By SUSAN JONES
Anantha Shekhar, Pitt’s new senior vice chancellor for Health Sciences and dean of the School of Medicine, won’t get a honeymoon period to slowly move into his job. Since arriving on June 1, he’s been thrown into the middle of the University’s planning for faculty, staff and students to return to campus.
On a late June day, he was still in a temporary space waiting to move into the office recently vacated by Arthur Levine, who Shekhar replaced. And he was about to head to his first face to face meeting (masked, of course) since coming to Pitt with some of the leadership from the Health Sciences schools.
“That’s been a bigger handicap than I had imagined, just not being able to meet people face to face and get to know them faster,” he said.
Don’t expect Shekhar to stay a stranger for too long, though, as he settles into one of the biggest jobs at Pitt — overseeing the six health sciences schools, more than 6,000 faculty and staff, and approximately 5,000 students, all while working closely with UPMC.
Shekhar comes to Pitt from Indiana University School of Medicine, where he was executive associate dean for research affairs. He was born in India and earned his medical degree from St. John’s Medical College there and Ph.D. in neuroscience at Indiana University. He also was founding director of the Indiana Clinical and Translational Sciences Institute, the only statewide institute of its kind.
Pitt first came to his attention as a leading institution in psychiatry and neuroscience, then he was on the external advisory board for Pitt’s Clinical and Translational Science Institute. The opportunity to lead the six health sciences schools was incredibly appealing.
“Pitt is very unique … to have six top 10 health sciences schools in one university and have a position to oversee all of those and to coordinate a truly modern version of health and health care through that,” Shekhar said. “And then at the same time have the largest academic medical center and largest academic insurer as your partner, I mean that’s really a dream platform for someone who wants to think big about health sciences and about the future of medicine and future of medical and health education.”
New dynamic with UPMC
One major difference between Levine’s tenure at Pitt and Shekhar’s is that the new SVC will be paid exclusively by the University. In the past, UPMC paid a portion of Levine’s salary.
Chancellor Patrick Gallagher said previously that, “This reflects the maturing scale of this position and the fact the position has a primary responsibility to represent the interests of the University with UPMC.”
Shekhar agreed and added, “As the dean of the School of Medicine and a senior vice chancellor, I’m an officer of the University. I’m also a board member at UPMC. So really, in corporate governance, I shouldn’t be paid by UPMC and also oversee UPMC as part of their board.”
His yearly compensation package includes a base salary of $1 million, along with five $100,000 payments in annual deferred retention incentives that he will receive if he remains in the position until May 31, 2025. Shekhar also will be eligible for an annual performance bonus — a minimum of $300,000, up to a maximum of 40 percent of his then-current salary.
He has already agreed to join other members of Gallagher’s senior leadership team in donating 10 percent of his base salary back to the University to help in pandemic recovery.
The relationship between Pitt and UPMC needs to be a “closer and aligned partnership in some areas,” Shekhar said.
On clinical services and patient care, Shekhar said, “There’s absolutely no separation between faculty and their desire to provide the best patient care and UPMC’s desire to provide the best patient care.”
Similarly, Pitt is “outstanding in research,” he said, and UPMC wants to be known nationally as a top academic medical center, which boosts the company’s commitment to cutting-edge research.
Where Pitt and UPMC are “misaligned,” Shekhar said, is on educating students in the Health Sciences schools. “I don’t mean that UPMC is not committed to education,” but because the health giant has a statewide footprint and Pitt’s students are in Pittsburgh, the opportunities for in-hospital education don’t always line up. “I hope to work on that over the next few years, especially in the areas like nursing and in other areas of health sciences.”
Indiana University’s School of Medicine had a similar arrangement with IU Health, an independent health system. Fifty percent of the board of IU Health is nominated by the president of the university and the dean of the School of Medicine sits on the board. The big difference is that UPMC is about three times larger than IU Health, “so that makes it much more challenging as well,” he said.
Working with all the health sciences
When Levine announced in January 2019 that he would be stepping down, one hotly debated issue was whether the jobs of SVC for Health Sciences and dean of the School of Medicine should be split. Eventually, the chancellor decided to keep the jobs together, and Shekhar agrees with that decision.
In most academic medical centers, Shekhar said, the medical school accounts for about 65 percent of the research funding and it’s almost always associated with a health system that can have a budget three to five times the size of the university’s. “You end up having a medical school dean who has a much bigger financial footprint than all the other health sciences combined.
“In some places where that is happening, it becomes a real challenge for management, because then the person who runs the medical school is reporting to the health sciences, but (the med school is) not willing to share any of the resources, because it’s not part of their core mission. It creates much more complexity than the current this model, which I think — with an enlightened kind of leadership — can really work well to the advantage of all the other health sciences schools.”
At Indiana University, a Center for Interprofessional Education was formed in the health sciences to make sure that curriculum in medicine, nursing, public health, dental medicine and more were “intertwined, so that there were periods when medical students and nursing students and dental school students were all working in teams on certain courses. You learn to respect other providers’ schools, as well as work with their students as early as your first and second year in medical school and in nursing school.”
That’s only possible, he said, if you have one leader overseeing all the health sciences. “The synergy of the health sciences schools is best exploited when you have coherent governance of it,” he said.
Living with the pandemic
Shekhar and the Healthcare Advisory Group have begun releasing Health Standards and Guidelines for the entire campus as the fall semester approaches and more will be coming.
The group is working now on “all the things we think would be best practices, as well as most feasible practices, for mitigation and protection of students.” They’ll also be looking at how to best implement these guidelines.
“Our hope is that we would create a new normal where the University can function to its fullest extent possible with appropriate protections and mitigation,” he said.
