Dr. Lee Learman became the second dean of the Virginia Tech Carilion School of Medicine on July 1.
He came to Roanoke from Florida Atlantic University’s medical school, where he was a senior associate dean. He is an obstetrician and gynecologist and has served on national committees with Carilion Clinic practitioners.
Learman, 59, first visited Roanoke about five years ago when Carilion’s chief medical officer, Dr. Patrice Weiss, invited him to visit and speak to staff. Last year, he was asked to apply for the dean position.
We sat down with him for a question-and-answer session. The responses have been edited for length and clarity.
?What attracted you to Roanoke and the Virginia Tech Carilion School of Medicine and makes this a good fit for you and your career?
This represents a real convergence between my sense of making a contribution by becoming a dean and the wonderful things I’m aware have been going on in Roanoke for a while. …
There are some unique aspects of the collaboration with the two outstanding partners coming together to create the medical school. Situating it in Roanoke is an amazing thing because it represents an enormous opportunity to engage the community in a third alignment. A community here that is looking for an opportunity to develop a new identify around biotech and health care represents a third partnership that has unlimited potential here.
?Were you looking at a lot of other opportunities?
Having been at Florida Atlantic University for less than three years when I was first approached to look at this position, I was hesitant because I had made a very strong commitment to build their residency programs and that it was somewhat premature. I hadn’t yet been able to accomplish what I was doing.
I was not looking actively. They [the search team] beat me to the punch because around this time is when I would have started to look, because those things I came to do had been achieved and it was time for me to grow and move on. …
I heard from my mentors that there are always at least a dozen deanships available. However, the mentors also told me if you feel a sense of fit, alignment with the culture of the organization, don’t assume you are going to feel that again. It doesn’t always happen, and it’s incredibly important.
?With this having been a fairly new school, your mentors were aware of it?
Yes, Carilion is a very important player in value-based health care. … [CEO] Nancy Agee being the immediate past president of the American Hospital Association has been able to bring onto the national stage a lot of the outstanding work Carilion has done quietly to serve the community through population health strategies, through value-based care, through a largely publicly insured population receiving truly outstanding care here.
That is unique in academic health centers. Many academic health centers have the public health mission as a part of their business model but not as a major part. …
We’re talking about a culture of service at Virginia Tech. We’re talking about a culture of community and population health and public health at Carilion. And we’re talking about an entrepreneurial approach to the collaboration. Let’s make it creative, let’s make it able to pivot and be nimble and try things and different things and make this as a start-up as successful as it can be. So to see all those building blocks in place, to see the culture of the two organizations being what they are and to understand the support of the local community, the business community, for success here and to understand what led to the Amazon result for Virginia Tech in the D.C. area — all of those things really speak to vibrant institutions that are aligned in their mission where the mission is one of service to the community, where margin is only a part of what fuels that mission rather than an end itself.
All of those things to me were so aligned with my sense of the right place to train the next generation of physicians. That was a real attraction.
?As the second dean, you are arriving after the school, which started as a public-private partnership, has become fully integrated as a college of Virginia Tech. What changes do you envision?
Firstly, I have to acknowledge the tremendous start this school has had under the leadership of Dean [Cynda] Johnson. About 25 to 30 medical schools have started in this same time period, and here at Virginia Tech Carilion, it is clear this is one of the schools that has made a very, very strong start. ... So anything we build upon that foundation needs be acknowledged because some deans would be coming in now to fix things or rebalance the tires. ...
The vision is a very general one now because our strategic planning process and visioning process needs to involve many stakeholders. Only through co-creating the vision can we achieve the vision. So that involves reaching out to community members, community business leaders, Virginia Tech folks, Carilion folks and understanding together what we hope to grow in this next phase.
There are some things that are important to me to consider during strategic planning. Many people would like to see the school grow over the next five to 10 years. The largest medical schools have 200 to 300 members per class, and, my goodness, we never want to get that big. With 42 per class now, we have the opportunity to responsibly grow without sacrificing any of the beneficial things our small size allows us to do. ...
