October 6, 2025 • 29 mins
Welcome to MGMA Insights, the podcast for medical practice leaders. In this episode, host Daniel Williams speaks with Jonathan Leer, Senior Director of Clinical Business Operations at the University of Maryland School of Medicine.
Recorded ahead of the MGMA Leaders Conference, their conversation highlights the evolving role of academic medicine, including leadership development, physician recruitment and retention, research and clinical trials, grant management, and resource management amid shrinking reimbursements.
Key Moments:
- 00:00 – Introduction and Jonathan Leer's background
- 01:07 – Defining academic medicine and the tripartite mission
- 04:14 – Research and clinical trial highlights
- 06:32 – Public health focus on carbon monoxide safety
- 07:39 – Expanding academic practices into communities
- 12:18 – Leadership, recruitment, and resource management in academic medicine
- 28:00 – How to connect with Jonathan Leer
Resources:
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Daniel Williams (00:02):
Hi. This is Daniel Williams, senior editor
at MGMA and host of the MGMAPodcast Network. The following
is an interview that wasrecorded before the MGMA Leaders
Conference in Orlando, but webelieve this conversation about
academic practices containsvaluable insights for practice
(00:25):
leaders. So in this interview,you'll hear from myself and our
guest, Jonathan Leer. Jonathanis senior director of clinical
business operations at theUniversity of Maryland School of
Medicine.
Let's go to that conversationnow. So bring us up to speed.
(00:46):
You were telling me offline. Youmade a move, back in January. So
just bring us up to speed foranybody who hadn't listened to
our previous episodes or hadn'theard you live before.
Who is Jonathan Leer? What areyou doing these days?
Jonathan Leer (01:02):
Oh gosh. Who is Jonathan Leer? What what a what
a interesting question. I don'tthink we have the two hours. So
I'll keep a 30,000 foot view.
So, yeah, last time I was on thepodcast and and last time I was
in in front of individuals at aconference, I was at Johns
Hopkins, working in a, you know,administrator capacity over
(01:24):
there. Really just a fantasticorganization. Very much
appreciate all my time there,but was able to be provided with
an opportunity to move over kindof across the street really.
We're only about two miles awayto the University of Maryland
School of Medicine here inbeautiful Downtown Baltimore and
(01:45):
so from there, I'm a seniordirector in the Department of
Medicine and right now, I'moverseeing about three different
divisions. I oversee pulmonarycritical care and sleep medicine
working collaboratively with myclinical chief and my division
chief and all the other kind of,you know, associate
(02:05):
administrative individuals inthe Department of Medicine, the
largest department in the entireschool of medicine.
So big job, big shoes to fill,I've been enjoying it since
January.
Daniel Williams (02:17):
That is wonderful. So you, I was joking
with you offline. You're goingto be speaking a lot. People are
going to see a lot of you inOrlando if they're anywhere near
that academic track. But let'stalk, let's take that wider lens
view on academic medicine forjust a minute.
(02:38):
So, what are some of the thingsgoing on there? I know you were
telling me offline that you hadbeen pitching this track at
Leaders Conference for a while,2025. We're going to have it But
let's just talk about academicmedical centers. What are some
of those trends going on? Whatis what's happening there right
now in that space?
Jonathan Leer (02:58):
Yeah, it's a great question, Daniel, and I
appreciate tee up there. Youknow, I I think, you know, I
kind of fell backwards intoacademic medicine. You know III
went off and got my MHA andthought I was going to be kind
of you know acute care in thehospital or be on the physician
side of the coin and really didnot have a great understanding
(03:21):
of what academic medicine was.Through a series of events after
a consulting career, I startedat University of Texas
Southwestern Medical Center inDallas, Texas where where my
family used to live. And itreally just kinda opened up my
eyes, to what academic medicinewas.
It is, you know, and I say thisa lot and people will probably
(03:44):
get tired of hearing me say itat the at the conference too.
You know, it it really is muchmore of a broad lens than just
clinical operative, you know,needs and actions and things
that we do on a very, you know,daily basis. It's it's a
tripartite mission. You'll hearthat a lot. You'll hear a lot of
(04:05):
academic medicine people saythat a lot.
And what that tripartite missionis just to kind of boil it down.
