Leading the Change: Introduction

(The introduction below is excepted from Leading the Change: Johns Hopkins Medicine from 2012 to 2022, published by Johns Hopkins Medicine in June 2023. It can be purchased through Johns Hopkins University Press: press.jhu.edu/books/title/53724/leading-change.)
 

A Time of Growth and Change

When Paul B. Rothman became dean of the medical faculty and CEO of Johns Hopkins Medicine on July 1, 2012, he took the reins of a storied institution in the midst of tremendous growth and change.

The health system had recently added three community hospitals: Sibley Memorial Hospital, in Washington, D.C.; Suburban Hospital, in Bethesda, Maryland; and All Children’s Hospital in St. Petersburg, Florida.

Two massive clinical towers were about to open on the East Baltimore campus, the Sheikh Zayed Cardiovascular and Critical Care Tower and The Charlotte R. Bloomberg Children’s Center.

The Genes to Society medical school curriculum, launched in 2009, taught future clinicians to recognize patients as individuals whose health is impacted by their genetic makeup and accumulated experiences.

At the same time, the health system was beginning the complex process of moving to Epic, the electronic medical records system, creating the infrastructure for a big data revolution that was just beginning, one that piggybacks on the Genes to Society idea by helping clinicians understand the complexities of each patient’s health and respond accordingly.

As just the second dean/CEO of Johns Hopkins Medicine (JHM), Rothman ushered in a generational change, following the leaders who had brought the health system and medical school together to create the governing structure known as JHM in 1996.

Kevin W. Sowers would soon become the second president of the health system and executive vice president of Johns Hopkins Medicine, Robert Kasdin would join JHM as its first senior vice president and chief operating officer, and legal matters would be helmed by G. Daniel Shealer Jr., followed by Annemarie Martin-Boyan.

On March 10, 2022, Rothman announced he would retire on June 30 — 10 years, to the day, after becoming dean and CEO.

Theodore DeWeese, vice dean for clinical affairs and president of the Johns Hopkins Clinical Practice Association, began serving as interim dean and CEO on July 1, 2022.

“I have long envisioned myself as a 10-year dean/CEO,” said Rothman, who was 64 at the time of his announcement. “A decade felt like the right time horizon to help advance the mission of JHM,” he continued in a letter to JHM colleagues.

“That vision was crystallized by the COVID-19 pandemic, which demanded so much of our institution and our community. Two years later, I believe that we have navigated the worst of the pandemic, and it is time for a new leader to guide us forward.”

“The pandemic took a devastating toll on patients and their caregivers, the community, and our colleagues — both professionally and personally. It tested our strength and resilience. Lives were lost. Lives were changed. The challenges continue. However, we are optimistic and hopeful about what lies ahead.”

Throughout the pandemic, JHM responded with both expected strength and surprising nimbleness, setting itself apart as a beacon of light through a time of confusion and darkness. Under the leadership of Rothman and Sowers, Johns Hopkins provided caring, evidence-based treatment and clear-eyed information.

In the first days of the pandemic, Johns Hopkins Medicine set up a Unified Incident Command Center with experts and leaders from across the health system and university, who would navigate rapidly changing conditions and information to craft compassionate, science-based decisions and policies.

To limit the spread of the virus, leaders expanded the use of telemedicine and at-home support for patients, virtual learning for students, and remote work for employees.

Speed was of the essence in the scramble to learn about the new virus and how to contain it.

Clinical microbiologists Karen Carroll and Heba Mostafa created an in-house COVID-19 test that gave results in hours instead of days. Facilities teams quickly converted regular patient rooms and floors to ones with negative air pressure to contain the highly infectious coronavirus.

Researchers went into high gear to learn all they could about the disease, focusing on how to predict disease trajectory and tailor treatments to individuals.

Rothman and Sowers teamed with community partners to bring COVID-19 testing, information and vaccines to senior citizens, people with disabilities and other populations with barriers to health care.

Rothman said two principles guided his COVID-19 leadership: follow the science, and do everything possible to keep patients and staff safe.

“The decisions we made were hard, but I think we did the right thing,” he said. “If you’re always guided by the values that we’re guided by — honesty, integrity, making sure we’re improving the health of our community — ... If you follow that North Star, you’re never really going to go wrong.”

A Legacy of Leadership

Rothman arrived at Johns Hopkins Medicine from the University of Iowa and led the institution through a time of immense innovation and integration.

As Rothman shepherded the institution into a more integrated era, one of his first actions was to bring in about 150 stakeholders to participate in the development of JHM’s first comprehensive five-year strategic plan, using a “bottom-up” approach to ensure buy-in across the sprawling organization.

The resulting plan, launched in June 2013, had six priority areas:

People: Attract, engage, develop and retain the world’s best people.

Biomedical Discovery: Become the exemplary model for biomedical research by advancing and integrating discovery, innovation, translation and dissemination.

Patient- and Family-Centered Care: Be the national leader in the safety, science, teaching and provision of patient- and family-centered care.

