Steed Rollins introduced one of them on Monday. Dr. Ralph Snyderman, who for 15 years was the Chancellor of the Duke University Medical Center, guiding it through periods of great challenge and transformation.
Dr. Snyderman, was also a member of our Rotary Club for many years and is still an honorary member. Recently, the Duke University Press published his book, The Chancellor’s Tale, Transforming Academic Medicine and his presentation was an overview of the book’s focus which reflects on his role and the insights he gleaned leading the changes that made the medical center internationally known for its innovations.
Dr. Snyderman began with a couple of anecdotes that framed his challenge early on. The first was an encounter at a gas station when he first came to town and was lost looking for the hospital. The attendant burst his bubble by declaring that yes, “Duke was the best hospital,” at least in Durham. The second was of a day while on hospital rounds that he watched an attendant stripping a bed and wondering where the sheets went and how they got back on the beds after they were washed. He then set off on a journey that took him first to a non-descript laundry building where the African-American workforce labored in 110-degree heat under their white supervisors. Not only did he get the building air conditioned but began chipping away at the culture that gave Duke Hospital the not-so-fond appellation of the plantation.
Back in June when we visited the Eye Center, I first understood that the foundations of academic medicine were teaching, research and clinical practice. Dr. Snyderman shared that until managed care came alone, each specialty basically operated as an independent business unit with the clinical leg providing the revenue that supported the other two legs. Managed care drove the necessity to share revenue and capture more clinical activity. Long-time residents of Durham have watched that take place as Duke has developed a regional network of primary care physicians that feed the specialty clinics and the acquisition of Durham County Hospital. Dr. Snyderman shared how this latter was difficult because of the County Commissioners’ concern that Duke would not be as responsive to community needs.
This was one of those presentations that I felt could have gone on for another half an hour at least with no diminished interest. Dr. Snyderman never got to share his insights about integrated medicine and personalized medicine and questions hung in the air about his thoughts concerning the Affordable Care Act, its future under the new administration and nationalized healthcare in general. Fortunately, many of those questions can be answered by the book which is available at https://www.dukeupress.edu/a-chancellors-tale including a Kindle version from Amazon. At that page, there is also a link to a two minute video that describes the book and more background on Dr. Snyderman. The video is also embedded at the end of this report. If you watch the video on YouTube, you will probably also see in the sidebar links to several other videos from Dr. Snyderman including two that discuss personalized medicine.
In the last three years, I’ve spent many hours in different areas of the Duke University Hospital (most not as a patient.) Some in areas as serene and lovely as a fine resort or antechamber to the executive suite of a major corporation, and at least one barely a level higher in Dante’s Inferno than the original laundry room that Dr. Snyderman described. Despite what might still need to be done, the evolution of Duke Medicine has been a boon to Durham and the region and there is no reason to believe that it will not continue to grow in service and stature and remain and institution that breeds leaders like Dr. Snyderman.
Submitted by Jay Zenner