Episode Transcript
[00:00:14] Speaker A: Hi, everybody, and welcome to another edition of the Southern Fried Podcast, a production of the Arkansas Democrat Gazette. Really delighted to have as our guest on this edition the relatively new chancellor, not new to Little Rock, obviously, native Arkansan, but relatively new chancellor of the University of Arkansas for Medical Sciences, Dr. Lowery Barnes. Dr. Barnes, thank you for joining us this morning.
[00:00:40] Speaker B: Thank you, Rex. It's great to be with you.
[00:00:42] Speaker A: Yeah, it's great to have you.
So much going on, and I know we're going to 30 minutes is going to go fast. I'm going to have you back because I'm still going to have a ton of questions that I that I don't get to.
But I like to assume that I know you know so many people across the state, but I like to assume that there's some of our listeners out there who may not know.
So I'm going to let you give a little background first. You grew up in Pine Bluff. Like I said, you're in Arkansan. But did you know you wanted a medical career at a young age? Is that something that came to you fairly young?
[00:01:21] Speaker B: I really did. It's strange to think about it because nobody in my family had ever even gone to college before.
And when I was five or six, somehow I knew I wanted to be a doctor. My father was a newspaper man, but for some reason he would always stop at car wrecks and help. And a neighbor had a heart attack and he went over to help. So no training, but he always seemed to be there and would try to help. And I liked it. I liked everything about science growing up, and I was very lucky. I grew up in Palm Bluff, as you know, got to know you in high school.
[00:01:56] Speaker A: I was going to say, I was just thinking to say this we always talk about, but it's so true that Arkansas is such a small state, which is what I love about it. You mentioned your father was a newspaper man. One I worked for.
[00:02:11] Speaker B: There you go.
And in high school, I was working at the hospital, initially in the pharmacy, and then I worked as an orderly at Jefferson Regional 3 Southeast, and that's where the orthopedic patients were.
And I worked the 3 to 11 shift.
Back then they would have patients come in the night before surgery or they're going to have their hip or knee replaced.
And they sent me in to shave this man for his hip replacement to get him ready for surgery.
Well, needless to say, I had never shaved a man's leg. I nicked him of many, many places. Wow. And so Shorter was the nurse and the charge nurse. And she said, Boy, Dr. Blackwell's gonna kill you.
Banks Blackwell was the orthopedic surgeon who's gonna care for this man. So instead of getting off at 11 that night, I just stayed at the hospital and waited for Dr. Blackwell around this morning, the next morning. Oh, wow. And introduced myself to him and he said, well, let's go see what you did. And he came out and jokingly said, well, it looks like you started my operation. Why don't you come go the OR with me? So I watched him do a hip replacement. And I was, I knew from then on that's what you.
[00:03:18] Speaker A: Wow.
[00:03:19] Speaker B: No doubt about it. And Banks became a mentor. Actually paid for my medical school.
[00:03:24] Speaker A: Really?
[00:03:24] Speaker B: And it's very pretty. Incredible. My first tears of joy when I got in medical school. I got this letter that said, you've been awarded the Banks Blackwell Scholarship. And I got that scholarship letter eight semesters in a row.
[00:03:35] Speaker A: Wow. All starting with nicking a man as you shaved his leg.
[00:03:39] Speaker B: Yeah. Banks was an incredible person in that I went to him that night to thank him and he said, two rules. You can't tell anybody about this until I die. And try to do it for others in the future if you can. Something pretty special.
[00:03:51] Speaker A: Yeah.
[00:03:52] Speaker B: But anyway, so I graduated Pom Bluff High, went to Fayetteville to school and then went to UAMS for medical school.
Was lucky enough to match the orthopedic program there. Five year program.
And then went to Boston for a year. Went to Brigham, one of the Harvard hospitals. Specialized in hip and knee replacement and then always thought I'd come back and do academics, but it didn't really work out.
