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President’s Q&A, March 2017
March 28, 2017
“Boy, can I attract a crowd,” UMB President Jay A. Perman, MD, joked upon entering Room N103 at the School of Pharmacy on March 28. Ten minutes before the start, few were assembled for his quarterly Q&A, which eventually grew to a cozy group of 30 to 40 who posed many interesting questions as Perman immediately opened the floor. Excerpts of some of them follow.
QUESTION: I just saw the governor’s supplemental budget. It looks like they took another $30 million from the system’s fund balance. Is that going to impact us?
DR. PERMAN: I think it’s a bit of a trade. What the legislature is doing is harvesting some fund balance, which is not going to disappear forever, and in turn it is making up a good deal of it in our operating budget as a system. I’ll let Dawn Rhodes, our chief business and finance officer and vice president, tell you more.
MS. RHODES: I actually was just on a conference call with the finance vice chancellors, and this is much better than the General Assembly taking $30 million base funding away from the system. Our share will be $6 million of that $30 million. That’s what we anticipate. This is something the legislature has done in the past when it needed money to balance the state budget. It’s a much better tradeoff to do that versus giving them $30 million of base, which means that’s dollars that are tied to salaries and utilities, etc.
DR. PERMAN: The concern that we have in this kind of maneuvering is that it could become a steady diet. In other words, if this device becomes a year-after-year issue, chipping away at the fund balance, it’s a problem. But if it’s a device they’re using just this year, I think it’s an advantage for us.
QUESTION: I have a personal interest in the greening of the campus and I thought at one point the Carter Center was going to become a green open space. Now it’s going to be a parking lot. Additionally, do you have any updates on what they’re doing with University Square and the park there on Greene Street?
DR. PERMAN: We are about to roll out our 10-year facilities master plan—what we’d like this campus to look like over the next 10 years. Happily, it is full of ideas for greening the campus. But what you said is accurate: We are turning the Carter Center into a parking lot, and I’ll tell you why.
This was a tradeoff. Nothing will please me more than to see the disappearance of the Carter Center. With all due respect to Walter P. Carter, who was a great activist for this city 40-plus years ago and deserves to be honored, the building had decayed to such a degree that it was becoming dangerous. To demolish the Carter Center, we had estimates as high as $6 million. When we’re standing in a queue for capital projects, no one is eager to spend $6 million to tear something down.
Hospital leadership said, “We’ll spend the money; we’ll tear it down for you, but we need a parking lot for our personnel.” It was a way to take the first step leading to a greater vision of the Carter Center. Yes, it would have been nice to have green space there, but I imagine one day it will be another academic building for us, perhaps a combination of teaching and research.
MS. RHODES: It won’t just be a massive concrete space. They’re very intentionally designing green spaces for the islands and trees so it will look better than just a plain parking lot.
QUESTION: How about the park across the street from the hospital?
DR. PERMAN: In the long-term plan, the plaza needs to be flattened. Nobody goes into a park if you can’t see where you’re going, if you can’t see the other side. That’s always been the design flaw with regard to the plaza. So in the long term, the idea is to truly make a plaza out of it that is flat. In the short term, I believe there are repairs being made.
QUESTION: Since you were talking about the Carter Center, I have a safety question related to HSF III, the Carter Center, and Fayette Street. Because of the construction on both sides of Fayette Street on the block between Arch and Pine streets, the sidewalk is impassable at times for pedestrians. The Carter Center side is completely closed and on the HSF III side, construction vehicles have been parking on the sidewalk and extending into the street on the Dental School loading dock, forcing pedestrians to walk in the street. Can the sidewalks on both sides of the street be closed completely and people directed down Arch Street to Baltimore Street so that no one gets partly down the sidewalk and then has to step into the street?
DR. PERMAN: What you’re describing is not acceptable to me, and I’m sure it’s not acceptable to Dawn Rhodes, who has facilities responsibility.
MS. RHODES: There have been several people working on it. We are going to close the south side of the sidewalk and redirect people to Arch Street. We’ve tried other things, such as having police officers there to monitor the situation. It’s just not working so we’re going to close the south side of the sidewalk and it will probably be closed until the June/July time frame.
QUESTION: I’m a second-year medical student who lives in the Hollins Market neighborhood. I have another sidewalk question. It’s about the walk between Poppleton Street and the BioPark.
DR. PERMAN: Where the hole is [873 W. Baltimore St., future site of BioPark Building 3]?
