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January 2008

Modern Medicine Man
Written By: 
Emily Perlman Abedon
Photographs By: 
Roo Way

MUSC president Dr. Ray Greenberg needn’t wait to see the future of health care; it’s popping up all around him, and he’s one of its guiding forces

Mark Twain once wrote, “Clothes make the man. Naked people have little or no influence on society.” Peek into the closet of Dr. Ray Greenberg, the president of the Medical University of South Carolina, and one single element of his attire appears to speak for the breadth of his influence.

Nearly every crisp shirt has a chest pocket, allowing him to wear close to his heart a three-by-five note card that tells him what time, and with whom, he is meeting all day long: doctors, nurses, teachers, students, contractors, architects, leaders in business and technology, government officials, maintenance crews, major donors, artists, photographers, and writers, to name a few. 

The gamut of people that has made it into Greenberg’s pocket over the last decade is a massive and diverse cross section that not only reveals the demands of his job and the array of individuals that call on him, but underscores the key to his success as an administrator and exposes the very thing that drives him as a human being. By all accounts, Greenberg’s leadership style is an unusual mix of visionary and micromanager. Each meeting is an opportunity for Greenberg to collect data, elicit opinions, put forth ideas, and, ultimately, make connections among the populace in order to serve the widest range of people possible.

“His schedule stays jammed year round, and even if we start off with a reasonable number of appointments for a given day or week, there are always unscheduled phone calls and issues that crop up that require immediate attention,” says Judy Holz, who, as Greenberg’s executive assistant, has made and managed those agenda cards for the past 12 years. “Someone once described Ray as having, ‘a ferocious work ethic,’ and that pretty much describes it.”

Working Together

Greenberg takes whatever opportunities he gets to speak of the benefits of the kind of creative relationships that he feels are critical to improving health care, enhancing education, and maximizing quality of life for South Carolinians. “For us to survive, and indeed thrive, in the new economy, we have to create a culture of cooperation in South Carolina,” he told University of South Carolina associates in 2004, addressing the integration of MUSC with USC’s pharmacy school. “I have every confidence that we can develop a model of collaboration that will become the envy of the country.”

That power-of-partnership philosophy—and the ability to make it work in real life—is a large part of Greenberg’s genius as a leader, say his colleagues, friends, and family, who point to numerous programs that he has initiated locally, regionally, and statewide—institutional relationships that could only be labeled “win-win.”
“He has set lofty goals for MUSC,” says Dr. Lawrence Mohr, professor of medicine and director of the Environmental Biosciences Program, who has known Greenberg since they were students together at UNC-Chapel Hill. “He also has the ability to bring people together in a way that will insure that these goals are fully realized.”    

Among the most high profile of Greenberg’s initiatives is Health Sciences South Carolina (HSSC), an enterprise that unites MUSC with Clemson, USC, Green­ville Hospital System, Palmetto Health, and Spartanburg Regional Healthcare System in the shared goals of increasing research, promoting economic development, and improving the health status of South Carolinians—no small feat considering that more than 13 percent of the state’s residents are uninsured. Last August, Duke Endowment granted their largest health-care award ever—$21 million—to HSSC, of which Greenberg chairs the board, citing the nonprofit’s “commitment and vision of working together for the greater good.” 

Hitting the Books

The trustee who made that comment might easily have been speaking of Greenberg himself, an M.D. and Ph.D. whose educational background has formed a foundation for his decades-long efforts to improve lives. The Chapel Hill native received a degree in chemistry from UNC, went on to attend Duke and Harvard for degrees in medicine and public health, and took a residency in pediatrics at Boston Children’s Hospital before returning to Chapel Hill for a doctorate in epidemiology. 

After 22 years in school, Greenberg joined the faculty of Emory University’s Medical School and was an assistant professor in the Department of Community Medicine when the offer to teach at a University of Minnesota three-week summer program brought him to the door of his future family. Leah, who was divorced with two grown stepchildren, was an energetic and sociable booklover who bicycled each day to work as conference director. She recalls becoming instantly flustered when she dashed around a corner and first saw the blue-eyed physician, who had arrived a week late because he had been leading a group of nutritionists on a medical tour of China. “Oh my gosh, I’m going to marry him,” she remembers thinking. While Leah may consider the realization prescient, Greenberg might be more comfortable with the term hypothesis. Either way, within days it became clear that her theory was correct. A few months later, she was headed for Atlanta, soon becoming not only a new wife but also the manager of foundation and grant support at the High Museum of Art. 