The chairman at the time, Carl Nelson, great surgeon, great man, but he wasn't really ready for a partner. And I was going to be like a resident for many years and then now. Didn't work well with my personality. So private practice, small group, but then merged bunch of groups together and formed Arkansas Specialty Orthopedics. I was the managing partner for 15 years or so and really enjoyed it. Had a great run, a lot of fun working in the community, working at St Vincent Hospital on their board and on their finance committee. And that's where I learned a lot about the business of healthcare. It worked out that there was not a. The chair position was open at uams and I had been working over there, volunteer and helping the residents, some with total joints because they didn't have a joint surgeon at the time. As it worked out, the dean, Rick Smith, reached out and asked me to meet with him and Offered me the chair position without a search, that he and the CEO and Chancellor had decided they'd like to offer me that position.
Well, we negotiated for a number of months, and I accepted, and it was a very fun run.
I was the 12th orthopedist at the time, and now we have over 50 in the group. Wow.
[00:05:30] Speaker A: I want to go back just a minute.
Dr. Barnes, folks. As being his usual humble self. I mean, he said he had some success in private practice. He became one of the top knee and hip people in the nation with patients from all over the country that would come here, headed national organizations. I mean, such a tremendous reputation.
And that's what I want to dig down a little more. Where you were just going, why give all that up to go back to academic medicine at the age that you decided to do so?
[00:06:07] Speaker B: It's a great question. I had always been doing research, and I'd been lecturing for 25 years at the time. I had.
I had lots of publications, probably close to 200 publications at that time. So I'd still been doing research and education, and I had. I loved my private practice, but I really thought, there's more to give back. As it's corny as it sounds, I really wanted to give back to this state that had been so good to me. And so going to the university and trying to build an apartment to something special meant a lot to me. And it was a great decision. Yeah. Literally, I was re energized. I had a new goal. I had great teammates, and I was excited to go to work every day.
[00:06:53] Speaker A: Yeah.
And you talk about how the department grew.
Talk about. Because a little over three years ago, opened the new hospital.
I went with you, toured it, walked all through it. I mean, what an addition for a state this size. Talk about that. The development of a separate hospital there for orthopedics.
[00:07:19] Speaker B: You bet. When I started, everybody knew that I wanted to build North Pittock Hospital.
Initially, they were telling me, we can't do that. And I said, pretty soon, you won't have any choice because we will grow this department.
[00:07:31] Speaker A: So we handle the patients.
[00:07:33] Speaker B: Exactly.
[00:07:33] Speaker A: Yeah.
[00:07:33] Speaker B: And that's what happened. And so we were fortunate enough to get to build. This was our pride and joy. Paul Stover, our administrative leader at the time, and I worked so closely together to build that he. He knew everything about that building. For me, it was a few things. As much glass as possible, no pink brick, because all the brick at UMS looks the same.
[00:07:56] Speaker A: Oh, it's a gorgeous building. Anybody who drives down 630, you see it, of course.
[00:07:59] Speaker B: Right.
[00:08:00] Speaker A: And I said, and the lighting on it at night.
[00:08:02] Speaker B: Thank you. That was important to have interstate presence, to have a name there, and. But it had to be a great place for patients and a great place for surgeons to work. And it is. It's really about the culture, not the building. And if you come in that building, everybody speaks to you, everybody takes care of you. It's a very, very special place. And now we've developed something called Ortho now, so that we have an urgent care center available on the first floor during each weekday and on Saturday morning. And that's just been a real addition for patients.
[00:08:33] Speaker A: Yeah. Before we move on to UAMS as a whole, let's stay with Orthopedics for a minute.
Tell our listeners all that's going on in Northwest Arkansas right now.
[00:08:44] Speaker B: Yeah, it's great. We. Soon after becoming chair of Orthopedics, we started developing our Northwest Arkansas group.
So we have a number of docs up there now, 11 or 12, 13 orthopedic surgeons and primary care sports medicine docs. We do take care of the Razorbacks and a ton of high school athletes in the area.
And we're building another hospital there that'll open next year, and we're excited about that. It's going to be another great design.
This one is designed by Marlon Blackwell. We have another healthcare architect working with him, just like at Tosh. But Marlon's done some amazing work up there in the Northwest Arkansas area, and this one is going to be very special.
Yeah.
[00:09:31] Speaker A: All right, next step we'll get to now. So you develop all of this in Orthopedics when the chancellor's position becomes open.
Last year, you become the interim chancellor, but not that typical interim who just fills the seat and keeps it warm until somebody can be hired.
