Thinking Glocally - Dr. Dele Davies, Senior Vice Chancellor for Academic Affairs and Dean for Graduate Studies at the University of Nebraska Medical Center

DR. RISHI DESAI: Hi, I'm Dr. Rishi Desai. Today on Raise the Line, I'm happy to welcome Dr. Dele Davies, Senior Vice Chancellor for Academic Affairs and Dean for Graduate Studies at the University of Nebraska Medical Center. In that role, he's responsible for overseeing UNMC's six professional colleges, fourteen graduate programs, and the Office of Postdoctoral Studies. Before joining the leadership ranks at UNMC ten years ago, Dr. Davies was Chair of Pediatrics at Michigan State University for many years. I'm looking forward to talking to him about the journey academic medicine has been on during the pandemic, and learning more about UNMC. Dr. Davies, thanks so much for being with us today.

DR. DELE DAVIES: Thank you for inviting me, Rishi. Great to be here.

DR. DESAI: Absolutely. It's wonderful to see you after many years. For our audience, I want to share that we got together in person at UNMC a number of years ago. So, it's a nice chance to catch up with you.

DR. DAVIES: Absolutely. Yes, you helped to inspire our whole e-learning program here at UNMC when you came and spoke to us, with the work you were doing at the time, right, with Khan Academy?

DR. DESAI: That's right.

DR. DAVIES: It's so great that that has progressed on to Osmosis and other activities for you.

DR. DESAI: Well, listen, I know a little bit about your background, but our audience doesn't. Maybe you can share what got you interested in medicine, and particularly pediatric infectious diseases, which as you know, is an area that's near to my heart.

DR. DAVIES: So, Rishi, I was born in Nigeria, and I grew up in a family of attorneys actually, believe it or not, but I had a cousin who was raised by my dad, who was a physician. He was sort of the go-to person in the family for all kinds of health issues. I just thought he was really cool. He was my first real inspiration for medicine. Then I went to England, and then subsequently went to medical school in Canada. During medical school, the people who inspired me the most were the pediatricians. Initially, actually, I was doing internal medicine. Then I switched to pediatrics in those days. I just really enjoyed the fact that they seemed to really enjoy what they were doing, and I love children. So when I stepped into the Children's Hospital in Toronto, I just really fell in love with the specialty.

In terms of infectious diseases, there were three people who really inspired me to go into infectious diseases. One was my master's mentor, Elaine Wong, who was a really superb ID doc at SickKids. Then two giants of ID docs in Toronto, Dr. Allison McGeer and unfortunately, Don Low, who passed away a couple of years ago. They were just so passionate about ID. They were so knowledgeable, they were great leaders, they were great team players. They invited me as a fellow in infectious diseases to really come join some really incredible studies. I learned so much from them. It's really a specialty that crosses all organ systems and you can be a real doctor, and do everything in infectious diseases. Plus, I love to travel internationally and ID gives the opportunity to give back.

DR. DESAI: Have you taken trips to Nigeria?

DR. DAVIES: I have, I've taken trips to Nigeria, and I've taken trips in many other countries, all tied to ID.

DR. DESAI: I'm curious, a lot of folks do clinical practice in pediatric ID or other specialties, but never really get involved in admin or leadership. So I guess two questions: how did you get involved, and then what inspired you to want to pursue that?

DR. DAVIES: Interestingly enough, when I finished training at the Hospital for Sick Children in Toronto, I was recruited to go to Calgary. I had a master's in clinical epidemiology in those days. I was in some of the earlier waves of people were trained in that in that field. So I was recruited to help start a clinical research institute, which was initially a clinical research which I took to become a university-wide research institute. At each level as I was there, being a smaller organization at the time, I kept on getting tapped to come help lead this committee here, or chair this scientific review committee there. As I was touched to take on more and more of these leadership roles, I realized that I had certain skills that I wanted to develop. I started taking more professional development opportunities, leadership classes, and doing certificates that helped me improve my skills.

