February 4, 2002
At the beginning of this new year, I would like to reflect
upon our strengths and achievements, bring you up to date on some
important initiatives and future objectives, and talk about some of the
With this message, I would also like to begin 2002
with a commitment to ongoing communication with you about our continuing
efforts to improve the services provided by the Vice Chancellor's
office, and to keep you apprised of new programs and progress on other
fronts. As part of this
commitment, we will launch a new Vice
Chancellor's website and will share that with you in the coming
I have been at UCSD a little over a year now, and I am
as enthusiastic about this campus as I was when I first
arrived. This is an outstanding university, and our School of Medicine and UCSD Healthcare
system are tremendous assets for the campus and the region in every
respect. The new School of Pharmacy and Pharmaceutical Sciences promises
to further enrich our university community.
I am as excited by opportunity as I am by
accomplishment. What sets
UCSD apart is our powerful potential to be a leader in the design and
delivery of 21st century medicine, while further
strengthening our unique role as this region's only academic medical
center. First, I'll share the good news and the challenges regarding our
We finished the last fiscal year in good shape. The primary
financial "engine" of our clinical enterprise is the UCSD Medical Center,
which has maintained positive alignment of costs and revenue since
the deficit crisis of FY 95/96, with income not only covering costs, but also contributing to a
comfortable margin every year . UCSD Medical Center ended FY 00/01 with
a $36.7 million margin. We achieved this despite the fact that
while UCSD has about 9% of the total San Diego inpatient market, we
provide 45% of uninsured inpatient care in San Diego.
Our faculty, staff and hospital leadership are to be congratulated
for ensuring that UCSD Medical Center has maintained a favorable margin,
enabling us to reinvest in our institution. This margin supports
clinical enterprise development, primary care, recruitment, academic
enrichment and department support, as well as hospital infrastructure
improvements, equipment, capital investments, and so forth. It has
been a sustained and concerted effort, and it has paid off.
we've seen a steady trend of increased patient volumes at both of our
hospitals - UCSD Medical Center, Hillcrest and the John M. and Sally B.
Thornton Hospital in La Jolla. While this is good news, an
idiosyncrasy of today's market is that a busy hospital presents its own
financial challenges. For example, much of our increase in volume
is attributable to managed care patients for whom we receive fixed
monthly payments irrespective of health status or use of services. The
result is significant under-reimbursement, a problem not only for UCSD
but for health care providers throughout the nation.
Further, our labor costs are increasing at a higher rate than
reimbursement levels; this dilemma is exacerbated by the nursing and
other health professional shortages which have resulted in the use of
contract personnel at much higher costs.
Consequently, while the Medical Center is still maintaining a
positive bottom line, we are currently short of our projected FY 01/02
profit margin by approximately 24%. We are tracking this closely
and are taking steps to adjust our costs and improve revenue to address
this shortfall. We anticipate completing this Fiscal Year on
In FY 00/01, approximately $76 million of our total medical center revenues
of $415.9 million was
made up of 'funds at risk' -- state and federal support provided to
help compensate hospitals that care for uninsured patients
(disproportionate share funds), and for the
additional costs we bear as a teaching hospital (medical education
These funds are critical for maintaining our
positive bottom line. With the economic downturn affecting our state and
our nation, and with the redirection of federal funds as our nation
engages in the war on terrorism, we anticipate
substantial reductions in these funds at risk.
It is still unclear what the impact of the current state budget
situation will be on the support provided to the University of
California, and we are watching closely as this takes shape.
These factors all add up to diminished resource and leaner budgets in
the coming year. We are working with our faculty and staff to
ensure that our costs are in line with projected revenues, even with
these projected revenue reductions.
As we look for opportunities to be more efficient
and cost effective, we will also be working with the Office of the President
in their lobbying activities to protect and restore cuts to
some of these sources of public funding. We are carefully evaluating and
enhancing our managed care and health care contracting strategies.
Finally, we are working vigorously to
bring funds in from alternate sources in the private sector through aggressive
fundraising and other strategies.