At Emory, Greenberg was nationally recognized for his cancer research and became chair of the epidemiology and biostatistics department. When, at just 34 years old, he became the founding dean of Emory’s Rollins School of Public Health, Greenberg garnered the label “Boy Dean,” a title that lead the young administrator to quip in his own defense that he was “actually 34 and a half.” In 1995, while vacationing in Hilton Head, the Greenbergs discovered they loved the South Carolina coast. Though he’d consulted for MUSC about Savannah River Site cancer studies, he never imagined the role he would one day play there. “Maybe when I retire we’ll move to Charleston,” Leah recalls him saying. 

But when, three months later, MUSC called to ask Greenberg to be a candidate for provost and vice president for academic affairs—a position that would have him overseeing education and coordinating research at the institution’s six colleges— serendipity seemed to be at play. When he was offered the job, it became clear they would not have to wait for the Low­country chapter of their life. He got the job, and, than five years later, MUSC’s Board of Trustees put their faith in Greenberg as president, choosing a man who, in many ways, little resembled the traditional face of the position. When he was appointed, Greenberg became the youngest and first Jewish man to lead the institution in its history. After the selection was announced in 1999, MUSC’s previous president, Jim Edwards, summed Greenberg up as, “energetic, articulate, brilliant.”

He is also disarmingly funny, and his tendency to infuse self-deprecating humor in what might otherwise be perceived as staid topics garners him many invitations to be the commencement speaker at graduation ceremonies all over the country. “After having listened to many such addresses, I have come to the conclusion that the truly great speeches have one thing in common,” he recently told the audience at Simpson College. “They are short. So I promise you, if nothing else, this talk will be brief.”

Greenberg, now 52, says the life-and-death topics that arise in his field can provoke the kind of tension that requires a dose of light banter to put people at ease. “In this occupation, there is the hazard of taking yourself too seriously,” he explains. “It’s important to take the anxiety level down a little bit.”

As provost, Greenberg proved himself to be an ideas guy who created a bevy of “supplemental instruction” programs—the Center for Academic Excellence, Center on Aging, Office of Gender Equity—that speak loudly for his focus on inclusion and diversity. “Dr. Greenberg’s personality is such that students often seek him out for input, guidance, and counseling,” wrote Dr. Tom Waldrep, Ph.D., director of the Center for Academic Excellence, in nominating Greenberg for the Earl B. Higgins Achievement in Diversity award, which he won in 2003. “He personally answers each e-mail he receives, and having been in academics for more than 35 years, I can assure you this does not happen at other universities.”

Critical Condition

But as Greenberg stepped into the top spot in his place of employment, he faced a daunting challenge. Though Edwards had lead MUSC through 17 years of unprecedented growth, the institution was mired in huge financial troubles—a $75 million deficit that the new president needed to address with unpopular job cuts and department closings. The shakeup repaired the bottom line within the first year, but also left morale low and faculty turnover high. Greenberg worked to show that his was an open administration, interested in all opinions, by holding town hall-style meetings, giving the Faculty Senate a seat on the President’s Council, and encouraging anyone with a gripe to contact him personally. “He turned things around so quickly—it was unbelievable for somebody to be able to do that in such a short time,” says Melvyn Berlinski, who has served on the MUSC Board of Trustees for the past 36 years. “It was his honesty and straightforwardness that won people over.”

If his interpersonal style has served him well as an administrator, it is also consistent with a personal mission he cares deeply about: building bridges and uniting the medical community’s voice in an effort to eliminate health-care disparities. Greenberg acknowledges that the barriers to this goal are immense, as he speaks of the interrelated factors of race, education, and socioeconomic issues that keep a large number of South Carolinians from receiving adequate services. “The mindset of this place has been, ‘Everyone has to come to us,’” he admits. “The reality is, you have to step into those communities that have a heavy concentration of poor, undereducated, and underserved people.” 

Among the issues in this state, minority women are more than twice as likely to die of breast cancer than their counterparts. Hispanic women have the highest incidents of cervical cancer. Ethnic minority infants are more than twice as likely to die before their first birthday than white babies. Racial minorities are also more likely to die of diabetes. 

Greenberg points to numerous initiatives currently in place. MUSC’s College of Nursing recently received $4.25 million in funding from the CDC to establish the South Eastern African American Center of Excellence to Eliminate Disparities, which is implementing programs to decrease hypertension, stroke, and amputations in African Americans with diabetes. MUSC’s Alliance for Hispanic Health provides prenatal and other health-care services for Spanish-speaking patients, particularly in rural communities. The Presidential Scholars Group works with inner-city schools to encourage fitness among children who are at high risk for disease.

