Of Multitasking and Medicine
As the University of Utah’s health care chief, Vivian S. Lee relishes balancing her many roles.
Dr. Vivian S. Lee doesn’t use an alarm clock. She wakes up on her own around 6:30 a.m. and grabs her laptop. Balancing it on the stationary handles of her stair stepper, she answers email as she tries to ignore that she is exercising. She and her husband, Benedict Kingsbury, an international law professor at New York University and a visiting law professor at the University of Utah, then get their four daughters ready for school. That “mostly entails making sure their teeth are brushed and they have suitable (sort-of matching) clothes,” as well as putting together four meals for breakfast and four “reasonably health-packed” lunches, she says. (She has no full-time domestic help, but relies on a couple of babysitters.) After a day of back-to-back meetings at the U, she returns home, and she and her family sit down for a dinner Lee prepared over the weekend and pulls out of the freezer. Then she reads bedtime stories to the children and tucks them in for the night. It’s “just one day in the life of the SVP,” says Lee in a blog she also finds time to write almost weekly for the University of Utah’s Health Sciences.
“SVP” refers to her job as the U’s senior vice president of Health Sciences, one role in her triple title that also includes chief executive officer of University of Utah Health Care and dean of the School of Medicine. Any one aspect of her life and work could be overwhelming. But Lee delights in the hectic pace of bringing change to the nation’s health care industry. She smiles at the intricate challenges she is tackling as a leader of a $2.4 billion integrated health sciences system, and she revels in figuring out what she sees as puzzles waiting to be solved.
“I’m taking it on step by step,” says Lee, who came to the University of Utah in the summer of 2011. “I don’t feel overwhelmed. There’s a phased pattern to it. You can’t change everything at once. There’s some foundational work that first has to be done before you bring in the next level. There is a logic to it and kind of a flow—even though it does feel like a lot sometimes.”
In her job at the U, she oversees a health care system of four hospitals, multiple specialty centers including the John Moran Eye Center, a network of 10 community clinics, more than 1,400 board certified physicians, and five colleges, including the School of Medicine, the colleges of Nursing, Pharmacy, and Health, and beginning this year, the School of Dentistry—the first new academic dental school in the nation in more than 25 years. “We’re all thinking together, ‘How do we create the best academic health care system in the country?’ ” she says.
She already has achieved several hefty goals since her arrival at the U. The School of Dentistry enrolled its first cohort of students this fall and named its first permanent dean. The U also has a new dean of the College of Nursing, and Lee recruited from Harvard University a new chair of the Department of Surgery. More students will be able to enroll in the School of Medicine, thanks to a law the governor signed in June that expands the school’s class size from 82 to 122 students by 2015. And the College of Pharmacy dedicated the $75 million L.S. Skaggs Pharmacy Institute in April.
Dr. Dean Y. Li, associate vice president for research and chief scientific officer for University Health Care, attributes Lee’s success to “energy, vision, excellence, and what we call B-HAG—Big Hairy Audacious Goals. Skin in the game. She’s willing to work harder at what you’re supposed to be doing.” Li says he often finds himself communicating with Lee by email at 2 in the morning. “She’s a little crazy. Right? I mean, she has how many kids and all of this. But she just wants to move, move, move.”
Lee grew up in Norman, Oklahoma. Her parents, both faculty members at the University of Oklahoma, showed her that any challenge can be overcome and anything is possible. They had immigrated from China when they were graduate students, both coming to Berkeley, California, in the early 1960s “with just a few dollars in their pockets,” Lee says, and to this day, “refuse to retire.” Her father is a professor of electrical engineering, while her mother, a former dean of Oklahoma’s School of Public Health, teaches statistics and epidemiology.
Lee was born in New Jersey, where her parents were working at Bell Laboratories. Following Chinese tradition, her grandparents bestowed her with her middle name, Shu-Ching. “It comes from a Chinese poem, and alludes to the clarity and light of the moon,” she says.
During those years after her family moved to Oklahoma, her childhood was also filled with lots of Americana. She admittedly watched a “boatload of TV” as a child and was raised on “that whole afternoon rundown of Gilligan’s Island and Brady Bunch and Star Trek,” she says. While she and her younger sister were expected to do well in school, her mother and father were “not pushy parents by any means,” Lee recollects. “They really let me do what I wanted to do. I had a carefree childhood, pretty unstructured.”
As a young student in Norman’s public schools, Lee was already interested in science and math. “Much to the credit of my parents, I was never told that there was any reason why I shouldn’t, and so I was completely oblivious to gender biases and those kinds of things,” she says. “I think sometimes kids might be told or have the sense that they can’t do things, and I was just never told that.”
Her parents encouraged her to explore. “I think I am internally motivated, and I attribute that to my parents just letting me do whatever I wanted to do, and then eventually I got really interested in some more serious things,” she says.
Starting in seventh grade, at the request of one of her teachers, her parents also shuttled her to Norman Regional Hospital, where she spent her Saturday mornings shadowing a local doctor, Hal Belknap, on rounds. Lee now credits Belknap with not only sparking her interest in medicine but for showing her the importance of connecting with others, whether treating patients or leading organizations.
After high school, Lee attended Harvard-Radcliffe College and graduated at age 19. She applied for—and won—a Rhodes Scholarship and went on to Oxford University, where she met her future husband, and graduated with her doctorate in medical engineering at age 22. Three years later, she completed her medical doctorate from Harvard Medical School.
