February 11, 2014

Vickers shares his vision of transformation

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Selwyn M. Vickers, M.D., was prepared for the inevitable question about the weather. “Although it’s a great city and great people, it’s snowing in Minneapolis tonight,” said the new senior vice president and dean of the School of Medicine at UAB, just a few days after his official October 15 start date. “We’re excited to be back home at UAB and in a warm climate.”

Vickers cover-1 12-18After seven years at the University of Minnesota Medical School, where he chaired the Department of Surgery, served as associate director of the Masonic Cancer Center, and was named to the Institute of Medicine, Vickers has come home to a warm welcome indeed. Born in Demopolis, he grew up in Tuscaloosa and Huntsville, where he met his wife, Janice, an Alabama native herself. Vickers also treads familiar ground at the School of Medicine. Here he became a nationally known surgeon and expert in the research and treatment of pancreatic cancer after arriving in 1994 as a young investigator and clinician.

“I came to UAB when it had reached academic and clinical heights,” says Vickers. “It had tremendous aspirations and growth, and it was an exciting time.” He eventually became the John Blue Professor of Surgery and director of UAB’s Section of Gastrointestinal Surgery and was named a Robert Wood Johnson Research Fellow. Vickers also co-directed UAB’s Minority Health and Health Disparities Research Center, was a senior scientist in the Comprehensive Cancer Center, and received numerous honors from medical students and colleagues.

Now, Vickers says, he returns to a UAB that is rising once more. He credits the “tremendous alignment” among the School of Medicine, the UAB Health System (UABHS), the UA Health Services Foundation (UAHSF), and the UAB president’s office for setting the stage for growth. In Ray L. Watts, M.D., UAB’s president and the school’s former dean, “you have someone who understands the current world of medicine and the growth that is necessary to meet our academic challenges. There is an overall desire to help Alabama grow and to make a significant impact on a national level in health care, research, education, economics, and leadership.”

The new dean is eager to contribute to those efforts. Vickers, his wife, and their four children “are proud to be Alabamians,” he says. “And we’re happy to be back here to truly make a difference.”

Transformative Medicine

Vickers’s vision for the future encompasses not only the School of Medicine, but all of Birmingham and Alabama as well. He cites the example of the Mayo Clinic, which is working to redevelop its hometown of Rochester, Minn., into more than a destination for health care, but a thriving, economically and culturally diverse city for citizens of the upper Midwest. “It’s an example of what an institution can do to its environment if it seeks to lead and be transformative for the entire community,” Vickers says.

In UAB’s case, the AMC21 Strategic Plan lays the groundwork for that transformation. “AMC21 is consistent with what I think UAB should be doing,” Vickers says. “It focuses on transformative research, quality, patient and employee satisfaction, innovation, and great clinical care. Its emphasis on investment in research and education is fundamental for increasing our National Institutes of Health rankings and defining ourselves as a national leader in quality benchmarks. We want to be the country’s preferred academic medical center.”

Right now it’s crucial for the School of Medicine, as it builds partnerships with the UAHSF, the UABHS through UAB Medicine, and with providers throughout the state—the Comprehensive Cancer Center’s Cancer Care Network is one example—to concentrate on population health, Vickers says. In part, that shift reflects changes in health care under the Affordable Care Act. “America has become a great place for managing acute care—if you get a heart attack, we can fix it; if you get a broken leg, we can pin it,” Vickers explains. “But we don’t do well in managing health for individuals before they get sick, and that has put the cost of health care in America on an unsustainable trajectory.” Moving forward, academic medical centers must develop platforms to engage communities and their health challenges, he says. “UAB will need to participate in RCOs—regional care organizations—with the goal of providing high-level care for individuals that helps prevent costly episodic care at major hospitals. If we are preemptive in our planning and management of their overall health care, then there is the potential for improved health along with significant cost savings.”

