From now on, Johns Hopkins means business.
Hopkins' survival as a successful research and educational institution depends upon its success as a commercial enterprise.
This tricky balancing act is the impetus behind a major organizational reform announced last week by trustees.
"I am most explicit about the success of Johns Hopkins Medicine as a commercial enterprise, as a health care delivery operation," said Morris W. Offit, chairman of the university board of trustees.
The trustees' action is a strong endorsement of the marketplace mind-set of Hopkins Hospital and Health System President James A. Block. It is also a culture shock for many School of Medicine doctors and scientists, who have traditionally seen themselves as above the business fray.
Relentless pressure from health insurers and competition with other hospitals are forcing Hopkins to change.
Trustees envision a medical center without walls, stripped of divisions between hospital and medical school. Satellite clinics will sprout throughout the region, bringing Hopkins medicine to patients who live far from Baltimore.
It won't just be renowned specialists performing transplants, but an expanded cast that includes family doctors relieving sore throats. Doctors will be as likely to be appointed professors at the medical school for their ability to treat patients as for their scholarship.
This business strategy could dilute the research concentration of the medical school faculty, as some Hopkins doctors fear. But Hopkins trustees and officials said this approach is the only way to pay for the operation of the medical school.
From the trustees' perspective, there's no better person to oversee Hopkins medicine now than Dr. Daniel Nathans, acting president of the university and an ardent supporter of reform.
This Nobel-winning scientist will head the new governing organization created by the trustees to streamline business-related decision making, unify the often conflicting hospital and School of Medicine and bring together in a single office the men who lead them, Dr. Block and Dr. Michael E. Johns, dean of the school.
Dr. Nathans' sterling credentials as a research scientist, a Nobel prize in 1978 for his work on mapping DNA, and his more than 30-year Hopkins career give him immediate credibility with the doctors and scientists whose cooperation is essential to Hopkins' business ventures.
