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New CEO of University of Utah Health Care aims to make a real difference in the challenges patients, doctors face

NORMAN, OKLA. — As they walked down the tile corridor, 12-year-old Vivian Lee stayed close on the heels of Dr. Hal Belknap.

He carried a clipboard filled with medical charts and test results, yet each time he walked into a patient's room he greeted them with a cheerful hello and asked about their families, as well as their pain levels.

Then, Belknap would step back and motion Vivian to the side of the bed, introducing her as his "shadow" for early Saturday rounds at the Norman Municipal Hospital in Norman, Okla.

It didn't take many Saturday mornings for Vivian to realize a hospital was where she wanted to be.

Today, that hospital is University Hospital nestled on Salt Lake City's east bench, and a nameplate on Lee's door proclaims her "Senior Vice President for Health Sciences."

Thanks to a litany of degrees — M.D., Ph.D. and MBA — Lee is also the CEO of University of Utah Health Care and dean of the U.'s School of Medicine.

Choosing her favorite job is like picking a favorite child, Lee jokes. She's just excited to be working with a world-class university and its nationally ranked health care system.

Even with the university's many accolades and accomplishments, Lee still sees room for improvement and is pushing for increased teamwork and creativity — all with the goal of providing more and better-personalized health care.

"If we (take) this very innovative organization, and have them focused on solving a lot of the health care challenges that we're facing," she said, "then I think we have the opportunity to see some real change and make a real difference."

She's the person to make it happen, say colleagues and friends.

"The best form of leadership is leadership by example," said Thomas Grist, chairman of the department of radiology at the University of Wisconsin, a colleague of Lee's f om their residencies at Duke University. "She presents an example of excellence in everything she touches. I don't think she's ever lost sight of the fact of what this is all about, that academic medicine is about improving the health of our patients."

A vision for health care

Bustling in the U.'s 10 primary and specialty health centers, four hospitals, four colleges and one school of medicine are 1,542 doctors and professors, 82 medical students and 719 medical residents or fellows. Last year, those health centers and hospitals saw more than 1 million patients with an additional 39,000-plus visits to the emergency room.

Lee is responsible for all of those people — which might explain why she's up every morning at 5:30 to check her email while she exercises on her stair stepper.

Her three-titles-in-one position, though somewhat rare at academic medical centers (colleges with hospitals attached), is a better way to manage, Lee explains, because it prevents power struggles between three people.

It also means that Lee is always busy. Since her July 1 appointment, she's jumped into administrative duties, started her own lab (with three active National Institutes of Health research grants) and tried to meet as many professors, doctors and students as she can by dropping in on department meetings and touring facilities.

"There are tremendous opportunities here," she told a group of OB/GYN clinicians and faculty members during a recent weekly meeting.

"There is a very positive culture … especially compared to other academic medical centers. There's a foundation to do a lot of fabulous things."

Lee is animated when she talks, but with a controlled, subtle type of energy. On the table in front of her is a slim black notebook with observations in meticulous handwriting, yet she doesn't need to refer to it when she speaks.

She praised the synergy exemplified by radiologists and maternal fetal medicine professionals who work together closely in the OB/GYN area — not a common practice across the country.

Another good example is Nobel Laureate Mario Capecchi, who has willingly shared his genetically engineered mice with other professors. The university's nationally recognized core facilities — where physicians and clinical professors from all disciplines can share expensive machines — also allows for collaboration and keeps costs low, Lee's second goal.

Despite being named No. 1 in the nation for quality by the by the University HealthSystem Consortium in 2010 (above place such as Mayo Clinic, Johns Hopkins and Stanford) University Health Care needs to improve in value, or quality divided by cost, Lee said.

Using money more efficiently means more can be directed toward personalizing health care, Lee's main focus.

"Walking into a shoe store where every shoe is a size 8 is just not as efficient as … getting a perfect fit for everyone and not having them come back in five times," she said. "We're all genetically and biologically different. The ways to treat us may be different."

Because some people are predisposed to pain pill addictions, heart disease or certain cancers, their treatment should reflect that.

Lee loves the example of the pilot program, Women's Midlife Assessment Clinic, where women ages 45-60 come to the Salt Lake clinic for a half-day, "head-to-toe" examination.

Each woman is seen by doctors from internal medicine, gynecology and dermatology who have already reviewed the woman's provided health history.

Women can also chat with health coaches about things such as exercise goals, stress management and lowering blood pressure. Finally, at the end of the day, the medical team summarizes the assessment and any test results, and sends the woman home with a plan of action.

