This month we had the opportunity to visit with our distinguished friend, Dean of Dell Medical School and Vice President for Medical Affairs at the University of Texas at Austin, Dr. Clay Johnston. Dr. Johnston left San Francisco with his wife Clarissa (an internist) and two adopted sons, Teo and Nico in 2014 to take the helm as leader of the much-lauded Dell Medical School at the University of Texas at Austin.
Dr. Johnston received his medical degree from Harvard University, and his Ph.D. in epidemiology from the University of California, Berkley. He completed residency and fellowship training in neurology at the University of California, San Francisco (UCSF).
Before moving to Austin, he spent 20 years at UCSF. As the associate vice chancellor of research, he directed the university’s Clinical and Transitional Science Institute and oversaw efforts through a $112 million federal grant to accelerate research advancements.
Dr. Johnston also founded UCSF’s Center for Healthcare Value, an initiative focused on solutions that reduce health care costs and improve quality through various methods, including launching several new educational programs. Yet still, as a professor of neurology and epidemiology, he also continued to see patients.
On behalf of the ATX.health Community, we focus our conversation on his transition from San Francisco to Austin, his philosophy on value-based care and Austin’s unique opportunity to transform healthcare. Of course, we didn't finish until we got his picks for favorite Austin breakfast taco and BBQ!
It's been almost 5 years since you left a substantial and important role with UCSF as the associate vice chancellor for research where you also directed the Clinical and Translational Science Institute and founded the Center for Healthcare Value.
At the time, what was so appealing about leaving the Bay area for Austin, TX?
This was the perfect opportunity. All the elements were in place to show how we could do this right. For me, it was a dream job, and Austin was pretty awesome, too.
In retrospect, what has surprised you most about the city of Austin and the community where you live, work, eat and play?
I was surprised at how public the job is. People recognize me at the movies; people ask questions about the med school… No one knew the dean of the med school in San Francisco.
What do you miss most about San Francisco/UCSF?
Start-up life is hard. You love it but also struggle with even the simple things. More importantly, I miss inexpensive and superb restaurants that cover all the countries of the world. We have lots of great food in Austin but the range in San Francisco is unmatched.
You have clearly carried your passion around value-based care to your role at Dell Med. Some would observe that it is the trademark of what Dell Med is doing differently than other medical schools.
What is the true opportunity to flip healthcare on it's head and what makes Austin and The University of Texas different?
Being a start-up helps tremendously. We have a community that wants to do it better and is willing to try new ways of doing things. We also have amazing breadth and depth at UT Austin with a truly collaborative spirit. Finally, we have now attracted some incredibly creative and driven faculty, tired of talking but not doing.
In a highly competitive market, how have you been able to collaborate across three competitive health systems (Seton - Ascension, St. Davids - HCA, Baylor Scott & White) and numerous health plans in the area?
This is complicated. We want all boats to rise here but our primary partner is Seton, set in motion by Central Health before our arrival. Seton fits us well given their mission to serve everyone. We are moving together more naturally now.
How do you scale your work beyond Austin and truly redefine how we deliver care across the country?
First, we develop and prove our models in Austin. Then, we work through partnerships to expand these models beyond. Tech is a part of this but systems of care are even more important.
You've made a lot of progress in your tenure at the Dell Medical School. We've seen buildings erected, Seton’s new teaching hospital opened, and this Summer the third class of students began their journey to become physicians.
How does the education of these students differ from other medical schools? Or maybe phrased differently, why would future doctors want to train at Dell Med over other schools around the country?
We are focused on training leaders who will change the future health system. Our curriculum includes a lot of new elements to train these future physicians. We are very focused on creativity and multidisciplinary. We are doing really well to attract the kinds of students we want.
How do the facilities and the faculty at Dell Med differ from when and how you trained at Harvard Medical School or UC Berkeley?
The facilities here are designed around the way we teach, and they are peppered with reminders of our mission. The majority of our faculty are here because they can do something in Austin that they can’t do anywhere else. Mission is at the center.
Twenty years from now, when you look back on the opportunity to build and lead one of the newest medical schools in the country, what will be the ONE THING you are most proud of?
Geez. No idea. Already, I’m so proud of our team. Most of us haven’t been here two years, and look at the progress… We’re going to need to slow our growth a bit now but we are focused on continuing to escalate our impact.
Like San Francisco, Austin is a community of innovation and technology. Austin is also known as a "weird" city.
How do you think about leveraging the talent and the technology aspect to influence Dell Med? Are there examples of how the unique characteristics of Austin have shaped the medical school?
The tech and the weird of Austin are part of our DNA. Both are part of our strategy for moving the health system forward.
What advice do you have for entrepreneurs in Austin who want to engage with Dell Med and how to best support?
Our vision is, a vital inclusive health ecosystem. We want to help entrepreneurs rise up and solve the health system problems. There are lots of ways to plug in - Mellie Price and Ruben Rathnasingham in the Texas Health CoLab are natural points of contact for many.
And the question all of our readers want to know:
Favorite Breakfast Taco? I love the Otto at Taco Deli
Favorite Austin BBQ? I like Black’s “lean” brisket. Amazing stuff!
Since March 2014, Clay Johnston has served as the inaugural dean of Dell Medical School and as vice president for medical affairs at The University of Texas at Austin. His vision is to create a new model for academic medicine that accelerates innovation to improve health and reduce inefficiencies in health care. That includes building a vital, inclusive health ecosystem to support new and innovative approaches to education, care, research and community impact — all with a focus on measurably improving health in Austin as a model for the nation. He is also a neurologist, specializing in stroke care and research.
In 2016, he was named Austinite of the Year by the Greater Austin Chamber of Commerce for his leadership in transforming health and health care in Austin.
Previously, Johnston was associate vice chancellor for research at the University of California, San Francisco. He also directed the Clinical and Translational Science Institute and founded the UCSF Center for Healthcare Value to engage faculty and trainees in improving the quality of care while also lowering costs.
He is a graduate of Amherst College and Harvard Medical School. He later received a Ph.D. in epidemiology from the University of California, Berkeley, and was a resident in Neurology at UCSF, where he later trained in Vascular Neurology. During his 20 years at UCSF, he rose the academic ranks to professor of Neurology and Epidemiology, and directed the stroke service.
Johnston has authored more than 300 publications in scientific journals and has won several national awards for his research and teaching. In particular, he has published extensively in the prevention and treatment of stroke and transient ischemic attack. He is perhaps best known for his studies describing the short-term risk of stroke in patients with transient ischemic attack and identifying patients at greatest risk, and also for his work related to measuring the impact of research. He has led several large cohort studies of cerebrovascular disease and three international multi-center randomized trials, two of which are ongoing.