Leaving the Ivory Tower, Crossing the Moat and Engaging the Community Family Medicine at The University of Chicago April 30, 2008 Bernard Ewigman, MD MPSH Professor & Chair

Founding President of the University of Chicago “Ours is an institution whose aim it shall be to push forward the boundaries of science, one from which announcements may be sent …so potent in their meaning as to stir the whole civilized world.” —William Rainey Harper, 1891 Founding President of the University of Chicago

Pushing Forward the Boundaries of Science Discovery of REM sleep Established blood banking First living donor transplant Defined estrogen receptors Identified genetic etiology of cancer

Leading to…. 81 recipients of the Nobel Prize $232 million in NIH funding in FY 08 Ranked fifth in NIH funding per capita Medical school faculty -58% researchers -spending 50% to 100% time doing research

….as one of the 18 best hospitals in the United States… the only Illinois hospital ever included in the honor roll                                              

Current President of the University of Chicago “The University of Chicago, from its very inception, has been driven by a singular focus on inquiry…with a firm belief in the value of open, rigorous, and intense inquiry and a common understanding that this must be the defining feature of this university.” Robert Zimmer, PhD Presidential Inauguration Speech 2006

Department of Family Medicine Created administratively in 1998 Funded by a large foundation grant in 2000 Founding Chair recruited in 2002 (Ewigman) First faculty member recruited 2003 (Hickner)

Success Strategies of the Department of Family Medicine Set a high bar for faculty recruitment Distinction trumps size Find the overlap between the vision and needs of the institution & the department 4. Work across disciplinary boundaries Identify our special strengths/niche Engage the community

Set a high bar for faculty recruitment Distinction trumps size 4 regular faculty; 3 part-time faculty All family physicians, 6 with masters degrees In the 2006-2007 Annual Department Report: 14 grants and contracts 23 peer reviewed publications, most reporting original research 9 books or book chapters AOA Teacher of the Year

Special Contributions of the Department of Family Medicine Licensing Council on Medical Education citations for poor ambulatory care education, lack of family medicine Developed family medicine core clerkship based exclusively with community preceptors, now the most highly ranked clerkship in the third year.

Special Contributions of the Department of Family Medicine 2. University of Chicago learned that they would lose their Robert Wood Johnson Clinical Scholars Fellowship in 2002 Ewigman lead a multi-disciplinary team to create a successful Primary Care Clinical Scholars research fellowship with multiple funding streams, including Title VII

Special Contributions of the Department of Family Medicine 3. Helped get NIH - CTSA application funded on second round Ewigman led the development of the “Urban Health Initiative” as the core community engagement activity, a more robust “Community Translational Science Cluster”, and a “Knowledge Translation Unit” Hickner led the development of the “Practice Based Research Unit”

Urban Health Initiative What: A collaboration of multiple providers on the South Side of Chicago to form a coordinated network of care through partnerships. Why:• To improve the long-term health of a community that ranks among the least healthy in the developed world. How:• Reorganizing care in a way that optimizes every provider’s expertise and ensures we all play the right role at the right time.

Key Intellectual Domains Genomics, personalized medicine and systems biology Cancer biology, Evolutionary biology, Neuroscience Computation, quantitative biology and bioinformatics Molecular engineering, nano-medicine and device technology Imaging, Immunology, Gastrointestinal disease Urban Health Initiative

Institute for Translational Medicine NIH funded CTSA at the U of C The primary “community of engagement” is the primary service area of the U of C Medical Center, the “target community of the Urban Health Initiative”. A primary goal of the ITM is to engage in research that is relevant to our Community, build trust through a bi-directional process, and to translate new medical knowledge into our Community to improve health and health care

Challenges -Loss of foundation funding, becoming more dependent on institutional funding -Establishing clinical practices beyond CHCs -Establishing a residency program

Value to Academic Family Physicians and Leaders in Other Institutions Helping to solve institutional challenges can create value for departments Understanding the institutional culture, values and priorities, and identifying a niche creates opportunities Engaging in the community, through practice, teaching and research, can add value, even to the “castles” of academic medical centers