Greenberg is thrilled that these and other programs reach places where doctors and nurses have traditionally been hard to find. But he dreams of a day when health care for all people will be easily accessible. “To implement real change, you need to set shorter term goals with realistic, achievable objectives,” he explains, “but the long-term goals must be set high, purely on moral grounds.”

Past, Present, & Future

Greenberg’s quest is a legacy handed down from the man he calls “my greatest teacher and most important role model”—his father. Bernard Greenberg was a World War II vet who became a groundbreaking public health researcher, started the Department of Biostatistics at UNC, and was the dean of the School of Public Health there until his death in 1985. After his death, the Greenberg family received hundreds of notes from people who shared stories of immense kindnesses that Bernard had imparted with great impact and zero fanfare. 

Ray’s mother, Ruth—who was the first woman to earn a graduate degree in chemistry from Yale—points out that, as a biostatistician, to collect all the crucial bits of information for analysis, Bernard had to be able to communicate effectively with a broad spectrum of people. It’s a quality she sees Ray has inherited. “He was always very sociable and comfortable with people of all ranks,” says Ruth, who remembers her son, as a child, dressed up in hats and pretended to be different professions to entertain his parents. “I’m terribly biased because I’m his mother, but I think it’s a plus for Ray to be able to work with people of all fields. It’s an advantage in public health and medicine, but it’s also a part of Ray. He really enjoys it.”

At the risk of understatement, it should be noted: Ray Greenberg loves his job. “They’re mostly good days right now,” he admits, having been in the position eight years—long enough to see many of his most wide-reaching dreams come true. Last year, as the total assets of the MUSC Foundation hit a record level, the physical landscape of the hospital began its dramatic transformation—a modern melding of architecture, technology, and humanity meant to announce in no uncertain terms that the 184-year-old institution, the first medical school in the Deep South, has evolved to be one of the most cutting-edge health-care and educational establishments in the United States. 

Greenberg leaves it to the experts in each field to qualify just how topnotch the new buildings are; but, as phase one in a 20-year expansion plan of a nearly billion-dollar complex becomes complete, it thrills him to hear it from his colleagues. “You take someone like Dr. Eric Powers, who has been in every major cardiac catheterization lab in the country,” says Greenberg, referring to the Harvard-trained professor of cardiology who is medical director of MUSC’s Heart and Vascular center at Ashley River Tower (ART). “When he says there is no other facility like it today, you know we’ve got something here.”

Greenberg’s involvement in the concept and realization of the headline-grabbing ART touches upon every aspect and detail of the project. Though he is quick to point out the enormous number of people involved in its construction, he worked closely with architectural firms, medical equipment vendors, artists, bankers, consultants, and review boards, overseeing and facilitating the building’s planning and design in everything from the art on each floor to the extra space in ceilings to facilitate the mechanisms of future technology. The resulting prominent facility offers towering evidence that MUSC’s number one guy is a renaissance man, with intellectual interests and accomplishments that bridge the gap between art and science. But it may be within some of the quieter achievements that the breadth of his impact lies. 

“To me, what distinguishes Ray is he does nothing out of self-interest,” says  Leah, who tells of recently hearing about an MUSC custodial employee who carries a three-year-old handwritten note of thanks from Greenberg in her purse. “He’s an incredible diplomat. And he’s totally uninterested in the status quo.”

Though his responsibilities to the board of trustees, and to the public at large for whom MUSC exists, require that he frequently quantify the successes that have followed his appointment, he knows all too well that in health care, there is no time to rest on laurels.  “I think, in general, the experience in medicine is that you can’t see more than five years into the future,” says Greenberg. “You can’t predict technology—the development of new drugs and equipment that alter the way, sometimes dramatically, in which we care for patients. You can’t predict reimbursement as federal and private insurance policies change. And you can’t predict population growth. South Carolina is a small state with modest resources; the only way to compete is to consolidate and aggregate rather than to split resources.

“I believe we are on the cusp of transforming health care,” he adds, rattling off with excitement a list of current and pending projects that utilize modern technology to bring medical services into places it has never gone before. “It’s not going to happen overnight, and it won’t be easy. But when you have a wide variety of groups working together, and they begin to see the greater picture, and they understand that it’s really the community we’re serving, this is why I come to work excited every day.” 

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