The independent operator

Dr Victor Dzau will be the president of the United States National Academy of Sciences' Institute of Medicine from July 1.
PHOTO: The independent operator

Dr Victor Dzau will be the president of the United States National Academy of Sciences' Institute of Medicine from July 1.

The independent institute advises the US government, health-care industry and public on medicine, health and biomedical sciences.

Dr Dzau, 67, is also on public health-care group SingHealth's board of directors and was instrumental in setting up the Duke-NUS Graduate Medical School, where he is on the governing board.

Q: The New York Times has called the institute the country's "most esteemed and authoritative adviser on health and medicine issues". What do you intend to do as its head?

I would like the institute to continue to have a major impact on health and health care in the US and globally.

To identify critically important issues we should tackle, I'll be going on a "listening tour" in the US and globally to listen to clinicians, researchers, governments and the public to find out what they think are important issues that need to be addressed.

Q:You believe that Singapore should have its own version of the institute. Why?

One of the institute's strengths is its independence. That allows us to tackle areas that may be very politically sensitive. For example, the institute will have an upcoming report on end-of-life care, which is relevant to Singapore too.

The American government was not able to address this issue during the discussions on the (health-care law) Affordable Care Act. It was too politically charged, with politicians saying "death panels" would determine who gets medical care.

At the institute, we conduct in-depth studies and analysis of any significant topic by convening thought leaders and people from different walks of life with all specific expertise and interests. The report is extensively reviewed by external experts and revised to assure objectivity and balance.

So when the report is done, it's impeccable, and people will say it's not biased by one opinion, it's balanced and it makes for a strong recommendation. It's not coming from, say, only one source.

I don't think Singapore has an equivalent of the institute. The Ministry of Health does a lot of that work. In Singapore you have lots of really bright people, great universities, a great health system and ministry. The question is, how do you bring all this together in an independent manner?

Q: Singapore's hospital bed shortage had been in the news recently. What are your suggestions on how to fix this?

The solution right now is to create more bed capacity. But as you create more hospitals and beds, you will need more doctors. To address this, you can create more medical schools, but the next thing is, what about more nurses?

There is a real need for a strategy to expand the workforce, but in the long run this approach may be difficult to sustain. A long-term strategy is to redesign care models that use doctors, nurses and other providers more efficiently, use new technologies to reduce labour needs and engage patients, families and the community in care and health.

At Duke University, where I'm the chancellor for health affairs, we address community health by involving our school of the environment, the business school, the county's health department and the city government.

We use geospatial mapping to look at every individual patient in the city - we know where a person lives, his area's crime rate and socio-economic situation, the location of the closest barber, church, grocer. This helps us make decisions in planning care delivery and prevention.

For example, if we see a cluster of diabetics in one area, we can make interventions such as creating clinics, putting a healthier grocery store there, increasing education efforts to prevent disease. Singapore could do something like our project in its neighbourhoods.

Q: The institute issued a landmark Future Of Nursing report in 2010 to boost the profession's role in health care. The recommendations included funding for nurses to get higher education and expanding their job scope. Do you think these will help solve Singapore's nurse shortage?

I think Singapore needs to think about its nursing education. I know nursing is not a very attractive profession here. People say that their sons and daughters should be doctors if they want to go into health care, not nurses. That's the wrong way of thinking. I think we must emphasise that caring for patients takes teamwork, and nurses are a very important part of that. It should be like football, where you have 11 members and everyone is part of the team.

One way to make the profession more prestigious is to have programmes that make sure nurses get advanced degrees, get more educated, paid more, and are able to do more clinically. Our report recommends that 80 per cent of nurses have a baccalaureate degree by 2020. At least 10 per cent of nurses with such degrees should enrol in master's or doctoral programmes within five years of graduation.

Q: You were instrumental in setting up the Duke-NUS Graduate Medical School. Why was this important?

At Duke-NUS the students already have a bachelor's degree. They have more work and life experience. That helps them to come up with ideas and solutions based on their experiences.

It's also a second entry point for people to become doctors, if they are not sure earlier in life. Duke-NUS is somewhat different from, say, the National University of Singapore's Yong Loo Lin School of Medicine.

Now you're going to have a third medical school, and you get the chance to recalibrate again, learn what works, what doesn't. I think Singapore is approaching it exactly right; having a diversity of approaches is a good thing.

Q: How would you describe a typical work day?

I'm always in the office at 7am at the latest. I work to about 7pm, usually have a business dinner, get home around 9.30pm and go through my mail and e-mail until about 12.30am. I usually sleep about five hours. But I always make sure my Sundays and half of my Saturdays are free to spend time with family, play golf, exercise and go to the theatre and concerts.

Winding career path

As president of the United States National Academy of Sciences' Institute of Medicine, Dr Victor Dzau will advise the US Congress, government agencies, the White House and even the President of the United States for the next six years on health, medicine and biomedical science issues.

But when the phone call came to inform him of the appointment, he did not even have time to celebrate.

"I don't remember what I was doing," said the 67-year-old. "It was probably one of my work days. I don't think I celebrated."

The American has had a winding career path. Born in Shanghai, he moved with his family to Hong Kong when he was a toddler after the communists took over the mainland in 1950.

Another move, this time to Montreal, to Canada's McGill University to study biology, set him on the medical path. He received a medical degree from McGill and then did post-graduate training at Harvard Medical School in the US.

An eminent cardiovascular researcher and president of the US Duke University Health System, he was instrumental in helping to set up the Duke-NUS Graduate Medical School in 2005. The school took in its first students in 2007.

He was in Singapore last month for three days, to attend the graduation of Duke-NUS' fourth class of students as well as Duke-NUS and SingHealth board meetings and retreats.

"I tend to travel long distances, then stay a short time at each place so I can get a lot done," he said. He also visited Japan during the trip last month.

At least one of his two daughters is following in his footsteps. She received a master's in psychology but decided to go into medicine after working with autistic children. The 34-year-old is now an ophthalmologist.

His other daughter is a senior marketing manager at fashion house Salvatore Ferragamo. "My wife loves that," he said with a laugh.

This article was first published on June 15, 2014. Get a copy of The Straits Times or go to straitstimes.com for more stories.