MERIDIAN —     University of Mississippi Medical Center senior leaders Drs. James E. Keeton and LouAnn Woodward may have only held their current positions since February, but both have a long association with the medical center.

    The two leaders were in Meridian this week to meet with representatives of the medical community, as well as alumni of UMMC's various professional schools – medicine, dentistry, pharmacy, nursing and allied health – who live and work in the vicinity. According to Tom Fortner, chief public affairs and communications officers for UMMC, the visit was one of several trips planned "to get around to different parts of the state and meet people."

    During their visit, Keeton and Woodward met with The Meridian Star Editorial Board to discuss what is currently going on at UMMC, including the focus on increasing the medical school class size as well as building supportive relationships with other hospitals in the state.



    The Star: Why are you in Meridian?

    Keeton: We're going around the state – we've been to Tupelo and Hattiesburg, and we're going to the Gulf Coast – and we're telling a bit of the story of what's happening at the University of Mississippi Medical Center. Because of this year being 2010 and Health Care Reform, and the disparity of health care in Mississippi –and the need of more health care providers in Mississippi – we feel that we play an important role in that.

    We (UMMC) are the main ones who produce physicians – we produce essentially over half of the







physicians in Mississippi – we're still the lowest number of physicians per capita in the nation. With all the health care disparity in our state – obesity, diabetes, heart disease – we feel we should be partnering and telling our story to other hospital systems and telling them about what our attempt is in growth, and how we can collaborate.

    And we're also telling those we meet with what the University of Mississippi of Medical Center is doing because it belongs to everybody. Most of the physicians who are here in Meridian trained over there (Jackson) 90 miles away. We want them to know what their school's doing and what their medical center is doing.



    Star: Whom have you met with in Meridian?        

    Keeton:  We visited Anderson and Rush (hospitals) and talked to their medical staff, just to give them an overview and to see if there's any particular things that we can do to help them, particularly in services that we offer that some don't have.



    Star: What services?

    Keeton: We are the only children's hospital in the state, we're the only one doing transplants (kidneys, heart and bone marrow), and we're the only Level 1 trauma in Mississippi.

    Putting all that together, we have some things that we service the state with that other hospitals are not able to do. We're not here to compete or take patients away from this Metro area, but we are here to say that we understand your problems and we to see if we can help you and you help us.

    We talked about the helicopter that we have over here in Meridian and how it helps them, we hope. We want to see how we can them with any children's services, transplants and any other way that they think we can.



    Star: Increasing UMMC's medical school class size is a major focus at the moment. Why is that important?

    Woodward: We have five schools on campus – nursing, medical, health-related professions, dental school and graduate school. The pharmacy students also spend time with us in their last two years, but their main home is in Oxford at Ole Miss.

    We have a lot of students there on campus, and all of our schools look at the health care perimeters in Mississippi – the rates of cardiovascular disease, diabetes, etc., where Mississippi tends to rank No. 1 in a place where you don't want to be No. 1. All of the schools feel an obligation as the only academic medical center in the state to do their part in improving the health of Mississippians and increasing their enrollment, therefore putting out more providers for the state. Particularly in the school of medicine, we're the only medicine school for the state; the dentistry school has just opened.

    When you look at physicians per capita, Mississippi ranks 50th – we're last across the country. We think it's important and part of our responsibility to try to change that. One of the things we're working on very aggressively is increasing the size of our medical school class. For a number of years, we took 100 students per year. The students that we take are all Mississippi residents; we feel the people who are most likely to come back and practice in Meridian and all other areas of the state are people who grew up in those communities, who have family there and have ties there.

    This fall, our new incoming class of medical students was 135. So we have increased over the last few years from that 100 per year, just a little bit at a time, to that number. That's not where we want to be. Eventually, in the next four to five years, we want to get to 160, maybe 165. We feel that will put us in a much better position to get those numbers of physicians in Mississippi up more where it should be.

    Once the students finish medical school, the next part of their training is the graduate medical education piece or residency. We do know from tracking our students over time, that the greatest chance of them practicing in Mississippi – which is the in-gain that we are shooting for – happens when they go to medical school in Mississippi AND when they do residency in Mississippi.

    So the first part of the puzzle is working very hard to increase the class size, and the second very important part of this puzzle is to also increase our residency positions so that we can continue to train our students in Mississippi, and then have that positive impact that we want to have on the number of practicing physicians in Mississippi.



    Star: You mentioned collaborating with the local hospitals being integral to the medical school class size increase. In what way?

    Keeton: As we enlarge our medical school class, we're going to have to have access to more clinical care, maybe even rotate some of our trainees over here. We obviously have to look at the larger areas, like Meridian, Tupelo and Hattiesburg. We're doing some programs in Tupelo and Hattiesburg, and we would like to have more involvement in Meridian.

    

    The Star: What will it take to achieve all of this?

    Woodward: It's much more complicated than just looking at a classroom and saying, "This is a really big classroom, can't you just go ahead and put 165 people in here?" In order to really have the total impact that we want to have, we need to increase the class, we need to increase the residency positions – that takes time, it takes money and it takes infrastructure. The accrediting body that gives us the permission and approval to pursue these increases look to make sure you have the infrastructure in place to provide the appropriate education. They want to be sure that you have, in the case of the medical students, all the things like the labs, library, all the technology, the right number of faculty members. And in the case of residency programs, they look at things like the appropriate number of faculty members, the appropriate number of patients, the right equipment, the right number of clinical sites to train these additional students and residents.