You hit the ground running, making changes, and make clear from the start you would love the permanent position of chancellor.
And I have to say, that is at an age when many doctors are retiring or considering retirement now, don't be
[00:10:16] Speaker B: reminding me how old I am.
[00:10:18] Speaker A: Well, we're the same age, so I'm allowed to do that.
Yeah.
[00:10:21] Speaker B: Believe me, people thought, what are you doing? I'm 66. I've got a lot of friends who are stepping back. And again, it just seemed like the right thing to do. I have realized that I really thought there was much more ums could do for our state, and I thought, there's much more that could be done out of that position than what I could do out of my current position as chair.
And at the time, I didn't know if I'd be considered for the permanent role because there was some thought that if you're the interim, you wouldn't be considered for the permanent role. And so I was talking to the president of the system and Jay Silveria, and I said. He said, are you sure you want to do that? Because you might want to be permanent chair? And I said, I might be, but, you know, I don't know if I like it.
[00:11:05] Speaker A: Right.
[00:11:05] Speaker B: So. Right, yeah. I'll take my chances. And if I do a good job, maybe the board would decide that it's okay to be interim and move forward.
So worked it out that I came into that role and quickly realized that we had an incredible senior leadership team.
They were ready to get things done, and they really just started doing everything, and I just had to try to stay out of their way.
[00:11:28] Speaker A: Well, like I said, you did hit the ground running because I kept up with all that's going on.
Talk about since both interim and the permanent position now, over the last year or so, some of the major new initiatives that we've seen at uams.
[00:11:44] Speaker B: Sure. I'd say the most significant one is a very much transparent approach to leadership.
Folks know what's going on at uams. They get routine emails from me. I share the finances of the month with 12,500 employees every month.
[00:11:59] Speaker A: Yeah.
[00:12:00] Speaker B: And that's significant because people want to know how we're doing when we're making decisions. It helps if they know how we're doing financially and how some of those decisions may be affected by where we are financially.
It's been fun, too, because the ship has turned and that we're in the black now. For the three years prior to my coming in, we had lost $100 million. Wow. I'm glad to say that we're no longer losing money.
I'll also tell you it wasn't because I came in. There was a timing issue there. You know, it's important when to come in as a leader. Right?
[00:12:34] Speaker A: Exactly. Exactly.
[00:12:35] Speaker B: I was very fortunate, but really good things have happened. Amanda George, our cfo, now delivers our previous month's financial report on the fifth business day of the next month.
Amazing. No other health system that I know of does that.
And all it took was a little nudging that you can do this. And she and her team have been absolutely incredible. And that helps us so much as we plan and see where we are.
We're also doing something called UAMS Cares, and that's an approach where we're Looking at how we improve, how we treat patients and how we treat each other.
I talked about the Orthopedic and spine hospital we finally refer to as tosh, and the culture there.
That's the kind of culture we want all across UAMs, not just in clinical care, but in research and education and across all our regional programs across the state.
[00:13:32] Speaker A: Yeah, I've got to interrupt here because this is an example of how Dr. Barnes thinks outside the box. So my phone rings a few weeks ago and I have written a lot about the amazing things that have gone on in Wilson, Arkansas, through the years. Become friends with Tom Smith up there. And it's my friend Tom Smith, and he's so excited. We've got this new partnership with uamas and I said I'd love to write about it, especially if you put me up at the Lewis Hotel for the night.
Love that place.
[00:14:09] Speaker B: Yeah, it's special.
[00:14:10] Speaker A: I said I'd really love to write about it, but I wanted to get on that one because it's such an example, thinking outside the box, a hospitality initiative.
You know, you're coming in for surgery, you're not going to a resort spa, but you want to make it feel as close to that as you can. Obviously, doing these kind of partnerships and training your staff.
[00:14:32] Speaker B: Absolutely. So much about communication and looking for those things where you can go a little above and beyond.
[00:14:40] Speaker A: I think that's fascinating.
[00:14:41] Speaker B: We can all learn from it to
[00:14:42] Speaker A: make it as pleasant as possible when you're at the hospital.
[00:14:45] Speaker B: Yeah.
So we're working with them.
