photos by Dan Bishop
Dr. Jonathan Ravdin, 58, was at the peak of his career in academic medicine. An international expert in infectious disease, the New York City native had been published more than 270 times and had a 27-year track record of continuous funding from the National Institutes of Health for his research into the causes and cures of amebiasis, the world’s third-leading killer among parasitic diseases.
At the University of Minnesota’s medical school, where he had been the chair of medicine since 1996, Ravdin helped turn around the school and transform his department into a national leader both in research and training subspecialty physicians.
Ravdin, in short, was a hot commodity, and was in the running for the dean’s position at the University of Virginia’s medical school, which ranked near the top quarter for NIH funding, the primary measure by which these schools are ranked. But Ravdin decided against Virginia, withdrew his name from consideration, and instead chose a comparable post at the Medical College of Wisconsin, a place that little more than a decade ago barely registered among its national peers.
Ravdin, however, had an insider’s knowledge of Milwaukee’s medical school, having visited it back in the late 1990s. And what he saw there surprised him. This, he felt, was an institution on the rise, free of the structural and bureaucratic problems that can often mire medical schools in mediocrity that even inspired leaders cannot overcome. The school boasted one of the nation’s fastest-growing research programs based on NIH funding.
And so, when Milwaukee came calling, Ravdin jumped at the chance. “It’s a marvelous opportunity,” he says, “because of the strong research and excellent hospital partners that already exist at the Medical College.”
Between 1994 and 2006, MCW grew its total research activities from $49 million to $130 million, with much of that funded by NIH grants. The Medical College now ranks second in the state only to UW-Madison in total value of research conducted and does twice as much NIH-funded research as all other academic institutions in southeastern Wisconsin combined.
Its two major teaching hospitals have mirrored the school’s rise in stature: Children’s Hospital of Wisconsin, once unknown, is now one of the nation’s leading pediatric hospitals. Froedtert Hospital, opened in 1980, has the only adult Level I trauma center in southeastern Wisconsin, and provides specialty care not found anywhere else in the region.
The impact of the Medical College on the local economy is huge. With more than 14,000 employees at the college and its affiliates, over a dozen spinoff companies, more than 50 patents (and dozens more pending), a partnership with GE Healthcare, and the growth of the nearby Research Park, the college is one of the most promising economic catalysts in the region. “In 30 years, we’ve created a $2.5 billion industry in southeastern Wisconsin,” says college President T. Michael Bolger.
And all of this has arisen from a medical school that was once nearly bankrupt and barely registered on the national radar. “To be where it is after just 25 or 30 years is almost unimaginable,” says former Dean Dr. Richard Cooper. “When I arrived in 1985, if someone had had an artist draw a picture of the medical center today … I’d tell them they were crazy.”
It could get all the crazier if Ravdin has his way. Though the Medical College still falls well short of the nation’s elite medical schools (it ranks 42nd among 126 in NIH funding), Ravdin plans to take it there in the next 10 to 15 years. “It’ll never be Harvard or Stanford because the immensity of size and resources could never be reproduced,” he says. But like the University of Pittsburgh and Vanderbilt University, whose medical schools have catapulted into the top 15 in NIH funding and reinvigorated their clinical enterprises, he says that all the factors are in place for the Medical College of Wisconsin to rise higher.
“There’s a very unique opportunity to continue to grow and really differentiate the college nationally,” he says.
It’s a remarkable prediction, but no more surprising than the progress made by the medical college in less than two decades. A school once given up for dead somehow overcame huge obstacles to become not just a successful medical institution, but an ever-more important driver of the regional economy.
Early Struggles
In 1967, after 54 years of operating the city’s only medical school, Marquette University announced that mounting debts would force it to abandon the ship. Alarmed business leaders moved quickly to save the situation. Attorney Louis Quarles, the medical school’s president, raised $1 million over a weekend to keep the doors open. A new board dominated by business leaders on the Greater Milwaukee Committee took control.