I wanted to avoid something known as the Peter principle. I'm not sure if you're familiar with that term. Peter's principle is a notion that you will keep getting promoted until you hit your level of incompetence. I certainly don't buy into that, but I do believe that when you get promoted, at every level, you're going to find things that you don't know, things you've never learned before. Even now, in my career, I'm still learning things every day. The idea that I can move away from personal goals, to creating a vision and inspiring other people around our shared vision and helping them develop their personal professional goals, while also building an organization and organizational strength, motivates me now. It means less recognition for me as a person, but more basking in the reflected light of those whose success I can enable by the visions that we jointly move forward. So, leadership is really exciting to me, because again, it's truly enabling and allowing other people to succeed, and also watching something that you can create out of nothing become a reality.

DR. DESAI: What is your take on how leadership is taught or not taught in med school and residency and fellowship? Do you feel that you learned any of that in your formal training prior to joining admin roles and leadership roles?

DR. DAVIES: I think the short answer is no, formally, but I had some incredible role models, who are leaders that I just basically watched and mentored and monitored myself after. I mentioned a couple of names earlier, Allison McGeer, Don Low. It's interesting, they will consider themselves just ID docs. But what I saw as a fellow coming from another lab where the leader was a micromanager, everybody was scared to do anything and did not have much productivity in that lab, once I stepped into the lab that was run by Allison McGeer and Don Low, what I found was a vibrant, thriving lab where everybody was contributing. They were very productive, putting out abstracts and papers. The thought crossed my mind, how is it that this lab is so productive, and this other lab that's also in the same CD also in the prestigious part of the organization was so stagnant?

I realized it was all about how they handle people. They allow people to be creative, they give people freedom, they welcome new ideas. It was a functional research lab, but they still allowed people to be creative and give them time to explore ideas. I learned so much from them, just watching how they handled people, how they enabled people to succeed. We would have grant deadlines where we would have maybe two weeks to put together a grant, but everybody came together. Everybody came together and wrote together and they would order food for us to eat, and we would all stay late. Honestly, didn't even know that I was working; I was having so much fun, and it was such an honor to be part of the team, that I really just enjoyed it. So I've tried to embody that myself in my career, to try and learn just by watching people, and I try to learn from different people and take nuggets of wisdom from so many people. Of course, I have a lot of formal training in the interim, but I think I've learned as much by watching and observing and being mentored by people as I have from any formal classes I could ever take.

DR. DESAI: That makes a lot of sense, and certainly has been my experience as well. I'm curious now to learn a little bit more about UNMC. What do you think are some of the things that set it apart? What are some of the strengths of the program?

DR. DAVIES: It starts with our mission. You always want to start with a mission. Our mission is to lead the world in transforming lives, to create a healthy future for all individuals and communities through premier educational programs, innovative research, and extraordinary patient care. That is what we do. I mean, it sounds very similar to a lot of other organizations, but we really take that mission very seriously. We have, in health, six professional colleges, graduate studies programs, and we have institutes of cancer and developmental disabilities. We've had 21 straight years of annual growth in our student body. Twenty-one straight years. We now have almost 4400 students. These are all health professional students and research students. 

We're anchored in Omaha, but we take our mission to serve the communities very seriously in that we have campuses all over Nebraska, which is a 500-mile-wide radius of urban and rural Nebraska. Our rural and urban programs are among the best in the nation. We have several programs that are ranked in the top 10. Our rural and primary care programs have, in the last several years, almost exclusively been ranked in the top 10. Our nursing program has ranked in the top 10; our PA program is highly ranked—I think it's number 15 right now. So we really take this mission—and, by the way, it's not about the rankings. It's really all about the people, the quality of people from all over the country, from all all the highest-quality institutions and all around the world who work here and make this such a great place. 

