New Dean of Medical School Terms Limited Research Major Weakness

              The Shreveport Times Metropolitan
News
Area News Local News Classified
Section C, Page One Sunday. Dec. 17, 1972
New Dean of Medical School Terms
Limited Research Major Weakness
By Margaret Martin
Times Medical Writer
CINCINNATI, Ohio - II Louisiana
State U n i v e r s i t y Medical School at
Shreveport has a specific weakness, it
lies in the research arm of its body,
thinks the man who will become dean of
the school on July 1.
Dr. Clifford G. Grulee, 60, and dean of
the University of Cincinnati College of
Medicine for 10 years, will replace IDr.
Edgar Hull on July 1. Grulee comes to
LSU March 1 as dean designate of the
local medical school at an annual salary
of $44,000.
In an interview in his Cincinnati office
this week, Grulee commented "I've said
it so much it sounds trite, but a medical
school is like a stool that stands on three
legs. Certainly education, certainly re-search
and certainly service are impor-tant."
"It is almost impossible to have a
truly strong f a c u l t y — capable of
teaching and service — who do not have
an investigative opportunity."
Would Enhance Research
"If my preliminary information is
correct, there is almost no grants for
research," he added.
Local medical school official Robert
Graves agrees.
Graves, business manager for LSU-Shreveport
Medical School, said that as
of the year ending June 30, only $46,000
of the budget was dedicated to research
grants.
The total expenditures were $3,492,000.
Of this only $607,000 or 17 per cent came
from nonstate sources. Although this is
not unusual for developing schools, the
ratio is usually 50-50 (state and nonstate
funds).
Grulee said although he has "no
magic formula, I'd like to see investiga-tive
activity developed to a greater
extent than it is now."
The dean-to-be said that he doesn't
expect the local school to compete with
Johns Hopkins as the research center for
the country, "but a wholesome amount of
e m p h a s i s on research will strongly
support other functions and aid in the
recruitment of faculty."
He feels that a school's investigative
interests should reflect the background
of the people in research, and not be
turned on and off with the latest popular
disease being financed by state and local
sources.
"There a,re reasonable limits to a
school's advantage to exploit interests
which are current at the federal and
state level," Grulee said.
He said he'd much rather see people
come to Shreveport who have teaching
and professional service ability as well
as research curiosity.
And, Grulee pointed out, "there is so
much to be done in research . . . "
Neither would he place priorities on
whether the teaching or research aspect
of medical education should receive the
most money.
Some professors need two beakers
and a few mice, another an expensive
electron microscope, and other fancy
equipment the dean said.
Grulee, who keeps in shape with
morning e x e r c i s e s at home, is a
pediatrician who descries himself as "a
storekeeper who used to be a good
doctor."
He rarely goes to Cincinnati General
Hospital now for any reason except
meetings.
Asked to comment on whether or not
medical school personnel should be
allowed to see private patients, Grulee
hesitated only a moment, predicted that
his answer would be "abrasive to some,"
and talked about the matter.
Favors Private Practice
In a word, Grulee s answer was
"yes."
"Medical school physicians are physi-cians
who should — in fact must — see
private patients.
"There is no other way to support the
medical faculty," Grulee said.
Besides, he added, "many of the
physicians are investigating in special-ized
fields and their knowledge and
experience should not be denied the
people of the area.
(At present, medical school physi-cians
can see patients only on a
consultation basis from a private physi-cian
in the area, according to a medical
school o f f i c i a l . Neither can private
patients be admitted to the teaching
hospital, Confederate Memorial Medical
Center.)
Grulee feels strongly that the pres-ence
of a first class medical center in a
community — and its associated pro-grams
— "really enhances the opportuni-ties
of the whole medical profession in an
area."
"I do not see it as a threat to the
medical economy of the private sector of
health care delivery. It (the economy)
will improve . . . ," he added.
Any medical school is first of all an
educational institution, Grulee said, "but
it is also a community resource."
"It is in my mind," he added, "a very
valuable asset to the practicing medical
profession."
"It can mean," he elaborated, "contin-uing
education, and helping to perpetuate
interest in the medical profession among
young people in the community. Grulee
feels, "this is very important."
The new dean also pointed out that a
school of the type and size of the LSU
medical School at S h r e v e p o r t will
continue to depend a great deal on help
from v o l u n t e e r faculty members."
(Members of the private medical com-munity
serve free on the m e d i c a l
school's clinical staff.)
''. . . and rightly so," he added.
Speaking of the local doctors, the
official said, "if the medical school is not
r e a l l y understanding and not open
minded about the problems of the
practicing physicians, then it isn't doing
all of its job."
OH the other hand, "the practicing
community must be willing to consider
our n e e d s and make some
concessions . . . "
In full view of Grulee's office is a
yellow brick building which is Holmes
Hospital. It is used to house the private
patients of the University of Cincinnati's
medical school physicians.