QUESTION: Yes. So I guess I have two questions. What’s going on with the hole? And why is there no sidewalk on one of the sides of the street there?
DR. PERMAN: I’m walking up the steps to Mr. Jim Hughes, who’s our vice president for economic development and entrepreneurship and the man for the BioPark.
MR. HUGHES: Thank you for your question. I’m sorry for your inconvenience. Part of what we’ve been living through with the hole is that we keep expecting within the next six to nine months to be starting construction and obviously that’s been going on for years. We’ve got a pivotal meeting on Friday with the state and we are very optimistic at this point that construction will start in the September time frame. On the western portion of that area along Poppleton we’re actually working right now to essentially create a sidewalk there and we’re looking into whether we can do that along Baltimore Street.
QUESTION: I would just like to make a pitch for the President’s Student Leadership Initiative by your campus Office of Student Services. Our pharmacy students are the most active in that program. I’d love to see expansion of that program on this campus plus the expansion to those students who don’t have the opportunity now.
ROGER WARD, CHIEF ACCOUNTABILITY OFFICER AND VICE PRESIDENT, OPERATIONS AND PLANNING: The President’s Student Leadership Initiative, which we call PSLI, is open to all students across the University and we do a number of workshops all year long, and you’re right, they’re very well attended. We haven’t considered expanding it beyond the Baltimore campus because quite frankly we’ve never had the request. It does make sense that the request is coming from pharmacy, another very robust program at Shady Grove and we’ll give some thought to that. I’ll talk with Flav [Lilly] who runs that program and see what can be done.
DR. PERMAN: Thank you for reminding us about the Universities at Shady Grove. In addition to the robust pharmacy program, we have a growing nursing program there, and social work in the last couple of years has added a second year. I’m glad you brought it up, and I think we have to take the suggestion seriously.
QUESTION: Those [PSLI] meetings are typically at noon, correct? When my medical school colleagues and I are doing rotations it’s unlikely we are available then. Maybe as you’re expanding the program you could consider adding evening sessions? That would help students if they wanted to come from other campuses, too.
DR. WARD: We haven’t had success in the past with evening programs. What we may want to consider with a new learning management system that we’re bringing up is whether we could do online modules to provide more flexibility to the students.
QUESTION: I have a question as it relates to interdisciplinary learning, particularly didactic earlier on in the curriculum. I was just wondering if there had been any discussions about trying to carve out specific times to have more of those interdisciplinary-type didactic sessions on campus?
DR. PERMAN: You know that is a major focus here at UMB because we would be terribly derelict if it weren’t. Here we are with the luxury of having all these disciplines and professions in the making. If we don’t teach team, who’s going to teach team? That said, one of the challenges that has kept interprofessional health care education from moving forward since 1970 in this nation has been the fact that we are organized—and will continue to be organized—as schools. And as schools, for understandable reasons, there is rugged individualism around curriculum, and some of it is hard to solve.
I know we all talk about it, but how do we go about preparing students for experiential learning and interprofessionalism by doing the didactic sessions? I give you one example of something that worked, but it’s not something that everybody’s willing to do.
The School of Social Work always has an interregnum. They have a couple of weekends during January where they put together an interprofessional course. Now, I understand not everybody can get excited about taking courses on a Saturday or Sunday, but that’s the way they solved the scheduling issue. We’ve got a challenge there. If you have ideas, please let us know.
Interprofessional Education Day is coming up next Wednesday, when 500 or 600 students find a way to get together for a day of simulation sessions and standardized patient sessions. So we can find a way to do it, but we have to do it more than once a year or on a weekend in January.
QUESTION: To follow up on the scheduling question, I do appreciate the different schools and their curriculums. But if it’s that important to train students, some kind of intervention is needed to legislate a time to educate the students. Weekends is a work-around. It’s not solving the problem. Until the interprofessional piece is prioritized over the individualism, we won’t be able to get the two together to maximize our potential in this area.
DR. PERMAN: I wouldn’t debate with you other than to say sometimes important things are done in an incremental way, and it’s maybe best to do them in an incremental way. We have an ally in all of this: the accrediting bodies that say, “Let us see in terms of your curriculum and your offerings, what you’re doing with regard to interprofessionalism.” I would say that pharmacy and pharmacy accrediting has led the way in that regard. I applaud your impatience.
QUESTION: What would you identify as the single leading issue you find at this University and who do you cling to as your No. 1, 2, or 3 aspirants from the universities in the country?
