Fifteen years ago, Dr. Paul Katz — the founding dean of Rowan University’s Cooper Medical School — learned a lesson that he hopes to share with all of his students.
Katz was hospitalized with an abnormal heart rhythm at Georgetown University Medical Center, where he served as a chairman of the Department of Medicine.
Despite his senior position, Katz was struck by the impersonal care he received. His caregivers were clinical and detached, rather than empathetic — as if they couldn’t connect with him and other patients.
“I think part of it is hearing conversations that you weren’t intended to hear,” Katz said in a recent interview. “Hearing people who are not necessarily as concerned about your well being, people for whom it’s more of a job and going through the motions.”
The experience touched Katz in a profound way, one that would change his thinking about the essential skills that caregivers need.
“One of things that we’re trying to change — and others are — is understanding what it means to be ill,” Katz said.
The Camden Connection
Connection also informs the mission of the state’s newest medical school, especially in its relationship to Camden, the city in which it is located.
Katz said the school’s first class of 50 students — less than 2 percent of the 2,900 applicants — reflects a commitment to serve Cooper’s home city.
“Half of our students live Camden, which is something I’m very proud of,” Katz said. He added that the school stressed to prospective students that it is located in a community that has long struggled with healthcare.
“We told them that this city and how it does is one of the metrics of success that we need to be judged by, and we challenged them . . . to be part of this, to help us do this,” Katz said.
“What’s really important is finding the right kind of student who we think could become the kind of physician that we want to care for us and our families — people who are committed to service, people who are professional, people who can communicate, people who are empathetic — the kinds of things that separate the great physicians” from the rest, Katz said.
A Family Tradition
Katz describes himself as “somewhat genetically predetermined” to be a doctor, following in the footsteps of his father. However, he spent much of his adolescence hoping to become a veterinarian.
“My interest in veterinary medicine really came from the fact that I liked dogs,” Katz said. “I wound up working for a guy who was really not a good guy. He was not kind, he was not caring, and he wasn’t caring for the animals. I sort of extrapolated this to veterinarians as a whole and said I’m not sure I want to do this.”
It’s a theme that Katz returns to repeatedly — that healthcare providers should be caring toward their patients.
Katz wants Cooper to take an innovative approach to medical education, which he sees as still working with a model influenced by a 1910 report by Abraham Flexner. It stressed that medical students should master scientific knowledge while faculty should pursue research.
An earlier focus on clinical training is one of the changes that Katz hopes to engender, “connecting the dots” between scientific knowledge and providing care.
“Healthcare has changed, technology has changed, the workforce has changed, so a lot of focus now is on critical thinking, problem solving, working in teams, understanding the social and economic contexts in which illness occurs and really being prepared to address the needs of a growing number of individuals who will now have access to care,” Katz said.
Katz also wants students to be better prepared for the rest of their careers and to gain an understanding at an earlier point of “what it means to be sick, what it means to have poor access to healthcare, what it means to not be able to afford your medicine because you have to buy food.”
After graduating from Georgetown University School of Medicine in 1973, Katz spent his residency at the University of Florida. At a Florida Veterans Administration hospital, he had an experience that has stayed with him. A young Vietnam veteran was suffering from tuberculosis-like symptoms. Katz pushed to treat the man for tuberculosis and the patient died from complications of the treatment.
“There was and probably still is some self-flagellation, and every physician has been in that, even if they don’t want to be admit they made an error,” Katz said.
“It wasn’t an error of omission, and I’m not sure that I would have made a different decision now, “he explained. “It just gave me some insight into what it means to have that kind of — I guess authority is the word, and to have the ability to make decisions that can not only help people but also harm them.”
Katz later decided to specialize in immunology, after seriously considering focusing on infectious diseases. He said he was attracted both by the range of knowledge and by the challenging uncertainty that the specialty requires.
“You have to know something about multiple organ systems,” Katz said. “And with all due respect to the cardiologists and to the gastroenterologists of the world, I think that infectious disease physicians and immunologists/rheumatologists, like generalists, have to have an appreciation of the entire organism.
Katz continues, “I also think it’s comfort with ambiguity. It’s not a question of whether it’s malignant or it’s not. It’s a question of not always being certain what the diagnosis is. And maybe that incident with the patient at the VA hospital was part of that, but I think that you have to be comfortable with not being certain.”
The Course of a Career
Katz eventually became the chief operating officer of Georgetown University Medical Center, before being named the founding vice dean for faculty and clinical affairs at The Commonwealth Medical College in Scranton, PA., where he helped to launch that school’s first class in 2009. It was this experience that led to his selection by Rowan.
When Katz moved to Cooper, he inspired some of Commonwealth’s administrators to accompany him. Patricia Vanston, Cooper’s associate dean for program and business development, turned down what she said was a lucrative offer in private industry to follow Katz.
“The thing that really matters to me is working for someone who you respect. He’s really ethical and that’s really important for me and also he’s a big thinker,” Vanston said.
“At TCMC he always supported me when I had new ideas and encouraged me outside of the box. When he said he was leaving I said, ‘Gosh, I’d really like to go with you’ — because I think it really makes a difference who you work for in your career,” Vanston said.
Katz said he’s been pleased by the support the school has received, from “the man or woman on the street” to Gov. Chris Christie. At the same time, he has been struck by the enormous healthcare needs of the state’s poorest communities.
“When you think of New Jersey, you don’t think of people not having access to care,” Katz said, adding that within 15 minutes of his school’s location, “we could drive to a community that has great schools, is safe, has a low crime rate, and great access to healthcare. So what’s different, what happens in that 15-minute drive?”
Cooper University Hospital president and CEO John P. Sheridan Jr. said Katz is “all about getting the job done, but at the same time he has a very even keel personality that works well.”
He noted that Katz made an immediate impact in 2010.
“We had started with the Rowan faculty and the Cooper faculty doing the accreditation document ahead of Paul’s arrival,” putting in months of work, Sheridan said. “When he saw the work that we had done, we were anxious to have it filed right away. He said, ‘No, no, take a deep breath. We are going to look at this carefully.’ ”
Katz then made significant changes to both the curriculum and the school’s approach to teaching, Sheridan said.
Sheridan has also been impressed with Katz’s focus on Camden.
“He walks the walk,” Sheridan said. ” He not only talks this language, but he has implemented this approach in his philosophy into not only the curriculum but the whole essence of the medical school.”
Katz, an avid, eclectic reader, believes that all doctors should read “The Immortal Life of Henrietta Lacks,” by Rebecca Skloot. The book, which the Cooper class was required to read, describes how doctors treated an African-American patient whose cancer cells would be used in medical research.
“There’s a lot here about race and equity and personal rights, family education, so it’s a very rich book,” Katz said. “I think the biggest lesson is about understanding that patients are more than just their illness. There’s a lot there about dignity and respect and social circumstance that we need to be cognizant of. We need to be champions for our patients.”
Before this class starts its residencies in four years, Katz hopes that his students will have learned the lesson that he gained firsthand as a heart patient 15 years ago.
“When you’re in medicine, your family has a certain level of access that others don’t, and you don’t really appreciate the challenges of trying to get an appointment or understanding your prescription or not getting a callback,” he said.
“While I don’t wish for any of them to be sick, I do wish for them to have experienced what it means to be on the other side.”