The situation seemed drastic. A school plagued by chronic annual debts had now been set adrift. It lacked a reliable revenue stream, had no endowment, no property or facilities, no connection to any academic institution and was renting space from Marquette. Had it been a private business, the owners would have closed the doors.
Yet the business community felt a city this size must have a medical school, and top leaders like Northwestern Mutual Life’s retired CEO Edmund Fitzgerald worked with the GMC to keep the school afloat. The school’s name was changed to the Medical College of Wisconsin, but the school’s dean, Dr. Gerald Kerrigan, continued on. “He kept it going at a very difficult time,” says longtime chair of radiology Dr. James Youker.
In 1975, the school brought in David Carley, a high-powered Madison businessman and former gubernatorial candidate, as the school’s first full-time president. Carley’s mission was to raise big dollars and move the school to its current location. He put together a matching grant with county, state and federal money, as well as private philanthropy, for $34 million to build a new basic science building. And business leaders pushed Milwaukee County to grant a 99-year sweetheart lease on the county grounds in Wauwatosa for $1 a year.
Louis Quarles’ law firm, Quarles & Brady, also provided key leadership from one of its young attorneys, T. Michael Bolger, who became secretary of the school’s board in 1974. The Medical College and County Hospital were supposed to split the costs of yearly services and capital improvement costs on county grounds. But Bolger and the GMC played hardball and got county officials to lower the MCW costs from $776,000 annually to just $50,000.
Business leaders were selling more than a medical college: The idea was to make the school the nucleus of a medical center that would connect to other hospitals, conduct research and provide high-level care.
But MCW continued to struggle for money. As late as 1985, when Cooper arrived as the new dean, the school was still in the doldrums.
“We had nothing,” Cooper recalls. “Virtually nothing in the bank.”
The school depended on pinch-penny accounting to keep the doors open. As Cooper recalls, the work of Chief Financial Officer Ron Cornelius was critical: “His contribution was to take an institution that had very little money and try to make it solvent. He was a brilliant financial manager.”
Cooper’s 10-year tenure helped give the institution some stability. He also began to grow the college. “That’s when we first developed our ambulatory care presence, built our practice, developed our research program. It was the beginning of everything that you see today,” says Cooper.
The components of a true regional medical center were also coming into place. The Curative Care Network opened on the county grounds in 1969, followed by the Eye Institute in 1976. Froedtert Hospital opened in 1980 and Children’s Hospital moved to the campus in the late 1980s. The Blood Center’s research institute also located there.
But there was one big obstacle to the school’s growth and success: John L. Doyne Hospital, the renamed county hospital that treated the indigent. The school had to remove “the 800-pound gorilla” blocking its path to progress, as Cooper puts it.
The best medical schools are affiliated with successful teaching hospitals, whose patient billings kick back revenue to the school. There was some revenue flowing back to MCW. In 1987, a Milwaukee Journal story estimated that about $19 million a year in property taxes was spent on health-related costs at the county grounds, mostly to help support Doyne Hospital and care for the indigent. A good portion of that paid doctors affiliated with MCW.
But it didn’t compare to the revenue flowing at Froedtert, the other teaching hospital for MCW, where the doctors had a much better deal. The disjunct between Doyne and Froedtert was divisive, recalls Dr. Michael J. Dunn, who would succeed Cooper as dean. “There were essentially two cultures, two classes of citizenship, in part, two salary levels, and it wasn’t working well,” he says.
Leadership at the county hospital was poor, Dunn says. “The CEOs came and went, came and went.”
MCW chafed at what it saw as interference from county officials. “It was intrusive, it was an overall impediment to our success,” Cooper says.
And county officials were chronically upset at the costs of Doyne. “The county board of supervisors was going bonkers because it was losing 12, 14, 15 million bucks a year,” Dunn recalls.
In 1995, Milwaukee County decided to sell Doyne to Froedtert, while continuing to make some payments to hospitals for treating the indigent. Froedtert eventually tore Doyne hospital down. “So there was one hospital, one faculty group of physicians, one level of care, not a public hospital and a private hospital,” Dunn notes.
