Dermatology Division Retreat November 4, 2016

Mission To provide outstanding patient care, Train and mentor future leaders in dermatology, And advance dermatological knowledge Vision To be a top clinical and research program in dermatology, the most expert center of dermatology care in the WWAMI region, and the most desirable dermatology work place.

2015 Derm Retreat pictured above

Theresa, Kelsey, Melina, Kelley & Heather

Additions to Dermatology: 2016

Erica Shantha-Tarabadkar Residents Vanessa Pascoe Maryam Safaee Erica Shantha-Tarabadkar

Fellows David Pate Mohs Micrographic Fellow Suzan Kavusi Dermatolopathology Fellow Cheryl Bayart Peds-Derm Fellow

Derm Admin Staff Roosevelt Clinic Jay Vary Roosevelt Clinic Medical Director Andrea Kalus Roosevelt Clinic Phototherapy Medical Director Melina Mambalam Division Administrator

New Dermatology Additions Lisa Maier, MD Clinical Associate Professor February 2016 Fan Liu, MD Acting Instructor July 2016 Aric Colunga, PhD Senior Fellow – Nghiem Lab October 2016 Song Park, PhD Senior Fellow – Nghiem Lab November 2016

2016 Division Highlights February Lisa Maier joins UW Dermatology Jen Gardner starts a weekly clinic at SCCA April Kyle Garton shifts to paid faculty; all day on Fridays at Roosevelt Paul Nghiem lab study (anti-PD1) published in NEJM May Scribe pilot began NCI Director, Doug Lowy gives Odland lecture June Nic Compton began e-consult telederm clinic in Issaquah Fan Liu, Carolina Simunovic, Gina Kwon graduate from residency program

2016 Division Highlights July Melina Mambalam joined us as Division Administrator Masaoki Kawasumi promoted to Assistant Professor; moves into new lab at SLU Welcome to new residents and fellows Dr. Maier began at VA hospital 3rd Derm Resident began at VA hospital August Stanley Hurst retires  Kristen Foster, PhD, PA-C accepts Roosevelt Derm Clinic Position (starts Jan 2017) September HSB-BB-13th floor renovations begin (target completion April 2017) Fan Liu began at Roosevelt Aric Colunga, PhD joined the Nghiem Lab

2016 Division Highlights October Andrea Kalus becomes Medical Director of Phototherapy at Roosevelt Jay Vary accepts Medical Director position at Roosevelt New Merkel Website launches www.merkelcell.org November UW HouseStaff contract approved Song Park officially joins the Nghiem Lab December Pommerening Speaker: Carrie Kovarik (U Penn) Hubio/MedSci Course

Goal #1: Strengthen Dermatologic Faculty 2016-17 Division Goals Strategic Plan Goals 2011-2016 Updated Aug 2013; July 2014; Sept 2014; Oct 2015; Oct 2016 Goal #1: Strengthen Dermatologic Faculty (last leader: Nic Compton) We will create a supportive, nurturing work environment with efficient, high quality patient care, state-of-the-art research, outstanding training and mentorship, with work-life balance and a competitive salary. Right-sizing the Dermatology Division is dependent on research and clinical space as well as access to financial resources for salaries and support staff. Focus on: Scientific & Clinical recruitments Derm/Pathology relationship Faculty Mentoring  

Goal #2: Development of Improved Dermatologic Care (last leaders: Andrea Kalus/Michi Shinohara) UW Dermatology will continue to provide the highest level of dermatologic care for patients. This is an ongoing process which will incorporate use of national metrics as well as local feedback measures to improve patient and provider satisfaction. All sites will implement site-specific QI/QA programs to allow for continuous evaluation and improvement. There are plans for growth in the next five years, including expansion in the number of providers, space, support staff, and residency positions. Overall, dermatology will work to stay aligned with the strategic initiatives of each site. Focus on: Development of Specialty Clinics Clinic space Clinical efficiency QI program

