Less than a month into his new job as dean of the University of Rochester’s School of Medicine and Dentistry, Mark Taubman M.D. is on the horns of a dilemma.
Like nearly all U.S. medical school deans, Taubman faces a climate in which the pool of public and private research dollars is shrinking.
Taubman, 59, is well aware that his primary responsibilities include oversight of the school’s more than 538 education programs and administration of its $406 million budget. He knows also that he oversees more than 5,800 workers, including URMC’s roughly 900-physician medical faculty group, which employs nearly one-third of the region’s physicians.
But at the moment his chief focus is on the school’s research funding pipeline.
Outside grant money is the lifeblood of U.S. academic medical centers. Even the richest private schools cannot pull enough income out of endowments and tuition to fully support their research programs. They need National Institutes of Health money and pharmaceutical industry grants to survive. Recognition of that fact is implicit in the ranking system that U.S. academic medical centers ubiquitously accept, which rates them by the NIH research grant dollars they pull in.
UR medical school researchers won $168 million in NIH funding last year, 84 percent of the university’s $201 million NIH research grant total. The medical school’s contribution is respectable.
In rankings compiled by the Blue Ridge Institute for Medical Research, the UR medical school came in 21st last year, one slot below the Mayo Clinic’s $175 million total and two above the Harvard School of Medicine, whose researchers scored $154 million in NIH money.
Taubman is not overly impressed by the UR medical school’s position. Blue Ridge does not count money pulled in by researchers at schools’ affiliated hospitals, he notes. If NIH grants to the Harvard-affiliated Brigham and Women’s Hospital were added to the Harvard medical school’s total, Taubman says, Harvard undoubtedly would top the list. And with the pool of public and private grant money shrinking, no school can afford to let its competitive guard down.
In past years, 20 percent to 30 percent of U.S. research-grant applicants succeeded. Now, 10 percent get funded. When approvals were more plentiful, each researcher needed to keep two projects going. Now, Taubman says, it is more like three or four apiece.
Still, Taubman says, in the tightening race for the diminishing pool of research money, "We’re in a better place than many."
He regards Harvard and other research colossi such as the Stanford University School of Medicine as institutions that UR could pull even with or best in the funding race.
Grant money follows individual principal researchers whose first loyalty generally goes more to their research projects than to the institutions providing their laboratory space. Even the most storied names are only as good as the individual scientists they manage to recruit and retain. And, as Taubman sees it, UR at the moment has an edge: It can afford to hire.
Finding itself in the second tier among academic medical centers and slipping in the 1980s and early 1990s, URMC started pulling itself up in the mid-’90s, pouring hundreds of millions of dollars into gleaming new laboratory complexes and recruiting scores of top researchers to fill them.
The investment paid off. The $201 million in NIH funding that UR scored last year is much more than double the $75 million it realized in 1997. The recruiting edge Taubman sees lies partly in the attractive new facilities.
Top-tier medical school research programs, including those of Stanford and Harvard, are contracting, in some cases shedding scientists, Taubman says.
"There are real opportunities for us," he adds.
Downscaling of research at big-name schools will provide an embarrassment of riches for UR, Taubman believes. As a research institution on its way up with money to hire, UR’s medical school in the current climate is an attractive suitor in a buyer’s market.
"That is an enviable place to be," Taubman says.
He also sees tough decisions ahead.
Though it has remained relatively small in class size with a current freshman class of 104, the UR medical school spread out laterally, fragmenting into a plethora of separate departments. Though he is not sure which departments might be folded into others, Taubman says, the school’s 39 departments are ripe for consolidation.
A cardiologist and researcher whose entire professional life has been spent in medical academia, Taubman is aware of the inevitable resistance that department heads would mount before seeing their bailiwicks eliminated.
In a year or so, he plans to start a review of the medical school’s curriculum, of which the university has long been proud. It endeavors to train doctors to consider social as well as biological factors in treating patients.
The school’s so-called Double Helix curriculum was implemented 10 years ago to add emphasis on community care to science and clinical education courses. While many at the school are proud of the curriculum, Taubman says, it could use some tweaking to bring it up to date.
He is perhaps more willing to consider shake-ups after having just stepped down from a seven-month stretch as URMC’s acting CEO. Having seen URMC from the perspective of his own boss, Taubman says, he has a different perspective on the dean’s job.
