A Bold Step

A 2009 trip to Mississippi inspired Campbell President Jerry Wallace to move on establishing North Carolina’s first medical school in 35 years; but the idea was planted much, much earlier …

BY BILLY LIGGETT

Jerry Wallace had already made up his mind.

There was no way little William Carey University — a Baptist school half the size of Campbell, tucked away in the center of Mississippi — could afford to launch a medical school. Especially in 2009, when the country was still trying to crawl out of the Great Recession.

Yet there Wallace was, part of a team tasked by the Southern Association of College and Schools to review William Carey’s application to launch a school of osteopathic medicine, a term (“osteopathic”) Wallace had limited knowledge of.

Fast forward four years — a mere four years — to early June 2013, just 60 days before Wallace and Campbell University will greet its own class of 162 osteopathic students to North Carolina’s second-largest medical school and the first in the state in 35 years. A fixed smile on his face, Wallace leans back in the couch in his office’s adjoining meeting room as he recalls that trip to Mississippi … the trip that inspired Campbell’s boldest move since the establishment of its pharmacy school in the 1980s.

The smile is there because Wallace admits he was biased about William Carey’s chances at accreditation and, ultimately, very wrong.

“When I left Mississippi, it was clear to me they could launch that school,” Wallace says. “And they’d be successful in doing it.”

‘SO AWESOME OF AN UNDERTAKING’

Long before he visited Mississippi and discovered that spending millions on a hospital to support a medical school is the old way of doing things — and long before he first picked up the study by the N.C. Institute of Medicine that warned of a massive shortage of physicians in the next 10 years — Jerry Wallace was asked to head a feasibility study on whether Campbell could and should launch a physician assistant program and a nursing school.

The year was 1981, and at the time, Wallace was the new dean of Campbell’s College of Arts & Sciences. Then-President Norman A. Wiggins had successfully created a law school five years prior, and he knew Wallace had an interest in starting a PA program (his daughter graduated from Wake Forest’s program that same year).

Despite what seemed like serendipity, Wallace concluded that Campbell wasn’t ready for either program just yet. Around that time, however, he visited the Southern School of Pharmacy at Mercer University in Atlanta to talk to its dean about Campbell’s interest in a pharmacy school.

“I met with the dean and asked him, ‘Is there a need for a new pharmacy school,’” Wallace recalls, noting the fact that the U.S. had not seen a new pharmacy school in nearly 35 years. “And he said, ‘Definitely yes. But they’ll all tell you no.’ … And that’s exactly what happened.”

In 1986, Campbell University defied the odds and turned a deaf ear to its critics and launched a pharmacy school. The school’s founding dean was Dr. Ronald Maddox, chairman of the Department of Pharmacy Practice and two time “professor of the year” at … you guessed it … Mercer University.

Today, Maddox is still dean of Campbell’s esteemed College of Pharmacy & Health Sciences and in 2010 was named the school’s vice president of health programs. Wallace says Maddox was instrumental in the University’s efforts to launch a medical school.

In 2011, Campbell began the physician assistant program it once considered 30 years earlier. This fall, the medical school will welcome its first class of 162 students in a new 96,500-square-foot facility just a quarter-mile from Campbell’s 126-year-old Buies Creek campus. And earlier this spring, the school announced its efforts to earn accreditation for a new four-year nursing program.

“It’s interesting how it all comes full circle,” Wallace beamed on June 3, 2013, the day he welcomed the first class of PA students as the first inhabitants of the new medical school facility, the Leon Levine Hall of Medical Sciences. “I believe strongly there is a religious foundation in all of this. Without a doubt in my mind, this is a God-achieved event. It could not be otherwise, because it was so awesome of an undertaking and has been so wonderfully fulfilled.”

SETTING THE STAGE

If the pharmacy school paved the road for the opening of Campbell’s medical school, its law school — which opened 10 years earlier in 1976 — beat the path.

While news of the school of osteopathic medicine has been met with optimism and positive press from state and national media outlets, that wasn’t the case for its predecessors. The Raleigh News & Observer, which had previously questioned Campbell’s law school, came out against the pharmacy school in 1985, writing, “Not all private schools are as expansionist as Campbell, which opened a law school in a state overrun with lawyers.” The Wilmington Star and UNC-Chapel Hill’s pharmacy school dean were also publicly critical of Campbell at the time, fearing the new pharmacy school would cut into public school funds and enrollment.