We're basing a lot of what we do on the book Unreasonable Hospitality by Will Guidera. It's part of a book club that Stephanie Gardner, our provost, works runs. She had that book soon after my coming as interim because she thought I would like it and indeed I did.
And Will describes in that book about the hot dog story and that's he took a restaurant in New York, five star, made it a five star Michelin restaurant. And much it was based upon service, not just the food and trying to go the extra yard. So the hot dog story was that he heard a. One of his servers heard a family talking at dinner saying that one of the things they did not get to do was they didn't get a hot dog from one of the street vendors. And that's one of the things they wanted to do.
[00:15:33] Speaker A: You got to do that in New York.
[00:15:34] Speaker B: Yeah, the server heard that.
And a few minutes later, somebody else had run down and gotten a hot dog down the street and delivered under a silver Cover at their dinner table.
[00:15:44] Speaker A: Oh, how neat.
[00:15:45] Speaker B: So big impact.
[00:15:46] Speaker A: Yeah. Above and beyond.
[00:15:47] Speaker B: Similar story.
Our nursing team had one of the heard one of the patients talking about she was really upset because she had to spend Easter Sunday in the hospital and how important Easter was for her because she wanted to hunt eggs with her grandchildren.
That team put together an Easter egg hunt and surprised her and had her grandchildren there for an Easter egg hunt on that Sunday.
[00:16:09] Speaker A: Oh, wow.
[00:16:10] Speaker B: Those are little things we can do.
[00:16:11] Speaker A: Yeah.
[00:16:12] Speaker B: But you know, it's also about safety and quality. And we had Jim Merlino here last week from the Cleveland Clinic and now Jim Joint Commission.
And he was, he wrote a book also called Service Fanatics about his experience at Cleveland Clinic.
And you know, the discussion was a lot about around. It's not just being nice, it's making people feel special because you're giving them the best care you can give them in a safe environment and treating them the way they ought to be treated.
[00:16:37] Speaker A: Yeah, yeah. So you're not just treating them as a patient, but you're treating them like a five star hotel would treat a customer.
[00:16:44] Speaker B: We certainly want to and we want to be the friendliest health care system in the region.
[00:16:51] Speaker A: Switching gears just a minute.
I travel the state a lot. I write, as you know, a lot about rural Arkansas.
We all know that our rural hospitals are in trouble.
Camden's already filed for bankruptcy. There's, you know, you've seen reports as many as half of our rural hospitals could close in the next few years. We've got large swaths of the state that are losing population.
I would have to think that that scenario puts a lot of pressure on UAMs as the state's premier flagship medical institution.
[00:17:34] Speaker B: No doubt it does.
We take referrals from so many hospitals and transfer.
The numbers are staggering. A year ago we accepted 2,600 patients and transfer from other hospitals. The team set a goal to try to get to 3,000 this year. We eclipsed 4,000 last Friday.
[00:17:54] Speaker A: Wow.
[00:17:54] Speaker B: With a couple of weeks to go in the fiscal year.
[00:17:57] Speaker A: Yeah, yeah.
[00:17:58] Speaker B: The challenge is there were still a few thousand we could not accept.
We just a capacity issue. So we know we have to get bigger. We have, we need to have more bed capacity because we need to be able to help these rural hospitals and we're going to help them in lots of ways.
We talk to them regularly. We had hospital reached out yesterday, first time I'd heard from them. But I've heard from many, many of our rural hospitals and what can UAMS do to partner with us and so we're looking at a number of those things. It's very important that patients can get care close to home for the things that can be treated there. And we want to be part of that mission to do that and make it available.
[00:18:38] Speaker A: Yeah, yeah. And again, I think a lot of Arkansans, especially those of us here in central Arkansas, you think of UAMS as that big campus that you see from Interstate 630, but you've got employees and facilities all over the state of Arkansas. People should realize.
[00:18:56] Speaker B: We certainly do. Years ago, we were one of the first in the country, developed AHECs, or area health Education Centers, and those have transitioned some into regional programs. But we. We train residents there, primary care residents who hopefully practice in the community.
One of my early visits was to Pine Bluff and our program there, of course, can't imagine why. It was my first one.
[00:19:20] Speaker A: Exactly, exactly.