Even as we tighten our belts, we are facing the
coming year from a position of strength both financially and
programmatically. Thanks to the dedicated efforts of many, we
celebrated a number of milestones last year:
- The Rebecca and John Moores UCSD Cancer Center received a stellar core
grant renewal from the National Cancer Institute, and was awarded
the prestigious status of NCI Comprehensive Cancer
one of only 41 such centers nationwide.
successfully partnered with Children's Hospital and Health Center
after a decades-long courtship. This relationship opens new
opportunities for growth and enhancement of our pediatric education,
research and patient care programs that will benefit our
institutions and, most important, our patients.
School of Pharmacy and Pharmaceutical Sciences is on
track, with the first class of 25 Pharm.D. students beginning in
September. We are
working on faculty recruitment and program development, with a focus on pharmacogenomics
research. As we develop the School, we are following the UCSD model of
cross-appointment and multi-disciplinary teaching and research
San Diego is the nation's largest city with only one School of
Medicine, and we continue to
evolve a clinical strategy that builds on our strengths and fulfills our
responsibilities as this
region's only academic medical system. We
ended 2001 with an outstanding JCAHO review, and are proud of the
accreditation equivalent of a blue ribbon earned by our hospitals and
Home Care colleagues.
We will continue to
provide a full spectrum of services for a diverse patient population in
order to meet our educational and clinical research missions, and to
maintain our commitment as a safety net provider.
We also plan to focus resources on specialty
programs that set us apart as a referral center, and we will
expand our role as a clinical trials center.
We will continue to support vitally important
community programs, from violence prevention to breast cancer screening
and free clinics. These are
programs that the university is proud of, as they truly benefit the
public's health at the grassroots level.
|Members of San Diego's DMAT
team relating their experiences to the media on their return
from Ground Zero.
An example of our faculty and staff response to
public health needs is the effort put forth following the attacks of
September 1l and the ensuing events. UCSD health professionals have conducted numerous public and
professional education sessions, and are working with the Medical
Society, and the County and City public health and emergency medical
systems, to improve disaster preparedness and train providers. And, a team of San Diego health professionals who volunteer for
San Diego's Disaster Medical Assistance Team (DMAT), with sponsorship
and leadership provided by UCSD Medical Center, did a tour of duty at
Ground Zero in New York City, providing first-aid to the workers on the
site of the World Trade Center disaster.
Finally, we will
continue to address clinical workforce shortages through recruitment, and by participating in training to develop new caregivers
and enhance the skills and knowledge of those already in the workforce.
The caliber of
our faculty forms our foundation of excellence. This year two
UCSD faculty members were elected to the Institute
of Medicine, bringing our total number of members to 21;18 of UCSD's 67
NAS members are School of Medicine faculty or affiliated faculty; six
School of Medicine departments rank in the 'Top 10' among their peer
departments in NIH funding, and of 29 San
Diego physicians named in the current 'America's Top Doctors,'
24 are UCSD faculty members.
faculty rank second in the country in research funding per faculty member.
Some of the sizable federal grants awarded this year include the $54 million
Alzheimer's Disease Cooperative Study and the $20 million Biomedical
Informatics Research Network, both national consortia directed by UCSD
faculty; an $11.6 million pharmacogenomics grant in partnership with
Celera, and partnership in a $34 million grant to The Scripps Research
Institute for a 'functional glycomics' consortium. These represent a
new, 'big' science approach with teams of
researchers working together, a model with which UCSD has great success.
|Chicano/Latino Medical Students
Association host high school and middle school students at
A school is only as good as its students, and ours
are among the best. This year's first-year class had a GPA of 3.7,
MCAT scores among the nation's highest, and their scores in the
biological sciences are in the 95th percentile. Our M.D. and M.D./Ph.D. students excel academically, and also
participate in activities that enrich our community, through clinics,
student outreach and education, and other volunteer efforts.
To continue attracting top quality students we must ensure that when
they are here, they have a positive experience academically and in more
personal respects. We must ensure a culturally and ethnically
diverse class, both to enrich the student experience and to fulfill our
commitment to serve a diverse community. We want to graduate
physicians who are skilled and knowledgeable, and also caring and
compassionate. To address these issues, a task force led by Dr.
David Bailey has developed recommendations that we are in the process of
SOLVING OUR SPACE CRUNCH
of this success translates to need for additional space to support our growth. A number of new projects, many funded primarily through
philanthropy, are under way that will provide additional opportunities
for enhancement of our academic and research programs in the next few years:
- The fMRI
center, 7,000 ASF, cost of $13.5 million, nearly complete.