A different role
Taubman was named acting CEO last May after URMC CEO Bradford Berk M.D., a close friend and longtime professional associate, was injured in a bicycle accident that left him paralyzed from the neck down.
Taubman-then URMC chief of medicine-was midway through a vacation in China at the time of the accident. He and his wife, Lois, cut short their trip to take the first available flight home. On debarking at the Greater Rochester International Airport, Taubman learned he had been chosen to step into Berk’s shoes temporarily.
Berk, now mobile with the aid of a motorized wheelchair, has after months of intensive physical therapy regained partial use of his limbs. He returned to work March 1, the same day Taubman moved out of the CEO’s office and into the dean’s office.
Announcing his imminent return to the CEO position, Berk described Taubman-who pursued several major initiatives, including a reworking of an ambitious URMC construction plan, during his stint as acting CEO-as "the only one who could have done the job."
Now Berk describes Taubman as his right hand and the relationship between the CEO’s and dean’s offices as one that will allow them to operate on nearly equal footing.
The dean’s position had opened up shortly before Berk’s accident when the previous dean, David Guzick M.D., announced his departure to take a job heading the University of Florida’s UF & Shands Health System.
The medical school dean’s post had evolved into one of increasing responsibility since former URMC CEO Jay Stein M.D. established the dean’s office in the mid-1990s, Berk says. Taubman, whose status as a researcher is greater than that of Guzick, should add further luster to the UR’s reputation as a top-flight research institution, Berk predicts.
Berk and Taubman met as cardiology fellows and research partners at Brigham and Women’s in the early 1980s. Similar in age and inclination, they forged a lasting friendship.
"We went out for falafels on our way home after late nights in the lab. We raised our kids together in Boston," Berk says.
They are jointly pursuing two research projects. Until recently, when Berk moved, they lived across the street from each other in Brighton.
"That was one of the great things about my house. I used to be able to walk right across the street to Brad’s house. Now I have to drive," Taubman says with mock chagrin.
Taubman came to Rochester in 2002. Berk, who had been promoted from chief of cardiology to chief of medicine, recruited Taubman as his replacement. When Berk was promoted to CEO in 2007, he named Taubman to head the department of medicine.
Taubman downplays his own aspiration to higher status, portraying his rapid rise as a matter of happenstance to which he almost passively acceded.
"I’ve never looked past the job I was doing," he said in an interview on being named dean. "I came (to URMC) to be chief of cardiology, and I expected to stay in that job. When they asked me to be chief of medicine, I applied because I could see what I could do in the job.
"I looked into the statistics and found the average time a chief of medicine stays at a job is three and half years. I thought, ‘I’m going to be the outlier; I’ll be here 10 years.’"
In a more recent interview, Taubman joked, "If I looked at my own (curriculum vitae), I’d wonder, ‘Why can’t this guy seem to hold a job?’"
Berk does not quite buy Taubman’s assertion of ambitionless advancement. For the last three years, Berk says, Taubman has been editor-in-chief of the premier cardiology journal, Arteriosclerosis, Thrombosis and Vascular Biology, and previously he held more than his share of prestigious posts.
"I think Mark has a pretty big ego," Berk says. "Every time he gets a promotion, he says he’d always expected to stay in his last job forever, but he’s had a lot of high-powered jobs. You don’t get those jobs if you don’t want them. What he is good at is schmoozing. He loves to talk to people, and he can get along with anybody."
Before coming to UR, Taubman had been a researcher at Mount Sinai School of Medicine in New York City since 1989. At Mount Sinai, he took on a series of administrative jobs. Those jobs included director of the school’s NIH training program in molecular and cellular cardiology, assistant director of the M.D. Ph.D. program, director of the school’s cardiology fellowship program and director of cardiovascular research.
During his tenure there, Taubman appeared as a guest lecturer and led grand rounds, a medical education staple in which medical students, residents and doctors are quizzed on particular patients’ conditions, at dozens of schools and teaching hospitals, including Columbia University School of Medicine, the Cleveland Clinic, Stanford, the University of Michigan and Massachusetts Institute of Technology.
Field of medicine
Taubman says he decided to become a doctor at the age of 12 after reading a book about heart surgery. For years he intended to become a heart surgeon, but he switched his ambition to cardiology after getting a taste of research.