Critics say the closing of the old county hospital meant less care for the indigent. “When county closed, Froedtert and the medical college worked very, very hard to really reduce the amount of care for the poor,” charges Ed Howe, retired chief executive of Aurora Health Care. “They worked hard at not admitting patients and not having access points in the inner city … So St. Joe’s and St. Mary’s and Mount Sinai [hospitals] – and St. Luke’s to some extent – all filled that void.”
Says Dunn: “We incorporated our fair share of county indigent patients into Froedtert.”
But Dunn and Cooper leave no doubt that the elimination of Doyne meant more money for the Medical College. “The county was a drag on the entire enterprise,” Cooper notes. “If the county had continued to extract resources as it did for many years, we would not have the medical center we have today.”
Beyond its financial impact, the closing of Doyne eliminated the need for MCW to deal with county bureaucrats. Across the country, many medical schools are part of larger entities that make decision-making more cumbersome. The UW-Madison medical school must relate to the university and the state legislature, two of the most powerful governmental entities in the state. MCW was now an independent entity unfettered by any other institutions. All it needed was the right leadership to take advantage of this.
The Dynamic Duo
When Mike Bolger was tapped as the college’s president in 1990, he already had a long history with the institution as a savvy negotiator whose connections in the community were virtually unrivaled. Bolger, called “a community icon” by many, made his mark raising $100 million for the Milwaukee Repertory Theater’s new development in the 1980s. He previously helped steer the Milwaukee Ballet and the Medical College through financially sticky situations.
Bolger has helped build the Medical College’s board of trustees to include most of the town’s top business leaders, including Steven Smith of Journal Communications Inc.; Katherine Hudson of the Brady Corporation; P. Michael Mahoney of Park Bank; Mary Ellen Stanek of Robert W. Baird & Co.; Sheldon Lubar of Lubar & Company; Dennis Kuester of Marshall & Ilsley Corporation; and Ed Zore of Northwestern Mutual.
“People say yes to Mike,” says Stanek, a board member for the past eight years. “He’s highly respected.”
When he recruited Stanek, he did so by arguing that having a strong regional medical center is a major selling point for her when recruiting top talent to Robert W. Baird. “He very quickly helps you see the linkage,” says Stanek.
Others agree. “He tells the story [of the Medical College] very well. He’s articulate, organized, well-known,” says ProHealth Care President Ford Titus. “He’s polished, if you will.”
The Bolger style is known nationally. He recently served as chair of the board of the Association of Academic Health Centers, and Dr. Steven Wartman, the organization’s president, now calls Bolger for advice. “It’s a combination of wonderful people skills, visionary leadership, and knowing how to organize and manage things. It’s an unusual combination,” says Wartman.
In the late 1990s, when Blue Cross & Blue Shield United of Wisconsin proposed to transition from a nonprofit to a for-profit company and pay the state’s citizens recompense for the loss of the tax-exempt nonprofit, Bolger leapt into action. He let the insurance company know about the MCW’s role in providing health care to the citizens, and conducted nine listening sessions in the state to hear what the public health needs were. He created the groundwork for the decision to have Blue Cross donate $600 million in endowment to be split equally by the UW-Madison and Milwaukee medical schools. (Both schools are required to spend 35 percent of the endowment proceeds on community and public health projects.) In no other state did the company’s transition result in this solution.
In 1995, five years after Bolger became president, Mike Dunn succeeded Cooper as dean and executive vice president. (Cooper is now a professor of medicine and senior fellow at the University of Pennsylvania’s medical school.)
Dunn is a Wauwatosa native who graduated from the Medical College in 1962 when it was still run by Marquette. He went on to make a name for himself as a nationally known researcher in nephrology and hypertension at Case Western Reserve University.
“Dunn was probably the most gifted student ever to graduate from Marquette School of Medicine,” says Cooper. “He goes all the way back to the beginning. He came in as dean with a history and very deep love of the institution.”