Model of the Basic
- The Basic Research Facility, 81,000 ASF, cost of $61.6 million,
construction underway. This
building, is being funded through indirect cost recovery on grants.
- School of Pharmacy/Pharmaceutical
Sciences, 60,000 ASF,
$29.7 million. This
building will be constructed largely with state funds.
- Shiley Eye Center Expansion (Glaucoma/Retina), 14,000 ASF,
- Rebecca and John Moores Cancer
Center, 148,000 ASF, $100
- Cardiovascular Center (CVC), 42,000 ASF, $60 million
MODERNIZATION AND THE SEISMIC MANDATE
We also must
plan toward replacing and expanding essential patient care facilities,
to accommodate patients and to ensure we have state of the art
facilities that meet current guidelines for safety.
This will include providing additional capacity at Thornton
Hospital, which is consistently operating at capacity.
An even greater challenge is addressing the significant state
seismic requirements in Hillcrest. In order to meet
the current mandates for earthquake safety, we must make substantial
facility and infrastructure upgrades at the UCSD Medical Center, in Hillcrest, which is over 40 years old. An alternative to retrofitting is phased replacement of the
inpatient tower on land adjacent to the current facility, which is
the better option both financially as well as operationally. We are
still evaluating options, and exploring sources of funding to
undertake this multi-million dollar project.
RECRUITING NEW TALENT
Our recruitment to fill key positions, and our administrative
restructuring to provide more efficient service to the organization, is
Tom Jackiewicz has joined our executive team as Chief of
Staff, UCSD Health Sciences. He will coordinate and operationalize many of the
initiatives we have undertaken, and oversee many of the administrative
functions in Health Sciences.
Bailey, M.D., is serving as Deputy Vice Chancellor and Deputy Dean, and
has taken on the additional responsibilities that will be assumed by the
new Dean for Education and Academic Affairs, a position we have not yet
filled that will oversee academic and student support functions. Until we begin recruitment for this position, Dr. Bailey will
provide oversight for activities in medical school admissions,
education, student affairs, academic affairs and continuing medical
We are recruiting a Physician-in-Chief, a new leadership
position to coordinate clinician-related issues across the UCSD
Kaushansky joined us February 1 as our new Chair of Medicine, and
recruitment is progressing for a new Chair of Radiology and we hope to
soon name our first
Dean for the School of Pharmacy and Pharmaceutical Sciences.
And I am delighted to report that Rebecca Newman has been named the
new Executive Director of Health Sciences Development, a key position at
a time when attracting new resources to support or missions is more
important than ever.
COILS: A NEW PARADIGM FOR PROGRESS
developing the concept for a College of Integrated Life Systems (COILS).
COILS will provide a structure for collaboration throughout the spectrum
of health sciences research, from molecules to mankind. Our multidisciplinary emphasis will engage our colleagues on the
main campus and at Scripps Institution of Oceanography, as well as in
the community and private sector.
COILS is designed to provide a continuum of programs and opportunities
bridging preclinical discovery, technology development, clinical
research and patient care.
Institute for Molecular Medicine (IMM), the
preclinical arm of COILS where scientists will apply molecular biology
and genetic techniques to the understanding and development of
treatments for disease. Through private sector partnerships, we will
accelerate the translation of discovery into technologies and drugs that
will treat or even prevent disease at the most fundamental level.
- The Clinical Investigation Institute (CII) will
provide structure and funding for early phase clinical trials to test
these new treatments and technologies.
- And, the Academy of Clinician
Scholars (ACS) will sustain a cadre of superb clinicians who will
receive support to improve their clinical excellence, enhance their
academic experience, establish new clinical programs, and who will serve
as mentors for others.
We will also continue to develop new opportunities for dual degrees,
whether doctorates in science, or in fields such as public health and
business, and are working on programs to offer in conjunction with
UCSD's new School of Management.
UCSD and the Health Sciences have had a rapid trajectory to the top,
and we enjoy a deserved reputation as the youngest of the best universities
in the country, and as a leading health care system, providing
high quality, advanced care. But we are committed to being even better.
We are in a position to create our own future, and to shape the
future of medicine. I look forward to working with you to meet the
challenges of the coming year and achieve the goals I have outlined.