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Music and medicine
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It’s not listed among the more than 180 journal articles and book chapters authored or co-authored by Debra Schwinn, but one of her earliest works might be the record she cut as a fiddle player with a bluegrass band at The College of Wooster in Ohio.
“I almost pursued music instead of medicine,” says Schwinn, who became dean of the UI Carver College of Medicine Oct. 31. “I was planning to attend conservatory after high school, but at the last minute I decided to go to college and become a chemistry major. For pizza money, I gave violin lessons to the professors’ kids.”
Schwinn played intermittently with orchestras, string quartets, and symphonies while earning her medical degree from Stanford University, completing an internal medicine internship and anesthesiology residency with University of Pennsylvania Health System, during her fellowship in cardiac anesthesiology, and as a faculty member at Duke University. She served as the Allan J. Treuer Endowed Professor of Anesthesiology, chair of anesthesiology and pain medicine, and adjunct professor of pharmacology and genome sciences at the University of Washington before coming to Iowa. She succeeds Paul Rothman and is the first woman to lead the Carver College of Medicine.
Schwinn is a nationally known investigator in molecular pharmacology with active funding from the National Institutes of Health (NIH) and is an elected member of the Institute of Medicine of the National Academies of Science. She intends to resume her clinical practice two days a month and has joined the UI Health Care Faculty-Staff Orchestra.
“In these jobs, if you take yourself too seriously, that can be trouble. With the orchestra, I regain some balance in life. I know I don’t have time to practice as much as the other musicians, and that’s OK. I’m in the back of the first violin section, not in the front.”
What attracted you to the University of Iowa and the Carver College of Medicine?
I would characterize the Carver College of Medicine at the University of Iowa as having a dual mission of cutting-edge academic medicine in real-world America. It’s rare to find an academic medical center that is ranked in the top 25 in NIH funding per capita faculty, located in the heartland of the U.S., and integrated into a health care alliance responsible for the health of 60 percent of a stable state population.
As health care reform accelerates, being able to establish new models of efficient health care delivery and test those models—using cutting-edge health services and comparative effectiveness research—honors the fundamental core of a physician-scientist. The coalescence of these realities makes the University of Iowa and the Carver College of Medicine a unique opportunity that really interested me. In addition to having top-notch departments and research enterprises, people here work incredibly hard, pride themselves on being collaborative, support and mentor young investigators, and generally want to do the right thing. Putting these all together was an irresistible combination.
What are the challenges facing the Carver College of Medicine and academic medical centers overall?
A couple of issues make today the perfect storm for academic medical centers and medicine in general. First is the anticipated overall decrease in NIH funding. This will challenge us to be creative in finding alternative revenue streams for research. One revenue stream would be the creation of companies to bring ideas to market. Over the years, academic medicine has been great about making new discoveries, but we’ve not always been as good at getting those discoveries to patients. Therefore having more public-private partnerships and academic startup companies honors that commitment to our patients and society.
Another challenge is the scope, breadth and depth, and speed of health care reform. It’s not immediately clear how we’re going to solve the high cost of medicine and provide high-quality health care at a lower cost in a rapidly aging global population. We have to think very carefully about who can appropriately practice in a given setting safely, and maximize team-based care. That brings us back to opportunities in our medical school curriculum. I am committed to inter-professional learning. We can’t educate people in silos and ask them to work in teams. We are quite fortunate at the University of Iowa to have all of the health science deans dedicated to working together as much as possible to integrate learning opportunities to practice team medicine. These disciplines include medicine, physical therapy, physician assistant, nursing, pharmacy, and dentistry programs. With ongoing revision of the medical school curriculum, it is the perfect opportunity to begin these endeavors.
What’s early on your agenda as dean?
I’m spending my first several months listening. Although I know many of the strengths of this institution, I am in the process of meeting with department chairs, basic and clinical scientists, students, residents, and others to understand from their perspective strengths of the Carver College of Medicine, opportunities where we can build stronger infrastructure, our areas of emerging cutting-edge medicine, and ultimately how the college can uniquely position itself to continue to lead in both science and medicine over the next five-to-10 years. We also take seriously our mandate to serve Iowa by training practitioners who ultimately stay in Iowa to practice. As medicine changes, new programs such as our rural track will be important in meeting that mission as well. I will be laying out a strategic plan in February or early March, developed with broad input, describing how we can creatively and boldly move forward.
The last line on your CV reads, “It is important to choose to see the glass half-full rather than half-empty.” What does this phrase mean to you?
I like to reframe situations and choose possibilities that exist rather than saying something cannot be done. Times of uncertainty are viewed by some with pessimism when in reality they are opportunities for growth and innovation. When I was building a department at the University of Washington, we had a strong faculty foundation from which to build. To describe this situation I used the analogy that the people in place had already “tilled the soil,” so it didn’t take much water for “flowers” to grow. Challenges can be seen as fertilizer in this case, helping flowers to grow faster and stronger than they might otherwise. Reframing situations helps us all keep going, understanding that while the work may be hard, it is very rewarding and can make a difference. Most of us recognize that it is a privilege to get up in the morning and come to work at a place such as the Carver College of Medicine where we truly can make a difference in medicine and our world.