Separate Facility Doubted
Asked if he would support or even
push for such a facility for the local
m e d i c a l school — or a wing of
Confederate to be used for the same
purpose — Grulee pointed out (not
facetiously) that the color of the United
States dollar is the same, whether it
comes out of private money, Medicare,
Medicaid or Blue Cross.
And, he added, there is "every
evidence that we are going to national
health insurance, so the payment in
principle will be the same dollars."
Therefore, he feels that the teaching
hospital of a medical school, including
Confederate, must be able to compete for
patients on the basis of any other
hospital.
"It's the same dollar. That's easy.
There's no other alternative," he a»-
swered.
"That federal legislation is coming,
there is no doubt," Grulee said.
"At the present time, no hospital or
'health facility can enlarge its facility or
spend money without approval of the
comprehensive health planning agency in
its state," he explained.
It's a very short jump, Grulee said,
from subsidies such as public assistance,
aid to dependent children, Medicare and
Medicaid to national health insurance.
And "like most things which originate
in the political arena, it will probably be
inadequately funded."
Especially the physician's fees will be
much belabored and easil,y criticized, he
predicted.
Grulee predicted "very contentious,
difficult times ahead."
He admitted, though, that despite
shouts from members of his profession
that health care is available to everyone,
"it is not."
And, he shrugged, "who can object to
the kinds of goals the proponents of
health care subscribe to?"
"I hope we don't destroy some of the
•finest things medicine is trying to
accomplish . . . new knowledge . . .
education in depth," he added.
In Cincinnati, Grulee has been called
"conservative" by s o m e who urge
change in the traditional emphasis on
leaching and research in favor of more
direct patient care.
Grulee feels that "there is a point
w h e r e b y you destroy a school by
imposing health delivery demands upon
it," but he feels that a medical school
must gel involved in the community to
help design whatever universal health
care system is developed.
The dean feels there has been "some
confusion over what is being talked about
when we talk about comprehensive
health or community health, primary
medicine, general practice or family
medicine."
He feels that the philosophy of the
medical school should have a basic
interest in seeing that the best elements
of all ideas are being taught.
The primary physician —• meaning
the physician who sees the patient first
—continues to be very important
whether he be the pediatrician, the
internist or even the general surgeon.
All of these disciplines, he said "are
doing general primary medicine and
tloing it very well."
In training the future doctor, the
medical school should make the ap-proach
broad.
Cincinnati Dean Dr. Clifford G. Grulee Jr.
. . . a medical school is like a three-legged stool
Dr. Clifford G. Grulee Jr., dean of the University of Cincinnati College of
Medicine, chats with Dr. James Schieve, associate dean of the medical
school, in the Medical College Building in Cincinnati.
At Cincinnati, he has started a
Division of Ambulatory Patient Cave
Service, headed by an assistant dean
who is responsible for the 150,000 people
who come through the e m e r g e n c y
service each year, and people who report
to all the clinics.
"It relates to all existing departments
and as a member of the dean's office,
the assistant dean has a pass key to all
departments.
He wonders aloud if the medical
service is concentrated in one area,
ghetto medicine, for instance — if the
area of interest would become too
specialized, neglecting other problems.
With the Ambulatory Care Service in
Cincinnati, i n t e r n s , emergency room
personnel and related fields revolve
around a central m e c h a n i s m with
coordinating activity.
"I can't translate this to Shreveport,"
said Grulee.
Grulee said he is not against the
medical school giving as much service as
it can to a community, for, he pointed
out, "medical education is preceptoral.
That is its strong point — teaching at the
bedside, at the clinic. . . "
He thinks, though, that the primary
responsibility of the medical center in
connection with health care delivery "is
in developing a prototype program,
developing a methodology. . . and doing
research and evaluation."
In other words, the medical school can
develop "some satisfactory health care
outpatient agency which could be dupli-cated
in a number of other needy areas."
Must Examine and Deliver
There is no question, Grulee said,
but that the proper role of the medical
school is to "examine and help solve
delivery of health care solutions."
"It should not be the main thrust of the
institution, it. can't be," he added.
One of the pilot project's of the local
medical school is a six-year medical
education program, where the student
goes to LSU-Shreveport and the LSU
Medical School at S h r e v e p o r t , and
receives degrees from both in six years.
Grulee says he has no objection to the
proeram as it wo'-ks in Shre-epo"!. He
thinks highly qualified students ran
graduate from medical seliool in loss
than seven or eight years.
"I'm not sure this is the rieht pathway
for every doctor. It was not right for
me." he explained.
He said he feels that the educational
process is good for the future physician
both socially and emotionally.
In an era when minority participation
is being looked at almost through ?
microscope, LSU Medical School at
Shreveport has only 15 black emnioves,
including eight maintenance personnel,
one clerical worker, and six research
clinicians. One member of the clinical
(Continued on Page 2-C)
HLSU Medical School Dean-Designate Dr. Clifford G. Grulee Jr.
I ... ansivers questions in Cincinnati office