From the June 2018 issue of HealthCare Business News magazine
HealthCare Business News recently spoke with Marschall S. Runge, M.D., Ph.D., dean of the U-M Medical School, CEO of Michigan Medicine, and executive vice president of Medical Affairs for the University of Michigan, to learn more about his background, the organization’s goals and his take on a number of healthcare topics.
HCB News: What inspired you to follow a career in healthcare?
I started out with an interest in science. At the time, molecular biology was just starting. This was the late ‘70s. As I did more research, I came to the conclusion that I was most interested in research that had the potential to improve health through the treatment of human diseases. At that point, I decided to go to medical school. Turns out I really enjoyed clinical medicine as well, and I ended up spending most of my career as a physician-scientist where I combined clinical work in cardiology with research on vascular diseases.
HCB News: How long have you been with Michigan Medicine?
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I’ve been here a little more than three years, I came here in March of 2015.
HCB News: With a good portion of your career as a physician-scientist, was that something that was attractive to Michigan Medicine?
I think so. And Michigan was an ideal institution for me. The traditions of clinical care and research, embodied by physician-scientists, are strong at Michigan Medicine. This is an academic center that, over many years, has managed to combine the three missions of an academic medical center: education, research, and clinical care, very synergistically. As time has gone on there are fewer and fewer academic medical centers able to focus on all three missions to the degree we can at Michigan Medicine.
HCB News: What attracts people – both patients and employees – to U-M Health?
Multiple factors are important. We’re known for our excellent and compassionate patient care and our major focus on patient and family care. We also concentrate on health in general, not just treatment of acute illnesses but also prevention. For staff, there’s a great breadth of patients – everything from primary care to highly subspecialized care for our patients, no matter the nature of their disease. We have the competencies to provide this breadth of care at a very high level. One of our major goals is to bring innovation to the treatment and prevention of disease, bridging our research and clinical programs. This, too, is very attractive to many of our faculty and staff.
HCB News: What advantages does a health system as a medical training institute have over a strictly clinical hospital?
Our broad expertise, really all the things I previously mentioned. Plus, this is a rich training environment. We have 170 medical students per year, Ph.D. students and postdoctoral fellows, and about 1,200 trainees that are residents or fellows. With what we’ve discussed, you can see how we can offer an enviable range of patient care experiences.
HCB News: What are the biggest challenges facing healthcare today?
There’s increasing pressure on the clinical mission to provide support for research. NIH funding, with occasional increases, has been on a gradual decline for a number of years. And no matter how efficient you are at research, it still requires additional financial support to have top-tier research programs, and we, like most institutions, help fund our research with money from clinical care. You can calculate how much additional support is required, on top of a research grant. Generally, that number adds up to more than 50 cents per dollar of funded research. We are in that range. This has always been a challenge, but never more than today because of changes in healthcare finances. The costs of clinical care increase each year with inflation. Additionally, we are seeing many new technological advances that can produce dramatically improved patient outcomes. A very recent example is the use of CAR-T cells, a novel immunotherapy for certain leukemias and lymphomas. Michigan Medicine is one of fewer than 50 centers in the U.S. that have approved CAR-T therapy. CAR-T therapy can be highly effective but is also very expensive therapy, up to about $1.0 million per patient. How we will efficiently use these and other expensive technologies at a time when the world is also migrating to value-based health and reduced reimbursement is a question for all involved in healthcare.