The Peck Era in Medicine
As William A. Peck, MD, concludes his 14-year deanship, Washington University School of Medicine reflects on its transformation.
Peck is an incredibly good communicator, articulate and perceptive of others.
RALPH G. DACEY JR., MD
Bill Peck combines excellent science with good business sense.
ANDREW B. CRAIG III
AN ACADEMIC LEADER IS
. . . educator, wielder of power, pump; he is also officeholder,
caretaker, inheritor, consensus seeker, persuader, bottleneck. But he
is mostly a mediator.
Bill could have been eminently successful in a
dozen walks of lifebusiness, finance, music, and anything that requires
skills with people. Luckily, he chose medicine and Washington University.
William Danforth was talking about William A. Peck, MD. And Clark Kerr, commenting on the work done by leaders of modern academic institutions, easily might have been.
Now in his 14th year in the dual offices of dean of the School of Medicine and executive vice chancellor for medical affairs, Peck has excelled in the tasks Kerr sets for an academic leader. And he has comfortably worn all of the hatsbusinessman, negotiator, political figure and morethat Danforth imagines for him. In a punishing 14-hour-a-day schedule that seems to some to have fused the school and the man into a complex hybrid, he even has found a way to incorporate his love of music.
The Peck era in medicine will be regarded as one of unprecedented progress, says Washington University Chancellor Mark S. Wrighton, PhD. Dean Peck has been a national and international leader in academic medicine and has contributed to the building of the school in every aspect of its mission: research, education, patient care and public outreach.
Ralph G. Dacey Jr., MD, head of neurosurgery and a colleague of Pecks, says, We all have our various talents, but Bills intellectual capacity allows him to function as a scientist and a clinician in a complex business and regulatory environment, cycling back and forth between roles in a way that few can.
The changes and challenges have ranged so widely that Peck himself says he cant identify an outstanding success. Instead, as he steps down, hes most proud that the school is a great institutionin every regard.
In 1988, when first approached about assuming the posts of dean and executive vice chancellor, Peck was at a regularly scheduled pizza lunch/science roundtable with a colleague. At first, I said, It cant happen. Its not on my agenda. But then, in an initial stroke of the vision that would come to mark his tenure, he began to see the opportunities and the needs to satisfy them, he says. When the offer came from the committee that was reconsidering the medical schools governance, there was little to negotiate.
Wet behind the ears, he says he began to learn as much and as fast as possible, from outstanding department heads like David M. Kipnis, MD. I also studied at the feet of great academic administrative leaders: then-Chancellor Danforth and Sam Guze, who was leaving the vice-chancellors job. And I learned by example from Ken King (the departing dean). Guze and I had perhaps 14 focused meetings, maybe 20 hours. Id ask questions and take notes. And I observed Ken King, a master at achieving his goals without people even knowing.
Managed care was about to disturb the established order, and with it came the concept of competition for contracts with insurers. We had to decide whether we wanted to compete. Its a two-edged sword, requiring time, effort and angst, with inevitable tension between academic divisions, Peck says.
As a result of the decision to compete, the school fostered a clinician track to accommodate physicians focused on patient care and teaching. That change enriched the academic environment and enhanced the schools competitiveness as a clinical entity. Revamping of clinical business practices included the formation of the Washington University Physicians Network, dedicated to negotiating health care contracts. What is now the nations second largest faculty practice plan, named Washington University Physicians, was created to manage the clinical third of the schools mission. And most recently, much of the treatment delivered by clinicians was relocated to the Center for Advanced Medicine, the Alvin J. Siteman Cancer Center and the Charles F. Knight Emergency and Trauma Center.
Peck says the secret to being able to manage so many projects
of such size is in three parts:
But equally important is step two of the three-part recipe for success, which many say is Pecks strongest talent. Dacey calls him, an incredibly good communicator, articulate and perceptive of others. Lois Hengehold, for 13 years Pecks assistant, says he is a wordsmith who can convey vision and bring together brilliant people with their own ideas. And Danforth says he is a master explainer, able to make complicated issues understandable to others.
Among the challenges that began almost immediately for the new dean was the recruitment of department heads to replace leaders who were retiring or moving on. Peck says he always has devoted the greatest attention to the task because, The secret of our success is good people on the faculty. The departments and divisions are the operating level, and the right department heads and division chiefs are key. They recruit and retain the best faculty members. Over his 14 years, Peck has named 17 of 20 department heads and created the departments of orthopaedic surgery and radiation oncology.
Hengehold, who has staffed those searches, says, Dean Peck always strives to take a department to the next level, to always improve. Ive never heard him say that an issue is resolved or complete.
