March 31, 2015: Dr. David Cole has been associated with MUSC since 1994 and has been the chief surgeon. He is listed nationally as one of the top U.S. surgeons and is President of the Southern Region of Surgeons, the nation’s largest such group. When approached to become president of MUSC he had to step back and ask of himself, “why me”? In reflection he noted that he had been with the university for 20 years and achieved a level of trust of his colleagues and associates. He further recognized that medicine is about people and as president he could have the biggest impact on change. While the ACA has caused turmoil, it has been a catalyst for needed change. His job role would be much safer as a surgeon but strong leadership is more needed in times of tough challenges, thus he accepted the trust offered to him by the Board.
MUSC is in a time of transition as medicine begins to focus more on patients and their families and their point of view, than on simply doing a series of predetermined tasks.
He spoke of a family member and their two week pre-death hospital ordeal. As president and not the doctor in charge he found it difficult to deal with the situation. But he finally asked him (the family member) “what do you want to do”, to which came the reply: “go home”. So he did and with the help of hospice he died several days later. Dr. Cole recognized that the two weeks in the hospital served no purpose for the patient and asked himself: “can we do better?” There must be cultural change because typically each department in a hospital operates independently. In the future each department must first think more about how to treat patients with respect, compassion and innovation. The future patient will be charged a fixed fee regardless of age 18 or 80 as opposed to a fee bill for each test or procedure. He further noted that the Federal government cannot prescribe medicine; that action must be done effectively at the patient level.
MUSC has 6 colleges, all under pressure to do research. Every doctor spends 7 years in training after receipt of the doctor’s degree. A part of this training must be learning to partner with the patient. At the present time there is no incentive to practice preventative medicine, but such treatment will become more important in the future as money is capped per patient rather than charged per procedure
— Fred Sales