[00:19:21] Speaker B: And it was fun to go back. Went to the high school and did a bunch of the community things and also had a town hall. And it was there that I learned that there are 115 doctors per practicing in southeast Arkansas now who trained at the regional program that UAMS has in Pine Bluff.
[00:19:41] Speaker A: 115. Wow.
[00:19:42] Speaker B: So if you think we have a physician desert now in that area, think what it would be without the influence of uams.
[00:19:50] Speaker A: Absolutely.
[00:19:51] Speaker B: So we. We understand that we are the workforce development institution for our state when it comes to healthcare, whether it be physician, Pennsylvania pharmacist, nursing, dietitian, dental hygienist. That's what we do. Oftentimes, folks think about us as place where you get care. And the med school, we are so much more than the med school. We have six colleges, and the College of Medicine is not even our biggest college. It's the College of Health Professions.
[00:20:22] Speaker A: Yeah. Yeah.
I'll give you one example of that. As you know, I spent four years with the Delta Regional Authority, and here in Arkansas, we worked very closely with those Delta hacks that you're talking about. But during that period, UAMS partnered with the Helena Howe foundation to build that new facility there.
And I tell people, like you said, it's so much more than taking care of six folks. They built an entire fitness club there, an indoor walking track that is basically the fitness facility for that whole part of East Arkansas.
That's just another example of what you do on the preventive side.
[00:21:07] Speaker B: You bet. It's about health and wellness, not just taking care of the sick.
[00:21:10] Speaker A: Right, right. Absolutely.
[00:21:12] Speaker B: All right.
[00:21:13] Speaker A: Before. Because we're going to start running out of time, and I knew we would talk about what you see happening, where you would like to go with the institution, let's say in the next three to five years.
[00:21:27] Speaker B: Great. We're working on our strategic plan now. It's called Aspire 2033, our seven year plan. And your question's a good one. We will have very defined goals which are also consistent with our UA system strategic plan. But we know we have to grow our clinical enterprise.
Healthcare is tough business, right?
[00:21:48] Speaker A: Really?
[00:21:48] Speaker B: Margins are very low.
[00:21:50] Speaker A: Yeah.
[00:21:50] Speaker B: We have to have a denominator big enough that if we're making one and a half percent margin that can pay for what we need to do in research and education.
Research and education are so important to who we are.
They don't, they can't pay for themselves. We can't charge enough to students because their tuition would just be too expensive. So we know financially we have to make up for that. We don't consider that a loser. We, we consider it our mission. And so we're gonna pay for it through our clinical enterprise growth. So you'll see that we'll be announcing growth initiatives both organically on our campus, but also partnering with other institutions and having a bigger footprint in not only central Arkansas, but across the state.
[00:22:35] Speaker A: Yeah, it is, really.
And I like writing big picture stories about Arkansas. It's an exciting time when you combine what's going on with everything that's going on in northwest Arkansas.
Central Arkansas, around Little Rock is doing well economically right now. You get the steel boom in the Northeast, you got lithium defense down in the Southwest. So you've got some quarters of big things and love writing about them because it is exciting for our native state.
But at the same time, you've got large swaths of rural Arkansas that are losing population, that are not only becoming less populated, but more poor, like I said, may be losing their hospitals. So it's also a story of kind of two states within a state right now.
And as the, again, the flagship statewide medical institution. You've got to bridge that gap, can't you? You can't just be doing business where Central Arkansas, northwest Arkansas, where it's growing.
[00:23:42] Speaker B: No doubt about it. And you know, I think if you talk to Randy Zuck, the president of the state Chamber of Commerce, he'd tell you how important health care is.
[00:23:49] Speaker A: Oh, absolutely.
[00:23:51] Speaker B: Industry. That looks.
[00:23:52] Speaker A: They're going to ask about that. Yep.
[00:23:53] Speaker B: So we have to be in that picture. We have to make sure that we are supplying the workforce for our state, that it is an economic engine. Not only the health care being an economic Engine, which it is, but it encourages other companies to come to our state because they can get great health care.
And we have to make sure that we can get great health care across our state, whether in a metropolitan area or a small rural community. We can't expect to do everything in small hospitals, but we ought to be able to do the basics very well.
