- (female announcer) Production funding for Behind The Headlines is made possible in part by the WKNO Production Fund, The WKNO Endowment Fund, And by viewers like you, thank you.

- The new chancellor of UT Health Science Center tonight, on Behind the Headlines.

[intense orchestral music] I'm Eric Barnes at The Daily Memphian.

And thanks for joining us.

I am joining tonight by Dr. Peter Buckley, Chancellor of UTHSC.

Thanks for being here.

- It's a great privilege, Eric.

Thank you very much.

- Along with Bill Dries, reporter with The Daily Memphian.

We'll talk about all kinds of stuff today.

Everything with the campuses and the research and teaching and a lot that's going on, around on the campus and that whole Medical District area.

But I couldn't not start with COVID.

And I'm curious for you, you are a doctor, a psychiatrist by training.

- Yeah.

- Dean of what I think of as the med-school, but I'm sure it has a more fancy name than that at Virginia Commonwealth before you came to Memphis in February, I think you started.

COVID was obviously the impact on the healthcare system.

It was profound and on, you know, the country and the world, but when you look at it from the point of view of the university, what are the impacts and what are the ongoing impacts to student, to faculty, to everything?

- Yeah.

So, in an odd way, Eric, while the impact has been huge in many ways, this has been academic medicine's finest hour.

Because what we do is create science that translates into care.

And as you know, when the pandemic started, there was no clear pathway forward.

There was no scientific information available that could turn into treatments and academic medicine at institutions like ours created the science that led to the novel vaccines.

And then I'm very proud of here as well as the institution that I came from and really academic institutions around the country.

We did a lot of outreach and support of our communities and really lived up to our mission to be a resource to the community in terms of education, in terms of testing, setting up pop-up testing programs that happened in Memphis as well.

And then also helping as part of that in terms of helping vaccinations.

The other part of this that's very significant is of course our raison d'être is to train tomorrow's workforce.

And we know that this has a very challenging pandemic on the healthcare workforce.

In fact, we have a new term, the great resignation.

And so the work that we do in training tomorrow's workforce not only helped out in the pandemic, but also is helping now in the shortages that actually preceded the pandemic.

- Yeah.

I'm curious if you, I mean, I know just anecdotally, everything from when I went to get my most recent booster and the, the medical technician who gave it to me said, "Hey, are you hiring at The Daily Memphian?"

And he was kinda joking with me.

And I said, "Well, I don't know."

And he goes "Cause if you want a medical correspondent I'm ready to make a change."

And I said, "Has it just been that hard?"

And he said, "Yeah, it's been horrible."

And he's just burnt out, you know?

And you hear those stories from doctors, physicians from everybody.

Has that created, you talked about the shortages, but has it also created some hesitancy among people who want to enter the profession, who look at that and say, "Ooh, I don't know, I don't know I want to do that."

- So that's a fantastic question.

So, there's actually two sides to it.

There is clearly some concern and some hesitancy, but actually when you look at the information, the bigger picture is the opposite.

That there has been an increase.

So for instance, last year there was an 18% increase across the country, a number of people applying for medical school.

And so think about it.

People are at home, they're wondering what they'll do with their careers.

And they see the impact of science and medicine on their lives, on their families.

They see nurses, doctors, and other healthcare personnel as healthcare heroes.

And they see the altruism that comes with that.

And so actually overall there has been increased interest in our fields.

- Yeah, let me bring in Bill.

- So, what do you think the pandemic's impact has been on, on the university's other mission, and that is research.

Because I think what we were all reminded of, if we didn't know it already from really the history of medicine in our country, is that science in times of crisis is really put in the crucible when it's mixed with political decisions.

What's the impact been on the path of research and building research capability?

- So that's another fantastic question.

Firstly, I'm really proud of our science community and our research community.

They were called upon like any other people in our society.

They were called upon to kind of step down and step aside from day to day work, practice social distancing, and create a safe environment.

In many instances that required an enormous, really rapid shift from people who are working daily side by side in the lab and training tomorrow's researchers, to maintaining the lab, but also working in shift work from home.

And, an experience that we've had across the country that I think has also played out here is actually people have been very productive.

So they've been able to focus on their work.

Some of the best science, the papers that never got written up, 'cause they didn't have the time 'cause they were busy in the lab.

Some of the best science got done during this time period.

And then as I was saying earlier, we really showed our mettle.

So the ability of science to provide a beacon and a way forward, there were lots of great studies that were done at US institutions, including here that contributed to not only the vaccines, but also other immunoglobulin monoclonal antibody studies.

And so we kind of raised our game.