DR. PERMAN: Others might say that given the fact that we’re a research intensive campus, the [U.S.] president’s initial offering of a budget is very threatening and is a huge challenge. But to me the No. 1 challenge that this University needs to address is the community in which it lives. And it’s not just because it’s the right thing to do or the just thing to do—as appropriate as those reasons are. This is a University right now that enjoys great staff, great students, and great faculty. If we don’t make the community in which this University resides better, then I predict that it’s not going to be as easy 10 years from now to attract a Ken Boyden from Philadelphia or a medical student from [asks audience member where she is from] Boston. It’s going to be hard, and all of us who have a stewardship responsibility for this University need to be totally invested and understand that in terms of making our community better and making our city better, it’s not just what we’re doing for others—as important as that is—it’s what we’re doing for ourselves. This is a win/win proposition and when I talk to people in the community, I always say that. In fact, I tell them I’m a selfish person. I tell them that that’s why we’re doing this. We’re doing it for ourselves, too.
Now as far as aspirant organizations, I’ll begin with the institution where I was fortunate enough to start my academic career, the University of California, San Francisco. I’d like us to be like UCSF. They are very much like us in terms of composition of schools. They don’t have a law school and they don’t have a social work school. They attract extraordinary amounts of funding because of the quality of their research. But they, too, have an extraordinary commitment to community, and for that I consider them our No. 1 aspirational peer.
QUESTION: An idea that ties together many of the things we’ve been discussing that a group of my classmates and I are working on is an interdisciplinary student-run clinic. I imagine the folks in the room may have some thoughts as we’re putting together a proposal to present perhaps to you and to the deans of our schools. What do you think would make a strong proposal?
DR. PERMAN: I always say the way to be successful in a university like this is to follow the students. When I was dean of the medical school at the University of Kentucky, we had a student-run clinic called The Salvation Army Clinic. It was run by second-year medical students, pharmacy students, nursing students.
They had faculty supervision, as you need because you’re not licensed. And it was a pillar of the community in Lexington, offering people needed care. Nothing would make me happier than a student-run clinic that is interprofessional. I encourage you to keep this moving because we’ll find ways to support you in getting this done—if it’s truly an interprofessional clinic. I’d like for Dean Eddington to talk about the clinic that we’ve set up in Prince George’s County that certainly is intended for student learning, too.
NATALIE EDDINGTON, DEAN, SCHOOL OF PHARMACY, AND EXECUTIVE DIRECTOR, UNIVERSITY REGIONAL PARTNERSHIPS: For the past three to four years we have been working with Prince George’s County Community Hospital to support some of the county’s primary care needs. I don’t know if you’re familiar with a study that the University of Maryland, College Park did about four or five years ago where one of the major findings was that there was a deficit of about 65 primary care physicians in Prince George’s County. Working with Dr. Perman we decided to take a look at the hypothesis that an interprofessional clinic with pharmacists and nurse practitioners could support primary care as well as the social determinants of care versus a typical clinic led by physicians.
Most recently we’ve received funding from Prince George’s County and from the local hospital and we’re also looking forward to some funding led by Dr. Perman to support the clinic as well as the Wellmobile in that area. So this clinic will be composed of nurse practitioners, pharmacists, social workers, as well as a JustAdvice Clinic from the Carey School of Law. The clinic will be starting the latter part of this month.
It’s an ambulatory care clinic within the hospital, and we’re going to focus from the hospital’s perspective on the high utilizers, those folks who have repeat admissions to the hospital.
We’re really excited about this clinic and I’m sure from the students’ perspective this is going to be a coveted rotation site because they’re going to have this real live experience of working as a team as opposed to talking about working as a team.
QUESTION: I am really excited to hear you say that the major challenge at this University is the community. If you were magic, and had the control to do one thing, what would it be?
DR. PERMAN: Could I have two? You know that a principal focus of ours and a principal interest of mine, given my pediatric training, is children, and I unabashedly say that if we can get the children of West Baltimore better educated so that they can get a job—economics is the great leveler—everything else will ultimately take care of itself. We have to get to our children early. With regard to early childhood education and beyond, we have to hold on to these kids and give them opportunities. It’s a long-term process. It’s not a quick fix.
The other thing we need in our community beyond education is decent housing—sustainable, good, affordable housing. We’re talking to our partners in College Park who have some expertise in this. Without reliable, affordable housing, we're not going to succeed.