Leaders in Medical Education

Dr. Gordon Bernard, Senior Associate Dean for Clinical Sciences at Vanderbilt University School of Medicine

Osmosis Team
Aug 21, 2016

Gordon R. Bernard, MD is the Chief Research Officer at Vanderbilt University Medical Center (VUMC). He received his B.S. from University of Louisiana (Lafayette) and his medical degree from Louisiana State University. Dr. Bernard undertook residency training at the University of Kentucky (Lexington) in Internal Medicine and subspecialty training in Pulmonary and Critical Care Medicine at Vanderbilt. He joined the faculty at Vanderbilt in 1981.Dr. Bernard’s research has primarily focused on improving the care and outcomes of critically ill patients with sepsis and the acute respiratory distress syndrome (ARDS).Dr. Bernard is a member of the American Association of Physicians and has written or co-authored more than 275 original articles and book chapters.Dr. Bernard is also currently the director for Coordinating Center for the NIH National Consortium of 62 CTSAs which are located at the nation’s most prestigious research hospitals

How did you decide on a career in medicine?
By going to the doctor myself at a young age, I was able to observe many of the tasks he performed. I realized that these were the kinds of things I wanted to do because I wanted to be engaged in helping people to the best of my abilities.

What were a few key steps in your journey from an aspiring medical student to your positions as Executive Vice President of Research and Senior Associate Dean for Clinical Sciences at the Vanderbilt University School of Medicine?
I started out thinking I wanted to be a family physician, but soon realized that I needed to specialize more and went into internal medicine. Later, I realized that further specialization was required and decided to go into pulmonary critical care medicine. Throughout this process, I developed a love for and interest in research and began what became several decades of dedicated research, specifically into sepsis and acute respiratory failure. In the latter stages of this work, I was asked to join the administrative side of health care and thus assumed my administrative duties.

What is the greatest difference between the clinical side of medicine and the administrative side?
These two aspects of medicine are dramatically different. The clinical side, especially in an academic institution, focuses on taking care of patients and working with staff and students to provide the best care possible. In administrative medicine, the approach is more business-like, engaging strategies around corporate behavior, corporate structures, research and finding cost-effective measures to reduce the cost of healthcare.

What was/were the most memorable experience(s) during your medical education?
It is difficult to pinpoint one particular experience; I would say that I was most impressed when I experienced people who engaged in concerted thought and discussion and dedicated themselves to a difficult medical diagnosis or treatment, working through the complexities and ultimately finding a successful intervention for the patient.

Given your multifaceted research interests and duties as Executive Vice President and Associate Dean, how do you balance cutting-edge research, clinical care and administrative duties?
As a senior investigator for research at Vanderbilt University Medical Center, I have the opportunity to work with a large team focusing on working strategically around what our program looks like, what studies we initiate, how we design or studies and where we seek funding. Clinically, I work in the ICU exclusively now with no outpatient consultations. I engage in several rotations a year and make sure to immerse myself in clinical care in these times. Most of the rest of my time is dedicated to my research and to administration.

What do you think is the biggest challenge facing physicians today?
There is an extraordinary amount of documentation that provides little to improve patient care, designed instead mostly for billing purposes. This documentation ends up taking up an inordinate amount of physician time and often impedes patient care to an extent. Many times, the documentation that physicians are tasked to handle is so structured for billing purposes that it obscures the main issues a patient is dealing with.

In a time where technology is rapidly advancing and there is a push toward “precision medicine” initiatives and moving medical records to electronic databases, how can we best streamline this process while keeping in mind patient privacy?
There is a massive effort underway to transition from paper records to electronic records. This process is not determined by whether we can complete this process; it is more so when. Fortunately, medical records are not as valuable to hackers as, for example, bank information. Other than dates of birth and social security numbers, hackers do not seem to have very much interest in private health information. In terms of protecting patient privacy, I think most physicians are doing an excellent job of keeping it in mind amidst this transition

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?
There is no question that we do not invest enough into preventative measures relatively speaking, given how much more effective prevention is to most disease. While I do not think it has to be an either or situation, there should be more resources dedicated to the distal causes of disease. However, it is understandable and reasonable that the highest priority is and always will be the sick person; the immediate attention will go to the sick patient, not the one who needs to change his or her diet to prevent diabetes, for example. I think we need to better allocate consumer money in the health field, as the amount of money spent on health-related products is unfathomable. Consumers spend a massive amount of money on health supplements, special diets, and to a certain degree and cosmetics. If that money was directed toward truly useful measures, that would increase overall health. In order to do this, we have to focus on educating the public better; for example teaching them that randomly taking health supplements purchased over the counter is not a good idea. It is far more important to read valid advice and push for better labeling, for example.