Synergizing Resources
Ralph Snyderman, MD, HS’65-’67, is chancellor emeritus of Duke University and James B. Duke Distinguished Professor of Medicine. He was dean of the School of Medicine from 1989-1999 and chancellor for health affairs from 1989-2004. He currently serves as executive director of the Duke Center for Personalized Health Care.
What were your biggest priorities as chancellor and dean?
When I assumed the position of dean of the School of Medicine and chancellor for health affairs at Duke, I had little experience in large-scale academic administration. My first priority was to understand the complex organization and help it fulfill its potential to be a leading institution. The medical school was already outstanding, so my initial focus was to enhance the research enterprise and to better understand the opportunities and threats facing us. I hoped that during my tenure, Duke would obtain its full capabilities to provide national and international leadership in education, research, and clinical care.
What was your biggest challenge?
Early on, I realized that I needed to fully understand the medical center in all its complexity. I met with faculty, students, and employees in each department and began learning the institution’s operational and financial relationships. I learned that the economic viability of the medical center, and indeed the university, depended on the clinical performance of the faculty practice and hospital. The development of managed care and HMOs threatened the sustainability of the medical center. Addressing the rapidly changing clinical landscape became a high priority, since virtually all the other components depended upon our clinical operations. We needed to move from a specialty-driven clinical practice to one that enabled Duke to provide a full range of services to a large population. This required a major re-examination of our clinical structure and operations that ultimately led to the creation of the Duke University Health System, which positioned Duke as one of the nation’s most highly innovative and important academic health centers.
In research, it was important to enhance our basic sciences. We brought in outstanding new departmental chairs and raised funds to recruit dozens of high-potential research faculty, many of whom became prominent leaders in their fields. Our strength in clinical research allowed us, with the leadership of Dr. Robert Califf, to create the Duke Clinical Research Institute, the world’s largest academic clinical research institution.
Our School of Medicine was already highly innovative and outstanding. We
needed to enable the School of Nursing to evolve into a leading specialty training institution, to create a new Master of Health Sciences track to support an evolving clinical research landscape, and to develop an international presence with the Duke-NUS Medical School in Singapore.
Looking back, what is the thing you’re most proud of?
I am most proud that during my tenure Duke became one of the most highly recognized academic medical institutions in the world. In addition to the Duke University Health System, we created the Duke Clinical Research Institute, one of the largest academic biomedical research enterprises, a leading School of Medicine, an innovative and growing Graduate School of Nursing, and a satellite international School of Medicine in Singapore. New approaches to health care, including personalized/precision medicine, originated at Duke and are now prominent forces in health care delivery.
These accomplishments are due to the quality, energy, vision, and collaboration of so many who not only love Duke but are compelled to improve the health of all. The ability of many individuals and entities to come together for the good of the institution and society gives me great satisfaction and pride. I had the opportunity to work with many outstanding people and make lasting friendships that continue to sustain me. Together, we envisioned and created new models of education, research, clinical care, and approaches to better health for all. We were recognized as the place for innovation in medicine and health care. This heritage has continued to grow in magnitude and excellence.
What sets Duke apart, then and now?
Duke’s distinction is the same now as it was then: outstanding and dedicated individuals who are committed to excellence in all they do, who value innovation, and who truly love Duke. Our institution is unique in that it not only appreciates the contributions of each individual but also is guided by the higher principle of synergizing all its resources to improve health. Most academic institutions have three core missions: education, research, and clinical care. At Duke, we created an overarching mission: to apply the core missions to improve the health of all.
Story originally published in DukeMed Alumni News, Spring 2024.
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