Goal #3: Excellent and Innovative Dermatology Education & Training (last leaders: Roy Colven/Jay Vary) With excellent and experienced faculty members, including generalist and specialist dermatologists, and a diverse and rich patient population, UW Dermatology has the foundation for excellence in education and training. The Division attracts smart and talented candidates for residency and fellowship training and fulfills its mission of graduating excellent clinical dermatologists, investigative dermatologists, procedural dermatologists and dermatopathologists who often go on to positions of leadership both within and outside of academia. Focus on: Adjusting Residency rotations and specialty clinics based on increased number of residents Development of residency QI program Increasing/improving med student rotations

Goal #4: Development of Dermatologic Research (last leader: Paul Nghiem) To optimize the impact of clinical, basic and translational investigative dermatology at the University of Washington by fostering the careers of young skin investigators and collaborating with scientists across the rich spectrum of expertise in Seattle. Focus on: Clinical research/trials Recruitment of new investigators

(last leaders: Philip Fleckman/Kyle Garton) Goal #5: Transitions in Leadership, Approaches to Health Care Reform, Development (Fundraising) (last leaders: Philip Fleckman/Kyle Garton) To create a UW Dermatology plan/agenda of priorities and specific action points to be addressed during the upcoming transitions of leadership within the Dermatology Division over the next 5 years. Focus on: Rewriting/repurposing this goal Division space for increased residents and faculty

Kathy Schwarzenberger, MD Recruitment Updates Melanie Clemenz, MD Lauren Guggina, MD Kathy Schwarzenberger, MD Katie DeNiro, MD Jennifer DePry, DO ----------------- Sam Lee, PhD* Mayumi Fujita, MD, PhD* Anna Mandinova, MD, PhD* *recruitment would be as physician/scientist

Dermatology Division FY16 Finances

Years FY08 through FY15 depict actual cash receipts Years FY08 through FY15 depict actual cash receipts. FY16 is a projection. FY14 was the year Dan Berg resigned. Factoid: Our actual cash receipts for FY15 exceeded our projection by $157K. (Our projection for FY15 was $2,690,000.)

Reimbursement of ‘Charges’   •No insurer pays 100% of the charges •The reimbursement rate (cash/charges) varies by insurer •For a level 4 New Outpatient visit, the professional fee is $282, what they pay: –Commercial $193 (68%) –Medicare $128 (45%) –Medicaid $ 81 (29%) •So, our revenue is linked to the payer mix

Reimbursement of ‘Charges’   •No insurer pays 100% of the charges •The reimbursement rate (cash/charges) varies by insurer •For a level 3 New Outpatient visit, the professional fee is $179, what they pay: –Commercial $113 (63%) –Medicare $73 (41%) –Medicaid $ 48 (27%) •So, our revenue is linked to the payer mix

UW Physicians Department of Medicine Income Statement 12 months ending June 30, 2016 The 35% of net cash is the max amount in the UWP income distribution plan. Medicine and surgery were the only two departments that requested a waiver from the Dean every year to exceed the 35% tax limit. With the migration to the new faculty funding in FY15 we were held to the same standards as the other departments, thus our allocation is now based on 26% of the NET CASH BALANCE. *

Other Division Funding Sources

You will notice our projected endowment income is $380K for FY16 You will notice our projected endowment income is $380K for FY16. What is included in our annual budget are just the funds that are committed. So on slide 3 it shows “Other Faculty Support” funds of $237K. The difference between $380K and $237K is $143K which is available for future recruitments or other project support.

Endowment Available Balances End of 2016 Odland Endowed Chair $375,238 Odland Endowed Research $234,553 Odland Lecture $ 12,575 Olerud Professorship $ 56,038 Piepkorn Chair $118,942 Bloom Research Fund $ 10,635 Total funds available* $ 807,981 The endowments have restrictions on how the funds are to be used. Nonetheless I thought this information would be interesting to share. * purposes are restricted by goals of fund

Administrative Priorities Administrative Re-organization Creating subject matter expertise Expanding fiscal responsibilities Creating shadow budgets for grants and tracking tools for clinical trials Expanding divisional financial reports Moving to electronic data storage Moving into new administrative space Setting timelines Coordination of moving into new space, room assignments etc.

Administrative Priorities Bridging the salary gap between tracks Increasing the salary of clinician educators Clarifying the requirements of the tracks Understanding the Clinical Enterprise Partnering with Med Dir and Clinic Manager Assessing clinical productivity reports