The Bequest of a Beloved Chairman
Goldberg has always been a star. He was chief resident at Wilmer in the mid-1960s and later did a fellowship in medical genetics with Hopkins' Victor McKusick. At 32, he was recruited as chairman of ophthalmology at the University of Illinois College of Medicine. He stayed there nearly 20 years, dramatically increasing the department's faculty and research budget, until he got the call from Hopkins.
When Goldberg arrived, he didn't expect to be jolted into the world of business affairs ("I went into academic medicine specifically to avoid it," he says), but the times demanded that he turn his considerable intellectual skills in that direction. It turned out he was something of an administrative genius. He involved the entire staff, from faculty to secretaries, to draw up a war plan and made everyone accountable. He planned an attack on two fronts: the internal operations of the Institute, like finances, human resources, information services and facility improvements; and the external environment, most importantly, managed care.
It's easy to forget just how difficult it was navigating through the early 1990s. Decisions had to be made that were never easy and often risky. Form a network, or join one? Provide only tertiary care, or expand primary care? Goldberg had a knack for this kind of leadership. He set up a satellite clinic (there are now 11) before the idea was a popular one, and he embraced "re-engineering" as a way to cut costs when it was still controversial.
When Goldberg steps aside at the end of June to make way for the Institute's sixth director, he will leave behind a breathtaking portfolio of accomplishments. He is responsible for a budget of $65 million and oversees 600 employees. Since 1990, Wilmer's inpatient beds plunged from 120 to 12 to convert to outpatient surgery, but outpatient visits went up 120 percent, and surgical cases increased 91 percent. During that period, Wilmer has been refurbished from the basement to the top floor, including the Wilmer Eye Care Pavilion, where nurses (who boast the highest retention rate at Hopkins) wear crisp white uniforms with the Wilmer logo. While grant funding has risen steadily, Goldberg's success at fund raising (gifts are up 615 percent since 1990, including the establishment of 22 endowed professorships), provides an enviable level of security within the Institute.
All the while, Goldberg has continued to see patients, remained a gifted teacher to his beloved medical students and residents, and done research on vascular diseases of the eye. Recently, Dome sat down with Mort Goldberg to commemorate the end of an era.
Are you happy to be stepping down?
I can't wait! I've had the same job description as department chairman since I left Victor McKusick's fellowship in 1969. That's enough. It's like you've got the watch on a bridge of a great battleship. It's exciting, gratifying and important, but then what a relief to pass it on to someone else you have confidence in.
As an alumnus of Wilmer, did you know what you were getting into when you came back?
No. There were some rough and painful times at first, due to plummeting revenues on the clinical side. A number of factors collided. There was a sharp reduction in Medicare reimbursement. At the time, it looked like there would be an enormous wave of HMO control of patient care and as if they were going to call the shots. Contracts were being offered by fly-by-night organizations paying very low rates of reimbursement. We also lost a number of key faculty members. The net result was a major deficit in the annual budget, when I had expected an extremely strong and positive one. It was unpredictable and very serious and for a year or two, an intense emotional experience for me.
We had to start paying attention to administrative details and made efficient management our fourth mission. We quantified everything we were doing-numbers of inpatients, numbers of outpatients, surgical cases, laser cases, ER cases, dollars billed, dollars collected, new grant money, gifts. It required tremendous perseverance, but people bought into that modest modification of the Wilmer culture. Now it's a machine on semi-automatic pilot. We've rebounded and are stronger than ever, but in 1990 my crystal ball couldn't have told me that would happen.
Where do you see research headed?
I'm excited about the inroads we're making into macular degeneration, the most common cause of legal blindness in adults. I had lived through the diabetic retinopathy scenario 20 years previously, and in both cases I've seen routine therapeutic approaches developed for what were initially completely untreatable, blinding diseases. We began treating macular degeneration using hot lasers to burn the bleeding tissue. About five years ago, we turned to cold lasers, which use a chemical reaction rather than heat to get rid of the abnormal blood vessels. Now we're evaluating an array of experimental drugs which will be given by injection without needing a laser of any kind. There are several drugs in a horse race at the moment, but one should prove to be beneficial within three or four years. So the future is brighter than ever.
What will you be doing after June 30?
I'll be working in professor Ran Zeimer's lab, helping develop new techniques of cold laser treatment. I'll be assisting the dean in any way he sees fit. And I'll be doing whatever it takes to make my successor flourish. I'll also have more time for my wife and two sons, each of whom has been an inspiration to me.
You have a good life.
I have a great life. It's tailor-made, and being at Hopkins is a rare privilege. It's one of the few institutions in the world that is worth devoting your entire professional life to. I've felt this way from the minute I walked in the door 40 years ago.
People self-actualize here better than any group I've ever seen. They're not only extraordinarily talented, but highly motivated. If you look at the population at large, there's only a small minority who want to achieve their inherent potential, but even if they want to, they can't. So this is an unusual place in that most people not only want to achieve it, but they do achieve it in large measure.
It's also the purest meritocracy I've ever known. It's what you can produce that matters and virtually nothing else. Not the family you come from or who you know, not what influence you can leverage, but what you can produce. What could be better?
-Mary Ellen Miller