A New World of Care

Vickers emphasizes that the school will continue to explore the frontiers of medical research and care. In particular, he is excited by the possibilities of personalized medicine, bioinformatics, and regenerative medicine. “These areas have direct research streams that the NIH is funding because they cover the spectrum of what a true academic medical center should do: Foster new ideas in basic science, create new environments for translational research, and develop new protocols for patients,” Vickers says.

  Vickers is committed to fulfilling the School of Medicine’s AMC21 Strategic Plan, which calls for building and sustaining key areas of strength, including cancer, neuroscience, diabetes, cardiovascular medicine, transplantation, infectious diseases/global health and immunology, as well as primary care and medical education. He also wants to see the school pursue additional goals that will support each AMC21 area and undergird the evolution of American health care:

• Faculty recruitment and retention
• Population-based care
• Bioinformatics
• Personalized medicine
• Regenerative medicine
• Partnerships with providers across Alabama
• Economic development opportunities involving technology transfer
“Personalized medicine will help us begin to tailor health care to the individual so that we can prevent, treat, and even predict outcomes,” Vickers says. Bioinformatics will help make that possible by collecting patient data and genomic information across a spectrum of diseases and putting it into a format that helps clinicians apply the results to each patient’s treatment.

As for regenerative medicine, UAB faces an “evolving opportunity” to harness stem cells with the potential to restore function to a number of organs, Vickers says. While UAB’s Tim Townes, Ph.D., the James C. and Elizabeth T. Lee Chair of Biochemistry, has shown that induced pluripotent stem cells can play a significant role in treating sickle cell disease, they may also be able to help treat diabetes, cardiac disease, and neurological deficits. That, in turn, could lead to a revolution in transplantation, Vickers notes. He describes how scientists in other parts of the United States are perfecting bioprinting machines that produce 3-D scaffolds of collagen; one group recently “printed” a trachea. “The dream is that one day we could develop the scaffolding for a kidney, for example, and populate it with stem cells that could turn into nephrons and develop the excretion and detoxification systems in order to replace an entire organ,” Vickers says. “That’s in the future, but it’s where medicine is going, and it’s where we need to be.

“UAB has always taken great pride in providing the most sophisticated care to the people in its own backyard,” Vickers notes. “When the trends of health care led toward cardiac disease in the 1970s, UAB became a world leader. In the ’80s, when transplantation was coming into its own, the people of Alabama didn’t have to go to Boston or Baltimore. In the ’90s, when cancer was the focus of health care, patients could get everything they needed in Birmingham. The translation of new ideas from the bench to the bedside was occurring right here. The things we’re talking about now—personalized medicine, regenerative medicine, bioinformatics, health disparities, population-based care—are key areas of focus for the new world of health care. And you won’t have to leave Alabama to find a leader in those areas, because it will be UAB.”

Leadership Lessons in the OR

Vickers is used to taking on big challenges. It’s something he does every day in the operating room and in the research laboratory, helping patients to fight pancreatic cancer—one of the most formidable types of the disease—and working to reduce health disparities among populations.

He became interested in pancreatic cancer at Johns Hopkins University, where he earned his baccalaureate and medical degrees and served as chief resident in surgery. “I had the good fortune to train with John Cameron, the longtime chair of surgery at Johns Hopkins and one of the fathers of successful surgical treatment of pancreatic cancer,” Vickers says. “He inspired me to seek out things that appear to be insurmountable, with the commitment to do them as well as, if not better than, anybody else.”

Following postgraduate research fellowships at the National Institutes of Health and additional medical training at Oxford University in England, Vickers served as an instructor of surgery at Johns Hopkins for a year. Coming to UAB “further developed my passion for pancreatic cancer,” he says. It also prepared him for leadership by immersing him in academic medicine’s triple mission of research, clinical care, and the training of future specialists.

He picked up a key administrative strategy from his clinical work: “To have a chance of treating pancreatic cancer successfully, you have to build teams,” he says. In fact, Vickers continued to build teams with UAB colleagues even after moving to Minnesota in 2006. He and UAB radiation oncology professor Donald Buchsbaum, Ph.D., are co-principal investigators for the UAB Comprehensive Cancer Center’s prestigious Specialized Program of Research Excellence in pancreatic cancer.