As he steps down as dean in May (he will stay on as a distinguished professor of medicine), he is one of the longest-serving medical school deans in the nation. Dunn has greatly expanded the college’s research potential, overseeing new initiatives in genetics, imaging and biotechnology. He hired 22 academic department chairmen, and five new departments were established: biophysics, plastic surgery, populations health, urology, and otolaryngology and communications sciences.
Dunn himself continued to conduct research, a rarity among deans nationally, which helped him attract talent.
“Dunn was one of the reasons I wanted to come here,” says Dr. David Gutterman, senior associate dean of research and a leading national cardiovascular disease specialist, who was recruited to the college nine years ago. “He was in the trenches. He had a good grasp of what needed to be done.”
“He’s an extremely bright and well-informed leader,” says Dr. Stephen Hargarten, chair of emergency medicine and director of the Firearm Injury Center and the Injury Research Center. Dr. Paula Traktman, chair of microbiology and molecular genetics and director of the interdisciplinary program in biomedical sciences, describes Dunn as “one of the very best deans in the country.”
Dunn’s gaze is intense from under his bushy eyebrows and he speaks frankly, without flowery language or convoluted speech. He sets himself apart from Bolger’s suit-and-tie look by instead donning a bow tie.
Dunn and Bolger have perfected the inside/outside partnership, which is often difficult to achieve. Bolger oversees fundraising, government affairs, alumni affairs and community relations. This leaves the dean free to run the medical side: academic programs, clinical programs, research, relationships with hospitals and recruiting of faculty.
Nationally, it’s rare for freestanding medical schools to have a non-physician as president, but the arrangement has worked beautifully for MCW. The structure was a key reason Ravdin was attracted to the job of dean. “That kind of partnership is actually unique in academic medicine,” he says.
“What happens in most places is that the president or leader is also an academic physician, and so is the dean, and everybody gets in everyone’s business,” says Ravdin. “Here you have a real division of backgrounds, capabilities and responsibility – and I think it’s brilliant.”
Indeed, the long tenure and happy partnership of Bolger and Dunn provided the perfect recipe to grow the institution.
The Money Makers
Medical schools are expensive. The budget of MCW is $676 million, compared to $509 million for UW-Milwaukee and $300 million for Marquette University. Medical schools lose money on teaching and research, which is why the clinical practice is so essential.
“Clinical revenues are the economic fuel for the school,” says Dunn. More than half of its budget – a stunning $350 to $400 million – comes from revenues earned in hospitals and clinics.
To cement the connection to clinical practice, Froedtert Hospital and the Medical College have developed a close relationship, co-branding and co-investing in new hires. Every physician practicing at Froedtert is a MCW faculty member, and the two institutions share the academic mission. “Whatever national prominence we’ve been able to achieve has been directly linked to the Medical College and its ability to attract quality faculty,” says Froedtert President William Petasnick. “We have grown together.”
Children’s Hospital, the only pediatric hospital in the region, is another key affiliate. Its relationship with MCW has helped it rise to become one of the top children’s hospitals in the nation. But since Children’s isn’t in competition with anyone else locally, it’s been careful about maintaining a separate identity. It doesn’t co-brand with the Medical College and wanted more control over its specialists, all of whom are faculty of the Medical College. Children’s made a move near the turn of the century to become their employer: The doctors would still have their academic title at the college, but Children’s would control their pediatric practice for contracting purposes.
“I thought that was a disaster,” says Dunn. Losing control of the pediatric practice could have had devastating financial consequences for the college, affecting its ability to negotiate with the insurance companies. So Dunn advocated that they split the college’s practice group into a division of pediatric specialists and a division of adult physicians, thus separating Children’s doctors from Froedtert’s. All billing and managed care contracting is handled through one Medical College office. “Now those practices have flourished,” he reports, with an 8 percent average growth over the last five years.
“This has worked so well that Children’s isn’t talking about employing the doctors [anymore], and the doctors are happy with the practice group,” says Dunn.
