Nancy W. Dickey
Since it was established in 1999, the Texas A&M Health Science Center has received full accreditation by the Southern Association of Colleges and Schools, experienced a nearly two-fold increase in research funding, maintained exemplary performance on professional licensing exams and established several new degree programs.
Here, Nancy W. Dickey, M.D., president of the Health Science Center and vice chancellor for health affairs for the Texas A&M University System, describes her experiences at the helm and the HSC’s plans for the future.
How does the Texas A&M Health Science Center differ from its counterparts across the country?
The Texas A&M Health Science Center is more like its counterparts than different. Virtually all are based upon a medical school and other assorted health professions schools. All offer both didactic (classroom) education and clinical, hands-on experience. Many have branch campuses. Ours is a bit different in that we have so many sites for our campuses and they tend to be the primary campus for a particular college rather than having all of the colleges based in one place with a handful of branches in distant geographic areas.
We are very rapidly growing with additions of two new colleges over three years (pharmacy and nursing) as well as growth in the size of existing programs (medicine, dentistry and public health).
We are in a minority in that we do not “own” our physician faculty. They actually work for someone else (many for Scott & White), and we contract with S&W for them to provide teaching. Like many, we do not own our teaching hospital but we have a bit more arm’s length relationship than most.
One of the things that I hope sets us apart is that we have chosen to see these things as advantages and opportunities to capitalize on the differences rather than bemoaning the fact that we are “different.”
The Board of Regents recently approved the donation of 200 acres of land in Bryan as the future site of the Health Science Center campus. Why was the property needed, and what facilities will be built first?
Since the inception of the College of Medicine 30 years ago, the campus of Texas A&M has been the home of the College Station-based components of the Health Science Center. This has allowed us the opportunity to craft wonderful collaborative relationships with Texas A&M, to share faculty and to jointly invest in facilities.
However, it has also made it more difficult to establish the difference between the two universities—Texas A&M University and the Texas A&M Health Science Center. In a time when philanthropy is important, it is vital that we can tell donors who we are . . . and who we aren’t! It is also important for student recruitment since we have some crossover of programs and students need to know what university it is that they are evaluating.
Having property upon which to develop our own campus will give us a home base that differentiates us, while being close to the Texas A&M campus will allow us to continue to build collaborations, use joint faculty and continue to share many expensive infrastructures.
A teaching hospital is planned for a later date. Why is this addition important to the Health Science Center and the region?
Actually, some plans about whether or not we will include a teaching hospital in the Health Science Center campus have always been tied to the growth in the population and medical care needs of the Brazos Valley.
We currently are well served by two community hospitals, which are eager and willing to partner with the Health Science Center to provide clinical teaching sites. However, should the need for more hospital beds arise as the population grows, the possibility of having a teaching hospital on the Health Science Center campus is one that might facilitate cutting-edge research, recruitment of yet another level of expertise in terms of medical subspecialties and certainly would lend itself to innovative opportunities for interdisciplinary education.
The current growth rates of the community suggest that this possibility might exist in the not-too-distant future.
The news is full of reports of shortages of health care workers. How does Texas compare with the rest of the nation in this regard, and how is the Texas A&M Health Science Center helping to address these shortages?
Actually, the State of Texas is not competitive in terms of the number of health care workers that we provide. We are in the bottom 10 states in terms of physician-to-patient ratio and in terms of nursing-to-patient ratio in some parts of our state, particularly along the Rio Grande Valley, we are experiencing even greater shortages.
The Texas A&M Health Science Center is helping address these shortages by asking the State Legislature for funding to increase—more than double—the size of our medical school, by creating a nursing school, and increasing the size of our dental school. In addition, we collaborate with community colleges in the regions where we have a presence to help identify workforce shortages in allied health areas and to help them create programs for respiratory therapists, physical therapy assistants, phlebotomists, radiology technicians and other specialties.
Why does the Texas A&M Health Science Center have a dental school with the Baylor name?
Baylor College of Dentistry is over 100 years old. It was the second dental college in the State of Texas and early in the 20th century was affiliated with the Baylor University System. Baylor University shared its name with the dental college and, in fact, with the medical facilities now known as the Baylor University Medical Center.
The medical facilities, Baylor College of Dentistry and Baylor College of Medicine all broke away from Baylor University in the mid-20th century but continue to have agreements with the university to continue to use the Baylor name.
Because of the excellence associated with the name Baylor College of Dentistry and because nearly 100 years of graduates proudly wear that name on their diplomas and their alumni associations, we have chosen to continue the Baylor name on the college, making it the Baylor College of Dentistry at the Texas A&M Health Science Center. This is not significantly different from having a named college on any university campus. One example that all of us are very familiar with is Mays Business School at Texas A&M. Our graduates proudly wear both names and we can point to their excellence with pride.
One of the Texas A&M Health Science Center’s principles is “exemplary diversity.” What steps are being taken to increase diversity, and how successful have these efforts been?
The entire A&M System has been committed to increasing the diversity of our workforce, our student population, and our faculty. I am pleased to say that the Health Science Center has been very effective in this arena. Our School of Rural Public Health is regularly one of the top five schools for diversity of student population.
