Perspectives
Profile Victor Dzau: change and controversy at the Institute of Medicine
www.thelancet.com Vol 383 June 28, 2014
Chief Medical Officer, knows and admires Dzau, especially for the breadth of his vision for academic health science centres. “He’s even brought primary care into them, which is amazing. He’s used IT to connect everyone, so there’s real time data flowing around the system….He’s driven a dramatic change. Duke was fine before, but now it’s a world leading institution”, Davies says. At Duke, Dzau clearly had the energy to put his ideas into effect. Dzau’s colleague, Professor of Medicine Robert Lefkowitz, talks of the new training programmes and the buildings that have gone up at Duke, and comments, “I don’t think I’ve even seen anybody with a stronger work ethic than Victor Dzau”. Professor Michael Merson, of the Duke Global Health Institute, concurs. “When Victor commits to something he pours every ounce of his energy into it.” That includes backing global health. “He has a genuine concern for reducing health disparities around the world”, says Merson. And throughout his time at Duke, Dzau remained active in research, aiming to spend a fifth of his time with lab colleagues. Projects included gene therapy to minimise the damage of cardiac ischaemia, and stem cells for replacing damaged heart tissue and endothelium. “Research is very important to me”, he says. “It’s a reflection of my creativity.” His early research interests were in vascular biology. With the support of his family, Dzau left Hong Kong to study medicine at McGill University in Montreal. On graduating in 1972, he moved to the USA, first to Peter Bent Brigham Hospital in Boston, then to Harvard Medical School. By that time, he’d opted for vascular medicine. Why? “I always like to think about the next step, what’s in the future”, he explains, “and I’d noticed the emerging science of vascular biology”. He talks of work in the late 1970s and 1980s on the endothelium. “It’s not a Teflon lining but a biologically active organ. For me, the understanding of vascular medicine through vascular biology was where the action was.” Dzau joined that action and was soon helping to make it. In 1990, after 6 years as Chief of Vascular Medicine at Brigham and Women’s Hospital, he moved west to Stanford University, before returning to Brigham and Women’s and Harvard, where he remained until he got the job at Duke in 2004. Dzau views the IOM presidency as “an opportunity to think about what’s critically important for health care and medical science and to work with the right people to make a difference”. Davies sees Dzau as a good choice for the IOM, recalling a conversation with him about getting evidence into policy formation: precisely what’s needed, she thinks. To judge by Dzau’s record at Duke, the IOM should be bracing itself for what the Chinese proverb calls “interesting times”.
Duke Medicine
Victor Dzau knows how to cope with change. Born in Shanghai to a father who owned a chemical manufacturing company, he and his family lost everything when they fled the Chinese Communist Government for the safety, but also poverty, of Hong Kong. “For a year or two we lived in a single room with about five of us”, he recalls. Life was tough. It was then Dzau discovered the character trait that’s since served him well: adaptability. “My whole life I’ve been adaptive”, he says. “I’ve moved from an Asian culture to a North American one. I’ve gone from being a physician to a physician scientist. I’ve become an administrator. I’ve taken on broader issues of global health strategy and community health.” This trait will prove useful when Dzau moves from his role as Chancellor for Health Affairs and Professor of Medicine at Duke University, and CEO of the Duke University Health System, to take on the presidency of the US Institute of Medicine (IOM) on July 1. This new challenge might bring not just change but also controversy if a quiet background hum of concern about his past outside interests becomes publicly more audible. The poverty of Dzau’s childhood has long since given way to affluence—and not only on account of his salary for running an institution the size of Duke. His board level appointments and share holdings in companies, including Genzyme and Alnylam Pharmaceuticals, have brought him millions—but also provoked adverse comment about the propriety of pursuing outside interests potentially in conflict with his academic responsibilities. Taking on the IOM presidency, and so having to give up his interests, will cost Dzau financially. One of these interests, Pepsico, has already generated controversy. In response to my suggestion that advising a soft drink manufacturer was a rather odd role for a physician concerned with heart disease, his oblique reply was that no consumer product is perfect. “My job in Pepsico was…from a physician perspective, a public health perspective, a science perspective, to work with them. I’ve never seen in my years with them anybody saying how do we sell more of this to young people and how do we get more people hooked to this product. It’s always looking at how to improve their product.” He adds, “I choose very carefully who I work with and…whether they have the same values, and I ask myself, can I make a difference.” Despite the questions that have been asked about these now-relinquished outside interests, Dzau arrives in Washington DC well prepared for a task as demanding as the IOM presidency. One of his enthusiasms is for academic health science centres, and at Duke he brought the medical and nursing schools and much of its research together with the hospitals, clinics, and community services. “I think we’ve successfully integrated the pieces under one roof”, he says. Professor Dame Sally Davies, the UK Government’s
Geoff Watts 2203
