Q&A: Dr. John Mazziotta on the future of UCLA’s medical school and health system
Earlier in his life, Dr. John C. Mazziotta thought about becoming an architect. With a keen eye for form and function, he would apply his skills to the construction of great buildings. Instead, he chose medicine. Now, after more than 30 years at UCLA — where he has been chair of the department of neurology, an associate vice chancellor and executive vice dean, and founding director of the Ahmanson-Lovelace Brain Mapping Center — that style of visual thinking will serve him well in his new roles as vice chancellor for UCLA Health Sciences, dean of the David Geffen School of Medicine at UCLA and CEO of UCLA Health. “There are many parallels between architecture and construction and what we do in medicine and the building of a large medical enterprise,” he said. “And, on a purely administrative level, it doesn’t hurt to have some interest in the subject when you are managing millions of square feet of space and renovating a giant building. Having some interest and experience about how these things work is helpful.” Dr. Mazziotta spoke with U Magazine editor David Greenwald about his new roles and his aspirations for the future of the medical school and health system.
As vice chancellor, dean and CEO, you bridge the worlds of the health system and the medical school. How does each of these worlds inform the other?
We have one health organization with two big pieces to it: the health system — the hospitals, the clinics, the doctors and nurses and support staff — and the David Geffen School of Medicine at UCLA. The overarching goal of our medical enterprise is its academic purpose — to excel in research and education. To achieve that, we have to be excellent in all areas. We have to be good at the business of medicine — which has become very complicated over the years — in order to have the opportunities for our students, residents and fellows to have a place to train and to have the financial resources to support research and education. We have a responsibility to the citizens of California and Los Angeles, and to society in general, to produce great scientists and doctors and to develop new and effective treatments and, ultimately, cures for disorders of the human condition. Having one person over these arenas helps to ensure the correct balance and laser focus on our academic mission.
What are the opportunities that this presents?
When there is a significant change in leadership, involving more than one individual, as is the case now, there is the opportunity to actually review the governance structure of the organization. It is like starting with a clean slate and makes it possible to ask questions such as, “What are the functions we actually need?” and “How do we change the structure to become more effective, efficient and responsive?”
It has been perhaps 20 years since the overall structure of this organization has been examined, so this is a great opportunity for us to do just that. Chancellor Gene Block has assembled a task force to do exactly that, to look at the governance of the health sciences — not just medicine, but all of the health-science schools — as well as the health system. Change is healthy. It is good to have a chance to engage in self-examination and to think about whether or not we have the ideal approach to the governance structure. It is an exciting opportunity.
When Thomas Watson Jr. was the CEO of IBM, he said, in the early 1960s, “I believe that if an organization is to meet the challenges of a changing world, it must be prepared to change everything about itself, except its beliefs.” Like the business-machine and early computer industry of Watson’s time, today’s health care environment is undergoing dramatic change, and we need to be prepared to adapt without changing the beliefs that are embedded in our core academic missions.
As you assume your new roles, what are your priorities?
I’ve traveled all around the world in my career. What do you think is the first thing people mention when they identify someone as being from UCLA? Basketball. That is the one thing you will find that UCLA is known for pretty much anywhere in the world. So that makes me think we can work toward establishing a John Wooden-like dynasty of excellence in health science. In the future, people will say, “Basketball and medicine.” I believe that is possible.
We should strive to be the best in the world at the things we choose to do. We can’t be the best in the world at everything, but, when we pick a subset of those things, we should pick the ones in which we can be the very best. When I first became chair in neurology, the faculty said, “We want to be the best in research.” So we constructed a strategic plan, and we executed the plan down to the most minute detail, and in a short period of time, we were No. 1 in the United States in research funding, and we maintained that distinction for nine consecutive years. Five years ago, the faculty wanted to enhance philanthropy. So we developed an approach and implemented it. Last year, neurology raised more philanthropic dollars than any other department on campus.
The strategy worked well for the department. How would that be applied to achieve similar results on a broader scale?
