David J. Cole, M.D.
On July 1, 2014, David J. Cole, M.D., assumed the presidency of the Medical University of South Carolina. Dr. Cole established his national reputation as a skilled surgeon, noted researcher, and medical education leader for the most part at MUSC, having served in numerous executive positions at this institution over the past 20 years. He is the former Chair of the Department of Surgery and immediate Past President of MUSC Physicians. Progressnotes invited him to share his vision for MUSC.
PN: Congratulations on being selected as our new president. How did it feel when you received that phone call?
DC: I think it was somewhere between disbelief, excitement, and relief. It took a while for it to sink in. I remain very honored and humbled to have been given this opportunity.
PN: Why do you think it’s important that MUSC has a practicing clinician as president?
DC: As a nation we’re going to have to change how we provide health care. We’ve been focused on the “what” of health care—what we have, what scans we could do, what procedures we could do—and there’s clear need and opportunity for us to transform “how” we provide health care. We have to become more multidisciplinary, more team-based, and ultimately more patient-focused. That’s a cultural shift. Unless you’ve been in the middle of it, you don’t truly understand what the problem is and how to lead forward out of that. Honestly, I believe one of the reasons I was considered for this position is that there are inherent strengths in having a leader who has 20 years of clinical experience and knowledge plus enough presence at this institution to have established a solid level of trust.
PN: What is your vision for MUSC and its role in the transformation of health care?
DC: As I was noting previously, in the next five years we’re going to have to drive a fundamental transformation in how we provide health care. We’re being held more accountable, asked not to be wasteful. In the past, that sort of accountability was assumed but not really defined. Now, quality measures are a click away on the internet. We have to become a patient-focused, high-quality, value-based care provider. That’s what is expected by our patients.
PN: How important will affiliations with community hospitals and physicians be?
DC: Underlying my vision for providing patient-focused, high-quality care is an emphasis on efficiency of care. We have to be able to provide the right care for a patient at the right place at the right time. By definition, that means we need to start forming partnerships because not every patient needs to be at MUSC. We need to be a little more diverse and less siloed when we’re talking about achieving population health. We’re talking about maintaining health first, and that’s possible only through an alliance with community physicians.
Historically, a hospital CEO says a full hospital is a good hospital. That’s generally true, but now we need to start asking questions about whom we can best serve at the MUSC Medical Center. Do patients require the type of care that only we can provide? If the answer is yes, then they need to be here. If the answer is no, then maybe they need to be supported with our partnership with a local community hospital and physicians.
PN: How will you ensure that MUSC continues to attract the best future clinicians to its training programs?
DC: MUSC is emerging in the national academic medical center arena as a rising star. With our six colleges, we have our finger on the pulse of every dimension of health care. We have the ability to lead the way nationally in terms of multidisciplinary care and multidisciplinary education. We need to change the culture so that’s the expectation. To me, the exciting opportunity is that we can not only change the way health care providers interact with one another but also teach those new modes of interaction to our students. That’s how we will achieve the profound cultural shift that is needed.
We are already attracting high-quality students and residents to our programs. Why is that? Well, it’s the quality of our educators and clinicians. It’s our culture. I think MUSC provides a very dynamic, forward-thinking environment. We would rather do something, build something, than wait it out. That’s always been our strength. Part of the magic formula, if you will, behind our growth over the past 20 years has been that we’ve been able to share common purpose and figure out how to work together in a manner that’s productive rather than destructive. Students and faculty alike see something they want to be part of and choose to be here.
PN: How can MUSC continue to enhance its strong national profile in basic and clinical research at a time when research dollars are very scarce?
DC: Another challenge. You don’t have to read too many newspapers to hear about NIH and clinical funding being strained. As an institution, we need to acknowledge, align, and build on our clinical and basic research strengths. If we focus on our strengths and build into those domains, we will continue to receive national recognition. To do that, we’re going to have to intentionally diversify the financial base that provides support. That’s not to say that we shouldn’t be as competitive as possible for NIH funding, but there are many ways that we can get resources. One way is continuing to develop key industry partnerships based on our academic strengths. We need to identify the major programs that have enough of a name to attract industry partners that can provide resources for what we collaboratively need to do. Also, we need to be prepared to leverage new domains for funding, such as the Centers for Medicare and Medicaid Services and the Patient-Centered Outcomes Research Institute. Furthermore, we need to leverage more effectively our intellectual property. I think MUSC has an opportunity to continue to develop a more robust technology transfer platform that will add value to the institution.
Finally, strong development efforts provide critical resources for our programs. Obviously, as president, I am going to spend a significant portion of my time working on fundraising.
PN: Is there anything you’d like to add?
DC: Part of this position requires not only my presence, but also my wife’s as we are the external face of the institution. In the Department of Surgery we always tried to build a positive, forward-thinking culture that sent the message that we are family. It’s not “them” and “us.” We are “us.” I’d love to bring that feeling of engagement to the entire institution.
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