“To me, it’s worked quite well,” says Children’s Hospital President Jon Vice. The two institutions have continued to collaborate: They co-invested in the new research facility opened in 2007, which includes the Children’s Research Institute and the Medical College’s Translational and Biomedical Research Center. And the academic setting is a major draw when Children’s recruits new specialists. “We need the school; the school needs us,” Vice adds. “It’s a symbiotic relationship.”
Leadership stability and strength at both hospitals, with Vice leading Children’s since 1984 and Petasnick running Froedtert since 1993, have also helped the Medical College succeed.
The Medical College of Wisconsin now has the biggest group of physicians in a single practice in the state, with the combined divisions boasting close to 1,000 physicians. They’ve stayed competitive by aggressively recruiting specialists and subspecialists – those in short supply in the community. “We’ve emphasized tertiary or quaternary care,” says Dunn. Patients come from all over to be treated by Medical College specialists in digestive diseases, cardiology, rheumatology and pediatrics.
As a result, no company can sell health insurance in the metro area without including Froedtert and Children’s in the plans, giving MCW huge clout when negotiating with insurance companies. “We’ve got muscle,” says Dunn. “It isn’t a question of whether they’ll include us, it’s a question of how well they’ll pay us. Because we have the neurosurgeons and the bone marrow transplants and the cancer programs, the only pediatric hospital and the only Level I trauma center.”
To increase its advantage, the college and Froedtert developed the Primary Care Initiative, establishing clinics, both on-campus and off, run by general internists and family physicians, who then refer patients needing specialist care to Froedtert.
“We now have about 55 physicians working in the Primary Care Initiative at somewhere between six and eight sites,” says Dunn. “Those doctors now refer 25 percent of our total clinical business at Froedtert Hospital.”
Because Milwaukee’s medical school gets far less state funding than UW’s (just 1 percent of MCW’s budget versus 11 percent of UW’s), its clinical revenues are extremely important. About 57 percent of its budget comes from clinical revenue, ranking it in the top quarter of national medical schools in that regard. During Dunn’s tenure, the number of patient visits to the college’s hospital affiliates increased from 700,000 to more than 1 million annually.
The amount of revenue generated is suggested by a Milwaukee Journal Sentinel story, which found Froedtert & Community Health had made more money in 2005 than any other health care system in the metro area (though a later story noted Froedtert’s profit margin declined from 8 percent in 2005 to 3 percent in 2006). The clinical clout of Froedtert and MCW is likely to increase: Froedtert and Columbia St. Mary’s plan to combine their operations in a partnership called Progressive Health, eventually affiliating with SynergyHealth, which includes St. Joseph’s Hospital near West Bend.
As MCW and Froedtert have increased their financial advantages, there continues to be criticism in some quarters that they are not providing enough indigent care.
Cutting back on this care was probably necessary back when Doyne Hospital closed, says Howe, “but now it’s time for them to step up.” (Of course, the same criticism has been leveled against the group Howe had long led, Aurora Health Care.)
Whatever its critics think, MCW, through its success in growing revenues, has found a way to feed its growth. Typically, about 10 percent of clinical revenues are set aside for the dean to invest in the school, and MCW has used this to recruit top staff and construct new buildings.
A National Profile
Back in late 1960s, when Milwaukee’s medical school was in danger of folding, its research activities were minimal at best. Today, it ranks ahead of nearly two-thirds of its peers, and is expected to rise further.
More revenue and better facilities have attracted better staff, and that staff, in turn, has made it easier to attract more top recruits.
The school has been steadily expanding: In 1998, MCW completed the Health Research Center (the front entrance to the school), which combines a new teaching auditorium, library, faculty offices and research labs. In 2007, it opened the Translational and Biomedical Research Center along with the Children’s Research Institute, and a $150 million state-of-the-art clinical cancer center was set to open in April of 2008. With all of this growth, the Milwaukee Regional Medical Center is now one of the largest academic medical complexes in the nation.
