The University of Texas at Austin
  • Health & Wellness

    How Do You Reinvent Health Care?

    By Cory Leahy
    Video by Thomas Humphreys
    Published: April 13

    Start by re-imagining medical education, which is what drew Dell Medical School Dean Clay Johnston to Austin. “We have an opportunity to start from scratch to redesign what health care can be,” Johnston said.

    Dell Medical School Dean Clay Johnston

    Photos by Marsha Miller.

    Dr. Clay Johnston, the inaugural dean of the Dell Medical School (DMS), has taken on a big job: opening the first new medical school at a tier-one research university in more than 35 years.

    It’s an unusual opportunity, not only to get a new school off the ground, but to plant seeds of real change to the nation’s health care system by preparing future Longhorn medical students to practice medicine in a health care environment that’s on the verge of a revolution.

    “Medicine is a bad business,” he said in an interview during his first week in office in early March. “It’s built on a foundation that needs a reexamination, and there’s huge opportunity to change the business so that it’s focused more on delivering high-value health care, which it’s not so focused on now.”

    To do that, DMS will need to reinvent the curriculum for medical students to reflect both how medicine has changed over the last half-century and anticipate ways that health care as a system must transform to become more sustainable.

    “The real opportunity is to take the foundation built around the university and all the work they’ve been doing, and also a great network of hospital systems and clinicians in the area, and think about how the medical school should be designed not for the kind of health care we deliver today, but for the kind we want to deliver in the future,” Johnston said.

    Watch Dean Clay Johnston share his thoughts about the opportunity for a new medical school at The University of Texas at Austin.

    A Fresh Look at Medical Education

    Johnston joins UT from the University of California, San Francisco, where he was the associate vice chancellor of research, director of the Clinical and Translational Science Institute, and a professor of neurology and epidemiology. He’s also a practicing neurologist and conducts research on stroke prevention and treatment. And, at the moment, he’s the only faculty member at Dell Med. Topping his long to-do list is building the school’s leadership team.

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    “Clearly this is a job not for one person but for an army,” he said. “Looking for other leaders who share this vision to transform health care and who are excited about the opportunity to start from scratch — that’s job one.” Ensuring that the school is accredited and, of course, building the facilities — a medical school and a teaching hospital — are other key priorities.

    Beyond the logistical details, Dean Johnston gets energized when re-imagining a curriculum designed to prepare physicians for the reality of a future health care system that incorporates technology more effectively.

    That new vision includes the “flipped classrooms” being used in other parts of higher education, where lectures are absorbed via video outside of class, and class time is spent more interactively, working through problems in teams, guided by the professor. He notes that medical curriculum hasn’t changed much in the last 30 years, despite massive evolution in technology and medicine.

    “The amount of knowledge out there in medicine is growing so rapidly it’s not possible to get your arms around that any more, and that will become an ever-more-complex problem,” Johnston said. Just as telephone numbers were once recalled from memory rather than from our cell phones, many medical facts no longer need to be learned by rote. ”You need a general familiarity, but you do not have to devote this impossibly large tome of information to memory.” Instead, he says, medical students need to learn how to learn. “How to use the tools that are available” — such as Google or the science library — “to actually figure out a diagnosis in somebody with a group of signs and symptoms that you haven’t seen before.”

    Partnerships are Crucial

    He also acknowledges how crucial it will be for physicians to work in teams with other professionals, including nurses, pharmacists, social workers, and others, both to improve patient care and the efficiency of the overall health care system. “More and more there’s a recognition that team-based care makes sense, but we need to get that to be part of the culture of health care from the very beginning. So interprofessional education will be a key part of what we do,” he said. (The School of Nursing recently launched UT-Interprofessional Education, a website that provides a centralized location for interprofessional education information available to all health providers and professionals.)

    Johnston is also interested in the possibilities of partnerships. From working with DMS founding partners Seton and Central Health, to forging relationships with other colleges at the university, biotechnology companies in Central Texas and other organizations, Johnston believes improving health is a collaborative effort.

    Infographic about health-related work happening at UT Austin
    Click on the infographic to see a larger version.

