A Conversation With David H. Perlmutter, MD
David H. Perlmutter, MD, joined Children's Hospital of Pittsburgh of UPMC as physician-in-chief and scientific director in 2001. He also chairs the Department of Pediatrics in the University of Pittsburgh School of Medicine. In an interview with Pediatric INSIGHTS, Dr. Perlmutter discussed the core principles underlying his leadership.
Pediatric INSIGHTS: What is your overarching goal for Children's Hospital?
Dr. Perlmutter: I want the hospital to provide outstanding clinical service and to excel in education and research. In terms of our clinical goals, I have made it clear to the chiefs of all 18 subspecialty divisions that access and quality are our top priorities. Our target is for a new patient appointment to be available in seven calendar days. Currently, you can get an appointment in every subspecialty division of the Department of Pediatrics in three to seven days with the exception of Child Development. And we are committed to continuing to improve access. In terms of education, we want to recruit the top resident and fellow candidates in the country. Our research program is the fastest growing pediatric research institution in the country in terms of NIH funding from 2000–2005, and our goal is to be among the top five in overall NIH funding.
PI: What makes Children's Hospital of Pittsburgh of UPMC unique?
Dr. Perlmutter: It is the only pediatric subspecialty presence in this region. This means demand for our subspecialty services is intense, at a time when national manpower in every subspecialty is insufficient. This presents us with an enormous challenge.
PI: What is your strategy for meeting that challenge?
Dr. Perlmutter: There is no single answer to this question. You have to have the right people and the right organizational structure, but the major component of the strategy is to make a philosophical and financial commitment to excellence in each subspecialty division. Further, that commitment has to include excellence in education and research as well as in clinical care. Excellence in clinical service and in research go hand in hand—we must do both in order to be an attractive place for resident and fellowship training, and those programs then become the source of new recruits for a steady stream of subspecialists in each of the clinical services.
PI: How does an active research program boost the hospital's clinical mission?
Dr. Perlmutter: We must do research in order to make progress in solving the many pressing problems in child health today. In addition, having a nationally recognized research leader in charge of a subspecialty program demonstrates a commitment to excellence, which is attractive to clinicians, researchers and fellowship candidates. Perhaps even more important, and certainly more subtle, is that research brings with it a philosophy of rigorous thinking. The scientific method forces you to test all your assumptions and to question whether you are doing the right thing. Furthermore, the scientific approach values someone who develops a new method and can prove that it's better. This philosophy carries over into clinical care—you are constantly asking for advice, bringing in consultants. You are never satisfied with the most conventional explanation. You also have to be organized, thorough and methodical to be successful in research; these are essential qualities for providing excellent clinical service and the best possible pediatric care for the most complicated clinical situations.
PI: Does clinical care suffer if clinicians have to spend time on research?
Dr. Perlmutter: At Children's Hospital, we recognize that very few people possess the skills to be both superb clinicians and superb researchers. To be outstanding as either, you need to spend 80 percent to 90 percent of your time on that activity. We encourage our clinicians to focus on doing excellent clinical work; we don't expect them to do research as well. This is a controversial philosophy because it goes against the grain of the traditional "triple-threat" philosophy of academic medicine, but I believe it is essential to the future of modern academic pediatrics. It has certainly helped us recruit top clinicians and researchers. We strive to be a triple threat as a program, not necessarily within each individual faculty member. The clinical, educational and research activities in our program are like sections of an orchestra. Great music requires talent and synergy among and between the sections.