Also early in Pecks tenure, the Liaison Committee
on Medical Education, which accredits medical schools, visited, and necessary
changes to curriculum became clear: We had no central oversight
of the curriculum, and no planning for curriculum changes. Today, the
curriculum bears almost no resemblance to what it was when I began,
Peck says. For much of the advance, he credits S. Bruce Dowton, MD, at
the time associate dean and associate vice chancellor for medical education
and now dean of the medical school at
Recruitment of an extraordinary group of academic deansincluding W. Edwin Dodson, MD, in medical student admissions; Will R. Ross, MD, in diversity; and Leslie E. Kahl, MD, in student affairshas enabled the school to attract what Peck calls, the best students in the world.
While dealing with the demands of an uncommonly diverse
institution, Pecks commitment to students always has been both resolute
Locally, he picked up the baton created in 1973 when work began to rescue the Central West End (CWE), the schools own neighborhood, from deterioration. Peck worked to empower Washington University Medical Center and its spin-off redevelopment corporation to further revitalize the CWE via projects such as the Forest Park Hotel and the Buckingham/Yorkleigh housing project. That work drew additional development attention, until critical mass was reached and the CWE was again a community in which to live and work.
More recently, attention has turned to the needier and higher
crime Forest Park Southeast neighbor-hood (FPSE) that also abuts the medical
center. Pecks appointment of I. Jerome Flance, MD, gave the project
a dynamic leader. With the assistance of Richard Baron, of redevelopment
expert McCormack Baron, three years of work have brought stunning
changes, Peck says. The
With an annual total impact of $2.3 billion-plus on the St. Louis economy, Washington University School of Medicine assumed its place in the business community in the person of Bill Peck, who quickly gained the respect of its leaders. Says Andrew B. Craig III, former chairman and CEO of Boatmens Bancshares, retired chairman of Nations Bank and a partner in Rivervest Venture Partners, Bill Peck combines excellent science with good business sense. He knows how to set priorities and follow through, and that has earned him the respect of the business community.
Joined at the table by Fetter; Charles F. Knight, then chairman of the Barnes Hospital board, and Max Poll, then president of Barnes Hospital, Peck renegotiated and advanced the schools 1964 contract with Barnes Hospital, retaining a bottom-line profit sharing arrangement that is unique in American medicine.
He also stepped out onto the larger stage, taking leadership roles in national organizations to represent the school in public affairs. The world at large and even many in academic medicine didnt recognize us, he says. Pecks efforts, a concerted media relations push, and attention to the U.S. News & World Report rankings have changed that.
At the particularly influential Association of American Medical Colleges (AAMC), Peck served first on the Council of Deans, then as the councils chair, and finally as chairman of the entire association. Bill Peck brought a measured tone to our debates and was able to guide discussions so that diverse opinions were heard and crafted into a consensus. This is not always easy to do on our Executive Council, comprising as it does deans, hospital directors, faculty, students and residents, says Jordan J. Cohen, MD, president of the AAMC, in yet another recognition of Pecks abilities as a consummate consensus-builder. Today, Peck is vice-chairman of Research! America, reflecting his continuing interest in biomedical research.
Another interestalumni relationshas taken Peck to meet with alumni around the country and the world. They love their school, he says, but they hadnt been spoken to lately, and they were stunned to learn all that was going on. In large measure because of Pecks interest and involvement, alumni interest has grown so that there are now 5,000 alumni donors, compared to fewer than 3,000 when Peck began. The interest in the school that he has fostered has resulted in 67 endowed professorships.
Though he rarely speaks of it, the energy and broad involvement
that now define him were not always Bill Pecks to enjoy. At the
age of seven, having suffered a spate of child- hood diseases before
The son of a physician, Bernard C. Peck, MD, who kept an office in the family home, Pecks early years revolved around medicine and music. Social life centered on his fathers colleagues, and Pecks health meant that he spent many long stints in the hospital. Hes certain now that those experiences aimed him in the direction of medicine, perhaps even to the extent that his research interests in bone metabolism spring from his childhood condition.
They also forged his strong sense of family: An elegant portrait of his father hangs so that it is over Pecks right shoulder when he is at his desk. The sideboard in his office holds more than a dozen photographs of his wife, Pat, children and grand-children. He attributes much to Pats great support and understanding.
Early talk of a career in music faded when, he says, it became clear as a teenager that I would not be one of the worlds great pianists. Nonetheless, he continues to play the piano at a near-professional level and has issued a CD of his music, Listen to the Beat. He often performs at social functions and at fund raisers.
And excellencethat notion of being one of the worlds best that nixed the music careeris still Pecks determining factor, his raison detre. Dacey says its at the center of Pecks character: Some people just do; theyre compelled to achieve, to perform in a superior way.
Speaking to the subject, Peck says that the school under its new dean and executive vice chancellor, Larry J. Shapiro, MD, is poised to be successful into the future and to take the next step toward still greater excellence, despite many uncertainties. It wont be easy. But then the pursuit of excellence is a strange journey. You never really arrive; you never are all that you can become.