In just the time that Dunn has been dean, the faculty has grown from 650 to 967. He and Bolger have focused on filling department chair positions with superstar researchers such as Dr. Howard Jacob, a human and molecular genetics researcher recruited from Harvard and the Whitehead Institute for Biomedical Research in 1996. (“He was a No. 2 chomping at the bit to be No. 1,” says Bolger.) And chair of medicine Dr. G. Richard Olds, nationally recognized for infectious diseases, particularly tropical diseases, was recruited in 2000.
Others recruited in the last 10 or 15 years include Traktman, brought in from Cornell University’s medical school to be the chair of microbiology and molecular genetics; Dr. James Wade, an internationally recognized oncology and infectious disease researcher recruited from Seattle’s Fred Hutchinson Cancer Research Center ; and Dr. Brian Kopell, a neurosurgeon recruited from the Cleveland Clinic who does groundbreaking cortical stimulation research. The radiology department has grown from three faculty members to 30 in the past 35 years. The school is nationally known in research circles for its work in physiology, cardiology (particularly vascular biology and myocardial protection), EPR electron, radiology and biophysics, among others.
Under Dunn, the college has enjoyed a dramatic growth in research. Total research activities at the Medical College grew from $49 million in 1994 to $130 million in 2006; National Institutes of Health research support grew from $26 million in ’94 to $92 million in 2007. Since 1994, the school has advanced its ranking in NIH funding among the nation’s 126 medical schools from 57th to 42nd in 2007.
“The NIH, in the aggregate, spends $30 billion on research [grants]. They’re the hardest to win, have the most prestige, create national leverage and visibility,” says Dunn. “We’ve advanced in our research output and competitiveness to be near the top third of U.S. schools in NIH funding.”
This growth is all the more impressive considering that, even as total NIH revenue has been declining, the college has continued to grow its share. “We’ve actually increased our research revenue … at a time when it’s shrinking nationally,” Dunn notes. The college’s NIH funding went up 9 percent between 2006 and ’07. Currently, about 80 percent of MCW’s faculty is involved in some research and an estimated 25 percent in NIH-funded research.
And the campus includes other federally designated and international entities, like the Center for International Blood and Marrow Transplant Research, the National Center for AIDS Intervention Research, and the National Center for Medical Countermeasures against Radiological Terrorism, just to name a few.
Continued growth in national clout won’t be easy. It used to be that 30 to 35 percent of grant applications got funded, notes Gutterman, but now that’s down to single digits.
“We have people with excellent [projects] who can’t get funding,” says Youker.
With that in mind, the school has submitted an application to the NIH for a $48 million clinical and translational research grant, which represents the new direction in federal funding. The NIH’s initiative in translational research – which started in 2006 and will go into full effect in 2012 – aims to speed up and strengthen the “bench-to-bedside” connection between scientists working in the lab and patients in hospital beds. The Medical College has created a new Clinical and Translational Science Institute to unite scientists, academics and researchers from other area institutions with industry, pharmaceutical and manufacturing companies, private practice groups and hospitals.
“The NIH recognizes that research cannot be done in silos,” explains Dr. Reza Shaker, senior associate dean for clinical and translational research. Incoming dean Ravdin’s vision for the future of the college – to move toward a more strategic, interdisciplinary model rather than the departmental model it had been using – reflects this thinking.
As its national profile has risen, the school has become more attractive to students. MCW admits 200 medical students a year and receives at least 5,000 applicants for those slots, admitting about 40 percent from Wisconsin and 60 percent from around the country – mostly Illinois, California and Utah.
The Graduate School of Biomedical Sciences was established in 1992, and in 1999, the college developed an interdisciplinary program in biomedical sciences that coordinates five basic science departments.
“The program made a huge difference in the quality of the students we train,” says Traktman. Today, the graduate school enrollment is just under 500, plus 800 medical students, and the college also has some 750 residents working in its academic departments in hospitals around Milwaukee.
