Hopkins candidate to go under microscope Brody will be quizzed about president's job

March 25, 1996|By David Folkenflik | David Folkenflik,SUN STAFF

Today and tomorrow, Dr. William R. Brody will be poked and provoked by doctors, administrators and professors weighing whether he is the right person to lead the Johns Hopkins University into the next century.

Those who know him suggest the University of Minnesota administrator and former Hopkins department chairman wants the top job here. And those who like Dr. Brody say he would be good at it.

"I've always had the sense that Bill was interested in becoming a university president," said Dr. Michael E. Johns, dean of Hopkins' Medical School, an admirer and an occasional fishing companion of Dr. Brody's. "He's on the right track."

Dr. Brody, who is on Hopkins' campus for interviews, declined to comment.

Hopkins has been seeking a president since Dr. William C. Richardson announced in December 1994 that he was leaving to head the W. K. Kellogg Foundation. Dr. Daniel Nathans became interim president last summer.

Dr. Brody is provost of the University of Minnesota's Academic Health Center, which consists of a 500-bed hospital and seven professional schools. He oversees a $750 million operation that has severe financial problems -- among the worst in the nation -- caused by a sharp drop in revenue from patients and government sources.

This decline started several years before his 1994 appointment, and Dr. Brody's arrival at a time of wounded morale signaled an effort by Minnesota regents to bolster the flagging center.

Senior professors and observers praise Dr. Brody for the work he has done in the $290,000-a-year job. But Dr. Brody also has ruffled a lot of feathers in his short time at Minnesota, where he has proclaimed everything up for grabs -- even tenure.

"It's very difficult, very sensitive, very inflammatory," said Carl Adams, chairman of information and decision sciences at the university's school of management.

"There are always people that are concerned when you start making changes, which he is doing," said Winston Wallin, an unpaid adviser to University of Minnesota President Nils Hasselmo and chairman of Medtronics, the Minneapolis-based medical device manufacturing giant. "But the University of Minnesota must change or there will be a disaster."

Budget-conscious health insurers are less willing to pay higher costs for treatment provided by academic health care centers, an issue that also bedevils Hopkins. But the problem is more acute in Minnesota: Of people not on Medicare in Minneapolis and St. Paul, an estimated 90 percent are enrolled in a handful of insurers and patient networks, university hospital administrators said. Those health maintenance organizations can demand discount prices.

In response, Dr. Brody has created and backed several initiatives that have upended the Minnesota health complex. The Minneapolis medical school (a second medical school is in Duluth) has cut the number of specialists it trains by a quarter -- a result of the increased call for family practitioners and preventive care. Dr. Brody has pushed cost-cutting at the hospital, which has reduced its annual expenses by $40 million from $340 million in 1992. He also forced the corporations created by the center's physicians for their private practices to merge, replacing a bewildering apparatus with one billing system.

During his first year, Dr. Brody aggressively pursued a buyer for the university hospital, which consistently has filled only about half of its capacity. The university hospital will be absorbed into the Fairview Health System, in a deal he brokered to reroute basic care to Fairview's seven hospitals, 26 clinics and 500 doctors.

Those among the system's 500,000 patients requiring intense treatment would go to the academic health care center, to be run by Fairview administrators. Layoffs are expected from a work force of 14,600, doctors said.

In September, Dr. Brody announced a fundamental "re-engineering" of the medical center that was led by a task force. According to a transcript of his speech, he promised faculty members that they would direct the move for change.

He told them, "It starts with a blank piece of paper. It assumes that everything is on the table for change, and I have to emphasize that: There are no sacred cows."

Dr. Brody's mandate allows him to reconsider the most sacred academic cow of all: tenure, a protection of academic freedom. Traditional wisdom holds that such freedom is possible only with a near-complete guarantee of job security and pay. If permanent, full-time professors are denied tenure, the decision is tantamount to dismissal.

Dr. Brody's call for a change in the meaning of tenure is based on his belief that the university cannot continue to pay doctors the same salaries if the income they bring in drops.

That approach alarms many faculty members inside and outside the medical complex.

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