Education: Lead the world in the education and training of physicians and biomedical scientists.

Integration: Become the model for an academically-based, integrated health care delivery and financing system.

Performance: Create sustainable financial success and implement continuous performance improvement.

Note that people are first.

“This institution is so mission-driven, and people here have such a great set of values that it allows us to attract people who come here to make an impact on the broader community, rather than just themselves,” Rothman said in 2022. “I think that’s the key to our success.”

Rothman led creation of the Office of Diversity and Inclusion and the Office of Well-Being to foster an environment in which all clinicians, researchers, nurses and staff can thrive personally and professionally. He guided the successful appointments of 30 stellar interdisciplinary faculty through Johns Hopkins University’s Bloomberg Distinguished Professorships Program.

He helped to create a more diverse class of medical students through an initiative, launched in 2022, that aims to replace education loans with scholarships.

The precision medicine initiatives Rothman championed are transforming medicine by using data from Epic and other sources to better understand how diseases vary by individual and how treatments can be tailored to specific patients.

Johns Hopkins Medicine now supports dozens of precision medicine centers of excellence, which are breaking new ground in the diagnosis and treatment of diseases, including Alzheimer’s, cystic fibrosis, prostate cancer and COVID-19, and in ensuring that all patients get the treatment that is right for them.

He supported creation of the Catalyst and Discovery Awards programs to help early-career faculty and cross-divisional teams, and championed the Johns Hopkins Medicine Clinical Awards for Physicians and Care Teams to support excellent clinicians.

To foster innovation, Rothman helped marshal philanthropic support to launch several important institutes, including the Bloomberg~Kimmel Institute for Cancer Immunotherapy, the Skip Viragh Center for Pancreatic Cancer Clinical Research and Patient Care, the Armstrong Institute for Patient Safety and Quality’s Center for Diagnostic Excellence, the Cochlear Center for Hearing and Public Health, and the Center for Psychedelic and Consciousness Research.

Johns Hopkins Technology Ventures, which started in 2014, represented a new era for Johns Hopkins inventors — and the many people who have benefited from the technologies, products and services these researchers have been able to bring to market.

In its first seven years, JHTV fostered more than 170 commercial ventures based on the discoveries of Johns Hopkins faculty. One of those discoveries was CancerSEEK, a noninvasive blood test developed by Ludwig Center co-directors Bert Vogelstein and Ken Kinzler, which screens for eight common cancer types.

During Rothman’s tenure, doctors performed The Johns Hopkins Hospital’s first bilateral arm transplant and a world-first penis and scrotum transplant. Genetic medicine professor Gregg Semenza won the 2019 Nobel Prize in Physiology or Medicine.

Looking Ahead

As Johns Hopkins Medicine positions itself for the future, it is following its “Clinical Road Map” that is expanding outpatient offerings and strengthening referrals to specialized care. Green Spring Station Pavilion III, which opened in 2019, is an important part of that plan, as is the current development of Belward Farm, in Montgomery County, Maryland.

In 2019, the health system and university unveiled an ambitious project to renovate the former Johns Hopkins Hospital Children’s Medical and Surgical Center (CMSC) and construct a 12-story tower on the site of the former Brady Building.

The project has been strongly supported by Sowers, who succeeded Ronald R. Peterson, now president emeritus of The Johns Hopkins Health System.

Rothman, self-effacing by nature, said the successes of Johns Hopkins Medicine over the past 10 years are due to its talented and caring people, “the very best that mankind has to offer,” as Rothman said in the March 10 letter to colleagues.

Bill Conway, chairman of the Johns Hopkins Medicine Board of Trustees, and Ronald J. Daniels, president of The Johns Hopkins University, said in a March 10, 2022, letter to the Johns Hopkins community:

“Paul has led Johns Hopkins Medicine through a remarkable 10 years as it continued its preeminence in education, discovery and patient care and served as the nation’s — and indeed, the world’s — most trusted resource during the COVID-19 pandemic.

“It is Paul’s humanity, humility and willingness to do ‘whatever it takes’ that has kept our patient care and research missions moving forward. This was never more evident than in his steadfast and humane leadership during the pandemic. Whether briefing policy makers or leading the quick and safe reopening of Johns Hopkins clinical services, Paul’s commitment to caring for others, rooted in the best science, helped us all navigate the rapid and ever-evolving virus and its variants, from alpha to omicron.

“And we will never forget the time in the wake of Hurricane Sandy when Paul donned waders, rolled up his sleeves, and worked cheek by jowl with colleagues to move research materials out of the flooded basement of our research building in East Baltimore, salvaging countless hours of work and ensuring that potential discoveries were not lost to the elements. In moments like these, and so many others, Paul demonstrated the essential ethos of persistence, collaboration and care that define Johns Hopkins Medicine.”

Leading the Change: Johns Hopkins Medicine from 2012 to 2022

A new history of Johns Hopkins Medicine describes a remarkable decade.

The Book cover for Leading the Change