    That's part of what is driving us as we go out and talk to people in different communities in Mississippi. We think, as we continue to grown these education programs, we will need to partner with some of our community partners across the state to help us in the sites for residents and students to rotate through, to have that opportunity to experience sort of a community medicine perspective. The benefit to the community would be that once the students and the residents are exposed to some of these places, very often they find that that's a place they would consider coming back to when they establish their practice. And perhaps if they had not had that experience, they would have never really thought about that. It's a recruitment opportunity for those hospitals and medical staff.

    Students do leave the state for residency training for a variety of reasons. Occasionally, it's because we don't have a specialty here, but there's a whole list of reasons why students go out of state. And that's not all bad, as long as they come back. But we know that when we lose a medical student graduate to a residency out of state, we only get about half of those back. Even though when they are freshmen medical students, they all have certain plans to practice in Mississippi. We don't want to increase our medical school class from 100 to 160 just to send them out of state. We want them to stay here and practice.



    Star: What other changes are going on at UMMC?

    Keeton: From a standpoint of who we are, we're trying to change our image. We're an academic, health, science center; there are 140 of them in the nation and we're one of that 140. By that term, we are not just a hospital, we also do research and education. Those are our three missions, we've added a fourth one: diversity and disparity.

    We're keeping our minority students in the state, particularly in education. We have lots of grants available and have increased our minority enrollment. Before we had scholarships, minorities would go where the scholarships were. We're doing a better job at keeping minorities in the state; we need to do that.

    The big thing that we are doing now is touting our economic impact. We are the second-largest employer in Mississippi, with a $1.3 billion annual budget (only about 12 or 13 percent of that from state funds) and 8,873 employees. Ole Miss just completed a study showing that UMMC has a $2.1 billion annual economic impact on the state, more than 2 percent of the state’s economy. Our graduates, when they go out and set up a practice or go to work for a hospital, have a significant statewide impact. One new physician in a community can account for as many as 25 new direct and indirect jobs.  More than half the state’s physicians graduated from UMMC.



    Star: What are some other things going on at UMMC that people should know about?

    Fortner: Our research programs have shown dramatic growth recently, nearly doubling in size over the last four years to about $80 million in research grant funding. We’re building the infrastructure now for major new initiatives in cancer, Alzheimer’s disease and obesity.

    Our clinical programs, which for some years had been burdened by an image as exclusively for charity patients, are growing in quality and complexity. We remain the state’s foremost safety net hospital, but we’re also the go-to place for the most advanced clinical care, on par with University of Alabama at Birmingham and similar out-of-state rivals. And of course the Blair E. Batson Hospital for Children is well known and has wonderful grassroots support throughout the state.

     In short, we think UMMC is living up to its role as the state’s only academic health science center and we hope it will increasingly be perceived as one of Mississippi’s most important assets.



    Star: What impact has the Health Care Reform Act had on the state?

    Fortner: We’ve absorbed about $20 million in state budget cuts over the last year. Health care reform should be good for our medical center in the sense that we see so many uninsured patients who will gain some semblance of insurance, but the transition to full implementation will be interesting.

     Keeton: With the Health Care Reform Act, health care has changed and it's going to continue to change. But we've got to do something about this health care disparity in Mississippi, if we don't we're going to be dragging behind for a long time. We've got to get our populace healthy.

Background Information



    Following is background information on Drs. James E. Keeton and LouAnn Woodward, senior leaders of the University of Mississippi Medical Center in Jackson:

    Dr. James E. Keeton is vice chancellor for health affairs and dean of the School of Medicine at the University of Mississippi Medical Center—the equivalent of CEO of one of the state’s major corporations.  Named to his current post in February, he had been serving as interim vice chancellor since his predecessor, Dr. Dan Jones, was appointed chancellor of the University of Mississippi on July 1, 2009.

    The Columbus native attended the first public elementary school in Mississippi and the S.D. Lee High School in Columbus. He is an Ole Miss graduate and earned his M.D. at UMMC in 1965. He did a rotating internship here, and completed residencies in general surgery and urology here. He trained further in pediatric urology at the Hospital for Sick Children in London and was a lieutenant commander at the U.S. Naval Hospital in Great Lakes, Ill.

    Back in Jackson, he was on the surgery faculty from 1973-1975 and was in private practice in Jackson for 27 years. He returned to the pediatrics faculty at UMMC in 2000 and was clinical director of pediatric surgical services. In that capacity, he oversaw the design and ultimately the building of the two-story pediatric surgical suite as an addition to the Batson Hospital.

    Jones named him the Medical Center’s first associate vice chancellor for clinical affairs in 2003 to facilitate communication among the faculty practice, the hospital system and the vice chancellor.  He later served as Jones’ chief of staff.

     Dr. LouAnn Woodward is vice chancellor for health affairs at the University of Mississippi Medical Center and vice dean of the University of Mississippi School of Medicine. She works closely with Mum’s vice chancellor for health affairs in the day-to-day management of the Medical Center and the school of medicine. Previously she served as associate dean for academic affairs at the medical school.

     A native of Mississippi’s Carroll County, Woodward graduated from Mississippi State University and attended medical school and completed a residency in emergency medicine at UMMC. She joined the faculty in the Department of emergency medicine, where she currently holds the rank of associate professor. She continues to provide patient care in the emergency department.

     Woodward has published a number of research articles and is a frequent presenter at academic and professional meetings. She is an active member of the Association of American Medical Colleges, the Mississippi State Medical Association and the American College of Emergency Physicians, among other groups.