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I hope that all of you were able to spend quality time with your loved ones over the holidays and I want to sincerely thank and acknowledge the many of you who were on duty taking care of our patients. Find below a few words of thanks for the work that you have all done to make our department one that we can call be proud of.

In my recent State of the Department Grand Rounds, I attempted to summarize the broad impact of our department’s achievements and impact. Below is an abbreviated summary of some of the highlights of the presentation.

The department of medicine is the largest department within UCLA Health with nearly 2,000 faculty and growing. Over 1,200 faculty are in the health sciences series, followed by volunteer faculty which includes 528 members. With over 900 faculty serving as assistant or associate professors, the department recognizes that we must strengthen mentorship programs and provide the necessary resources to ensure that our junior faculty achieve their professional  and academic goals to ensure promotion and advancement to professor. Importantly, in response to directives from  the Board of Regents, the school of medicine has modified the  teaching  expectations  and protocols for reappointment of volunteer faculty in the health system, which may impact the number of volunteer faculty in the department of medicine (DoM), in the future.

Our clinical mission reached new records as clinical faculty achieved 2.3 million encounters and significant RVU growth in FY22. Also, our hospitalists are caring for patients that are more complex, contributing in part to increasing lengths of stay. Importantly, justification of the acuity of our case mix requires greater levels of care coordination and appropriate documentation to ensure that the health system is adequately reimbursed for the work that you are doing.  From a financial perspective, the department realized a total revenue of greater than $1.6 B, 73% of this was from clinical operations and 21% from grants and contracts.  Our largest expense categories were nearly $700M in salaries and benefits for faculty and staff and $571 million to pay for services, supplies, and non-capital equipment.  RVU revenue accounts for 41% of our clinical revenue and non-RVU revenue for 59%. We use non-RVU revenue to support expenses associated with all our missions. The department now has reserves that will enable us to sustain our missions for 4.3 months. This is now at a place where we can begin to consider bold strategic investments, that will be informed by our strategic plan.

Important accomplishments in the past year were initiatives to support faculty and staff wellness. Over the past year, our wellness committee has been implementing policy changes to address some of the frequently expressed concerns in a wellness survey conducted in spring 2022. I am pleased to share some of the progress which has been made and includes some template flexibility and incorporation of sustainability blocks across primary care and subspecialties.  We have implemented   training for staff and faculty and to ensure reimbursement and rVU generation for time spent responding to patient messages. The health system has agreed that this is an initiative that should be deployed system-wide.  We have also expanded peer-to-peer coaching.

We also look to the future with a strengthened commitment to advancing health equity. This is an important core value for our department, and we are exploring opportunities for collaboration with federally qualified health centers (FQHC) in the area. We are currently exploring how we can best partner with FQHC’s to provide our expertise to communities in need and determining the levels of support needed for our faculty to work in FQHCs without experiencing RVU credit loss.  I am pleased that many faculty have expressed strong interest in participating in this initiative.

Our research mission experienced an increase in overall extramural funding. However, it is important that we closely evaluate potential risks that could negatively impact our federal research funding trajectory relative to that of peer institutions. Importantly we should continue to increase the base of funded investigators to hedge against our dependence on a small number of very large awards.  We should continue to compete for these very large awards, but we must encourage and incentivize our existing investigators to obtain multiple awards while we continue to increase the ranks of and mid-career faculty through mentoring of our junior faculty, retention, and recruitment. One way to increase our likelihood of recruiting the best across all career stages to UCLA is to increase the national visibility of our incredibly accomplished faculty by nominating them for nationally recognized awards and accolades.

Speaking of recruitment… our education team experienced an outstanding recruitment season with the largest class of our residents placing in the most competitive fellowship programs across the country, and our fellowship programs preparing to welcome over 100 of the best and brightest residents for subspecialty training across all specialties. The holistic recruitment strategy employed by our education team has resulted in the recruitment of diverse classes of interns who are evaluated for their medical school performance metrics, resilience, service commitment, emotional intelligence and leadership potential. I look forward to seeing the outcomes of their residency recruitment efforts in spring 2023.

It has been an incredible year serving as the chair and executive medical director of the department. I have had a wonderful time learning from each of you and looking forward to working together on various initiatives that will continue to position us as the premiere department of medicine in this country. Stay tuned for more details next week!

Dale

P.S.

On Christmas morning I did a 10K run. Consider this a down payment on calories that were consumed later that day.

Enjoy a few pictures from my run, which includes vistas, fake snow and a corgi wearing a Santa hat.