
“This is a job made in heaven for me,” said Dr. Arthur Rubenstein, the newly appointed dean of the School of Medicine and the University’s executive vice president for the Health System. “I love universities; I love academic medicine.” Besides, he added: “This is a special university, and an important health system, and a great medical system, and it’s just an honor for me to come in and be part of it.”
Given the turmoil that the Health System recently went through, the “Made in Heaven” label might strike the casual observer as a stretch. But in a quiet, gentle way, the 63-year-old South African native made a convincing case for his delight—above and beyond the fact that he is arriving at a time when the Health System is back in the black and the medical school and hospital components are very highly ranked.
Rubenstein, who started at Penn on September 1, spent the last four years as dean of the Mt. Sinai School of Medicine in New York and the previous 30 years on the faculty of the University of Chicago, including 16 as chair of the Department of Medicine. At Chicago, he said, the relationship between the medical school and hospital were “very similar” to the set-up at Penn, and he regards that relationship as “very, very special.”
Dr. Judith Rodin CW’66, president of the University, described Rubenstein as a “seasoned pro” as well as “an exceptional educator and an accomplished physician, scientist, and leader who possesses the experience and skills necessary to lead Penn’s Health System into the future.” Moreover, she added: “He is committed to closely coordinating the medical school’s education and research mission with the clinical care offered by Penn’s specialists, primary-care doctors, and other health-care providers. He brings both a practical and erudite vision to ensure the continuing viability of our biomedical-sciences efforts, which we have established as crucial to the University’s strategic ambitions.”
Dr. William N. Kelley, the former medical dean and Health System CEO (now a professor of medicine), told The Philadelphia Inquirer that Rubenstein is an “outstanding choice” and “one of the top people in the country.” Kelley was ousted in February 2000 after the Health System lost nearly $300 million in fiscal 1998 and 1999 and was forced to cut some 2,800 positions, approximately 20 percent of its workforce.
By the time Kelley was replaced by Dr. Peter G. Traber —who resigned four months later to take a position with the pharmaceutical firm GlaxoSmithKline—the financial turnaround had begun. In fiscal 2000, the operating loss was down to $30 million, and the unaudited results for the first three-quarters of fiscal 2001 showed the Health System posting a $24 million operating profit. Still, the earlier losses affected Penn’s bond rating as well as that of the Health System, and shook the University’s financial confidence.
While the turnaround “has been truly amazing,” Rubenstein said, “one has to be absolutely sure this never happens again, within whatever power one has. And I’ve tried to study why it happened, and I’ve tried to learn from any mistakes that might have been made.” He was reluctant to second-guess any of the decisions made by his predecessor, though, noting that many of the nation’s academic hospitals are losing money, thanks in part to changing marketplace pressures, the need to provide indigent care, and underpayment by insurers.
Until Rubenstein’s appointment last month, Dr. Arthur Asbury was serving as interim dean of the medical school, while Dr. Robert D. Martin had risen from chief operating officer of the Health System to interim CEO to permanent CEO [“Gazetteer,” July/August]. In that position, Martin will report to Rubenstein, who, in turn, will report to Rodin (in his capacity as executive vice president of the Health System) and to Provost Robert Barchi Gr’72 M’72 GM’73 (as dean of the medical school).
Saying that Martin has done an “outstanding job” in righting the Health System’s financial ship, Rubenstein added: “I look forward to working with him very closely as a partner, because this [Health System] is a huge thing. I’m hoping that we will complement each other in a way that will bring real value here.”
After the financial losses, a joint committee of medical faculty and University trustees recommended creating a separate, not-for-profit 501(c)(3) organization for the Health System and its components, which would provide some financial protection to the University. That recommendation, which has not yet been acted upon, came after Penn had been considering selling off part or all of the Health System. Rubenstein said he would “have an open mind about the final structure” of the organization.
“I’m going to work with my colleagues in the medical center, with Dr. Rodin, with the board, to try to find exactly the right structure over the next several months. The opportunity actually to do that is a very interesting challenge to me.”
Asked about the immediate challenges at the medical school and the Health System, Rubenstein replied:
“Well, Dr. Rodin’s putting them back together again, as they were originally under Kelley. And I’m really, really pleased about that, because it allows the clinical mission of the institution to be aligned in a way that is just very special. It’s consistent, I think, with other great medical centers that are really successful at this time: Hopkins, Duke, UCLA, and Michigan, among others. And I think Penn in a sense always was a leader in that kind of creative organization.”
While “there was a lot of review and evaluation of it,” he said, “I still do believe—and I think this university now still believes—that that’s the appropriate organization.
“On the other hand, I think we need to be creative and be sure that the Health System and the medical-school conglomerations don’t negatively impact a great university, because these things are so big now, and they are so driven by marketplace issues, that you want to shield academic university issues from it as much as is reasonable—because universities are there forever, and health systems deal with the vagaries of this year and that year.”
While acknowledging that it must have been “painful and horrible” to make the personnel cuts, Rubenstein said he thought they had been made “judiciously,” and as proof of that cited the “remarkable” faith in the institution displayed by the faculty. Unlike some medical centers, where cutbacks have prompted “the best people to bail out,” Rubenstein said he has seen “no serious disaffection of the senior faculty” at Penn.
Rubenstein, an admirer of the noted physician and teacher William Osler (chairman of clinical medicine at Penn from 1884 to 1889), stressed his fondness for teaching. “I wouldn’t have come if I couldn’t teach,” he said. “I love to teach. It’s in my bones and my blood—and that’s why I love universities.”