Vickers also has established collaborations to address health disparities—a national problem that is acutely felt across his home state of Alabama. With James Shikany, Dr.P.H., a UAB professor of preventive medicine, Vickers is the lead principal investigator of a $13.5-million grant to create the National Transdisciplinary Collaborative Center for African-American Men’s Health. The collaborative effort—involving 100 Black Men of America Inc., the National USA Foundation, and the National Football League—will create community partnerships to design, deliver, and evaluate interventions targeting the four most significant causes of death and disease for African-American men and boys: unintentional and violence-related injury, cardiovascular disease, cancer, and stroke. The goal is to help narrow the gap in life expectancy between African-American men (72.1 years) and Caucasian men (76.6 years).

Vickers will continue to see patients and conduct research as dean. In addition to health disparities, his scientific investigations focus on gene therapy for pancreatobiliary tumors and the role of HSP70 and Minnelide in pancreatic cancer oncogenesis, the assessment of clinical outcomes in surgical treatment of pancreatobiliary tumors, and the role of death receptors in pancreatic cancer treatment. He also is following the progress of Minnelide, a novel therapy for pancreatic cancer that he and Ashok Saluja, Ph.D., in Minnesota were instrumental in developing. It entered a phase 1 clinical trial in September 2013.

029vickers.NAL2013Cultivating Leadership

The school’s strides toward national leadership are bound to attract the attention of the best and brightest minds from around the world. Vickers says he originally chose UAB as a place to work because it was ambitious, opportunistic, and collaborative. Now he is encouraging departments to spread that message and continue efforts to recruit outstanding new investigators. UAB should be synonymous with excitement and discovery, he says. “This is the place you need to consider because it’s where you can be successful.”

He also wants to fulfill that promise for faculty who are already excelling in the school’s clinics, labs, and classrooms. “I want to see more endowed professorships and chairs because we need to recognize the great people we have and highlight their accomplishments,” Vickers says. With changes to health care and reductions in federal research dollars, “we are asking our faculty, more than ever, to be leaders—to display the willingness and ability to reach new heights of achievement in spite of limitations.” Endowments provide resources to help UAB’s faculty meet those challenges, explore new avenues of investigation, protect the research gains they have made, and position them to compete for NIH grants.

Pieces in Place

Thanks to the milestones that AMC21 has already reached, UAB has a head start on achieving the goals on the new dean’s to-do list. “We have all the pieces in place,” he notes. “In personalized medicine, for instance, we have some of the best genomic leaders here, including Dr. Bruce Korf, and a wonderful partnership with Rick Myers of HudsonAlpha, along with Dr. Kevin Roth, who chairs our Department of Pathology, and Dr. Ed Partridge, director of the UAB Comprehensive Cancer Center.

“The other head start we have is simply our collaborative leadership at UAB—Dr. Will Ferniany, the Health System CEO; Dr. Jim Bonner, the Health Services Foundation president; President Watts; and myself. It creates an environment that, as a shared vision comes forth, aligns all parts of the enterprise to make it happen.”

A head start doesn’t always guarantee success, however, and Vickers encourages the community—and particularly alumni—to invest in the School of Medicine and help it move toward its goals. “Our alumni attended a school that has a national presence and international respect,” Vickers says. “Their investments allow us to recruit the best and brightest students—including Alabama students who might otherwise look outside the state for their training—and give us the ability to recruit and retain the best faculty.” Each gift, Vickers adds, helps the school transform the environment for medical education, research, and patient care in Alabama.

“I value our strong partnership with alumni, and I want them to be excited,” Vickers says. “We are positioned and committed to be a national leader. We have aligned our leadership and resources for growth, accountability, and success. We want to raise our rankings. We want to be a top hospital and health system. We want to make them proud of their school—and proud to be part of its growth.”

This story originally appeared in the Winter 2014 edition of UAB Medicine Magazine.