Catherine Jacobson

But you have to have enough infrastructure to be able to support the things you're doing in clinical research around cancer, cardiovascular, neurosciences, transplant, and so on.

And so you just have to balance that and make sure that enough of your investment is going to be ROI because it does all come back to clinical revenue.

which funds all your investments in research and education?

How much research can you really do that's productive if you're focusing on clinical care?

And how do you balance that with faculty who went into academic medicine for a reason?

They went into that because they like the teaching environment, because they like the research and the discovery.

How much of that can you actually balance?

And so that's the other conversation that we're having.

One of our departments has every single faculty member is 20% productive time or protected time for their research.

So kind of challenging is every single faculty member or on a balance in terms of your department, I think is the other way we're looking at balancing mission.

Our academic medical centers are full, like 99% full.

When you are like that, though, you have immense motivation to get patients out of the hospital.

So we have actually been very, very thoughtful and intentional about working in population health, working in risk-based scenarios,

about moving patients first from inpatient to outpatient and then outpatient to clinics and then clinics to home.

So I think what you're going to see in the future of the academic medical center is I do see a trend towards aggregation around specialists because we do more of that than anybody else.

And we are starting to demonstrate the value that because we do more of it than anybody else, we can do it better, better outcomes, and we can do it at less cost.

And that's our challenge to be able to do that.

At the same time, we have to be very, very diligent about moving out the things that don't belong there.

We treat over 90% of the sickle cell patients in the state of Wisconsin because we are the urban academic medical center where that's congregated.

Probably going on about six or seven years ago, we opened an outpatient sickle cell clinic.