One question for our strategic planning would be how fast and how big to grow. The second would be how we take a look at our value domains and how we would use those domains to prepare our students for the future of health care.
?What do you see as being the biggest challenge?
The challenges are really internal challenges around our pace of growth. As I answer this question, I’m hearing the wonderful sound of tools and equipment across the road as we build our new research building with Hokie Stone.
So we have enormous opportunities here with a nice footprint to grow on, but making sure we don’t get ahead of our skis, and that we are able to keep up with our infrastructure growth to support the growth of our ambition, that’ll be the major challenge. These are good challenges to have.
?Students at VTC are required to undertake a research project. How important is that to developing the next generation of physicians?
I see it as very important in ways that are not that obvious. There will be some of our students that not only enjoy the research requirement, which attracted them here in the first place, but do go on to research-oriented careers in medicine. And we are very happy that will occur.
However, all of our graduates will develop rigors of thought that come out of the scientific process. That sense of inquisitiveness and curiosity will help them to stay up to date with the medical literature that is constantly changing. … So it’s those habits of thought and critical thinking that are the most sustainable over the careers of our medical students.
?When did you know you wanted to be a physician?
I was about 12. I can’t say there was a family member who was a role model. I hate to say the word “calling” because there wasn’t some mystical thing going on, beckoning me. But there was a sense of wanting to help people and being really good at science.
?You attended Harvard Medical School and earned both an MD and a PhD in social psychology. What is social psychology and how has it influenced your medical and academic careers?
Social psychology is a research branch of psychology that focuses on the impact of people on each other and of the environments on human behavior. … The way I would refer to it when family members asked me about this back when I was pursuing the degree is, I basically said to simplify it a bit: It’s the science of studying the art of medicine. …
It helps us understand doctor-patient communication, patient preferences for different treatments, physician decision-making. It helps us understand leadership and how to motivate and encourage others to achieve their best.
?How do you foresee the field of health care changing, and how should medical schools adapt to prepare students?
Once upon a time, a hospital was where you went for health care and it was the center of the universe in terms of the administration of care for patients. Now we are understanding that by the time someone gets to the hospital, in many cases, there were multiple opportunities to intervene earlier in the course of progression of their disease, either to prevent it in the first place, or to prevent it from causing so much harm to patients as they live their lives. …
I say that to preface my answer that medical students now need to learn about how to prevent disease and promote health just as much as they learn to treat disease using the most innovative cutting-edge technologies. The medical student who learns only the cutting-edge approaches to bariatric surgery, for example, or to care for cancer, and that is all they learn, is really going to be missing out on a larger sense of needs.
?Medical training is still very much hospital-centric.
I would agree with you, but it is becoming less so. … Hospitals of the future are downsizing their hospital beds and increasing their outpatient services.
We’ve tended to glorify not relationships patients have with their primary care physician, which is some of the examples I saw when I was a medical student, but instead we glorify the highest tech and most invasive technology that we have available, over a belief that technology will somehow solve the medical problems of society.
I don’t believe in choosing between those two. We need to innovate and develop new technology; however, in balance of that, we also need to focus on prevention of illness and on creating long-term relationships with patients in order to help work with them on their health behaviors and lifestyle choices. I would say right now there is an imbalance in the way the public values these. It’s one of the reasons our health outcomes in the United States are quite different than other developed countries.
?What do you enjoy doing in your leisure time?
Leisure time? We still have a hundred boxes to unpack. I have the blessings of enjoying my work, and trying to stay healthy and fit and connected with my family [wife Beverly and daughters Becca and Lisa, both graduate students] takes the most of my time. In addition, we definitely love the outdoors and biking and hiking. …
When I do have time, my wife and I enjoy engaging in community service activities to help those in need. I also like to sing in community choirs. I look forward to any opportunities here that would forgive the dean’s schedule in attending rehearsals. I really look forward to being involved in the musical world here.