The law school immediately set out to prove its critics wrong with an inaugural class of 97 students who matched the larger schools’ performance on the North Carolina Bar Exam and would go on to pass their peers consistently, hitting a 100-percent passage rate for the first time in state history in 1994. Campbell became the only law school in the state capital when it moved to Raleigh in 2009.

The pharmacy school also excelled. After becoming the nation’s first pharmacy school in 35 years in 1986, the inaugural Class of 1990 had a 100-percent passage rate on the national pharmacy board exam, and the school has since maintained a 98-percent passage rate.

“The pharmacy school, in particular, has brought Campbell hundreds of new undergrads who’ve come here because they wanted to study to enter our pharmacy program,” said Britt Davis, Campbell’s Vice President of Admissions and Advancement. “It’s strengthened our undergraduate science base and has expanded our clinical research and ultimately led to our physician assistant program and now the medical school.

“No doubt about it, law and pharmacy have helped set the stage to open the med school. All of this has been years in the making.”

And now, the media is embracing Campbell’s medical school with open arms.

“Many of us are fond of raising a toast to good health,” wrote the Fayetteville Observer in December 2011.

“Up the road at Campbell University, they’ve hoisted the cup in the biggest way imaginable — breaking ground for a medical school that will change this state’s health in ways more profound than any toast can induce.”

IDEA TAKES HOLD

Wallace’s doubts about William Carey University’s ability to launch a medical school were rooted in his understanding at the time of how medical education worked.

For decades, North Carolina has been home to some of the nation’s top medical programs and university-run hospitals. UNC-Chapel Hill’s medical program dates back to the post-Civil War era, while Duke University Medical Center traces its roots to the early 1930s. They and the Brody School of Medicine at East Carolina University and the Wake Forest School of Medicine are all affiliated with large medical centers that serve as both classroom for the students and hospital for the general public. That’s where the big costs come into play — funding and manning a hospital. That’s why Wallace found it difficult to believe William Carey, which has about half the enrollment of Campbell, could handle such a large undertaking.

“My first interview was with the dean,” Wallace recalls. “I wanted to make sure the school was behind this and that establishing a medical school was not robbing Peter to pay Paul. I wanted to make sure the English or math departments weren’t being affected and that the school could finance itself and not drain everyone else.”

As Wallace interviewed the dean, the school’s vice president and the president, he learned more about the osteopathic medical education model and how it differs from the “MD” model. Unlike the medical schools at UNC and Duke, osteopathic schools do not house a hospital. The didactic portion of an osteopathic education occurs on campus (usually the first two years), while the clinical part is distributed among partner hospitals and clinics.

“As I learned this, I thought … ‘goodness, this is the way we’re doing pharmacy,’” Wallace said. “Instantly, this whole idea just really took hold of me. I kept asking questions, and when I returned home, I read about other osteopathic medical schools.”

Wallace didn’t just learn about osteopathic education, he read as much as he could about osteopathic medicine in general. His one experience with a DO had come a few years earlier when his son, McLain, then an attorney in Rocky Mount and chief counsel for Nash General Hospital, was scheduled to have shoulder surgery. Before the procedure, Wallace met his son’s surgeon, and noticed a “DO” where he thought the “MD” should be.

“I knew nothing about DOs,” Wallace says. “This surgeon was a nice young man, but I thought he was some kind of specialist in orthopedics. McLain explained ‘osteopathic’ to me briefly, but I didn’t think much about it until, of course, just recently.”

What Wallace learned is that a DO degree is the equivalent of an MD degree, legally and professionally. The big difference? Osteopathic physicians are trained to take a holistic perspective of medicine based on a belief in treating the whole patient (mind, body and spirit) and the primacy of the musculoskeletal system and utility of manipulative medicine, while DOs emphasize prevention.

Because of their equality, in addition to substantial decrease in costs to launch one, osteopathic schools have nearly doubled in the United States since 2000. In 2011, there were about 74,000 osteopathic physicians, compared with about 29,500 in 1990.

With the additions of Campbell, Alabama College in Dothan, Ala., and Marian University in Indianapolis — all opening this fall — there are now 29 colleges of osteopathic medicine, four branch campuses and four additional teaching locations.

A quarter of all medical students in the United States are currently studying to become a DO.

‘THE ANSWER IS YES’

North Carolina ranks 30th in the nation in physician density, with approximately 202 practicing physicians per 100,000 people. For primary care physicians — the “front line” physicians who are typically the first contact for an undiagnosed patient with a health concern — the state ranks 34th.