At 30, she finished her residency in diagnostic radiology at Duke University. At 39, she completed an MBA at New York University’s Stern School of Business while working at NYU and after giving birth to her third daughter. That year, she was among Crain’s New York Business magazine’s “40 under 40: New York’s Rising Stars.”
In New York, where she and her family made their home for 14 years, they spent weekends bicycling around Manhattan and visiting the city’s museums, zoos, and aquariums, while she spent her days helping scientists advance their work as well as investigating new models for understanding health care delivery in her job as inaugural vice dean for science, senior vice president, and chief scientific officer at New York University’s Langone Medical Center. Her own scientific career also advanced as she became a leader in magnetic resonance imaging, with multiple grants from the National Institutes of Health and a flourishing lab. She also wrote a textbook. “I was very happy,” she says. “I was not looking at all.”
But a few things kept needling her. Not only was she impressed by the University of Utah’s reputation as a leader in genetics research and by the work of Nobel Prize-winner Mario Capecchi, she was keenly aware of U Health Care’s No. 1 ranking in 2010 by the University HealthSystem Consortium for quality and accountability in patient care, above “the likes of Hopkins and Stanford,” she says. The same year that the University of Utah topped the list, NYU was ranked No. 10, the only New York academic medical center to make the top 10. “We were very proud of it. I saw that list frequently. Our PR guys really drove that home throughout the city,” Lee says with a laugh. “And every time I saw the list, the University of Utah was No. 1.” At the same time, she had been learning about Intermountain Health Care. “Between the University and Intermountain, Salt Lake City seemed like a place really pushing the envelope of health care,” says Lee.
She had those “data points” in mind when headhunters from the U came calling. They didn’t have to do much convincing.
Lee was especially lured by the opportunity to lead an integrated medical center, in which the academic, research, and clinical sides all report through her office. Only about a dozen academic medical centers in the nation are structured that way, even though, Lee says, such integration brings opportunity for synergy and partnership across the entire health sciences system. She sees that integration as the key to broader health care reform, by focusing efforts on improving the quality of patient care while reining in costs.
Dr. Darrell Kirch, president of the Association of American Medical Colleges, was one of the health care leaders who encouraged Lee to consider the job at the U. “[She] is well suited to transform medical education, research, and patient care—both at the University of Utah and on the national stage,” he says. “Vivian embodies the vision of leadership we need across academic medicine. In a word, she is a ‘multiplier’ who increases the potential of those around her to solve our health care system’s most pressing challenges.”
Once in Utah, Lee was awed by the state’s beauty. “Plus, I was struck by the people I met and by the culture here—the sort of attitude that ‘Well, we can do it. If you’ve got some good ideas, we’ll figure out a way to get it done.’ ” She has plenty of ideas on her list. “I am often asked what has surprised me the most about the job, and one of them is simply just how much opportunity there really is here,” Lee says.
At present, she has in mind three main endeavors for the U’s health care system. She and her team are focused on leading the transformation of academic health care, which includes strategically and innovatively changing health care delivery, advancing science and discovery, and training professionals for a changing future. Success will depend on maximizing the integration of the University’s research, educational, and clinical strengths, she says. She aims to further the Utah Genome Project, which was launched in 2012 to investigate the genetic signatures of diseases and drug responses in large families and which has the potential to transform personalized medicine and accelerate drug discovery. And she wants to expand the U’s Center for Medical Innovation, which encourages invention by students and faculty.
Lee also sees advantages in collaboration between health sciences and the broader University. For example, faculty members at the U’s David Eccles School of Business are “partnering with us to train our faculty and administrative staff in principles of lean management and continuous quality improvement for our hospitals, clinics, and academic departments,” she says. Students and faculty members also are working with colleagues in engineering, physics, and computer science, among others, to develop better technologies, including devices and software. “I love the energy that comes from teams of people working together to come up with ideas that are better than the sum of the parts,” she says.
In preparing the U for reforms mandated under the federal Affordable Care Act, which takes effect next year, Lee and her team are developing new infrastructure, information technology tools, and methods of delivery. Her efforts to help the U increase the Medical School’s class size this year in part were aimed at addressing the physician shortage in Utah, as the demand for health care will only grow under the new federal law. Lee expects the University of Utah to emerge as a model for the country as health care systems evolve to focus on high-quality, low-cost, and patient-centered accessible care.
“She’s willing to let people try new things, and she’s very engaged in trying to look at the health care system and bring us through these times of challenge and transition,” says Dr. Carrie Byington, vice dean of Academic Affairs, whose position was created by Lee after she recognized the need for faculty to develop cross-skills in research, education, and clinical care. Dr. Sean Mulvihill, CEO of the University of Utah Medical Group, says Lee is willing to raise fundamental questions. “She’s not afraid to ask, ‘What should we look like? What’s our role in health care delivery? What’s our role in science and discovery, in medicine, and how can we make the most contribution?’ ”
Associate vice president Li, in the School of Medicine, says it’s a responsibility that Lee takes on at “all hours of the day and all hours of the night,” and he notes that “the hand she was dealt is actually perfect for her personality.”
Lee says her plan is to keep forging ahead. That means fixing those meals for her family and taking her children hiking, biking, and skiing. It also means delivering health care in a timely and cost-effective way, working on new models to transform the industry, and leading an integrated health sciences system into the future.
“My typical day? No such thing,” she says. “Right now, I just want to help move us forward each day so that we can make the contributions to patients and to society that we are so well suited and well positioned to make.”
—Kim M. Horiuchi is an associate editor of Continuum.