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Healing Artisan

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By Jack Feuer, Photos by Eric Schwabel

Published Apr 1, 2010 10:00 AM


Dr. A Eugene Washington, the new dean of the David Geffen School of Medicine and vice-chancellor of health sciences at UCLA, talks about his ideas on leadership, where medicine is headed and what he'll bring to Westwood.

True to his reputation as an engaging, razor-sharp public speaker and forward-thinking health-care leader, Dr. A. Eugene Washington is making a serious point with a funny story. Describing how vital it is for health care to fully embrace the digital age, UCLA's newest dean recalls how a physician friend recently stopped by the Washington residence in San Francisco to "deliver our medical records in two packets."

Pause.

art

"In the 21st century, he's bringing me paper medical records?"

Beat.

"It is ridiculous that I have before me this bundle of papers."

It is not surprising that colleagues, friends and former students describe Washington in often ebullient terms. He is hailed as an "excellent mentor" and "very approachable, very interested in people and very interested in excellence," says Dr. Wade M. Aubry M.D. '77, the San Francisco-based UCLA Medical Alumni Association board member who has known the new Geffen School chief for years.

Washington came to Westwood on Feb. 1 from UC San Francisco, where he served as executive vice chancellor and provost, and professor of gynecology, epidemiology and health policy. A respected clinical investigator and health-care educator, the good doctor is also a tireless advocate for the most at-risk patients and a sought-after thought leader on health-policy issues.

And now, a doctor on a new mission.

"Dr. Washington wants to learn how to make medical education relevant for the next generation," says Aubry. "He is very motivated to succeed and take UCLA to the next level in terms of the school of medicine and the hospital and medical services in general. We are most interested at the Medical Alumni Association to work with Dr. Washington and help him in whatever we can to succeed."

UCLA Magazine caught up with the new dean during his first week on the job and in a wide-ranging interview, asked him to provide a glimpse of the shape of things to come for UCLA medicine. Here's what he told us.

Three words that describe your management style

Consultative, evidence-based and decisive.

The first because I see the value of having the benefit of all the expertise and knowledge and experience that is embodied in the individuals that I'm working with who are in very competitive positions. They've been very successful because they have demonstrated that they're analytical thinkers and prudent decision-makers, often under stressful conditions, and they also have shown themselves to be committed to a cause.

The second because even when I have all the information, I like to sort out what's fact and, as you may imagine, that's not as easily done as it might sound. And what else is opinion, what we think. We really make progress when we all agree on the facts — and sometimes the facts themselves are enough to dominate the decision.

And the decisive part is from personal experience and also seeing colleagues become frustrated with a leader who keeps talking but makes no decisions. It can create morale problems and it also doesn't solve the issue at hand. So I say, here's the timetable. We'll consult this group and that group. We're going to solidify our assumptions. And by this date or this hour, I'm going to make this decision.

Where medical technology is taking us

There are many great professions. But medicine creates a broad base from which to work if what you're driven by is improving the lives of people.

-Dr. Washington

Medicine has not even begun to leverage the transformative power of information technology. We tend to think immediately about new devices and new instruments, but the truth is, in large measure, health care is about exchanging information. Between patients and providers, providers and health-care systems, locally, nationally and globally.

And not just for medical care, but for education as well. Increasingly, our medical students want their lectures on the iPod. Instead of coming to class and falling asleep like we did, I think it's OK if they're getting the information they need in the most efficient way through technology.

We're now hearing about telemedicine. What if there was a program on your phone that is UCLA Health, and when you push that you are connected and it's a two-way exchange, we can send you reminders, or you have a question and can be very easily linked to the answer? It's what one colleague describes as ambient care, on a day-to-day basis, very convenient for patients regardless of resource level, and it reinforces the messages we need to communicate for treating chronic disease, curative medicine, and to help promote a healthy lifestyle.

Diagnosing the nation's health-care policy

That's why I came to UCLA. There are a handful of institutions that, because of the quality of care they provide, the comprehensive nature of the health system they offer, and who have the intellectual capacity to help create new models, can test to see what works and what doesn't work for the future.

Why women's health is one of his specialties

I've done work around the world and when you go to these places, you tend to think it's a one-way street. But it's really bidirectional — you pick things up. And if you really want to transform a society, you focus on the women. If you can get them good health care, you can change a whole village. That's been proven.

Years ago, I saw that in families and communities where change was happening at a real grass-roots level — and particularly for me having observed this in the African-American community [in the United States] — it was being driven by women. So ensuring the health of women meant that you could ensure the health of families.

And at that time, when you looked at where the NIH was spending their money, they were based on studies that included only men. You extrapolated to women. So I saw it as an area of need as well as opportunity.

The state of diversity in health-care education

The numbers speak for themselves. One set of numbers shows that, if you look at the demographics of a population, say California, and you look at the demographics of the students, in medical schools and other areas, there's a mismatch.

Now, I do not believe you need a person from the same ethnic background [to treat] patients; however, I do think that the current emphasis on cultural sensitivity is not only appropriate, but spot-on. If you can't communicate with the patient, then you're not going to understand what he or she needs, and you'll miss the target more often than not. And patients pick that up very quickly.

It's also true at the institutional level. If you don't have these perspectives represented, your view becomes skewed and, of course, actions follow views. We have to find a way to have these perspectives represented in our institutions. And by the way, UCLA is one of the most diverse medical schools in the country and the Health System is one of the most patient-centric institutions in the country.

Medical education's greatest challenge

You could get multiple answers here. I think the greatest challenge is educating students for a future when we're not quite sure what that future is going to look like. The tricky part is where we place our bet on what that future will look like.

If you follow the current bills [in Congress], what will it look like in 10 years if we do go through a dramatic health-care transformation? The roles for the physician in some cases could be different. Something as simple as the office visit could be very, very different.

If it works the way many would like to see it work, including me, the physician would spend his or her time with the patient assessing the data available from the technologies we've been talking about, and helping to make decisions with that patient based on that information, their perspectives and the provider's input.

The challenge is seeing exactly what that role will be, and what the skill sets and knowledge that are different from what we have today are going to be. For example, there's a great discussion about curriculum in med schools today. It's almost like buying new computers; they change so often you have to get a new one every two or three years. And when I'm in Washington and around the country, [it's clear that] UCLA is at the forefront in this debate and testing what the future might look like.

Top priorities at UCLA

The first priority is to listen and observe and more clearly understand the UCLA community. I think of myself as a very quick study, but I know from experience that every institution has its own culture.

You have to bathe in it for awhile before you fully grasp it. Until then, you can't take full advantage of it. There's a Japanese proverb I like to quote: Vision without action is a daydream. Action without vision is a nightmare.

Medicine as a force for social good

My goal in life was to have continued impact on the lives of others. When I was in college, I was a mathematics major and didn't really think about medicine until I was tutoring premed students. Some were quite idealistic. Many had different ideas and paths to making a difference, but always within the confines of medicine. I began to think, what am I going to do with a doctorate in math? There are many great professions. But medicine creates a broad base from which to work if what you're driven by is improving the lives of people.

Were you a difficult medical student?

Yes. I could give you a few professors who would agree.

Are you a difficult patient?

"Impossible," is what my doctor and my wife would say.

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