Despite North Carolina’s reputation as a mecca for medical education, the state simply isn’t meeting the needs of the population, according to Dr. John Kauffman, the founding dean of the Campbell School of Osteopathic Medicine.

“One of the first questions in Campbell’s feasibility study was whether or not the state needed a new medical school,” Kauffman says. “The question was answered in a 2007 white paper put out by the Institute of Medicine, which concluded that by 2020, our state will be 90,000 physicians short. And that’s not just primary care physicians … we’re short on surgeons and specialists as well.”

The need is even greater in the rural parts of the state, according to Kauffman. Twenty of North Carolina’s 100 counties are without a single general surgeon, many of those counties are east of Harnett. Kauffman pointed out that counties without an obstetrician suffer from a higher infant mortality rate.

“So to answer the question, ‘Do we need a new medical school?’ … the answer is yes,” Kauffman says. “Our current doctors are getting older. People are living longer. If our graduates head out into primary care, emergency medicine and other areas, and if the majority of them are practicing in underserved regions of our state, that would justify Campbell’s decision to launch this school.”

Wallace learned of these shortages while reading the 2007 report as part of his feasibility study for the PA program. Wallace says Campbell’s PA program — a two-year program which will graduate around 40-plus students each year — will provide much-needed manpower and assistance to MDs and DOs across the state.

“Launching the PA program was a very important step for us,” Wallace said. “The idea of the medical school was born out of the research that justified bringing in physician assistants. The stars have lined up for us, and the PA program has been eminently successful.”

‘UNDER CONVICTION’

Benjamin Thompson, now chairman of Campbell University’s Board of Trustees, was in his second year with the board the day when Wallace first brought up the idea of establishing a medical school.

He remembered it well.

“We quickly understood that he not only had the vision, but had also thoroughly considered the impact,” says Thompson, an attorney in Raleigh. “First and foremost, we knew he had considered the purpose of the medical school would be consistent with the longstanding principles of Campbell University.”

Second, Thompson said, the board had confidence that Wallace had thoroughly analyzed the costs and the economic impact the school would have. And third …

“Dr. Wallace likes to use the expression, ‘In order to make things happen, you have to be under conviction,’” Thompson adds. “He was clearly under conviction that we could raise the funds to make the medical school a reality.”

The Board of Trustees unanimously approved conducting a feasibility study to consider establishing the state’s first medical school in 35 years on Aug. 4, 2010. Five months later, they picked Kauffman to lead as the school’s founding dean, and in October of 2011, just 14 months after that first vote, Campbell’s medical school was awarded pre-accreditation status by the Commission on Osteopathic College Accreditation.

Around the same time Kauffman came on board, Britt Davis joined the team as the University’s Vice President for Institutional Advancement, moving over from his position as director of development at Campbell’s law school. On Day 1 in early January 2011, Davis was tasked with creating a fundraising plan for the med school.

Davis calls the first six months of 2011 “quiet fundraising,” as he, Wallace and their team reached out to Campbell friends and involved alumni.

“We spent a lot of time explaining our vision of medical education and trying to generate support,” Davis says. “We weren’t going public with our fundraising yet, because we were still trying to determine how much we needed to raise and trying to understand the full financing model of the school.”

They spent months learning how much to invest in lab equipment and faculty [their initial guess on faculty salaries was far less than what reality demanded]. In August, after announcing the news of pre-accreditation, Davis kicked off an official, public financing campaign with an announced goal of $30 million to make the school a reality [three times their initial fundraising estimate].

“This is by far the most costly initiative the University has ever taken on,” Davis said. “We’ve been able to fund it through a combination of external support and Campbell resources. The fact that it’s a medical school [and something much-needed in North Carolina] has opened the doors to support from individuals and organizations that otherwise may have never become involved with Campbell.”

An example — the University received $4 million toward the school in 2012 in the form of two $2 million gifts from the Kate B. Reynolds Charitable Trust and the Golden LEAF Foundation. The school, in turn, is naming its state-of-the-art simulation labs for the two organizations.

“It’s been tremendous to have some of the biggest names in North Carolina philanthropy and health care involved with us in such a meaningful way,” Davis adds. “They believe in what we’re doing here. It’s a tremendous validation of our pursuit of medical education.”

Davis says even in the early days of fundraising for the program, the words “medical school” raised eyebrows and caused people to sit a little straighter in their chairs. He recalled a meeting with Raleigh News & Observer Publisher Orage Quarles in 2011 when Davis went asking for media coverage of Campbell’s bold step.