People used to mistakenly think the Medical College was a sister school to UW-Madison, but as it’s become better known, that image is changing, say alumni. The college’s continued growth in clinical practice, facilities and research capacity has generated positive word of mouth in the national medical community.
Dr. Van Schalin, a former student who graduated back in 1987, recalls saving a patient from taking medication wrongly prescribed by a pharmacist. It could have killed her. “Even as a first- or second-year student, I probably played a role in saving someone’s life because the school got us out in the community to have us interacting with patients so early on,” he says.
He also remembers a technological coup. Medical College researchers were instrumental in the development of specialty magnetic resonance imaging (MRI) surface coils and published one of the first papers on brain imaging. “I can remember seeing some of the very first pictures produced by an MRI,” he says. “We were seeing parts of the body – the brain, the spine – that no one had ever seen before in imaging studies, and the resolution was just amazing. Of course, now it’s the standard of care all over the country.”
Serving the Community
When Dr. Cheryl Maurana first arrived at the Medical College of Wisconsin in 1995, she noticed the word “community” wasn’t even in the school’s five-year plan. Maurana had come from Wright State University in Dayton, Ohio, where she had founded a Center for Healthy Communities.
Within two years at MCW, she had established a similar program, an academic-community partnership, as she rose to become the college’s senior associate dean for public and community health. As the journal Health Affairs has noted, one of the top issues facing the medical profession today is the need to more closely align medicine and public health, and Maurana is at the forefront of that effort for MCW. Today, community engagement is one of the college’s four missions, and it won the Spencer Foreman Award for Outstanding Community Service from the Association of American Medical Colleges in 2005. The school now boasts a federally funded injury research center, a new department of population health, and a new doctorate degree in public and community health offered in collaboration with UW-Milwaukee.
Today, more than 60 Medical College faculty work with nearly 200 community organizations. That has grown immensely over the past 10 years, notes Maurana. Spurring that growth has been the Advancing a Healthier Wisconsin initiative made possible by the Blue Cross conversion endowment, enabling the Medical College to invest about $55 million in some 171 different projects so far.
A number of community-based programs are co-sponsored with Children’s Hospital, such as the Center for the Advancement of Urban Children founded by professor of pediatrics Dr. Earnestine Willis. Like Maurana, Willis came to the college in 1995, and notes that in the past 13 years, the Medical College has become much more anchored in the community. She facilitates the school-based clinics run in Milwaukee Public Schools in collaboration with Aurora, Children’s Hospital and Wheaton Franciscan Healthcare. These clinics have increased from five to 37 in the time she’s been here, and she works with a dozen community organizations to promote early childhood literacy at urban clinics, immunization studies in poor neighborhoods, oral health initiatives, and nutrition programs aimed at combating the epidemic of obesity.
“We’re much more, really on the front line, working side by side with community organizations,” notes Willis. “And I’m proud to be a part of that.”
MCW also has a huge impact on the regional economy. It has trained one-third of all practicing physicians in Wisconsin despite receiving very little state support. And its research program has become the best hope for creating the kind of cutting-edge, high-tech companies that a vibrant economy needs.
“Biotechnology is being viewed as a potential catalyst for economic growth, and that doesn’t happen unless you have a framework built around an academic medical center and a medical college to allow you to do that,” says Petasnick.
Since 1986, MCW research has led to more than 50 patents, (with 75 pending and another 90 pending in foreign countries). It has founded 17 new companies – 15 in southeastern Wisconsin, two in California – and is spinning off two more this year. It also helped recruit two companies to relocate here: ZyStor Therapeutics and InvivoSciences LLC, both from St. Louis.
Bolger draws a comparison between today’s Milwaukee and Houston of the 1970s. When Houston’s economy was tanking because of the oil crisis, it was able to sustain its economy due in large part to the Johnson Space Center and the Texas Medical Center. “The same thing is at play here,” he notes.