And then the other thing that we did, that's very interesting is we had to redesign a lot of our processes because a lot of things were done on Zoom and a lot of things were not in the same time frequency.

And so some of the ways that we conducted research, we found ways of doing it that were quicker than the normal, usual way and we've now inculcated some of those and that's helped us provide clinical trials to people as well as access to research opportunities.

So paradoxically, while it caused us to step back at the beginning, we're an incredibly resilient research community and I'm very proud of what America did.

America stepped up to the plate, took the challenge and led the world in showing how science can really improve life.

- How do you teach researchers, physicians, people in the healthcare profession in general, how do you teach them to weather some of the criticism or the controversy that we saw in, in dealing with basic science?

I mean, that I take it has been a part of the curriculum before this.

- It's always part of what we do.

And of course, medical ethics and societal ethics play into what we do.

And our beacon has to be the good for humanity and the broader good.

And then also, to be integral and high in our ethics of our research.

And so that's why just even as we were chatting about COVID, that's why we still, while we had a number of processes, we still had to practice the time honored efforts of ensuring that we got informed consent, that it was in no way coercive given the fact that somebody may have been in a more difficult situation with this pandemic.

It's always a challenge, but it's part of what we train people for.

It's part of, as you said, what's in our curriculum.

And then of course, we always obviously monitor each of our studies.

We have things called an institutional review board and that evaluates, first of all, whether the research could bring potential value and then also what are any potential risks or harm.

And then that is always evaluated on an ongoing basis through a clinical study.

- Talking about the university and the work there.

You mentioned that prior to COVID, there was a shortage of medical professionals.

- Yes.

- What is driving?

Is it, is it at all, I know there's been a nursing shortage, it feels like forever.

The physician shortage as well.

- Yeah.

- What is driving that and how is UT, the community of medical schools around the country, how is it adapting to that?

- So let me answer those six questions.

- Yeah, I know.

[laughs] Yeah, yeah, yeah.

But where did it start?

Let's let's start there.

The doctor shortage is a result of what?

- It's a result of the problems that we have.

So for instance, if you look at issues like obesity, we have about a 30% obesity, childhood obesity rate in this state.

We have very high rates of hypertension.

We've high rates of diabetes above the national rate.

We have very high rates of mental health.

And so there are, beyond even getting to the stage of looking at preventative care, just managing chronic conditions is a huge need in this state, in Memphis, and in America.

We pay, we spend 17.5% of our GDP on healthcare.

So there's a huge need.

There's longstanding shortages and so even though we train well over a hundred medical students here, every year we graduate a hundred or so medical students, across the country, there's still a fall short.

And of course we're not, we're also subject to the issues of the Baby Boomers to early retirement.

- Yeah, right.

- And we have estimates of somewhere between 120 and 150 shortage of doctors by 2030.

So these are longstanding shortages.

We also have shortages as a, as you indicated in nursing.

So there's a kind of a supply/demand issue.

- Yeah.

How much is, is a hundred?

That's fascinating to me.

So about a hundred future doctors graduating every year.

- Correct.

- The rise of nurse practitioners, physicians assistants, the kind of, I don't want to diminish that work, but it's between, it kind of fills a gap it seems like.

- Very much so.

It's very important.

- You're much more apt, if you got a cold you go to a, you're gonna more apt to see a nurse practitioner now, or physician's assistant.

Is that a result of this change?

And how is UT, how many of those folks is UT training?

- So we're fortunate as a health science university, we have five colleges.

And so we train all across the board.

We train nurses, we train respiratory technicians, a whole gambit of health professionals, including pharmacists, including doctors, and as I said, nurses.

And so the shortages are different in each areas, but they are chronic.

This year, actually, we graduated and it gave more degrees than any other year, just over a thousand degrees.

And so we are training a very substantial workforce and we train and retain about 70% overall of our healthcare professions within Tennessee.

- Retain, they end up working in Tennessee after they graduated.

- Exactly.

And that's really important because otherwise, although everybody has a choice where they work otherwise as a public institution, nothing against Alaska, but you wouldn't want us to be training the healthcare for Alaska.

We do well when we train and retain within the great, great state of Tennessee.

- Okay.

About 13 minutes left, Bill.

- So in your experience here in Memphis, a good deal of the city's business, so to speak, is healthcare, is the healthcare industry.

And we also have much need for healthcare services here.

Is that unusual for a community that has a medical school in it?

- No, actually we're very fortunate.

So first of all, we do indeed have many healthcare providers and facilities and they're actually excellent.