It may seem like a lot of time to devote to one patient, but if it prevents future problems, Lee believes it will save energy and money in the long run.

"She has a vision," says Debiao Li, director of the Biomedical Imaging Research Institute at Cedars-Sinai Medical Center in Los Angeles and a friend of Lee's since the mid-1990s. "She always has something that she wants to do. And she really does it. She doesn't just talk about it. She has a real talent … to mobilize people, motivate them to get things done."

Journey to the top

A college graduate by 19, a Ph.D. by 22 and a medical doctor by 25, (30 when she finished her residency and fellowship) Lee, now 45, is somewhat of a rock star among medical professionals.

But there's no haughtiness in her smile and her confidence is a pleasant mix of capacity and curiosity.

"When I first met her, I knew how bright she was," Grist said. "But what took me back was how modest and approachable (she was). She has this straightforward, unassuming, modest, sincere approach to life, which is amazing, considering how accomplished she is."

As a radiologist, Lee uses magnetic resonance imaging to study diseases, particularly in the kidneys, and in the heart and circulatory system. She wrote a textbook on the topic, spent years leading the International Society for Magnetic Resonance in Medicine and loves to work in her lab, where co-investigators and graduate students all call her Vivian.

"Oh well," she says with a smile. "It's fine with me."

For Lee, it's not about titles or prestige, it's about the joy of discovery and using those discoveries to help others — lessons she learned from her endocrinologist mother and electrical engineer father. Both immigrated to the United States from China as children, studied at Berkley and still teach at the University of Oklahoma.

Lee grew up loving math and science, but only after she was working at New York University did she develop an interest in management.

As a relatively new professor, Lee was asked to help other new professors secure competitive research grants. She did a good job and was asked to lead more committees, deal with finances and organize group efforts.

Feeling underqualified, she enrolled in NYU's executive MBA program and spent the next two years of Fridays and Saturdays learning about the science of management — while finishing her book and having her fourth child.

"I don't know how I did that," she says with a small laugh. "I must not have been sleeping."

Armed with an MBA as well as an M.D. and Ph.D., Lee was appointed as the inaugural vice dean for science at New York University Langone Medical Center — the post she left to come to Utah.

"She had to build a whole infrastructure in administration and professional staff and she did an outstanding job," said Judith Hochman, director of the Cardiovascular Clinical Research Center at NYU's School of Medicine and one of the members of Lee's leadership team.

"She is brilliant, with very good common sense. She is able to understand the problems and find solutions, and she works well with people in the process."

Settling in Utah

Looking out her fifth-floor office window in the Clinical Neurosciences Center, the Wasatch Range almost seems touchable — something Lee never saw in downtown Manhattan.

Utah, with its wide-open spaces and friendly atmosphere, has been a pleasant change for Lee and her husband, international law professor Benedict Kingsbury, and their four girls, 4 to 10 years old.

"People would stop us in New York and say, 'Are those all yours?' " Lee says. "People make a big deal (in New York) about four kids. But here I could just be beginning."

She laughs quietly and adds, "People do value the family a lot more here, and I just love that."

Lee grew up with one younger sister, but Kingsbury comes from a family of five children plus additional foster kids and always wanted a large family of his own.

The couple met at Oxford where both were Rhodes Scholars, but in very different fields.

"Vivian worked extremely hard in the lab," Kingsbury said, "but she was also full of life and always doing a million things for fun and community service."

During her radiology training at Duke, Kingsbury said Lee made time to cook meals for people at an AIDS hospice there.

"Vivian tries to instill in our children the same values she has always had," Kingsbury said. "Working hard, having fun, living moderately, thinking about other people."

And having fun is best when done as a family, Kingsbury added. This winter the family learned to ski, ice skate and two of the girls joined an ice hockey team. Come spring, the family is eager to climb and bike the craggy cliffs behind their home.

Lee smiles when she's asked how she balances a demanding work life with family.

"Balance is always a funny word," she says. "It suggests things are under perfect control. I'm not sure I'd use that to describe my life."

Rather than control, Lee says it's about prioritization and eliminating nonessentials.

"I don't get my nails done," she says, showing neatly trimmed, colorless nails. "I don't get my hair cut very often. I keep it simple. If I have any time, I want to spend my time with my family."

Each night she leaves her office a few minutes before 6 p.m. and walks home for dinner and homework. She encourages her daughters to do their best and dream big. But there's no pressure to follow her into medicine or academia.

In fact, right now her daughters frequently change their minds about future plans.

"They're still vacillating between princess fairy and veterinarian," Lee says with a smile.

"They're keeping their options open."