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To thrive in a world of change, welcome the new

Posted by on Thursday, March 12, 2020 in From the Dean, Spring 2020 .

Photo by David Bailey

Today’s medicine sits at the intersection of expectation and limitation. We work amid breathless acceleration of technology, science and demand for what clinicians are expected to know and manage.

So much progress has been made in the last 20 years that it can seem an insurmountable task to stay on top of it all. In moments of self-reflection, we wonder if it’s even possible to offer our patients the most up-to-date guidance.

Retail genetic tests are among the most publicly visible touchstones of change. The interest in commercial DNA testing fuels patients’ demand for personalized care. Studies consistently find consumers rank “personalization” at or near the top of their health care preferences.

In seeming conflict with consumers attempting to understand their DNA as a personal Rosetta Stone for disease risk, the waterfall of genomic advancement has been slow to suffuse into everyday clinical practice. And with good reason. While discoveries add volumes to the library of genetic associations almost daily, the vast majority of this information is nuanced, impacts relative risk for patients with considerable uncertainty and is challenging to use for advising patients.

That’s where Vanderbilt is working to change the game. Our physician-scientists, many of them alumni, are working to fuse medicine with technology — massaging “big data” into a framework that’s not only trainable and tractable but embedded intuitively into clinical workflow.

We’ve taken on the challenge of educating clinicians and scientists for the lifelong learning that will put them at the vanguard of implementing and leading change. That is, in fact, why we overhauled the medical curriculum in a paradigm shift that is now a model for medical schools across the country (see page 26).

As a Vanderbilt medical student, I couldn’t have dreamed of the seemingly boundless diagnostic advancements that are under development. Our national leadership in biomedical informatics is allowing us to develop novel ways to guide clinicians at the point of care, making it possible to bring formerly inaccessible information to the forefront, impacting our patients’ lives.

For example, in behavioral health, suicide risk-scoring is on the cusp of revolution. Smarter deployment of information technology and machine learning resources trained to catch what clinical eyes might miss is an astounding step toward sparing untold numbers of people from devastating loss. Please see the story on page 28 for more information.

Enterprise-wide, interdepartmental collaborations like these — a true “melting pot” of capabilities — are the distinctive strength of a leading academic medical center. The academic programs supporting these advances are attracting the brightest minds in the nation and across the globe, as we strive to know more than we did yesterday.

At Vanderbilt, we constantly experience the latest — new students, new technology, new ideas, new science. We welcome it all with excitement, seasoned discernment and a healthy dose of experience. It’s who we are — and it’s what our patients will always require.


Jeff Balser, MD, PhD
President and CEO, Vanderbilt University Medical Center
Dean, Vanderbilt University School of Medicine