    “I think Austin seems like a really great place to focus on how we can make this the healthiest city, and that will mean different and interesting partnerships,” he said. “The school district, transportation, food, all those things play into the health of an area. How can we work together to think about ways in which Austin can demonstrate leadership in improving health?”

    As Johnston gets settled in Austin and dives into the complex work of getting a new school off the ground, he’ll be able to measure his progress by his closing remark at his introductory press conference back in January: ”I’m interested in creating the med school that represents what we want health to be, what we want health education to be in the next century, and making it nimble enough to keep Austin at the leading edge in health for years to come.”

    Learn more about Dean Johnston’s vision for Dell Medical School in the video above.


    In Pursuit of Health graphic

    This story is part of our yearlong series “In Pursuit of Health,” covering medical news and research happening across the university.

    You may also like:

    Interview: Dr. Clay Johnston on Innovations at Dell Medical School

    Video: Press conference introducing Dr. Clay Johnston

    • Quote 2
      Judi Nudelman said on May 10 at 1:22 p.m.
      Team based medicine is integral. Let's not forget the patient and his/her family / caregivers / loved ones as key participants in that team. Very often it is the insights from daily interaction that can provide diagnostic and treatment clues needed for the most effective approach.
    • Quote 2
      John Goodroe said on May 8 at 1:23 p.m.
      Many thanks to Dr.Johnston for being the inaugural dean of the Dell Medical School at UT Austin and reinventing medical education in Texas.
    • Quote 2
      Agencia Mocho said on April 29 at 5:50 a.m.
      Thank you for this article. Gracias.
    • Quote 2
      S Q Kong said on April 26 at 5:10 a.m.
      I am glad that we have Dr Johnston who is committed in improving the health education. With his dedication and like-minded communities in partnership, I hope that healthy lifestyles in Austin will become a role model for other states to follow.
    • Quote 2
      Chris Morley said on April 23 at 11:57 a.m.
      I hope that Dr. Johnston considers integrating problem based learning into the curriculum. PBL has proved very successful in the Joint Medical Program between UC Berkeley and Dr. Johnston's prior institution, the University of California, San Francisco. (jmp.berkeley.edu) UT's School of Public Health would make a marvellous partner for a small program emulating the JMP model, and any program would benefit from proximity to and collaboration with the other health-professions schools and colleges at the university (Nursing, Social Work, Pharmacy). I must admit to some bias, as my wife (Plan II/Classics '09) has just earned her MS and is pursuing her MD at the JMP, but I do hope that Dr. Johnston will consider integrating the same model into the Dell Medical School. Chris Morley, Plan II/Spanish '08.
    • Quote 2
      johny said on April 23 at 1:03 a.m.
      Thanks for your great article and I totally agree with Dr. Johnston.
    • Quote 2
      Irina Keenan said on April 18 at 8:19 a.m.
      We, students here in UT, are so excited about a new medical school and looking forward to a new, reimagined medical education.
    • Quote 2
      dang said on April 17 at 1:53 p.m.
      Very instructive article. The concept of remodeling the medical education is necessary.
    • Quote 2
      vlora said on April 15 at 4:04 p.m.
      thanks for sharing this great article.
    • Quote 2
      Kimari said on April 15 at 12:21 p.m.
      We need more mental health care/therapy/counseling for the un- and uner-insured and also to TEACH CHILDREN TO AASSKK for the help they may not know they need.
    • Quote 2
      David Harkleroad said on April 15 at 9:36 a.m.
      I totally agree with Dr. Johnston that reinventing medical education and collaboration are critical to transforming health care as a system. In tandem, we also need to ensure full collaboration with patients and to re-imagine how health care data is used, with a single focus for the patient: "What is the best treatment for my disease?" Unfortunately, the current siloed structure of US health data repositories requires access a variety of proprietary databases, making it difficult, if not impossible, for physicians, researchers and patients to access valid, non-biased and non-confounded information on what treatments work best for a specific condition. Patient-owned Our Health Data Cooperative (http://ourhdc.com) is being developed to help millions of patients benefit from better use of health data and become part of a larger movement to create a comprehensive, evidence-based clinical research Learning Health System by anonymously sharing their data.
    • Quote 2
      Rohit said on April 15 at 7:37 a.m.
      Thankks a lot for an article
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