Physician Spotlight: Jeff Balser, MD on Nashville Medical News

Physician Spotlight: Jeff Balser, MD

By: SHARON H. FITZGERALD

When asked for a vision of the Vanderbilt University School of Medicine a decade from now, Jeff Balser's predictions — and his dreams — spilled out. Today's job, he added, is preparing for that future. A physician who also holds a doctorate in pharmacology, Balser became only the 11th dean in the Medical School's storied, 133-year history when he was named to the position in October.

The biggest challenge? "If we're going to provide effective and efficient and safe care in the future, we need to become 'smarter' about how we make decisions and how we access information to make those decisions," Balser said. "The number of facts available that physicians in the next decade will need to manage in the process of care is expanding beyond belief. So our challenge is to find ways to use information technology and other resources to provide point-of-care decision support."

Acknowledging that students now are "comfortable accessing the entire world of information," Balser said medical educators must ensure that students are turning to evidence-based sources "in the right context, so information is evaluated relative to competing ideas and not influenced by proprietary biases." The challenge extends to ensuring the same for the continuing education of practicing healthcare professionals. No small feat, he noted.

The school's Office for Teaching and Learning in Medicine tackles the issue of how best to instruct tomorrow's healthcare providers and devises strategies for conveying near-overwhelming volumes of data, Balser said. "There's also a lot of work with simulated patients and modeling and practicing doctor-patient encounters in a way that assures students feel fully prepared to engage patients," he said.

Balser predicted one of the most profound changes in healthcare over the next decade will be personalized care, thus putting that doctor-patient relationship at center stage. "The notion of the blockbuster drug that everybody takes is going to gradually change such that we will be able to prescribe not just medications but lifestyle changes and preventative health measures based on the needs of the individual, the social background of the individual and the genetic background of the individual," he said. "Vanderbilt is working very progressively in all of those areas to really try to personalize health." The implications will be improved patient health and lowered healthcare costs, he explained.

Much Vanderbilt research is focused on this customized medicine trend. "Genomic medicine and improving our ability to diagnose disease very early, as well as tailor therapy to the biochemical and genetic makeup of the individual, is an area that we've put great emphasis into and are leading in many ways the national efforts to make that possible," said Balser, who was associate vice chancellor of research before taking the helm of the medical school.

Despite the economic downturn, Vanderbilt continues to nab government and private research grants and contracts. In fact, the university is moving up the National Institutes of Health ranking. "I'm certainly cautious about how rapidly we can continue to grow in this economic climate. That said, I would consider us to be in a much stronger position during this time than many of our competitors," Balser said. That position is attracting investigators from other medical centers, he noted, and they are bringing their federal funding with them.

Vanderbilt's research with Meharry Medical School is also reeling in federal dollars. "We consider the Vanderbilt-Meharry Alliance to be one of the most important things we're doing … we basically have complementary strengths," Balser said. In particular, the two schools continue to develop initiatives to move research results and care into the broader community, "so we can start to see the impact of the discoveries we're making," he continued.

Tomorrow's physicians will have more distinct choices to make about their career direction, Balser speculated. As healthcare becomes more technologically challenging, increased specialization of medical fields will be a result. Yet, as the population ages, expanded capabilities in primary care will be critical. But are today's medical students interested in primary care?

"As healthcare reform provides greater value to intellectual services, which is the trend we are now starting to see, the interest of students in primary-care areas will increase," he said. "I think that most people are now thinking about a more holistic approach to providing healthcare, and the role of individuals providing primary care will be emphasized in that holistic approach as we move forward in the next decade."

Many of those future doctors hope to study at Vanderbilt. While medical school applications are down nationally in the last year, applications to Vanderbilt are up. Since 2003, the number of applications has increased more than 40 percent compared to a 20 to 25 percent increase nationally. "We will have well in excess of 5,000 applications for 104 positions this year," Balser said.

Less than two weeks after Balser stepped into his new role, it was homecoming weekend at Vanderbilt, and the medical school enjoyed its largest alumni turnout ever. "Vanderbilt has a special bond that partly derives from our culture of collegiality. The people, even though they leave to go off in the world to practice medicine, still feel very much tied to Vanderbilt because of the experiences they've had here," he said.

Balser speaks from experience. With an engineering degree from Tulane University, Balser simultaneously earned an MD and a PhD from Vanderbilt in 1990. Then he trained as a resident and fellow in anesthesiology and critical-care medicine at Johns Hopkins University, where he joined the faculty in 1995. He returned to Vanderbilt three years later as associate dean for physician scientists. In 2001, he was appointed the James Tayloe Gwathmey Professor and chair of anesthesiology, and then took the research position in 2004.

A native of Evansville, Ind., Balser and his wife, Melinda, stay on the go, attending the school and sporting events of their three children: Jimmy, 18, Jillian, 16, and Maddie, 12.