This post is by Meredith G. Moore, who participated in the Value-Based Health Care Research Fellowship in 2018-2019.
An energy pervades Dell Medical School that evades description. Those who’ve found their way here truly settle into this “home,” and their passion for it is contagious. There’s a sense of untainted idealism that’s actually fueled by action rather than floating in the ether as an intangible idea. The drive to break barriers runs rampant. This is a place where thought leaders let loose in a playground of scientific inquiry and clinical experimentation.
After careful weighing of the pros and cons of delaying my M.D., I took a year off medical school for the Value-Based Health Care Research Fellowship at Dell Med’s Department of Surgery and Perioperative Care. This was not a solution for how to spend 12 months off, but rather a reason to petition for 12 months off. The opportunity was too tempting to ignore and then too tantalizing to turn down.
Following time at big banks PNC and J.P. Morgan Chase, I found I really had no complaints about crunching numbers and dealing in spreadsheets. In fact, between Excel wizardry, status dashboards and weekly team huddles, I kind of missed these things! The fellowship offered a partial focus on strategy and operations in a team-based environment. I sensed a unique opportunity in being part of a “startup” atmosphere at the first brand-new medical school on a Tier I research institution’s campus in the last 50 years. Dell Med was small, with dedicated stakeholders and a fresh take on how to deliver both medical education and patient care. I had no sense of the legends I would be working under (and for the sake of the interviews, I’m quite glad their reputation did not precede them), but I knew this energy and mission was something I wanted to be part of.
I knew I was signing on to a good thing when, shortly after I had accepted the position following multiple rounds of phone interviews (with Austin site-unseen!), I heard that Clay Johnston, M.D., Ph.D., was speaking at my home medical school for neurology Grand Rounds. I’d missed the actual talk but went ahead and dropped him a note anyway. To my surprise, he emailed back right away with congrats and enthusiasm for my future arrival in ATX — now that was one approachable dean.
After arriving at Dell Med, I attended nearly every event offered: visiting lecturers, film nights, an unforgettable art opening composed of pieces inspired by the medical students’ clinical care experiences, the list goes on. Present at most of these, Clay continued to be emblematic of the welcoming, accessible nature of all involved. On that note, while it took some rewiring to get used to calling M.D., MPH, Ph.D., you-name-it professionals by their first name, I really like the hierarchical flattening this practice facilitated and have missed it since leaving.
Over my first few weeks as a fellow, I met with as many new faces as I could. From one I received the advice to simply take it all in over the first six weeks and paint the entire landscape before selecting projects to dive into. This was sage advice and at first seemed quite doable. Then the true Candyland of the research world of Dell Med and UT Health Austin, Dell Med’s clinical practice, came into view: I was interested in everything! With an energetic Harkness Fellow from the U.K. soon on the scene, the sky felt like the limit.
We took on projects from fairly traditional psychometric assessments of patient-reported outcome measures to a wireless activity tracking pilot study partnership with The University of Texas at Austin Cockrell School of Engineering to testing out revolutionary facial recognition software. I got hands-on patient experience by managing a burgeoning team of keen undergrads and first-year medical students in the clinic through prospective enrollment, as well as the opportunity to manipulate huge data sets such as statewide prescription monitoring program data and national osteoarthritis-related insurance claims. There were multi-institution partnership projects and high-visibility presentations to plan.
Every two weeks, we had a research meeting that was an exercise in stretching the brain. We’d go through design thinking exercises to craft new project ideas and flush out frustrations with current work. Many new initiatives were born out of this Monday gathering, and you couldn’t help but leave inspired.
Patients, too, were inspired by UT Health Austin. I will never forget watching our patients cry during their clinic visit because, they said, they were “treated with dignity for the very first time” in a health care setting.
Visitors from preeminent institutions across the country seemed equally as inspired as I led them through the Musculoskeletal Institute as part of a quarterly visit program I helped build from the ground up. They were in pure awe of the boundaries the trailblazing multidisciplinary staff had broken in this clinic space. For this program, I was able to be curriculum guide, logistics lead, chief marketer, graphic designer for the brochure, photographer and event planner. Of course, nothing would have come together without our entire team (shout out to Kate DiMaggio), but this full-spectrum role was representative of my comprehensive year and what it came to entail.
As I found out later, Kevin Bozic, M.D., MBA, has been cultivating the value-based care spirit in fledgling physicians since his days at UCSF. After meeting one of his former fellows at the AAOS Annual Meeting in Las Vegas, I could tell I had entered a sort of brotherhood. Reunions near and far with those involved in the yearlong or summer fellowship have followed, and there’s a palpable sense of longing (manifested as a perpetual desire for updates!) for the Department of Surgery and Perioperative Care in Austin, Texas, that has shaped all of us forever.