I'll mention just one, I shouldn't, I should mention everybody, but there's a place called St. Jude Research Hospital that is world renowned, and there's also other world renowned care being provided here.

We're part of the mix of that.

And so, we're fortunate that our doctors, our nurses, our colleagues that are in training, we have the opportunity to work and interdigitate with, with each of those facilities in Memphis.

And that provides a richness, both in terms of providing all the specialties and subspecialties that you might need, but it also provides a richness in terms of the training, because our trainees can get an experience in one great facility and in another great facility.

- In terms of the need for healthcare and the chronic healthcare problems that you've mentioned, is the Memphis community out-sized in that?

Or is it, are the problems here about the same in our population, as there are in other places where you've worked?

- So the problems are substantial.

I'm getting to understand whether they're more or less here, but they are substantial.

And they are very broad and they fall under a category of called social determinants of health.

And so it's not just a physical problem that you have.

It's interrelated with financial difficulties, with housing difficulties, with schooling difficulties, with learning difficulties.

And it's that whole amalgam that creates the kind of disparities in health that we see that are really very difficult and require institutions like ours to really reach out and be part of the community and work with the community.

I'm really very proud of how we have worked with the community to develop health hubs.

And that's where some of our trainees and our faculty have worked together with the community to provide basic information and support in healthy living, including healthy diet.

And that's been done with the support of the community that we're very proud when we get that opportunity.

- Dr. John McCullers, who's on the staff at UT and is also at Methodist Le Bonheur.

Yeah, has been on the show a number of times, during COVID he came on and, you know, tried to help explain the unknown a number of times and has been very available to the whole public here.

One time pre-COVID, I was at a presentation and I think he came on the show and talked about, to your point, about the holistic kind of approach, that Methodist Le Bonheur had developed a really extensive and really effective childhood asthma treatment program.

But, they kept sending the kids home and they come back and the asthma was back and they couldn't, no matter what they did at Le Bonheur, it wasn't really sticking.

They finally thought, well, we need to go into the homes.

And I'm gonna do a bad job explaining this, and obviously Dr. McCullers did better, but they found in the homes were huge problems with mold, huge problems, all the issues, the social determinants, the holistic approach.

So in your, and so they began to work with people to try to help those homes, and those kids then would stay healthier.

But that was a big shift, I think, into how healthcare professionals used to approach.

You come to your doctor's office, you get your medicine, you go home.

- Yes.

- That was the beginning, simplistically, the beginning and the end of the role of the medical profession.

That must, that has shifted dramatically I assume in the time you've been in this profession.

And again, like what you're talking about, how do you guys teach all these thousand graduates to embrace the fact that it's not just sitting in your office, it's not only sitting in your office and doing that, it's this holistic approach.

- So you, you couldn't be more correct, it has really shifted over the time period.

And then back to the beginning of our discussion, it's really been further propelled by our response to COVID because we got out into communities, we provided support in a very practical way.

And so the idea of our institution's been really in lockstep with the community and not being, as you said, somewhere that somebody goes for office-based care.

That our efforts and therefore our training is more community-based.

That's part of the direction that we're going in.

And I'm really proud, I really think Memphis offers great opportunities, both because of some of the disadvantage that we've mentioned, but also because of the altruism and the community support.

- Yeah.

- And you mentioned Le Bonheur Methodist, another amazing institution that is so anchored in this community, and that's the kind of ethos when our trainees get the experience to rotate around these hospitals, with that kind of nurses and doctors, that's inculcated into them as part of what they need to buy into as they do their further training and then as they practice.

- I think you and I met briefly, the first time we met was outside Church Health Center.

- That's right, yes.

- Dr. Scott Morris also been on the show, the show program.

Yeah, I mean an example of that.

We talk about the big changes in healthcare.

We're, I don't know, some 12 to 15 years since the Affordable Care Act, Obamacare has come in as the law of the land.

How, I mean we could do a whole show and many shows probably on the impacts, but just some of the biggest impacts you've seen from that, that change.

There's people who think it's done amazing work, people who think it was really terrible, but for you, how has it changed things?

- So I'm originally from Ireland and we have socialized medicine in Ireland.

So coming to America was a great kind of eye opener in a ways because we have the best healthcare in the world.

And sadly at times we have the worst healthcare in the world.

And of course the major overhaul that ended up being Obamacare was kind of an effort to try to bring that a little closer together, particularly in enabling more insurance and then greater access to care.

So I think that has been helpful.

Obviously, it's something that's highly political and comes back up again.

But overall, the importance of being able to give access and insurance and support to people, particularly the most disadvantaged sectors of our community, who not surprisingly are the ones that harbor the greatest risks and chronicity, that's a win when we can do that.

