Issue link: https://tmcpulse.uberflip.com/i/662005
t m c » p u l s e | a p r i l 2 0 1 6 9 and then we do that. And to different degrees, we keep that trade. I still practice, so I have kept that, too. I knew I wanted to be involved in leadership in medical school. But I didn't know quite what that meant, and actually, I owe a lot to Ralph Feigin, a major mentor for me. So Ralph was always really good at attracting great students from Baylor to stay in his pediatric program and convincing great students to go into pediatrics. My wife was going into pediatrics, so he had his eye on her to be there, and he was trying to convince me to go into Med-Peds [combined internal medicine and pediatrics] because he knew I didn't want to do pediatrics. He knew I had this interest in leadership, and I thought that meant I wanted to be an academic chair someday. That's what I thought it meant at the time. But of course, those were the role models you have in that setting. So he offered for me to spend six weeks in my fourth year of medical school, right around the time we were turning in our match list, doing his administrative rotation that was normally reserved for the top third-year pediatric residents. For about a month, I followed him around. I remember going to board meetings, city council meetings, helping him write book chapters. It was a really cool experience. He had it all, from a leadership, academic and pediatric base. One of the two smartest physicians I have ever known. I went to Mass General and thought I wanted to be a cardiologist because everyone at Mass General was in cardiology. And I liked cardiology, I enjoyed it. My wife wanted to do neonatology, and we, at one point, had a heart to heart, and about three weeks before the match list for fellowships was due, she said, 'I want to start a family, and I don't know how to do that as a neonatologist. It's just brutal.' And I said, 'I don't think I want to be a cardiologist. I want to do something a little different than that.' I was getting this admin- istrative bug, and I had figured out that there were other tracks, and I had done some research and knew someone at Mass General and figured out that there were a number of people who went the business track to get into leadership. So we backed out of the match two weeks before we had to turn in our lists, and that summer started doing research into options. Wharton was ranked number one in business schools at that point, but more impor- tantly, it had the oldest health care management track in the country. I was 28 years old at the time, and they specifically took about 45 health care people, of which usually four or five were physicians or were in an M.D./ MBA program. So I applied to Wharton and decided, 'If it's meant to be, it will be.' So I became a general medicine fellow, while working on my MBA. I did both simultaneously. My wife worked as a pediatrician at CHOP (Children's Hospital of Philadelphia). So that was busy. We had our first child two months in. My first round of final exams were Monday, and my wife went into labor at 11 p.m. on Saturday night. So as she is in labor on Sunday, and then, as our first daughter is born, I am sitting there during the quiet time studying for my exams and multitasking. Q | Often when physicians go on to be administrators or leaders, they leave clinical practice altogether. It is really unique that you stayed with it. Has that proven to be helpful to you as you lead this organization? A | Very much so, and I love that. In business school, I knew I wanted to stay working on the provider side, whether hospitals or physician practices. I didn't want to go into managed care, which was hot at that time. I could have gone consulting. I could have gone finance. There were people doing lots of things. But I knew I was interested in the provider side, so I started working 50/50 clinical practice and administration in Houston for a joint venture between Baylor and Methodist. And really since 2004, when the adminis- trative side was ramping up so much, I took what was a very robust 20 percent practice—a typical primary care doc, if you look at their panel, let's say 3,000 is pretty busy, we counted up my active patients and it was over 800 at that point—and had to ramp that way down. It was hard to do. But in 2004, I went to family, friends and some patients that I had a longstanding connection with and said, 'Hey, would you like to stay with me and my small boutique practice here while I spend most of my time administratively?' And that's what I did. So for about 12 years now, I have had about 70 patients in my prac- tice. Most of them are the same as they were 12 years ago. I have picked up some. I have three-generation families in many cases now. So it's really neat. I love that part of what I do. I joke with my head of IT that I'm his worst night- mare, because I'm a CEO that actually uses his IT system. And he comes back and says, 'No, it's the best thing ever.' Because I get what has to be done. I am doing the same exact training as every single one of our physicians. We are in the midst of an Epic transition. I won't use it nearly as much as they do, obviously, but I will use it. Especially on the outpatient side. I don't really do inpatient anymore, but I will follow along with some patients of mine when they are in. And I am actually going to do all of the training for the inpatient side, too, because I want to be part of the experience. successful academic pediatrician at Baylor and Texas Children's Hospital. Q | What led you to Baylor? A | We looked around the country and knew we were probably going to stay in Texas. There was no couple's match, but we knew we were getting married by then. In medical school, we were never Marc or Julie, we were Marc and Julie, so we looked around within Texas, and Baylor was our first choice. Q | What shaped your discipline once you got to medical school? A | I had no idea what exactly I wanted to do, or if I had an idea it was totally wrong. When I was in high school and said I wanted to be a doctor, it was actually more that I wanted to be a surgeon. And in college, I actually spent summers doing the usual kind of pre-med stuff. I spent two summers at MD Anderson, and then I did the heart surgery program at Texas Heart Institute. There is a picture of the 10 of us in the program with Dr. Denton Cooley, and me with my eyes closed. Not the best picture, but that was pretty neat. But looking back now, it was the start of me realizing I didn't want to be a surgeon. Because while it was pretty interesting, there were moments of sheer boredom punctuated by lots of excitement. So I did that and then went to medical school, and I really got grabbed by internal medicine. I loved the intellectual challenge. I loved the diagnostic puzzles. In fact, my two favorite parts of medicine are the diagnostic puzzle part of it and the relationship part of it. I ended up doing primary care and I love knowing people through their lives and helping them with a myriad of things. One day it is one thing and the next it is something totally different that you are helping them with and guiding them through. It's kind of special having come back here and working my way into this position. There are still a bunch of people in significant leadership positions here who taught me in medical school, either in lecture halls or one on one. Our chair of OBGYN, who just retired about a year ago, Alan Kaplan, the first time I stepped into an operating room as a medical student, and the first time I stepped into an operating room at Houston Methodist, was with him. It was actually my first clinical rotation out of basic science, watching him. And many years later, he was our chair and I got to work with him that way. So there are lots of great ties like that. Q | When you were at Massachusetts General Hospital, at what point did you decide to go to Wharton? A | With the benefit of hindsight, it was actually clearly while I was still in medical school that I became interested in the business side. And I say it's sort of in my DNA. My grandfather left the farm, became a cabinet maker, built a business. My father, an engineer, ends up on the management side after a few years. My brother is an attorney, and ends up on the manage- ment side after a few years. I'm a physician and end up on the management side. So we have all got our trade, It's kind of special having come back here and working my way into this position. There are still a bunch of people in significant leadership positions here who taught me in medical school, either in lecture halls or one on one.