We have a strategic plan for the health system and the medical school, and we will continue to implement the plan, particularly in this time of change. We have great teams in place. Our previous leadership left their legacy in the people who served with them. Our people are ready and, without question, able to execute on these plans to enhance our momentum. That is in the short term.
For the long term, we want to be the best in the world in specific areas. For the health system, that means being the role model nationally for enabling an academic medical center to truly deliver patient-centered and integrated care to heal humankind one patient at a time. Instead of being compartmentalized into the “department of the eyeball” and the “department of the nervous system,” where the patient must go from one center to another to receive care, we want to create a system where whatever is needed for the patient surrounds him or her in a cost-effective way. No one has done this in academic medicine. The first one to do it will be the role model for the rest of the country, perhaps for the rest of the world. I want UCLA to be that role model.
For the school of medicine, we have identified six research themes in which we want to particularly invest and excel. These areas are nondepartmental. They are thematic: cancer; immunology; cardiovascular medicine; neuroscience; metabolism; and degeneration, regeneration and repair. In education, through the enormous generosity of David Geffen and the David Geffen Medical Scholarships, we attract the brightest medical-student applicants, and they can attend UCLA without financial burdens. Dr. Clarence H. Braddock, our vice dean for education and chief medical education officer, will continue to restructure our pre- and post-graduate medical training. Our new bioscience graduate program ensures optimal education for biomedical scientists. With this clear focus, we will be the future of medicine.
What are some examples of how we already excel in the research areas you have identified?
There are many, but let’s highlight one: cancer. Within this past year, three new cancer therapies developed at UCLA have been approved by the U.S. Food and Drug Administration. These therapies are the result of years of investigation led by UCLA researchers, and they offer new alternatives for patients with such cancers as melanoma, non-small–cell lung cancer and estrogen-receptor–positive breast cancer.
I will highlight one other. In the area of cardiovascular research, our scientists have developed an entirely novel therapeutic approach to fighting vascular plaques — a synthetic protein that is designed to mimic HDL, or “good cholesterol.” This therapy was brought to clinical trial, which resulted in a licensing agreement. These are just a couple of examples of the incredible work that is being done at UCLA, the kind of work we want to support and advance even further.
We are speaking in your office in the Center for the Health Sciences building — what used to be the old UCLA Medical Center before the hospital moved to Ronald Reagan UCLA Medical Center. This building has been undergoing a significant transformation. What is happening here?
This has been the single largest renovation project in the history of the University of California, to transform this building into a space for high-intensity research laboratories. The building has been seismically retrofitted, and now it is being reassembled into clean, open spaces with all new infrastructure. That phase is scheduled to be completed this June.
The final phase will be outfitting the labs, which will be customized to serve different purposes — there will be a floor devoted to each of the six research themes that I previously mentioned. That phase will take another six to nine months. Other areas will be used to facilitate different kinds of partnerships — public-private partnerships. We will partner with established organizations and businesses in the private sector to do joint research projects, possibly startup companies. As a university, we’re not a bottom-line organization that focuses only on the money that can be made from these opportunities. Rather, we will pursue intellectual property that can lead to societal benefit, even if it isn’t necessarily a financial winner. That’s going to be a very exciting activity.
What have been the most pivotal moments in your life and career leading up to where you are now?
I will go back to my childhood, growing up outside of New York City. My father was an individual who was a pretty structured guy. And whenever I would want something, for example, “Dad, I need a car,” his response was to say, “If you want it bad enough, you’ll figure out how to get it.” So, I would come up with a proposal for how to accomplish what I wanted. He would look at it and say, “You’re getting there. You’ll figure it out.”
I would have to be creative, knowing that I had a certain amount of money, and maybe I could borrow some from him and perhaps earn extra money doing more jobs. And he would just say, “You’ll figure it out.” That taught me perseverance and to try to think in a variety of different ways to solve a problem. Rather than to just say I want something and get it, I had to come at it from five or six different directions. Eventually I knew some combination of those different approaches would be successful. There’s a proverb that I like: “In the struggle between the river and the rock, the river always wins, not through strength, but through perseverance.” That was a good lesson for me to learn. I believe every problem has a solution.
This Q&A appears in U Magazine’s spring 2015 issue.