Dean Johnson on Future of RU Medical Schools and of Health Care Itself

Lilo H. Stainton | February 24, 2020 | Health Care
Rutgers dean welcomes change at the university’s medical schools, sees health care evolving from focus on hospital beds to emphasis on social determinants of health
Credit: Rutgers New Jersey Medical School
Dean Robert L. Johnson

This is the second in a two-part profile of Robert L. Johnson, dean of Rutgers New Jersey Medical School and interim dean of the university’s Robert Wood Johnson Medical School. Read part one of the profile.

Rutgers University Dean Robert L. Johnson, 72, is an unabashed fan of change.

Johnson has led  Rutgers New Jersey Medical School in Newark for 15 years and was named interim dean at the university’s Robert Wood Johnson Medical School in New Brunswick in December, following the departure of the previous leader. This makes him the only person in history to lead two medical education programs at once; he is also one of a few African American medical school deans in America.

As part of this unique role, Johnson is now poised to guide the two massive organizations — home to close to 6,000 students, faculty and staff all told — through controversial and uncharted territories. These include an evolving collaboration with RWJBarnabas Health, one of New Jersey’s largest health care providers, and the potential merger of the Garden State’s two public medical schools.

The dean — an adolescent pediatrician who still sees patients several days a week and claims to actually enjoy learning new electronic health record systems — reflected on the challenges and opportunities these reforms present during a wide-ranging interview with NJ Spotlight earlier this month.

Crafting a complex clinical partnership

Johnson is particularly excited about the clinical partnership he helped design with RWJBarnabas that he said would offer new opportunities for students, create more effective and efficient primary-care models and bolster biomedical research at Rutgers.  The wide-ranging interview, signed in 2017, calls for RWJBarnabas to oversee the network of medical practices run by Rutgers doctors and invest in the university’s research and academic programs.

“I’m really pleased with it,” Johnson said. “It sort of fits with my personality. I don’t like to keep things the same,” he added.

In fact, Johnson said he has been working for years to establish this kind of partnership in the Newark area. “One of the things I know is that health care needs to be run more efficiently,” he explained. “And academic health centers have not been the best places to do that. We’re really good at research. We’re really good at teaching students. We’re good at taking care of some of the more unusual things people have. But in designing large health care systems that are efficient — and quite frankly make money — that’s not what we do.”

“The Barnabas system however does that really, really well,” Johnson continued. “So what will happen in this partnership is we will get the advantage of a great health care system as well as places for our students to learn medicine. And they will get the benefit of our academics and they will also contribute to research, especially clinical research. So I think it’s a good thing.”

The evolution and future of medical education are hot topics on the two campuses these days, for multiple reasons.  In pursing a possible merger, leaders at Rutgers Biomedical Health Sciences program — which oversees the two medical schools and a half-dozen other health-related colleges — have asked the university’s legislative body to endorse their quest for structural reform. Options include a controversial plan to combine NJMS and RWJMS as one school, accredited under a single name but with two “co-equal” campuses in Newark and New Brunswick. (The proposal remains under review.)

Man with a mission

Johnson said the goal of any dean is to grow their schools’ mission, educate students well, attract qualified new talent at all levels and support innovative research. Combining NJMS and RWJMS would give students more diverse classroom options and allow the two schools to pool their research dollars for more impact

“I think there are a number of good reasons to do that,” Johnson said. “From the standpoint of looking at research capacity and all those types of things, it’s better to have one school than two.”

BHS Chancellor Brian Strom made similar arguments in his recent pitch for reform to the executive committee. A faculty committee he appointed last year examined several scenarios, including maintaining two medical schools that collaborate and fully integrating the programs under one banner; both paths present opportunities for growth but also involve challenges, the group noted, including bridging what it said were vastly different cultures on the two campuses.

Johnson — who downplays his role as dual leader (“it sounds more daunting than it is…”) — said that NJMS and RWJMS now have similar missions to help the surrounding community and share a common pool of applicants. The two schools have already collaborated on several efforts, like the shared neurology department, he noted, and they are only 35 miles apart.

“Other than the fact that one is in New Brunswick and one is in Newark, I don’t think the cultures are all that different,” Johnson said. “Now I’m probably not the best person in the world to make these judgments because I’m the dean and people tell me what I want to hear,” he added, laughing.

Strom believes a merger would enable Rutgers medical schools to “leapfrog” other institutions and together become a more powerful entity than they are as separate institutions. But some faculty and staff have raised concerns about the process involved, which they said has been driven by the top and lacks transparency. Another fear is that consolidation would drain resources from Newark, including funding for University Hospital, the state’s only public acute-care facility and the sole level 1 trauma center in North Jersey.

Johnson agreed protecting health care in Newark was a very important aspect of any reform. He noted this was also at the front of people’s minds when the former University of Medicine and Dentistry in New Jersey, based in Newark, was dissolved in 2012 and its medical school was shifted to Rutgers. University Hospital depends heavily on doctors and students from NJMS to treat patients. (RWJMS has a similar relationship with Robert Wood Johnson Hospital, the teaching hospital in New Brunswick, which is part of the RWJBarnabas system.)

But Rutgers is already investing heavily in a new medical science building, expanding clinical practice and improving care at University Hospital, Johnson said, and he doesn’t see Newark as losing out under a reform. “No, I don’t think that’s going to happen,” he said. “But what I think is going to happen is we need to really carefully look at what is health care today. And that’s the thing that has to start changing.”

How health care is evolving

“Health care is not just going to the doctor’s office anymore. Health care is expanding and becoming greatly involved in the community,” Johnson continued, noting that many patients prefer to access care through an app on their phone than come into the office. “Health care is changing. It’s less hospital-bed focused and more focused on a large variety of ambulatory services that combine not only the direct delivery of care, but also have some connection to some of the social determinants” of health, like housing or education, he said.

“So that’s where we’re going in the future. And I think many people still measure the health of a community by how many hospital beds there are,” Johnson added. “But most people never go to the hospital,” he said. “You can have the hospital sitting in your community and you can feel good about it, but that’s not what is making you healthy.”

“The health of Newark is really more dependent upon transportation, the viability of supermarkets, the quality of the schools we have, the quality of the public water and all those things, more than University Hospital,” Johnson explained. Medical schools must better train students to treat the entire patient, not just their medical issues, he said, and this requires cultural competence and connections to social-service organizations.

“There is a part of the school that needs to do what schools always do and train people. There’s  a part of the school that needs to provide direct services,” Johnson said. “And there’s a part of the school that needs to be a public advocate for all these (other social) services.”

Luckily, Johnson feels that students today are eager to learn these skills and treat patients from diverse backgrounds. “I think they’re very, very smart. Much smarter than I ever was,” he said, laughing. “So I have a lot of hope for the future based on the students here.”