A well-respected fixture in Vanderbilt’s medical community has returned after a 10-year leave.
Walter Merrill, MD, assumed the position of chief of staff at Vanderbilt University Hospital April 1. The cardiothoracic surgeon also will hold a faculty appointment in the Department of Cardiac Surgery and will maintain an active clinical practice.
“This is a really exciting time in healthcare with an emphasis on improving quality of care, lowering cost of care, and trying to better coordinate care across the continuum of illness,” Merrill said. “I thought it was a great opportunity to come back and participate in these initiatives here at Vanderbilt.”
Building a Legacy
The Alabama native came to Tennessee to attend Sewanee: The University of the South before heading north to Johns Hopkins University for medical school and training. He also completed a research fellowship with the National Institutes of Health and served as senior registrar in thoracic surgery at the Hospital for Sick Children in London.
The young surgeon first arrived at Vanderbilt in 1983, and two years later started Vanderbilt’s cardiac transplantation program along with colleague William H. Frist, MD. More than 500 heart transplants have been performed at Vanderbilt since the first operation in 1985, making theirs the largest transplant program in the state and one of only four nationwide approved to provide heart transplantation to veterans.
“By the mid 1980s, it had become apparent that clinical heart transplantation had a place in the care of patients with advanced heart failure, because by then a new anti-rejection medicine called cyclosporin was largely responsible for improved results,” recalled Merrill, who helped perform Vanderbilt’s first heart transplant and has performed hundreds more since. “It was a great privilege to be a part of the program, but the credit goes to the courageous patients and the families of the donors who are a constant source of amazement for me. Were it not for the brave individuals willing to undergo a risky surgery or deciding to donate organs in the midst of personal tragedy, transplantation would never happen.”
After nearly two decades at Vanderbilt, Merrill left Nashville to become chief of Cardiothoracic Surgery at the University of Cincinnati. In 2009 he relocated to Jackson, Miss., as chief of the Division of Cardiothoracic Surgery at the University of Mississippi Medical Center. While at UMC, Merrill worked to expand the university’s quality and range of cardiovascular services and introduced the left ventricular assist device program — an interim treatment for patients running out of time while awaiting a heart transplant.
The Road Back to Nashville
Merrill said family, the Nashville community and Vanderbilt’s reputation for excellence are what brought he and his wife Morgan back to Middle Tennessee, which three of his four children still call home.
“Nashville is a terrific place to live, and we had a wonderful time here before,” Merrill said. “It’s a very vibrant place with great energy and also diversity. You’ve got education, music, strong industry and a great government. It’s a melting pot of interesting, talented people trying to make life better.”
Board certified in general and cardiothoracic surgery, Merrill has special expertise in heart transplant, heart failure and cardiac valve repair. He started accepting patients in his Vanderbilt Clinic practice mid-April.
Addressing Costs and Patient Care
While Merrill is eager to put his clinical skills back to work, he said improving costs and overall quality of care are his primary goals as chief of staff at VUH.
“Vanderbilt is an absolutely terrific medical center with a long tradition of excellence in patient care, education and research,” Merrill noted. “Although things are going well here and patients are getting great care, we should never be satisfied and always be striving to be better, and that fits into my mindset.”
Merrill’s commitment to cost improvement reflects a growing industry-wide concern. Like many healthcare leaders, he’s hopeful the industry will continue to receive adequate funding to support research and medical education.
A 2011 report from the Centers for Medicare and Medicaid Services estimates total healthcare spending will hit $4.6 trillion by 2020, 50 percent of which will be paid by the government. In fact, healthcare spending is expected to account for nearly 20 percent of U.S. economic output by 2020. While the statistics could present challenges to medical centers nationwide, Merrill is optimistic that Vanderbilt will overcome possible economic roadblocks.
“Fortunately, despite the overall uncertainties of national healthcare and national funding for research, Vanderbilt has been incredibly successful in maintaining its excellence in a position of strength,” he said.
“I’m just trying to be a little cog in a great big wheel, and that’s a real thrill,” Merrill modestly noted.
The surgeon holds membership in Alpha Omega Alpha, the American Association for Thoracic Surgery, the Society of University Surgeons and the Southern Surgical Association. Merrill has written more than 100 scientific articles and 16 book chapters and is on the editorial board of several medical journals. A long-time supporter of the American Heart Association, he also plans to volunteer his time to the Greater Nashville AHA chapter.