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an online version of the magazine Winter 2005

Success Without Silos

Edward D. Miller, M.D.
By Edward D. Miller, M.D.

Nine years ago, the trustees of The Johns Hopkins University and the Johns Hopkins Health System came together and created a new organization to be known as Johns Hopkins Medicine. To end bitter divisions between the School of Medicine and the Hospital, the academic medical center would now have a single management structure with a dean/CEO at its helm.

At the time, the restructuring was controversial, but the years have shown the wisdom of the trustees' action. It helped us knock down walls that exist at other academic medical centers and get rid of artificial distinctions like “the hospital side” versus “the medical school side.” All of us are Johns Hopkins Medicine. And with no organizational differences to get in the way, our full attention can focus on seamlessly blending our research, education and clinical missions.

Today, I can honestly say that I've never witnessed a more intense commitment to collaboration as at Hopkins . Nor have I known another institution that is better at marrying basic science with bedside care. That collegial spirit is enabling us to march in lockstep on a host of critical issues—new research buildings, a comprehensive campus master plan, fund raising for modern clinical towers, interdisciplinary programs and recruitment of department chiefs. As we continue to work comfortably as a single team, more and more silos disappear.

And so, because everything now is interrelated, it should come as no surprise to find the medical school dean leading a major fund drive for new hospital towers. The fact is, we have great nurses, doctors and technicians, but they work in antiquated buildings. We have faculty specialists to be envied, but they need hospital space worthy of them. Most of all, we need better structures for our patients. If Hopkins can find the resources to build these state-of-the-art, interdepartmental facilities for clinical work and research, we stand on the threshold of phenomenal advances. But accomplishing this huge building task requires a broad base of financial backers—broader than we've ever had. We need new donors who have little knowledge of Johns Hopkins.

And that is the reason why Johns Hopkins Medicine has embarked on a campaign to make a lasting impression on the most powerful people in America 's most important “power center,” and why I myself led a recent foray to New York City . In what is known as a “branding campaign,” we have aimed to fix firmly in New Yorkers' minds that Hopkins remains unsurpassed at turning laboratory discoveries into treatment. This institution offers patients hope, the campaign makes clear. Our research and our clinical skills are superb, and they are tightly integrated.

All of these facts may seem utterly evident to you who know Hopkins , but in today's world, there is so much conflicting noise about medical advances that most people don't spend time differentiating one institution from another. Not surprisingly, our particular message is starting to get blurred.

In my experience, however, if we tell people what we're doing and bring them here for a visit, they grasp the amazing possibilities. Sidney Kimmel is a wonderful example. He didn't know Johns Hopkins. Yet once he and I spoke and he visited with our cancer researchers and clinicians, he understood the impact a sizable gift could make. Not long afterward, Mr. Kimmel donated $150 million—the largest gift in Hopkins ' history. He saw that we stood at the threshold of exponential discovery. He “got it.”

Now, we are looking for more individuals who recognize Hopkins ' vast potential and want to make it a reality. As dean/CEO, my job is to help donors see the big picture. When they say they want to honor a helpful physician or a particular research program with their contribution, I remind them that modern, well-equipped buildings are what make it possible for these pioneers of medicine to produce.

Ten or 15 years ago, we could not have embarked on such an ambitious fund drive for clinical buildings. There were too many silos and barricades. Placing one person in charge of the medical school and the hospital is the step that allowed this to happen. And this campaign in turn will allow us to make “bench-to-bedside” research at Johns Hopkins Medicine the driving force of 21st-century medicine.

That is why I am convinced a consolidated management structure is the way to go for most academic medical centers. Medicine is evolving so rapidly that no single department or hospital unit can find all the answers. It will take the combined efforts of basic scientists, clinicians and experts in a host of new disciplines to cure diseases.

As our renowned urologist Pat Walsh is fond of saying, “The Hopkins Way takes physicians from the operating room into the laboratory and from the laboratory back into the operating room.”

That's the way it is with medical science today. Those who remain in silos won't succeed.

 Medical School Reformer
 Icons and Fundraisers
 In Spite of All Odds
 Circling the Dome
 Medical Rounds
 Annals of Hopkins
 Learning Curve
Johns Hopkins Medicine

© The Johns Hopkins University 2005