If the medical school had gone under back in 1967, it would have been devastating for Milwaukee, Howe says. “The intellectual growth and the health care field and the research base are all really important in keeping a vibrant economy in this area.” Without it, he says, “we could look like Detroit or some of the other rust-belt cities.”
Take, for instance, the relationship between the Medical College and GE Healthcare, which, for 30 years, has been at the forefront of diagnostic imaging. In 2001, Health Affairs declared that computed tomography was the No. 1 medical innovation of the previous 30 years – and it’s the flagship of GE Healthcare.
“It’s our most successful product line,” says Sholom Ackelsberg, general manager for global molecular imaging and computed tomography (CT) research at GE Healthcare in Waukesha. “And that partnership with the Medical College is what’s allowed us to be successful for so many years.”
MCW is one of only a dozen institutions worldwide that collaborates on all levels with GE Healthcare as it develops new products. The Medical College has helped GE develop everything from the first routine brain scanner with CT in 1978 (which eliminated the need for exploratory brain surgery), to the helical scanner in 1991 (which made routine abdominal imaging possible), to the first multislice CT in 1998 (which allowed routine vascular imaging), to the 64-slice CT in 2005 (still being studied, but projected to be a noninvasive replacement to invasive coronary angiography). Though GE Healthcare’s global headquarters are in London, the company’s diagnostic imaging business – which includes CT, magnetic resonance, X-ray, PET, and nuclear medicine – is based in Waukesha and depends on its relationship with MCW.
The Medical College is entrenched in the community in other ways. The school’s growing residency program works with many of the region’s hospitals. The school offers joint graduate degrees with Marquette University and Milwaukee School of Engineering, and its research collaborations will expand as it rolls out its Clinical and Translational Science Institute. The school’s faculty members also practice, teach and conduct important research, such as spinal cord injury studies at the Clement J. Zablocki Veterans Affairs Medical Center.
Yet the college still falls short in some ways, experts say. It lacks enough diversity in its student body, says Willis, who was associate dean of multicultural affairs for four years. “I think we could do more. And that’s true even when it comes to faculty. When you look at the greater Milwaukee community, it’s definitely more diverse than the medical profession. I hope the leadership will see that as a priority that we could put more resources and energy into.”
And the college is still dogged by the question of how well it serves the low- income community. Willis calls it unfortunate that county bus lines have not created more access to the Medical College for residents of the central city. The college does partner with the Sixteenth Street and Martin Luther King clinics on the city’s south and north sides, but still could do more, she notes.
“We have to be realists about this and say, ‘Are we readily accessible for everyday citizens?’ I would say we have a ways to go,” Willis claims. “There’s no reason why we shouldn’t reach and put our antenna in other neighborhoods.”
Whatever the college’s failings, it has come a long way in the last four decades, with most of that growth coming under Bolger and Dunn. At a recent meeting of student leaders, Bolger intimated that his days at MCW might be numbered. After getting Ravdin established as the new dean, finishing the ongoing capital campaign for $150 million and getting the new research building underway, “Then I want to ride into the sunset and say ‘Happy trails to you,’ ” Bolger told students.
Bolger and Dunn will both leave a remarkable legacy upon which Ravdin and Bolger’s successor can build. Ravdin is convinced the college can continue to move up the ladder in research dollars, at least into the top 30, if not the top 10. He also wants to create a nationally unique education program, both in terms of curriculum and in terms of its ability to attract a more varied and diverse student body.
“I want to look at ways to forge an identity that would make us unique with regard to medical students’ education,” he says, “to truly reduce the cost of medical education, to develop a more flexible approach that allows diverse approaches and pathways for different students.”
All this ambition hasn’t gone unnoticed.
Steven Wartman, president of the national Association of Academic Health Centers, recently visited the campus and came away very impressed.
“There was a sense of momentum about the place that was real. I could feel it,” he says. “This is an institution that is clearly moving up and ahead.”
Julie Sensat Waldren is a contributing editor for Milwaukee Magazine. Write to her at
julie.waldren@milwaukeemagazine.com.
