August 2018

Strong Medicine


August Issue 2018

by Dwain Hebda | Photography by Jamison Mosley

Cam Patterson writes the prescription for a healthier UAMS

 

Dr. Cam Patterson, new UAMS chancellor, has come home. Sort of.

No, he’s not sitting astride a major teaching hospital in his native Alabama. But in all the other areas that matter, he’s slipped back into the friendly confines of the South, where he was born and raised.

“(UAMS) is a truly special place,” he says, casually. “I felt like I was back home as soon as I showed up to work.”

“Work” is the operative word around UAMS these days, and Patterson has his cut out for him. The state’s foundational health care institution and medical school has foundered mightily and publicly for the past several years, running huge deficits and seeking to find its stride in a new era of health care, itself a maelstrom of churning regulatory and political waters hard to navigate and nearly impossible to chart.

“We are a large entity, and with that we have a big budget, but we also have a big mission,” Patterson says. “The landscape for reimbursement for health care, which is the primary source of our budget, is changing dramatically. There are attempts all around us to squeeze expenses out of the system.

“In addition to that, we are an academic medical center that has an enormous role in providing health care education within the state and doing research to address the challenges of the people here in Arkansas,” he adds. “Both of those are largely unfunded mandates.”

The complexity of managing an entity such as UAMS – comprised of seven health institutes, eight regional campuses, nearly 3,000 students, almost 830 medical and dental residents and 1,200 physicians – is mind-boggling. Imagine running one of Arkansas’ largest corporations that is simultaneously one of its largest nonprofits and channeling it through the framework of state government and you start to get the picture.

Patterson, whose career has largely been spent at teaching hospitals, finds such a model not only familiar but advantageous.

“My whole life has been wrapped up in this idea that health care, research and education are completely intertwined. In most freestanding hospitals that’s not the case,” he says. “The vast majority of the business that they do focuses simply on health and health care. By combining the three arms of our mission we are able to do each of them incrementally better. They become very synergistic with each other.”

For that reason, Patterson says, there’s much to be proud of at UAMS, financial woes notwithstanding. The organization annually delivers $4.5 billion in economic impact to Arkansas and commands $170 million in research funding. Its myeloma and orthopedics programs are headliners nationally, and the system provides extensive primary care services, including 50 pediatric clinics across the state.

“We’re getting a lot right here,” he says. “I do think that message has gotten lost.”

Drowning out UAMS’s accomplishments have been the staggeringly large deficits of recent years and the painful work that has been done, prior to Patterson’s arrival, to curtail said losses. UAMS flirted with a $72 million shortfall in FY 2018 until massive job cuts brought that deficit to around $39 million. Since January, more than 250 workers have been laid off in the cost-cutting measure, out of a total of 720 positions to be eliminated.

Despite these measures, Patterson says employees’ commitment to the mission of the organization is undimmed.

“We’ve had town halls, breakfasts with our staff,” he says. “I just walk around and talk with a lot of people here. I would say the consistent message is a desire to get back on track.

“Clearly,” he adds, “the economic challenges that affected UAMS over the past eight months were hard and affected our staff directly and were discouraging, but they were necessary. They were the right decisions and I think at a gut level, the 10,000-plus employees here understand that. What they are looking for is that sign that those challenges are all done and over and we are back in the business of creating new programs and thinking about better ways to provide care.”

That sign, Patterson says, came in July when UAMS implemented its 2019 budget, a $1.57 billion blueprint that’s the first balanced budget in at least four years.

“The components of UAMS that needed to be pulled out to balance the budget, that’s already taken place. That’s already said and done,” he says. “Issues that are easy to put off, like deferred capital, are not put off. Deferred capital for maintenance have not been put off this year.

“We’re locked and loaded for a really full year of growth and productivity,” Patterson adds. “There’s nothing that we are kicking down the road to make this happen.”

Patterson’s been through this process before, citing similar issues in North Carolina during a 14-year tenure there.

“We were also an institution beholden to the state for support, and we went through a couple of major downturns,” he says. “Look at where the University of North Carolina is right now – top 10 in the country in age funding, the largest health care system in the state with a lot of competition, including Duke right around the corner.”

As in North Carolina, Patterson believes there is room to augment the state’s level of appropriations but admits lawmakers will only respond to this as an investment, not as a mere handout.

“It’s obvious to me that we have to do a better job at UAMS of explaining [to legislators] what we do and how it benefits our communities,” he said. “I’ll give you a specific example: We are on a journey to receive National Cancer Institute designation for our cancer center. The cancer institute here is world class. If we can get that designation, it will have a $72 million a year impact on the state of Arkansas in terms of economic impact of all the services that we’ll provide.
“It’s up to me to articulate to the legislature why an investment in UAMS, in particular our cancer institute, would pay off in such an extraordinary way.”

Patterson was raised in Mobile and earned his undergrad from Vanderbilt University. He attended Emory University School of Medicine in Atlanta and conducted his residency, including a year as chief resident, at Emory University Affiliated Hospitals. He also holds an MBA from the University of North Carolina.

During his medical career, which included physician-in-chief at the UNC Center for Heart and Vascular Care and executive director of the UNC McAllister Heart Institute, his work received more than $60 million in grants from the National Institutes of Health, the American Heart Association and the Centers for Disease Control and Prevention. His work has also been published in 323 peer-reviewed scientific publications.

He says he transitioned into administration as a way to help a broader swath of the community, a prime motivator that continues to this day in his newest role in Arkansas.

“If I’m in the cath lab, I have the chance to take care of one patient at a time which is tremendously rewarding and you get slapped on the back and it feels good,” he says. “But in administrative roles, we take care of hundreds of patients every day.

“When I think of the scope of the job here as improving health and health care for the three million people in Arkansas who make UAMS happen, that’s an opportunity that you just can’t turn your back to.”

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