- About five minutes, Bill.

- So, let's talk about research capacity at the University of Tennessee Health Science Center.

Where is it currently, where do you want it to be?

- So I'm very proud that we, this past year passed our highest ever 126 million and a little more in change in research funding.

That's impressive.

And it's also been a steady growth over the years.

That provides the funding and the support to focus on both areas that we're strong in, as well as developing new areas.

We're always on the hunt, if you like, for more funding.

We do that in many ways, we compete nationally and compete well in terms of federal funding, but we're also supported and reliant quite frankly, on local and national support by foundations.

Another reason why I was proud to come to Memphis, there are fantastic foundations, and we've been very privileged to have some of our research supported by that.

And then another aspect that's really important is people being able to, that have the means and the interest, being able to support our work philanthropically.

And we find that over time, that's something that's increased over time.

Just before I came here, I was able to close a gift that was a $104 million for research back at Virginia Commonwealth University for a liver institute.

And so that kind of philanthropic support also goes a long way with the federal government when they're reviewing somebody's grant to say, "Oh, the community's got behind it as well."

So first of all, we never have enough money to do the research because it's an unending chart and commitment on our end.

And secondly, we like to have as many sources of funding as we can.

It gives us obviously both more money, but also a flexibility.

- The UT, which just a couple of minutes left, UTHSC has been, was one of the founding members I believe of the Memphis Medical District Collaborative, run by the late Tommy Pacello, in an effort to really transform that whole district from not just a destination where there were great universities and hospitals, and healthcare.

And everyone left, and it was a pretty grim surroundings and not a lot going on, not hard to even get lunch, let alone would you wanna live near there.

It has been slowly but steadily transformed.

Are you all, do you all remain a big partner in that?

And in that effort with, I think Methodist and some of the other hospitals have been very involved.

And if so, why?

- So a couple of points about that.

You're quite correct.

When you have that kind of engine within a region, you create economic development and there are an enviable number of companies, both device companies and biotech companies.

And we are still interested and involved in that.

I think quite frankly, with a great opportunity as we come out of COVID, but with our hospital partners, but also quite frankly, with our other higher education partners, I'm really delighted that we have new leadership in several areas.

I recently met with the very dynamic new president of University of Memphis who was part of that collaborative.

And I think you'll see, as we move forward, that we'll kind of reengage, now that we've got, we're at a different stage with COVID and we can literally come together again.

I think you'll see that energy and that momentum pick up again over time.

- The tie I was thinking, is that a VCU tie or a UT tie, or did you just get to keep the orange tie 'cause it kind of carries through?

- So, it's a fantastic question.

- That's why I asked.

- If you go back to Richmond where I came from, you can't find an orange tie.

I've brought them all up in advance of coming to Tennessee.

- Smart [laughs].

- Because I love the color and the brand of UT is fantastic and I'm very proud now to wear it.

- How has Memphis been?

You are obviously new to Memphis.

- Oh wonderful.

My wife and I, and we we've got a harlequin Great Dane called Harley and we've really enjoyed here.

We live right downtown, which is really fantastic, close to work.

And then also it enables us to really throw ourselves into the community.

Very welcoming and I'm getting used to testing barbecue.

So that's a lot of fun and the music is fantastic.

We went to the Beale Street Music Festival a couple of weeks ago.

Absolutely spectacular.

- You mentioned being from Ireland?

- Yeah.

- What, again, 30 seconds, what brought you to the United States?

- Opportunity.

It's the land of opportunity.

And I had the opportunity to come to Case Western Reserve, continue some of my research and work with some of the biggest figures in schizophrenia research in the world.

And again, I feel very privileged even to have this wonderful opportunity to serve Tennessee and serve Memphis.

Very, very excited about it.

By the way, I wanna say, tomorrow we have another great opportunity.

We are hosting the Irish Ambassador to America at our institution.

- Yeah, on Friday, this will air on Friday.

So that will happen by the time we've aired.

But that's right, the Irish ambassador.

- Yeah, excited for that.

- Well welcome to Memphis, thanks for coming on the show, appreciate it.

- My privilege, Eric.

- Thank you Bill, and thank you all for joining us.

Do join us all next week.

We've got coming up in the next few weeks, the Juvenile Court judge, Judge Dan Michael, we've recently had the mayor on.

We've had some other stuff coming up, so you can get all that at wkno.org, get past episodes or you can get the podcast The Daily Memphian site, iTunes, Spotify, wherever you get your podcasts.

Thanks, and we'll see you next week.

[intense orchestral music] [acoustic guitar chords]