The Johns Hopkins Medical Institutions moved yesterday to settle years of internal conflict and confront the painful new financial realities of health care, naming acting medical school dean Dr. Edward D. Miller to be the first medical czar over the East Baltimore complex.
With the appointment, trustees have elevated a popular physician and administrator to oversee both the Hopkins medical school, which is part of the university, and Johns Hopkins Hospital. The university and hospital were incorporated separately in 1867 under dual bequests by Baltimore merchant and banker Johns Hopkins.
Miller, chairman of Hopkins' anesthesiology department, became acting medical school dean in March after the resignation of Michael M. E. Johns. Miller indicated yesterday that he intended to retain the authority and duties of the dean in his new job, which he assumes immediately.
Colleagues yesterday said Miller's service during the past year proved his personality and experience were well-suited to address the financial stresses buffeting the world of academic medicine.
"This is a historic occasion," said Dr. William R. Brody, president of the university. "I don't think that [benefactor Hopkins] could have envisioned the kind of challenges that the delivery of health care could present.
"We are faced at the turn of the century with a dramatic constellation of changes, brought about by an effort to contain cost," Brody said.
Miller's new position, officially chief executive officer and dean of medicine, will allow him to lead one of the nation's premier academic medical centers. The president of the hospital will report to Miller, who in turn will report only to Brody and the trustees.
The arrangement can been found at a number of U.S. academic medical centers, including Penn State and Duke universities and Emory University in Atlanta, where Johns holds a similar post.
Yesterday, Miller said he would try to defend the quality of the work and instruction at Hopkins as the hospital becomes more efficient at offering care to patients. Equally important, he said, would be his role in articulating the medical center's priorities.
"Part of my job is to make sure that I'm the spokesman, so people know where Hopkins is going," the gregarious Miller said at a news conference yesterday afternoon. "There's so many different parts of Hopkins."
