.
Jackson acknowledged some key issues he'll be addressing - including the enterprise's finances. Like many other public academic medical centers, the UIHC has experienced cuts in state funding and has been hurt by changes in how providers are paid and how patients and consumers interact with the health care system.
The Hospitals and Clinics - which earlier this year opened its $360 million Stead Family Children's Hospital - reported starting the new budget year with a deficit of nearly $7.2 million.
Better months since then have turned the UIHC shortfall around, but Jackson stressed: 'We have to do better at controlling health care costs.”
'All these other problems we see with the individual market and health insurance, unless we control health care costs, this will continue to be a huge problem and become worse,” he said.
Growth, another of his priorities, would help with that - and with quality improvements.
'If you do a couple lung transplants a year, you're not nearly as good, studies have shown, as if you do 100 a year,” he said.
Considering the dramatic policy and financial shifts underway, Brooks said, fundraising and philanthropy is increasingly important. And education around the institution's broader mission helps, he said.
'Our mission overall is not to make a ton of money,” he said. 'Our mission really is to provide the health care workforce for the state of Iowa and to be able to provide the advances in new therapies, drugs, devices and health care delivery systems.”
In his transition into the leadership post, Jackson said, he's worked with his predecessor, Jean Robillard, who he said currently is taking some time off before returning as a faculty member to work on 'innovation projects.”
Robillard, 73, served as either dean of the medical college or vice president of UI Health Care, or both, since 2003.
He was earning $780,000 in his former position, which he left Nov. 30. Jackson will earn an annual salary of $825,000.
Robillard proved an innovative leader by forging new partnerships across the state and region, enlarging the health care footprint on the UI medical campus and expanding its research endeavors with new institutes and multimillion-dollar facilities.
In recent years, Robillard committed to restructuring the path to a medical degree and reducing the time it takes students to get into practice as professionals.
Jackson said he, too, is interested in cutting costs - both in time and money - for students and encouraging more to pursue medical careers.
'I do think we should explore those options,” he said. 'I went to three-year medical school, not a four-year medical school. And, in fact, one-third of all medical schools back in the ‘70s were three-year medical schools.”
Today, he said, most take four years though many - like Iowa - are considering changes.
'I worry that the debt of these students … will affect their decision of what specialty or area of medicine they go into,” he said.
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