Under Dr. Ed Block’s nurture, the department of medicine is primed for growth

With strong doses of both management strategy and philosophy, Edward Block, M.D., is guiding the University of Florida’s largest academic unit — the department of medicine — on a path of unprecedented growth in patient-care services, research and teaching.

Block, who accepted chairmanship of the department on May 13, 2002, expresses pride in the success of the 256 faculty members who have quadrupled their total research funding from $8.7 million during fiscal year 1995-96 to $40 million in grant support for 2003-04.

“The National Institutes of Health has doubled the amount of research grants it has awarded during the past five years, but our faculty have outstripped that rate of growth,” Block said. “This success is due largely to the recruitment of new division chiefs for nephrology, hypertension and transplantation, and for pulmonary and critical care medicine, and additional faculty strongly committed to research. We’ve recruited 21 new faculty since I became chairman, and we soon will recruit another 21.

“Our faculty are gaining national acclaim for the productivity and quality of their work,” Block said. “Our two-year physician assistant training program, for example, is now ranked among the top 10 programs of its kind in the United States. Each year, we graduate close to 60 new P.A.s, who find ample job opportunities across the state and the nation.”

Rapid growth also is occurring in the outpatient care services of the department, which runs most of the medical school’s primary-care services for adults.

“Our faculty physicians now handle 1,700 patient visits every month at our general internal medicine clinic on Tower Road, and another 600 visits per month at a clinic based in Shands at UF,” he said. “At the same time, our faculty are responsible for 20 percent of the teaching of medical students, and our department has the lion’s share of medical school faculty who’ve won the Hippocratic Award and Teacher of the Year awards.

“It’s very gratifying to see the kind of growth we’re experiencing in all key areas,” Block said. “It is especially satisfying in light of the fact that during my first 18 months in office, the internal medicine residency program was restructured to be fully compliant with new federal guidelines for graduate medical education. This has enhanced the educational experiences for our residents.”

This year, Block said the department will definitely expand programs that have new chiefs — the division of nephrology, hypertension and transplantation headed by Richard Johnson, M.D., and the division of pulmonary and critical care medicine led by Veena Antony, M.D.

“Aging is our latest area of development, as we collaborate with colleagues with the North Florida/South Georgia Veterans Health System to establish a division of geriatrics,” said Block, former chief of research for the local regional VA system. “We plan to bring together aging-related research and patient-care programs to better address the health problems and disabilities suffered by Florida’s rapidly growing population of seniors,” he said.

Efforts to recruit a chief for the geriatrics division are already under way.

In another rapidly growing segment of the department, the computer sciences division under Mario Ariet, M.D., meets vital needs for the college and Shands HealthCare. A team of eight computer professionals supports key patient-care services by generating reports of diagnostic procedures such as adult echocardiography, stress electrocardiography, nuclear cardiology and holter monitoring, and submitting the reports to the Shands SMS Lifetime Clinical Report. The data then can be accessed, with authorization, to support clinical research and aid the education of medical students, residents and fellows.

Ariet’s division also generates professional fees for the departments of medicine, pediatrics and psychiatry, and provides data acquisition and reporting systems under contracts with the state-supported Children’s Medical Services and the Medicaid section of the Agency for Health Care Administration.

Beyond the growth that’s measured in statistics, Block said significant progress is evident in recent discoveries by faculty, who are defining how certain diseases originate and finding clues that may aid the development of preventive treatments. He noted a few among many examples:

Sankar Swaninathan, M.D., an associate professor of internal medicine, while studying a virus linked to cancer, has identified a gene that regulates the virus’ ability to divide and multiply inside body cells. “As a consequence of this discovery, we have a target we can attack with therapies designed to stop the virus from replicating, and consequently destroy its ability to cause cancer,” Block said.

Richard Johnson, M.D., chief of nephrology, hypertension and renal transplant, is proposing new ideas about what causes high blood pressure. He has found evidence through studies in animals and tissue cultures that uric acid, a natural byproduct of metabolism, plays a critical role in elevating blood pressure.

Reuben Ramphal, M.D., professor of medicine, is helping to define the process by which pseudomonas, a virulent bacterial species that causes death and disease, especially pneumonia, becomes active and initiates disease. He has identified the bacterial genes that allow attachment of pseudomonas to sputum, and is studying how these genes are regulated.

Mark Brantly, M.D., professor of medicine, has defined the biochemical pathophysiology responsible for alpha-1 antitrypsin deficiency lung disease and is working on novel treatment strategies to ameliorate the genetic disease.

He added that many significant and practical advances in cardiovascular medicine are coming out of research led by Carl Pepine, M.D., professor and chief of cardiovascular medicine and president of the American College of Cardiology, and Marian Limacher, M.D., professor of medicine (also in cardiology), who directs a large regional segment of the National Institutes of Health-funded Women’s Health Initiative.

“To manage a department with 12 major divisions, 256 faculty members and 350 support personnel on two campuses requires effective leaders in charge of key segments,” Block said. “Fortunately, we have such leadership in people like Neil Boyle, CHE, associate director of medical/health administration; five vice chairmen: M. Lawrence Edwards, M.D., for housestaff education; Rebecca Pauly, M.D., medical student education; Fred Southwick, M.D., research; Edward Ross, M.D., clinical operations; and Richard Gonzalez-Rothi, M.D., veterans affairs; and associate department chairman David Coultas, M.D., who directs the clinical and teaching services of 55 faculty at the Health Science Center campus in Jacksonville.

“I see my main goal is to inspire people and to give them freedom to think outside the box, and to encourage open and free communication,” Block said. “I try to match individuals with where their passions lie and with the department’s needs, and I like to hire people who are smarter than me.We all sail higher when we sail on the combined unique strengths and skills that individuals bring to our department.”

To balance the demands of his administrative job, research and family life, Block said he employs specific strategies and philosophies. He said his wife, Joanne, “has an uncommon dose of common sense and exceptional understanding of people-to-people dynamics and is my chief source of advice and encouragement. “I try to work out at the health and fitness club two or three times a week for an hour each time, and I only occasionally fall off the wagon and fail to get there,” he said. “I’m also a big sports fan, especially enjoying women’s soccer, women’s volleyball and men’s basketball.”

About his philosophy, Block said that while much of his life was formerly driven by fears, his outlook changed during a seven-week cross-country biking trip with his daughter Lisa in 1995. For much of the journey, he said he worried excessively and unnecessarily about his daughter’s safety, “but through our experiences and certain people we met, I realized my life was overloaded, and I decided I would no longer make decisions based on fears of this and that. I changed myself.”