Dr. Robert Amler, Vice President and Dean of New York Medical College, School of Health Sciences and Practice
Jul 22, 2016
Robert W. Amler, MD, MBA, FAAP, FACPM is Vice President for Government Affairs at New York Medical College (NYMC) and Dean of the School of Health Sciences and Practice and Institute of Public Health, where he has engaged the private sector in co-founding a regional biotech corridor with NYMC at its hub. He has secured public-private partnerships for clinical training, biotechnology, disaster medicine, and a new dental school as well as a newly completed biotech incubator ([email protected]), to attract and support researchers and start-ups in early-stage development of new drugs, vaccine strains, medical devices and apps. As a top health official for the federal government, Dr. Amler secured major supplemental Medicaid funding covering a region of 32 million people. Previously as chief medical officer for the Centers for Disease Control and Prevention (CDC), Agency for Toxic Substances and Disease Registry, he established the nationwide network of Pediatric Environmental Health Specialty Units (PEHSUs), and created Healthier People v3.0, the best-in-class risk model for quantitative personal health assessment. Dr. Amler is a graduate of Dartmouth College, New York University, and Rutgers Robert Wood Johnson Medical School. He is board certified in pediatrics and general preventive medicine.
How did you decide on a career in medicine?
My grandfather died from cancer when I was 10 years old and already learning about science. I was determined that my career would be dedicated to preventing such deaths in the future.
What were a few key steps in your journey from an aspiring medical student to your current position as Dean of the School of Health Sciences at New York Medical College?
Residencies in pediatrics and public health, a 26-year career at the CDC and the US Public Health Service, ending up in the US Department of Health and Human Services as the Regional Health Administrator for the Northeast and Caribbean. Then I was asked to be the dean.
What is the greatest difference between the clinical side of medicine and the administrative side?
The clinical side provides specific interventions for individuals. The administrative side (including public health) provides broad interventions for populations. Each requires a particular set of skills, talents, and experiences. And each must follow up closely to ensure that interventions are both appropriate and effective in achieving the needed results.
What are the advantages of completing a dual-degree program such as MD/MBA?
In many cases, I have preferred hiring an MD with a complementary master’s degree, whether MS, MPH, or MBA. For the clinical MD the MPH is a great enhancement if one seeks additional opportunities in research, epidemiology, environmental health science, population health or international health. The MS is useful for biomedical research, and the MBA (or MPH in health policy and management) is useful for those who seek to administer health plans, hospitals, or other large organizations. For a smaller number of physicians, a law degree is useful for administrative or medical-legal career goals.
What was/were the most memorable experience(s) during your medical education?
One of my clerkship attendings was a CDC epidemiologist who expanded my medical vision to encompass the health of populations. He linked the illnesses of individual patients to regional and national trends so skillfully that I just had to learn to do it too.
What do you think is the biggest challenge facing physicians today?
Our profession leads the health care industry in value creation but is losing its ability to capture a proportionate share of that value. Non-medical players, while necessary, are capturing an expanding share of the value and also imposing new restrictions on our ability to exercise expert judgment in our daily work.
There is an enormous debate these days as to whether resources should be primarily allocated to fighting diseases or the distal causes of diseases. What are your thoughts on this issue of proximal causes versus distal causes?
What do you mean by distal causes of disease? Do you mean sequelae of disease (downstream effects) such as hemiparesis following a cerebrovascular accident (stroke)?
I consider smoking a proximal (upstream) cause (risk factor, precursor) of heart disease, cancer, etc.
Common sense tells us we should allocate resources to all three worthy objectives – fighting diseases, their proximal causes, and their sequelae. The first objective is urgently needed, the third is a long-term commitment, and the second is highly beneficial in avoiding pain and suffering as well as costs. And all three objectives need to be pursued efficiently and transparently.
What are some ways to best streamline healthcare costs and deliver quality care to underprivileged communities from a public health standpoint given we live in a world of persistently rising costs?
I personally favor private-sector initiatives in competitive arenas that minimize third-party power and maximize consumerism, buyer power and personal choice.