We also have something very unique in Omaha, in that we have an extraordinarily supportive community. I've lived in many communities, but I have never lived in a community where the leaders, the community, and the philanthropic community are so supportive of the organization. They invest in us. We have facilities that are second to none. We have core facilities, we have buildings, we have healing arts programs. When you come to UNMC, we have some of the finest art by Dale Chihuly. You might have heard of Dale Chihuly, who is a glass artist—we have some of the finest art that is ever put anywhere in the nation. So it's really not only just about doing, it's also about the way the whole program is structured to really heal, and also to be fully engaged within the community. We cannot do that without our community as support. Our research programs also have continued to grow. Now we have about $220 million worth of external research funding every year, which again, is really a testament to the fact that we have so much community support.

DR. DESAI: That support probably was strained or tested over the last couple of years with COVID. What were some observations that you made as UNMC got through this pandemic?

DR. DAVIES: Rishi, one of the things that struck me is how resilient our people are, our students, our faculty, and our staff. I mean, there was a lot of stress, obviously, many people lost relatives or friends, many people themselves got COVID. But we came together, that's really what struck me was how the whole organization came together. We had so many people volunteering in the community, so many of our faculty, staff, and students. Actually, because we have the Global Center for Health Security, we had a lot of the nation come to us for help. We were the first place that Americans who came off the Diamond Princess cruise ship were evacuated to. We have the nation's state-of-the-art National Quarantine Center, the only federally-funded quarantine center in the nation. So we were able to take the first group of patients and learn, very quickly, a lot, just from those patients, as to a lot of things that helped inform the rest of the nation as to what we needed to do to care for COVID patients. Our Center for Global Health, plus the College of Public Health, developed so many resource and training materials on COVID, that were distributed for free to the whole world, really, about  how to manage COVID, and guidelines for quarantine, etc. 

I really am especially proud of our faculty, staff, and students and how we pivoted from basically coming to work every day, to learning, teaching, and working remotely. I know every organization had to go through this, but I will tell you that our IT team, our faculty, our instructional designers, how were able to quickly come up with tools for allowing our faculty to keep teaching, and our students to keep learning, making sure that we had all the different equipment that we needed to make sure that this was a success. Also just having our staff be able to work from home, were all lessons that we've learned. 

A lot of those lessons have become permanent fixtures in our organization. They're not going to go away. We're going to continue to do a lot of the things that we were doing as a result of COVID. So it was really rough, obviously; it was really hard on a lot of people and it's changed the way we do a lot of things. But I could not be more proud of our of our faculty, our staff and our students.

DR. DESAI: That's awesome. It's great that you feel that way and that you were able to witness that. Do you sense that there's a change in how we're approaching faculty and students and staff with regards to the stress that they might feel, the chronic stress? Sometimes people use the word “moral injury” or burnout. Do you sense that there's a way that UNMC is managing that is different now that we've had two years of COVID experience?

DR. DAVIES: Yes, Rishi, thanks for bringing that up. We know that burnout is a major problem. You know, 20% of the healthcare workforce has quit in the last last year or two, just because of the stress related to COVID. We have invested a lot of resources—to be fair, not just during COVID, but certainly we expanded the resources during COVID. The first thing we sought to do was understand the needs of our faculty, staff and students. We wanted to meet them where their needs were. So we allowed flexible work schedules for most of our employees whose jobs did not need them to come to campus. We granted a lot more paid emergency administrative leave, 160 hours for employees to use, in cases of self-quarantine, quarantine or care of a loved one. Maybe they have a child whose school was closed and they needed to be home. You know, a lot of scenarios like that are related to COVID, we paid a lot of attention to facilitating those things. So we actually had surprisingly very few turnovers because of a lot of that. 

Probably more importantly, we activated and expanded our behavioral and wellness teams. We have an Assistant Vice Chancellor for Wellness. The team did a lot of town halls to listen, to respond, to give tips on how to stay healthy and to reduce stress. We made a lot of resources available for stress prevention and management and wellness. Then we also did a lot of things on campus where we recognized there were really stressful times. Rishi, remember those times just before you had to do anatomy exams or something, how stressful those could be during medical school. We actually in the library had massage chairs, we had refreshments that students could go and get some refreshments and just distress before the exams. Then, we have, as I alluded to earlier, one of the world's best healing arts programs. We actually have a symphony on campus. So it was actually fortuitous that just before COVID, about three years ago, we started a Nebraska medical symphony, with faculty, staff, and students that are actually led by a choir director from the University of Nebraska, Omaha music department. A lot of faculty, staff, and students use that as a means of stress relief as well. So a lot of different things. Of course, we have 24/7 professionals available to talk to people in the case they are feeling depressed, or suicidal, or anything like that. We really ramped up a lot of things to try and support our people here on campus.

