How the Pandemic Is Influencing Academic Medicine’s Next Research Leaders
As COVID-19 rapidly spread, we witnessed the remarkable leadership of investigators and research executives across the nation’s academic medical centers. They were forced to quickly put thousands of studies on hold, while working as, or closely with, front line providers to care for COVID patients and to develop new vaccines and treatments. There is no doubt COVID has put unprecedented cost pressures on academic health systems, which will accelerate biomedical research discoveries and impact the type of research leadership we will see in a post-pandemic world. In the following conversation, WittKieffer senior partner Jeff Schroetlin and principal Joyce De Leo, Ph.D., consider how research leaders are managing during the pandemic, how research leadership will change, and how institutions have changed their approach to recruiting senior research leaders and academic medicine investigators.
Schroetlin: Joyce, how has COVID changed the outlook for research leadership in academic medicine? What are you seeing?
De Leo: From a funding perspective, Jeff, everything is really up in the air. It’s not certain what NIH grants will look like in the next few years, and the competition for other avenues of funding will be incredibly competitive. This means that there has to be a more practical component to any research initiative. The pendulum is swinging now even more quickly from pure discovery research to that focused on direct patient impact and population health, where there’s a clear connection to the public good and the institution’s clinical mission.
Schroetlin: One silver lining from COVID is that, especially in larger health systems, there’s been a recommitment to the value of research – even for community health systems, many of which have seen the value their researchers have made in how to treat COVID patients. At the same time, as you suggest, Joyce, these research groups can’t be siloed. Because of cost pressures, they really need to be closely aligned with clinical strategy. Systems are saying, “We’ll commit to research but it has to partner with our key service lines and support clinical trials.” Many systems were already embracing a learning health system model, and seeing the value for attracting leading sub-specialists by creating opportunities for them to practice while contributing to impacting the future of care delivery. By viewing research as a practical and valuable component of delivering higher quality and cost effective care, health system executives are showing a willingness to continue to support research.
What Types of Leaders Are Needed?
De Leo: How is this trend changing the type of leadership skills that institutions are looking for in research leaders?
Schroetlin: If you look at chair or dean recruitments now, there’s already been a shift. While for some institutions there is always going to be value in having a research luminary in those roles, the trend for many academic medical centers in recruitment is toward those leaders who have strategic clinical programmatic experience first and foremost, while being able to understand and support the research mission. This does not mean an abandonment of basic research, though deans, chairs and chiefs are being called upon to re-align research to make it sustainable, translationally focused and more collaborative.
De Leo: In fact, you don’t want someone with such a huge research portfolio that it takes away from their leadership position. If someone says, “I can’t commit 50 percent to this leadership role,” it likely means that they don’t have the time or passion to be the leader who is needed in today’s challenging research environment. It’s more important as a Chair, Division Director or even a Vice President of Research that one recognizes the mechanics of grant applications, the spectrum of funding opportunities and the tenacity it takes to obtain external research funding. Leaders can help identify research mentors from both within departments and across units and colleges. Team science not only is often required by federal funding agencies but also leads to more innovative and impact science and discoveries.
Implications for Recruiting Research Leaders
Schroetlin: One of the most important jobs for any chair is recruitment and retention. Because there is more pressure on justifying every dollar spent for research, good leadership of the department and the vision of the chair become more important. The days when you can recruit a department chair largely based on the thickness of his or her CV are in the past. For any department with a vital research mission, you need someone who is a well-rounded leader: someone with a high EQ, who builds a supportive culture, develops faculty, supports diversity and inclusiveness, and who can work proactively to build a thriving clinical service which aligns with hospital and health system strategy. Academy-based health systems are looking for impactful researchers who are also great leaders; you can’t separate the two.
De Leo: I agree. Because of COVID, there is much less emphasis on recruiting researchers, even renowned ones, who operate in siloes and are known primarily for their publications and H-index. I’m hearing academic system leaders say, “We don’t need more papers. We need healthcare change.”
Schroetlin: Research has been under pressure anyway, as the cost is not sustainable for medical science without endowments and clinical funds support. A primary strategy of chasing NIH dollars will continue to work for the top echelon of academic medical centers, but it becomes a harder goal for everyone else. COVID is unfortunately going to mean recruitment packages for new research leaders will not be as rich, will have qualifiers attached, and will rely on closer alignment with institutional goals.
De Leo: I’ve been seeing some institutions during COVID scaling back their packages, and/or they are willing to make future commitments because they don’t have adequate resources to commit right now. They’re counting on researchers coming to their institution with the expectation that funds will be available once the COVID crisis has passed. I think that’s remarkable and a potential new norm.
Schroetlin: It is. Certainly, the “haves” – the big-name medical schools with deep endowments – will continue to thrive and support their large research missions. It is a little more uncertain for those institutions, especially public ones, which really need NIH dollars to support their basic science programs and research missions. The outlook is unknown, which makes it hard to recruit research leaders who are apt to go to better resourced universities.
De Leo: The key for these institutions will be to identify, focus and leverage current institutional research strengths, retain and recruit investigators within these areas, and seek alternative funding sources from NIH including philanthropy, foundations and other agencies.
Schroetlin: I agree. It is a very difficult and volatile research environment today with many unknowns about the future. However, it has been exciting witnessing the rapid evolution in how we can deliver healthcare in a virtual environment and our increased ability to move scientific discoveries to potential treatment and impact the health of people throughout our country and world.