The entering class of the Baylor College of Dentistry is believed to be the most diverse entering dental class in the country, with 48 percent of the class being underrepresented minorities! The College of Medicine has twice been named by the Hispanic Business Journal as one of the top 10 schools for Hispanic students.
We have reached these milestones by having committed leaders who have communicated from the president’s and deans' offices that this is an important measure on which we want to succeed. We have a number of programs that reach out to the college and high school level to enhance interest in health professions in minority student populations. We have some early admissions programs (Partnership for Primary Care, the state’s Joint Medical Admission Program – JAMP) that help underrepresented populations see the possibility of being a health professions student.
We still have some work to do but we have made a great beginning.
When you were young, a school counselor told you that it was impossible to be a physician and also have a family, yet you have managed to do both, as well as serve as the first woman president of the American Medical Association. To what do you attribute your success?
My father would tell you that the counselor did me a great favor by telling me “it can’t be done.” According to Dad, that would have highly motivated me to prove him wrong!
In reality, another very important component was accepting the proposal of marriage offered by my best friend, my future husband Frank. Anyone who has worn multiple hats knows that a supportive spouse is a key. Frank went above and beyond in helping raise the children, encouraging me when my enthusiasm waned, and traveling with me over hundreds of thousands of miles. Lesson: Selecting the right help mate is key! It didn’t hurt any that supporting his profession (he was a high school coach) often offered me a great break from my career demands!
Finally, serendipity and a willingness to open the door when opportunity knocks have played a role. Many times in my career I have had an opportunity to pursue a job, fill a role, etc. Often, I have asked myself if this is the right time or whether it would fit better later in life. But, being a bit greedy, I usually said to myself that I may not be offered the opportunity later in life. Thus, I have often determined that if I wanted to do something, I should accept the opportunity when it is offered . . . and deal with the consequences later!
I suppose it helps that I have a high energy level, a relatively low need for sleep, and a very eclectic and broad range of interests. Add to that three wonderful children who proved flexible and tolerant of a nontraditional home, and you end up with a strange but true tale of medicine, politics and academics!
You have led a strategic planning process for the Health Science Center. In summary, what would you like the organization to be like in 10 years?
It is clear that I have had the opportunity to be a leader of a new, young but emerging health science center.
I believe that the Health Science Center’s strategic plan, Vision 2015, is a road map to moving from an emerging school to a school of recognized excellence. We have looked at each of the three missions that form the tenets, the foundation of academic health centers and have identified areas in which we want to excel.
For example, we have had double-digit percentages of increase in our research expenditures over the first seven years of the Health Science Center. While we want to continue to grow the size of the research enterprise, we are working through a process to identify three to five areas in which we will specifically invest, with the goal of becoming a national leader in areas like genomic medicine, rural health care delivery, health policy with specific concern about access issues, and health matters related to the military and veteran population.
In addition, our strategic plan looks at the infrastructure of the Health Science Center and has provided a mechanism for growth to address the state’s needs in terms of the health care workforce in areas such as nursing, and has also looked at the importance of a young health science center continuing to build infrastructure in areas such as student services and information technology.
As with any good strategic plan, this lays out a road map, but as navigators, we must reassesses our position and the best route or pathway to be taken as the environment changes. While our strategic plan has addressed a wide variety of issues, we will annually review our progress, evaluate the continued appropriateness of the goals that were set and modify specific aspects of the planned route based upon changes in our environment locally, nationally and internationally.
You were named to your current position in 2002. What accomplishment or accomplishments are you most proud of so far during your time with the Texas A&M Health Science Center?
So far, during my time with the Texas A&M Health Science Center, I am exceptionally proud of the immense amount of work that our leadership team has been willing to invest in mobilizing to meet the state’s needs in health care workforce and health care delivery.
We have begun to implement a plan to double the size of our College of Medicine in response to the state’s recognized need for more physicians. Our community said that they need nurses, and we are 12 months away from opening a College of Nursing and, through collaboration, have been able to offer two classes of graduates to the community even while working to implement our own program.
When the College of Pharmacy was unable to get funding to open the doors of its magnificent new building, we were able to work with the A&M System, Texas A&M University-Kingsville and the Health Science Center to define a means of funding to get the wheels moving again. All of these things were done with a small central administration team that was willing to go above and beyond to meet the needs of the state and the mission of the HSC.
I am pleased that the faculty and administrative leadership of the HSC has worked to define who we are and then work to become that entity. We came together as a disparate collection of colleges and programs that ranged in age, experience and expertise, and I believe we are now well on our way to becoming a university of colleges that cooperate and support one another even as they meet their individual missions to the people of the State of Texas.
Of course, I am very proud that I have been allowed to play a role in envisioning a campus for the state headquarters of the Health Science Center and selling that idea to the Board of Regents as well as to the City of Bryan. It is very exciting that we are well on the way in the planning that will put the first structures on that campus.
But, of all of the exciting things and wonderful people I have been allowed to work with, nothing that I do is more rewarding or invigorating than having a chance to teach occasionally, to get to know some of the students, and to regularly see the exceptional graduates produced by our HSC. We are here for the students and because of the students. So, seeing them graduate and go on to represent our school and our System in wonderful ways is as good as it gets.