DR. DESAI: It's obvious that you have a very student-centric view, thinking very carefully through how students like to learn and how they optimally learn and remember, as well as thinking about faculty needs. You yourself, interestingly, I came to learn, got your master's in healthcare management from Harvard School of Public Health a little bit later in your career. So in a way, you've been very much an exemplar of a lifelong learner. For those in our audience planning out their postgraduate studies for themselves, what impact would you say that particular degree had on your effectiveness as a leader?

DR. DAVIES: I would say that it had a profound impact on me in many ways. Quite honestly, before I stumbled, shall I say, on that program, I was going to do a traditional MBA, like a lot of other leaders do in healthcare. What really drew me to the master's at Harvard were a couple of things. First of all, it's a program designed just for physicians. Again, it's not that the traditional MBA may not cover a lot of things, but just being around other people who are already leaders, I was able to learn a lot—not just from my professors, but from my colleagues, because they all came in with so many different skills that I brought to the table and I didn't bring to the table, some of which I brought and many of which I didn't. 

The second thing is that the program gave me a solid and practical foundation, and the traditional business classes like organizational behavior, stakeholder analysis, negotiations, financial management, cost accounting, etc. However, it also allowed me to delve deeper into our healthcare systems, understanding our health policies and payment systems and healthcare quality improvement, things that you don't get in a traditional business degree. For me, it was really the ability to learn more about management and leadership and business principles, while at the same time understanding better how our healthcare systems work in the United States and around the world. Maybe the most important thing for me was also the profound friendships I developed during my time there, and not just with my classmates, but with the professors and how I've been able to tap into many of them since I left. It's definitely had a profound impact on me.

DR. DESAI: One thing that we love to do here is fill in knowledge gaps, things that may be myths or misconceptions. Is there a topic that you think would warrant a little bit of clarity, anything you'd like to educate us on that you think everyone ought to know?

DR. DAVIES: Well, there are a lot of things I could pick, Rishi. Maybe one of the things that I learned during the pandemic, or that the pandemic's taught all of us, is that we need to be resilient and flexible organizations. We can no longer do things the way we did it. There's a term that I learned about, I guess in the last couple of years, that we need to think glocally. I'll say that again, glocally. It's not globally, it's not locally, it's glocally. That means that we need to basically think and look globally for trends and patterns that can impact us, but we need to act locally, to ensure that we're ready. That readiness could be readiness for a pandemic. I mean, the moment we heard something was going on in China, we started to think right here on the med campus, “What are we going to do?” We knew that a sneeze in China or London could cause an outbreak in Omaha very quickly. 

I think if people don't think glocally, they're going to be caught off guard on a lot of issues. The pandemic is one thing, but thinking glocally is also important if you want to lead the world. You've got to know what the emerging trends are. You've got to understand what the signals are in terms of where our educational programs are going, where our clinical programs are going, all the things that we do with research, what the key things are that we need to be thinking about. So I think that people should try and get used to the term glocal and start to think glocally and look globally for trends and patterns, and act locally, to have an impact.

DR. DESAI: That makes a lot of sense. I think oftentimes, with infectious diseases, the analogy is so easy to grasp, because you think, obviously, these things don't respect boundaries and borders. My sense is that this is also true when you think about things like the war in Ukraine, climate change, and other topics that aren't necessarily infectious diseases, but still affect—probably in a disparate way—some regions of the world more than others. I'm just curious, have you seen UNMC take the lead on some of these issues? If so, what are some examples that you can share with our audience in terms of having a glocal view on on these world topics that we're bombarded with in the news every day?