[00:24:27] Speaker A: In recent years, we have seen, first we saw, outside of uams, two osteopathic schools of medicine that were developed in the state, one in Fort Smith, one in Jonesboro. We saw, a year ago, I was up there on the day that the students reported the Alice Walton School of Medicine open in Bentonville. We have seen Lyon College open, this first dental school in the state here in Little Rock.
Do you see those institutions as complementary rather than competition?
[00:25:03] Speaker B: Yeah, it raises the tide. Right. So all boats rise and everybody has good ties.
[00:25:09] Speaker A: Just curious. Yeah.
[00:25:10] Speaker B: So a decade ago, there's one medical school. Now there are four. And I was there. The students reported at Alice's school as well.
[00:25:18] Speaker A: Yeah.
[00:25:18] Speaker B: And a lot of excitement. But you know what? Everybody gets better. Right.
And you see that now there are more scholarships for kids to go to medical school. And the other schools we started the Chancellor scholarship program. We have 40 full ride scholarships now for not just medical students, but for others that's as well.
[00:25:39] Speaker A: Yeah.
[00:25:39] Speaker B: So those. Those things will get better and better in all areas. And we're working with the awesome school of Medicine as well.
I think their students would rotate with us and do some research with us, most likely. So we have a good relationship.
[00:25:57] Speaker A: Good, good.
I was hoping that would be because I, you know, again, especially going back to my Delta Regional Authority days, I know the great need that we still have out there in Arkansas. And we've got to. If we're going to move forward as a state overall, we've got to meet that need for doctors, for dentists, for specialists, for everybody in the healthcare industry in all 75 counties of the state right now.
[00:26:24] Speaker B: No doubt about it. And in what you do, you may learn of needs faster than we do.
You have to know you can pick up the phone and call us and give us the area that we need to be helping with. And we. We take it very seriously. And we have a team who's dedicated to doing what we can for this state.
[00:26:42] Speaker A: Yeah. Yeah. So we have run out of time, as I knew we would.
I do want to ask, because I know how driven you are, and it's. Anybody who sits down like this and talks to you realizes it.
Do you have something I Mean, not literally say out loud, but when you wake up in each morning, something along the lines of, you know, how am I going to make UAMS better today? How am I going to make Arkansas today? What drives you still at age 66?
[00:27:15] Speaker B: That's so funny because people often ask me what keeps you up at night? Yeah, absolutely nothing keeps me up because.
[00:27:23] Speaker A: Oh, me neither. My wife says I go to sleep way too fast and I said when I really become elderly I'm probably going to have insomnia. Just for you saying that drive you cross.
[00:27:34] Speaker B: But when I go to bed, I feel like I've done everything I can possibly do that day. So I have no problem going to sleep. My problem is I wake up early anyway. My clock set for 4:09. It's been that way for 20 something years.
[00:27:45] Speaker A: Wow.
[00:27:46] Speaker B: But it's rare that I hear my alarm clock go off. I'm usually waking up an hour or two earlier than that, unfortunately, oftentimes because I need to go to the bathroom like men our age. But once I do, I can't go back to sleep because I'm so excited about what we have to do for the day. So I get up and my team is glad that I've learned how to send delayed send on text messages and emails. So they're not getting them at 3:30 in the morning.
[00:28:07] Speaker A: Exactly.
[00:28:08] Speaker B: But it's so I'm excited about what we do and I do every day. It's what are we gonna do today to make the institution or the state better or both?
[00:28:16] Speaker A: Yeah, yeah. Well, it's exciting times. Like I said, so much going on in our state and UAMS is right at the forefront because again I mentioned that term flagship healthcare organization. But let's never forget, with the thousands you employ and the tens of millions that you spend, UAMS is also one of the top economic engines in the state of Arkansas.
[00:28:45] Speaker B: No doubt about it. Yeah.
[00:28:46] Speaker A: Dr. Lowry Barnes, Chancellor of UAMS. Dr. Barnes, love to have you back soon.
[00:28:51] Speaker B: Love to do it, Rex, thank you very much.
[00:28:53] Speaker A: All right, thank you for joining us for another edition of the Southern Fried Podcast, a production of the Arkansas Democrat Gazette.