“We were in his office, and Orage was relaxed, leaning back in his chair when we began talking about Campbell’s next big project — a school of medicine,” Davis says. “I remember when we said that, he immediately leaned forward in his chair, put his elbows on his desk and was instantly engaged. ‘Tell me more about this.’”

A week later, the N&O ran a front-page, above-the-fold feature on Campbell’s venture. After that, the milestones were fast and furious.

In October 2011, on the heels of pre-accreditation for the medical school and the launching of the PA program, Campbell announced it would launch a new doctor of physical therapy program in 2013.

On Dec. 8, 2011, hundreds gathered in a bare pasture on a cold, windy day under a tent to celebrate the official groundbreaking of the Leon Levine Hall of Medical Sciences, a 96,500-square-foot facility, which finished major construction in spring 2013 and will open its doors to the first class of medical students in the fall.

In April 2012, the medical school received a $1.75 million pledge from BB&T.

That same month, Campbell received provisional accreditation from COCA, allowing it to recruit students in the summer of 2012.

“I believe in this life, we are put in certain places for certain reasons,” says Jim Roberts, Campbell’s vice president for business and one of the key administrators, according to Wallace, who made the medical school a reality. “When all of this comes together, and we look at how this happened so quickly, we’ll simply have to admit there was a guiding hand that made all of these pieces of the puzzle fit. And everything has certainly fit.”

‘BIG IDEAS & BIG DREAMS’

“The question I’m always asked is, ‘How can North Carolina compete?’” former North Carolina Gov. Bev Perdue asked the crowd of a few hundred huddled under a large tent on a particularly cold and blustery early December morning in 2011.

The tent stood in the vacant field of grass roughly a quarter of a mile west of main campus — the site where a 96,500-square-foot medical school now stands.

“The answer is simple,” Perdue continued at the groundbreaking ceremony for the Levine Hall of Medical Sciences. “We compete by having big ideas and big dreams. Campbell’s big dream will transform the town of Buies Creek, Harnett County and the state.”

Sixty days before the first medical school classes — still leaning back in the couch in the building on campus named for University founder J.A. Campbell — Jerry Wallace said his dream has come true.

“Campbell will make a huge difference,” Wallace says. “Come August, we will be the second-largest medical school in North Carolina, and soon we’ll have graduates in the communities where they’re needed most. This will open many doors for Campbell. And I pray Campbell will be just as bold for the next challenge as it has been for the PA program and this medical school.”

Days after saying these words, Wallace was on hand to welcome the class of 40-plus PA students as the first students to study under the roof of the Levine Hall of Medical Sciences. PA students man a few of the classrooms in the building and will share all labs, lab equipment, libraries and other amenities with medical school students, physical therapists and, hopefully, nursing students (the University approved taking the steps to launch a nursing program last spring) in the future.

“Campbell will be a destination for health care education on several levels,” Wallace says. “It’s glorious to imagine having pharmacy, PA, physical therapy, osteopathic medicine, nursing, public health, athletic training, social work, community counseling, exercise science, chaplaincy and the other programs I’ve failed to mention … all here in a place called Buies Creek.”

That vision is exciting to students like Jeffrey Pennings, who’ll be in the first class of medical students at Campbell set to graduate in 2017. A graduate of Clemson University, Pennings says he chose Campbell because he’s convinced the school will help lead the way in changing the approach of medical education. He said he was asked by several friends where Campbell was located and whether or not he’d feel “trapped” in a small town like Buies Creek for the next few years. Pennings told them no.

“This school is right where it needs to be,” he says. “The community will benefit, and the students will be trained in an environment similar to the areas of this state that need physicians and improved health care. I’m going to be very comfortable here.”

Location doesn’t seem to be a hindrance at all in the early going. Three weeks after Campbell opened up student applications on June 1, 2012, the school already had 500 applications for its openings, more than many established schools received, according to Kauffman. That number had reached 700 by August 2012.

And aside from the influx of doctors the school will provide in the coming years, it’s also going to mean an economic shot in the arm as well. Already, about 65 full-time faculty and staff have been hired with more to come as the school grows and more classes matriculate in. In the first 10 years of operation, the school is expected to mean 1,158 new jobs created in North Carolina and a $300 million regional economic impact.

All of it the result of one man’s desire to launch a PA program and, eventually, something even bigger.

“I’m grateful to God,” Wallace says when asked to describe his emotions as his vision becomes reality. “I’m grateful for His provision and his guidance in opening doors we never could have dreamed we could open here at Campbell University.”