Marc E. Lippman, MD
Chair

 

As this will be my last chair’s report at the University of Michigan, it seems like an appropriate time to look back briefly on some of our accomplishments during the past six years and perhaps discuss a few of the challenges the department will face in the coming years.

Before doing so, let me say what a privilege and pleasure it has been for me to serve as chair. The faculty of the University, the Medical School and most importantly our department are an incredibly gifted and dedicated group of physician scientists who accomplished wonderful things in these past years. It is easier perhaps to look at metrics: the remarkable growth in National Institutes of Health funding within the department, the improvement of the department to eighth in the national rankings, with higher positions within our grasp. But these kinds of metrics fail to measure the importance of the science itself and its significance for better understanding and treatment of human disease. Much of that information will be found throughout this annual report.

In the past few years our faculty members have garnered nearly every award our medical school has to offer in recognition of excellence in science, clinical care, education and community service. And we have grown significantly from about 325 faculty to almost 500 in the past six years—with most of that growth in the tenure track positions. This has been further supported by the near doubling of endowed chairs in the department from 15 to nearly 30, due to the vision of our generous donors.

Our educational activities have consistently been excellent. The graduating medical students rate their medicine clerkships as their most valuable experience. Our house officer program has grown increasingly more competitive each year and I am particularly proud of the rapid growth of our “short track” program aimed at recruiting the best potential trainees for our academic fellowships.

The next few years will be challenging. Hopefully, we will soon have a new dean and that will be an opportunity for exploring new directions and initiatives. Nonetheless, our department will have to navigate some troubled waters. Our department, as is true for most academic departments, relies on federal dollars for many of our ventures. In fact, federal funding exceeds clinical revenue in our department.

The current distressing federal funding situation will place great pressure on the department to come up with alternative funds. This reality will require us to be aggressive in seeking new clinical opportunities at a time when professional reimbursements have generally been declining.

Clearly, the dismal state of the Michigan economy with concomitant effects on increasing requirements for care of the uninsured, more aggressive contracting by third-party payors attempting to control the upward spiraling of health costs, lack of growth of the population with increasing competition by other less expensive health care delivery systems, and declining state support of higher education will all put pressure on the department as it seeks to generate the financial margins it needs to support its research and educational missions. Fortunately, philanthropy is helping in these areas and support from wonderful donors has increased significantly during the past three years.

Another more subtle but nonetheless critical concern we will have to address is the national decline in the proportion of new physicians going into internal medicine, and an even greater decline in those seeking academic careers. The combination of debt burden, increasing societal emphasis on lifestyle driven career choices, and the uncertainty of the sustainability of an academic career have all contributed to a precarious state of affairs. This is particularly true for those subspecialties that are not based in procedures and are perceived as less financially rewarding. In 2003, we created a Medical Student Scholarship Fund to address this concern. Due to the generosity of our faculty, staff and alumni donors, thus far we have provided tuition support for five outstanding fourth-year students who plan careers in Internal Medicine.

Despite all this, I believe the department is in very strong shape. All of the division chiefs are exceptionally talented and experienced and have managed their constituencies with exceptional skill. Robert Todd III, MD, PhD, the interim chair, has great leadership skills and substantial experience as the head of one of the largest and most complex divisions in the department. I know the department will provide him with the support and advice he needs.

Finally, I would once again like to thank the faculty, not only for their efforts and dedication, but for their advice and support to me personally. Their dedication has contributed enormously not only to the success of the department but to my personal growth as well.