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A Conversation with Dean Brown

March 11, 2021

Yale School of Medicine Dean Nancy J. Brown, MD, officially assumed her role in early February 2020, six weeks before COVID began to dominate our lives. Aspects of those early months seem surreal, in retrospect, she recalls, such as “the early Saturday morning call with our Yale Medicine and Yale New Haven Health leadership when I was standing in line outside the DMV, discussing the problems of the moment and trying to get my license plates changed – which I did not achieve.” But overall, she says, diving in at a time of crisis “gave me, in many ways, wonderful opportunities to become immersed in the work we do here and to get to know our faculty and leadership very quickly.”

As she noted in her Thanksgiving message, “The history of our school will record the extraordinary efforts of our clinicians and the health system to move whole wards to create capacity and to care for over 5,000 COVID-19 patients to date.”

At the start of her second year as Jean and David W. Wallace Dean of Medicine and our second year dealing with the pandemic, with the number of COVID patients we’ve provided care for now exceeding 10,000, Dean Brown shared some thoughts and insights gained during the incredibly intense year that was 2020.

What was it like to come in as a new dean and almost immediately plunge into the COVID crisis?

I learned a lot, very quickly, about the commitment of our faculty and staff to our patients. I learned about the spirit of collaboration and innovation as, when faced with a common enemy, people rolled up their sleeves and worked together across institutions—and this needs to serve as a model as we approach more mundane, but nonetheless real, common enemies, such as the chronic health issues in our community.

But what didn’t change was my sense of our many opportunities to develop programs that offer unique care to patients. For example, our digestive diseases program is a tremendous opportunity. We have real strengths in diabetes and can enhance even further our clinical offerings. We are growing in cardiovascular medicine, which is really important. There are opportunities in the neurosciences—not just surgery but also neurology and psychiatry, especially given the strength of our science in those areas, allowing us to offer patients unique therapies. We are poised to have an impact on the nation’s opioid epidemic, with some very important research going on. The strength of our immunobiology program can have huge implications for our clinical work—for instance, our current cancer therapies are all based on intervening in the body’s immune response. So, we’ll be investing in immunobiology—not just scientific endeavors, but on making treatments available to patients.

What short- and long-term goals would you like to share?

Short-term, it is clear that YM can continue to grow outside the New Haven area. I’ve visited all the hospitals in the delivery network and there are opportunities for partnership there, where our commitment to working with physicians already there is appreciated. We’re also doing a lot of work on the chair/chief roles, to better define their authority and responsibility across the system, which will lead to continued improvements in service, quality, and the range of services we can offer. And we need to ensure patients have facile access to what we have to offer. This is difficult for all academic medical centers, but I think we will be able to do that well. Our long-term goal is for us to be truly aligned with YNHHS, in seamless coordination; working in partnership will allow us to reach our full potential.

Can you share a brief overview of YM’s financial health?

I tend to think globally in terms of the whole school and, of course, YM is part of that. We suffered a significant decline in clinical revenues in FY20, but not as much as we’d anticipated when we modeled it. That’s because we were able to ramp back up and provide care for patients who had delayed medical care faster than we’d anticipated. We have responded to that decline by pulling expenses out and also by increasing efficiencies. In addition, we have received stimulus funding that will offset our losses partially. In the future we will be a leaner but perhaps more service-oriented organization as a result of COVID.

What do you mean when you call YM a “well-kept secret?”

We offer superb care and access to novel therapies and diagnostics that others can’t offer. Obviously, the local community respects us very well, but we should also be drawing patients from large parts of New England and even from New York, to a certain extent. So, we need to get the word out. Nationally, Yale School of Medicine is known for basic science research, but we have amazing clinical investigation and trials going on that are only possible because our faculty understand the value of offering new therapies and studies to our patients.

What do you see as our most pressing challenge … and, conversely, our greatest strength?

As we work to shift our identity from a comfortable community hospital to that of a first-class academic medical center, where patients can feel at home, we are continuing to frame the challenges around alignment. As far as the greatest strength, that is clearly our people. Yale Medicine has very smart and talented people. It’s fair to say that the role of leadership is to remove barriers to their success and, when we do that, we can do anything.

Click here to read next article: Meeting the Extraordinary Challenges of COVID-19

Submitted by Barbara Steinberger on February 23, 2021