The Brooklyn native is an only child. His father, who died in his 90s a few years ago, worked in the men’s clothing trade. For a time he owned his own business, with an office in the Empire State Building. He later worked for the Mark Palestine Co., for which Taubman is named.
Taubman traces his inclination to medicine partly to his father. Before entering the Army in World War II, Taubman says, his father was a social worker. After the war, he would have preferred a career in medicine, but U.S. medical schools then put quotas on Jews, and there was a family to support.
Taubman studied biochemistry at Columbia University, earning a bachelor of arts in 1972. He earned a master’s in medical sciences from New York University in 1976 and his M.D. from NYU in 1978. He also met his wife, Lois, who was working as a secretary in the medical sciences department at the school. They have one child, a daughter, 29.
Taubman’s mother is in her early 90s. She lives on her own in the Brooklyn apartment the family occupied since the early 1960s. A well-known piano teacher, she is a co-director and founder of the Taubman Institute of the Piano, a school near Albany devoted to piano-instruction methods she devised.
She also gives lessons at her Brooklyn apartment. Key features of the Taubman method are what might be called ergonomically correct positions for pianists. In addition to scales and etudes, students are taught not to stretch their hands beyond natural limits and to use proper posture for sitting at the keyboard.
Taubman, who learned piano from his mother, describes himself as an accomplished pianist who realized he could never pursue a concert career because one of his hands cannot reach a full octave.
"It’s a genetic thing," he says.
The Met and the Yankees
Taubman travels to New York City at least once a month to visit his mother and to take in an opera at the Metropolitan Opera with Lois. Proximity to New York City was a big factor in his decision to take a job at UR, Taubman says.
"I was also being courted for a job at the University of Michigan. But the fact that Ann Arbor was more than a day’s drive from New York was a deal breaker. I have to get to the Met once a month."
Taubman’s musical tastes are eclectic, running mostly to classical. He professes an equal love for early music, romantic and both tonal and atonal 20th-century and contemporary music. His taste in rock music ends with the 1980s, however. Taubman likes Procol Harum but draws the line at Flock of Seagulls or Men Without Hats.
A passionate fan of the New York Yankees, Taubman considers annual attendance at Yankee Stadium a must. He confesses that most of the time he would as soon watch the team play on TV, but the beer and hot dog ambience of even the new Yankee Stadium is an experience he craves at least once a season.
Mark and Lois Taubman are patrons of Artisan Works, the local non-profit that runs an event venue cum local artists’ studio space and gallery. They first came to Artisan Works when they moved to Rochester from Scarsdale in 2002 and quickly became enamored of the quirky non-profit.
"They fell in love with it and became members. They are really special people," says Artisan Works founder and artistic director Louis Perticone.
Taubman’s predecessor as dean, Guzick, also had been an Artisan Works supporter, bringing students to the art space as part of their introduction to Rochester.
"(Guzick) was a sweetheart, but not that easy to hang out with," Perticone says. "Not that Guzick had such a big ego. Taubman is just easier to talk to. You’re more comfortable with him."
As he begins the deanship, Taubman sees the uncertainty surrounding health care reform as one of the medical school’s most pressing problems. He has followed the debate and the jagged progress of the Democrats’ attempt to pass a health care measure closely over the past year.
What happens or does not in health care reform would affect URMC clinical practices, research funding, funding for Strong Memorial Hospital and Highland Hospital and graduate medical education. And the process has become so frighteningly muddled that huge uncertainties remain whether a bill has passed or not, Taubman fears.
Taubman is placing no bets on where the debate might ultimately land.
"If I were to say I knew what was going to happen, I’d say it’s time to send me in for a head CT," he says. "I’m an optimist to this extent: I’ll say something is going to happen."
Mark Taubman M.D.
Title: Dean, University of Rochester School of Medicine and Dentistry
Education: B.A. in biochemistry, Columbia University, 1972; M.S. in medical science, New York University, 1976; M.D., NYU, 1978
Family: Wife Lois; daughter Janice, 29
Interests: Pianist, fan of opera and the Yankees
Quote (on the outcome of health care reform): "If I were to say I knew what was going to happen, I’d say it’s time to send me in for a head CT. I’m an optimist to this extent: I’ll say something is going to happen."
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