Part of that will include a testing strategy. He said the University will offer some form of testing for COVID-19 for specific subsets of people, such as those at high risk.
Students in the Health Sciences are better prepared to deal with the pandemic than undergraduates, Shekhar said, because many already spend a great deal of time in clinical settings. He said one concern is how to keep safe dental students who see patients.
And on the vaccine front, Shekhar said research at Pitt is going well with multiple candidates in development. Some are already being transferred to big pharma companies to develop large clinical trials, while others are still in the research stage.
“I would say we have the best researchers, and we have some of the best candidates so far, at least in terms of if we wanted to place a bet on it,” he said.
In a podcast interview with Pitt Med magazine in May, Shekhar said, “Pitt has one of the best vaccine research centers in the country with a high level of biosafety facilities as well as units with virology expertise to develop vaccines or antibodies or to treat other types of infectious diseases. …
“I wouldn’t be surprised if they repeat their success with polio again with COVID-19. That level of accomplishment is possible at Pitt. Very few academic centers, if any in the world, have all those facilities that Pitt has. In many ways it’s going to put Pitt on a leading position for research over the next five years, which will clearly be dominated by infectious diseases.”
The future of health sciences
Health care was already moving more online before the pandemic, Shekhar said, and the crisis has sped up that process.
“Google and Apple are already beginning to enter the health arena, and a lot of the work will become patient-centric,” he said. “A lot of the care will actually go to the patient’s home rather than patients coming to where the care is going to be given. We have already seen that with COVID, now telemedicine has become a standard for managing routine patient visits and routine care.
“I think our students need to be savvy with that need and need to be trained to do that,” he continued.
For example, if a patient said he was having chest pain, he would be asked to come to the emergency room and get an electrocardiogram. But in the future, Shekhar said, you might be able to hold your iPhone close to your chest to measure your heart rhythm, and doctors will be asked to interpret it there right away and provide care remotely.
This also applies to how health sciences students are taught. In the Pitt Med podcast interview, Shekhar said most health sciences have long been urged to adopt more asynchronous learning and electronic learning tools. Already the School of Health and Rehabilitation Sciences and the School of Nursing have been experimenting with electronic learning. He said Pitt has the capability to partner with large electronic platforms to deliver classes online for most students, whether its nursing, medicine or dentistry.
“I think given the sophistication of resources we have and the people that we have, Pitt’s better suited for a post-COVID rejuvenation of its health sciences than most top academic centers in the country,” Shekhar said in the podcast.
Another area he sees Pitt, UPMC and Pittsburgh taking the lead is on precision medicine and genome sequencing, which allow doctors to tailor their treatments based on an individual’s genetic background and personal lifestyle. Right now, the average doctor has very little training on how to use genetic information, he said.
Precision medicine can help reduce health spending, he said. Because UPMC is both a provider of health services and a payer through its insurance business, the savings can be appealing. For instance, genetic information can show that a person doesn’t need a colonoscopy every other year, but instead only every five years.
“Right away I have reduced the income to the hospital by half in that space, because that’s a highly reimbursed service that hospitals make a lot of money on,” he said. “On the other hand, if you’re also paying for it on the other side as an insurer, you can actually save money and that can be put back into research and innovation. So, in many ways, UPMC is better positioned than most academic health centers struggling to do precision health well.”
The computational powers of Pitt and Carnegie Mellon University can handle large data sets to better predict outcomes.
In the podcast interview, Shekhar said, “Pittsburgh could be the place that’s going to make precision medicine normal and actually routine. That would be my goal over the next five years.”
Striving for health equity
One of the biggest issues facing the health sciences, Shekhar said, is “the whole issue of disparities and health equity.” This problem has been become even more acute during the pandemic, where statistics show a greater impact of the disease on the Black community.
On his second official day at Pitt, Shekhar posted a letter to the Health Sciences community on racial justice and George Floyd, the Black man killed by Minneapolis police in May.
As part of the growing Black Lives Matter movement, a group of Black students met with Shekhar shortly after he started at Pitt to discuss demands made in a letter to Pitt administrators on ways the University can “move forward to protect and support the Black students and faculty on this campus,” and specifically to change the School of Medicine’s “Culture of White Supremacy,” the letter said.
Shekhar agreed to some of the objectives (see related story), such as increased counseling services and creation of an ombudsman’s office. He also set up a rapid response team made up of 14 faculty from the School of Medicine and 11 students to look at issues of racism and xenophobia in the school and to understand what the students’ concerns are.
He’ll also be looking at ways to attract diverse faculty, staff and students to Pitt’s Health Sciences schools. He’s already reached out to Provost Ann Cudd to help create a program similar to her LatinX hiring initiative in the Health Sciences schools that also would look at recruiting Black faculty.
“For us in the medical school, we also need to focus on not only medical students, but also on residents and fellows in the hospitals,” Shekhar said. “We have thousands of them and, there again, we can make an intentional effort to increase Black doctors being part of our residencies.”
The other piece of the puzzle in improving health equity, is addressing health needs of underserved communities near Pitt.
“I initiated a lot of programs like that in Indiana and especially focusing on underserved neighborhoods and populations in Indianapolis. I’m still in the early stages of learning, Pittsburgh, and various programs that are already there,” Shekhar said.
“I think it will be, for the first few months, mostly learning about what is there and what data we can gather. And then I think as a group of Health Sciences deans, my push would be to be more intentional and actively getting involved in changing those statistics. In some ways I feel that as the largest university and probably one of the top 10 medical schools in the country, it’s in some ways our moral obligation to do in our own backyard what we think is good for the country.”
Susan Jones is editor of the University Times. Reach her at email@example.com or 412-648-4294.
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