HJAR Sep/Oct 2022

DIALOGUE 16 SEP / OCT 2022 I  HEALTHCARE JOURNAL OF ARKANSAS   signature, and a project that identifies a key on-off switch that regulates the immune response that may be targeted to modulate how individuals mount immune responses. Editor According to the 2022 US News and World Report , UAMS College of Medicine tied for No. 36 in “Medical School Rank- ing” for primary care and in that same report was tied for No. 74 for research. This may sound a little tongue-in-cheek, but it does speak to priorities. Do you think the college of medicine at UAMS will ever have national ranking parity with the UA football team, which is ranked #19 pre- season according to ESPN? Smyth Our goal for the college is to be in the top 25 for primary care, and when we look at who’s above us on the list, we think that we are very well positioned to be in the top 25. So, yes. When you look at the number of our students that are practicing in primary care, the number of our residents that are prac- ticing in primary care, and where our learn- ers are going in terms of rural communi- ties, we’re at the very top of medical schools across the country. We really are in the top 10% for those numbers. The US News and World Report ranking has a series of crite- ria, but when you look at the outcome mea- sures, we’re already there. It really now just comes to tweaking some of the other met- rics that we have to demonstrate in order to get us to the top 25. Editor In your opinion, what is the dif- ference between the top rate at medical schools in the country and the rest? Smyth For USNews andWorldReport , histor- ically, it was reputation. I think that over the course of the last few years, they really have made a lot of good strides to move away from just a reputation score, and so, when we look at the hard outcomes that they’re tracking for primary care, we’re already in the top 10% of medical schools, which easily puts us in the top 25. There is still an element of reputation, and I think that’s important — that we’re gaining national attention for what we’re doing at UAMS for the State of Arkansas. Because, again, at the end of the day, I think we can be a national model for how an academic medical center leverages with partners and communities across the state to improve the health of a state. The more people that we can get excited about, that we can attract to that mission, the bet- ter off the entire state will be. Editor What do you think the difference between a good MD and a great one is? Smyth The best physicians combine really outstanding knowledge and skill with a clin- ical acumen for a sense for what is going on clinically, with a dedication to their patient, and the ability to not just listen to their patients but to hear what their patients are saying. That really feeds into that clini- cal acumen, allowing them then to deliver truly outstanding care. It goes beyond sim- ply having tremendous knowledge and skill to the ability to hear from your patients and learn from your patients in a manner that you can execute on. Editor How about the difference between a good residency experience and an amaz- ing one? Smyth An amazing residency experience exposes you to all of the facets of academic medicine. It’s grounded in an outstanding clinical experience that gives you a depth and breadth of exposure to patients with a whole range of types of conditions, includ- ing what’s required for really advanced subspecialty care, along with opportuni- ties for research, for quality improvement — to be engaged in research and/or quality improvement so that you understand the basis of the evidence that drives the clinical care — and combines that with a phenome- nal educational experience with faculty and others that are dedicated to the experience of the residents. Editor If you could change two things in the current healthcare system, what would they be? Smyth The first is howwe’re reimbursed for care. The second request is to magically pro- duce five times more nurses. Editor You had talked about diversity under health equity and that you’re try- ing to get more diversity in your program. It’s a bit of a sticky wicket. My generation was taught to be colorblind. We weren’t perfect, but I felt it was a goal. I went through public school, also. We sat next to kids that were every color, right? Now there seems to be a push to get more like- skinned people to take care of you. If I’m sick, I want the most qualified person to take care of me. I don’t care if that person is blue, purple, green, or orange. Explain the difference in those two thoughts. “Fundamentally, we need to have a system in place that rewards for outcomes and that incentivizes keeping people healthy rather than simply for the number of procedures or visits or some other arbitrary measure that isn't really a measure of an outcome or quality.”