DR. DAVIES: Yes. I will tell you that even before we have the first case of COVID in the US, we sent a team to one of the cruise ships to try and understand what to expect here at the Med Center and in the United States, because we wanted to have a better sense of what to expect. So that's still infectious diseases. However, I think that we at the Med Center are always looking for signals around the world as to areas that we're not, perhaps, as focused on right now that we need to be more focused on. A lot of those areas are tied to our academic programs. We want to be leaders in in some of the programs that we've started here. For example—and again, this ties into infectious disease, but it's actually more health security. We're in the process of developing the very first health security fellowship program in the world, and we've applied to the ACGME for this, and hopefully we'll find out that we got it approved. 

We're doing a lot in health security right now. We know that this is an area where we need to be resilient as a nation. A lot of places teach about disaster management, they teach about bio containment and infectious diseases, but there's nobody that's thinking about overall health security from a multi-layered, multi-dimensional point of view. We're leading that. 

It's always looking for signals. There are futurists, you know, that look for signals and try to predict what's going on. We want to be able to create our own future here, by leading and making sure that we are ahead of the curve.

DR. DESAI: I think that's a really helpful framing. Thinking about health as a security issue helps to explain why it's not just a moral imperative, but also an economic imperative and a security imperative to make sure that, in the case of COVID, the world gets vaccinated, for example, because disease anywhere can, as you said, strike people elsewhere as well. The same is true for issues of migration, issues of climate change, etc. I think that's a really wonderful way of framing up the issues that are increasingly upon us. 

Any final advice for folks in our audience? We have a lot of healthcare students, as well as faculty, that may be interested in learning what got you to where you are today. What can they do in their own careers to help create an arc that's maybe similar in some way?

DR. DAVIES: I would say find your passion and pursue it. I believe I love what I do today as much as I did the first time I stepped into what I was doing. A lot of that is tied to my just diving in and making sure that I fully interact with people, and ask questions. There's nothing better than to do what you're enjoying a lot doing, and getting paid for it. If you really go to work every day and you look forward to going to work, and you get paid for it, that's the best. Having said that, it's important that you continue to build and expand on your repertoire of skills. I learn every day. If I go to every meeting, my goal is to learn one thing. If I go to a conference, I want to make sure I come away with one or two takeaway points that I can learn. 

Have a mindset of learning continuously. If you stop learning, then it's time to find something else. Continue to expand your repertoire of skills, leadership, seek out mentors, seek out sponsors, and then be a mentor, be a sponsor. Find some balance with your work. 

Rishi, just before we went on, you told me about a new addition to your family. That's a beautiful thing, right? I think having things that balance your work will allow you to work for longer, and will allow you to enjoy your work more. The vacations, the breaks are critical. Then I would say, get ready, because there will be opportunities that will come, and make sure that you pounce on them when they come. That often comes wrapped as something that looks like hard work. It gets wrapped to something that looks like it's intimidating. But, you know, you're never ever going to hit a home run if you don't swing. Babe Ruth missed a lot more than he hit, but he's remembered for those hits that he got out of the park.

DR. DESAI: Yes, that's a very inspirational thought at the end there about Babe Ruth. I think that's a good point, and maybe a wonderful one to end on, that finding balance and bringing out the most in yourself, personally, helps enrich your professional career as well. Listen, thank you so much for being with us today. That was a marvelous chance to kind of get to know you and your career a little bit better.

DR. DAVIES: Thank you, Rishi. Thank you for the opportunity, and thanks for all you're doing. I think promoting important health topics like you're doing with Raise the Line is really very important. One of the things that we hear a lot about is misinformation, and bad information, and disinformation. I think having programs where you can actually get credible information out to the public is critical. So thank you for what you're doing.

DR. DESAI: I appreciate you saying that. I'm Rishi Desai, thanks for checking out today's show. Remember to do your part to flatten the curve and raise the line. We're all in this together.