Profile Victor Dzau: change and controversy at the Institute of Medicine
www.thelancet.com Vol 383 June 28, 2014
Chief Medical Officer, knows and admires Dzau, especially for the breadth of his vision for academic health science centres. “He’s even brought primary care into them, which is amazing. He’s used IT to connect everyone, so there’s real time data flowing around the system….He’s driven a dramatic change. Duke was fine before, but now it’s a world leading institution”, Davies says. At Duke, Dzau clearly had the energy to put his ideas into effect. Dzau’s colleague, Professor of Medicine Robert Lefkowitz, talks of the new training programmes and the buildings that have gone up at Duke, and comments, “I don’t think I’ve even seen anybody with a stronger work ethic than Victor Dzau”. Professor Michael Merson, of the Duke Global Health Institute, concurs. “When Victor commits to something he pours every ounce of his energy into it.” That includes backing global health. “He has a genuine concern for reducing health disparities around the world”, says Merson. And throughout his time at Duke, Dzau remained active in research, aiming to spend a fifth of his time with lab colleagues. Projects included gene therapy to minimise the damage of cardiac ischaemia, and stem cells for replacing damaged heart tissue and endothelium. “Research is very important to me”, he says. “It’s a reflection of my creativity.” His early research interests were in vascular biology. With the support of his family, Dzau left Hong Kong to study medicine at McGill University in Montreal. On graduating in 1972, he moved to the USA, first to Peter Bent Brigham Hospital in Boston, then to Harvard Medical School. By that time, he’d opted for vascular medicine. Why? “I always like to think about the next step, what’s in the future”, he explains, “and I’d noticed the emerging science of vascular biology”. He talks of work in the late 1970s and 1980s on the endothelium. “It’s not a Teflon lining but a biologically active organ. For me, the understanding of vascular medicine through vascular biology was where the action was.” Dzau joined that action and was soon helping to make it. In 1990, after 6 years as Chief of Vascular Medicine at Brigham and Women’s Hospital, he moved west to Stanford University, before returning to Brigham and Women’s and Harvard, where he remained until he got the job at Duke in 2004. Dzau views the IOM presidency as “an opportunity to think about what’s critically important for health care and medical science and to work with the right people to make a difference”. Davies sees Dzau as a good choice for the IOM, recalling a conversation with him about getting evidence into policy formation: precisely what’s needed, she thinks. To judge by Dzau’s record at Duke, the IOM should be bracing itself for what the Chinese proverb calls “interesting times”.
Duke Medicine
Victor Dzau knows how to cope with change. Born in Shanghai to a father who owned a chemical manufacturing company, he and his family lost everything when they fled the Chinese Communist Government for the safety, but also poverty, of Hong Kong. “For a year or two we lived in a single room with about five of us”, he recalls. Life was tough. It was then Dzau discovered the character trait that’s since served him well: adaptability. “My whole life I’ve been adaptive”, he says. “I’ve moved from an Asian culture to a North American one. I’ve gone from being a physician to a physician scientist. I’ve become an administrator. I’ve taken on broader issues of global health strategy and community health.” This trait will prove useful when Dzau moves from his role as Chancellor for Health Affairs and Professor of Medicine at Duke University, and CEO of the Duke University Health System, to take on the presidency of the US Institute of Medicine (IOM) on July 1. This new challenge might bring not just change but also controversy if a quiet background hum of concern about his past outside interests becomes publicly more audible. The poverty of Dzau’s childhood has long since given way to affluence—and not only on account of his salary for running an institution the size of Duke. His board level appointments and share holdings in companies, including Genzyme and Alnylam Pharmaceuticals, have brought him millions—but also provoked adverse comment about the propriety of pursuing outside interests potentially in conflict with his academic responsibilities. Taking on the IOM presidency, and so having to give up his interests, will cost Dzau financially. One of these interests, Pepsico, has already generated controversy. In response to my suggestion that advising a soft drink manufacturer was a rather odd role for a physician concerned with heart disease, his oblique reply was that no consumer product is perfect. “My job in Pepsico was…from a physician perspective, a public health perspective, a science perspective, to work with them. I’ve never seen in my years with them anybody saying how do we sell more of this to young people and how do we get more people hooked to this product. It’s always looking at how to improve their product.” He adds, “I choose very carefully who I work with and…whether they have the same values, and I ask myself, can I make a difference.” Despite the questions that have been asked about these now-relinquished outside interests, Dzau arrives in Washington DC well prepared for a task as demanding as the IOM presidency. One of his enthusiasms is for academic health science centres, and at Duke he brought the medical and nursing schools and much of its research together with the hospitals, clinics, and community services. “I think we’ve successfully integrated the pieces under one roof”, he says. Professor Dame Sally Davies, the UK Government’s
Geoff Watts 2203