It's to educate, heal, anddiscover. That's really the the
three things that we do everysingle day, right? We have
individuals that are eithergoing through medical school,
residency, or fellowship or orsome type of post doctoral
(04:25):
program in the educate partheal. You know, that's that's
your, you know, general come tothe hospital.
People, you know, get admitted,go to the Ed, you know, so on
and so forth. That that we needto take care of on a on a daily
basis and and really, you know,focus on the patients And then
the discover part, which is thething that really hits the
(04:47):
headlines and makes academicmedical centers, I think, shine
is the research aspect, whetherthat's bench research or whether
that's, you know, more academicresearch from a, you know, a
data analytic perspective. Itreally is looking at cutting
edge technologies, newtherapeutics, you know, how we
(05:07):
combat the diseases that thatnone of us want. Right? Like
nobody, you know, wants to getsick every single day.
And so, you know, we we'retrying to figure out what's
going on on a daily basis. Infact, I'll I'll share a a small
story with you. Actually, thestory just came out this
morning. My division chief,Doctor. Jason Rose, has been
(05:28):
working with the dean of theSchool of Medicine, who's also a
pulmonary critical care doctor,Doctor.
Dean Gladwin. And they mighthave found a protein and a
therapeutic that will combatcarbon monoxide poisoning, which
affects over fifty thousandpeople every single day. And so,
(05:51):
you know, that therapeutic thatthat protein that is, you know,
well beyond my comprehension asa as a business, you know,
professional, was developed hereon-site at the University of
Maryland School of Medicine. Andand, you know, it's taking it
from bench to bedside. Right.
(06:11):
And, you know, how can we dothat? And so that's a
fascinating, you know, kind ofannouncement that they had that
that we are now potentiallygoing into into clinical trial
phases on using this newtherapeutic for people that are
suffering from carbon monoxidepoisoning, which, you know, is a
silent killer, right? Carbonmonoxide is odorless, tasteless.
(06:33):
It, you know, it it reallyaffects a lot of people in a lot
of urban areas as well. So shoutout to Doctor.
Rose and someone that I get towork with on a daily basis, and
I'm just proud to do so.
Daniel Williams (06:45):
That is remarkable. Thank you for
sharing that. And we had acarbon monoxide alert recently
in our house. We had thedetector there in our home and
we thought something major hadhappened but actually it was
just I think the battery hadfinally, run down. We'd had it
(07:09):
for many, many, many years inour home and it freaked us out a
little bit, but we everythingwas okay, but that is something
not to take lightly.
So that is incredible that y'allare doing that work there.
Jonathan Leer (07:22):
So It is, Daniel. It is. Yeah. PSA for whoever's
listening to the podcast. Get aget a carbon monoxide detector
in your house.
A lot of them are paired withsmoke detectors. Right. Yeah.
So, PSA out there, be safe inyour home and with your loved
ones.
Daniel Williams (07:39):
Okay. So, as we mentioned that we have added
this academic track at Leadersthis year, If someone is, an
academic medicine leader, whyshould they make this event with
this track in mind, a priorityfor themselves and their
organization?
Jonathan Leer (07:57):
Yeah. It's a great question, Daniel. And and
again, I I I wanna I wanna stay30,000 foot view and talk about
these things. And and, you know,a lot of people hear academic
medicine and they don't really,you know, think, well, maybe
that's me, maybe that's not me.It's becoming more and more
prevalent.
And so I think this trackhonestly is for people that
(08:20):
aren't just at universitymedical centers, that aren't
just affiliated with academicmedicine. I think it's honestly
for people that are in metroareas that are in in close
proximity to an academic medicalcenter. Right. There's a lot of
private practices that we workwith on a daily basis, you know,
(08:43):
that that really feed the beast,so to speak. Right.
Because we are known forquaternary care. And so just to
define that a little bit, right.There's there's primary,
secondary, tertiary and thenquaternary care. And quaternary
basically means we have the sub,sub, sub, sub specialist in in
these, you know, things that aresuper rare or or, you know,
(09:04):
there's like three people in theworld that know how to cure
these diseases. And so, youknow, if I'm talking to someone
or if anyone's listening rightnow and and you're like, well, I
work at a primary care officein, you know, Lincoln, Nebraska,
then fine.
Great. That's awesome. But, youknow, we also have the
University of Nebraska and theyhave an academic medicine, you
(09:25):
know, presence there. And I'msure that there is a
relationship. In addition.
Right. If you've got someone whoyou're recruiting, if you've got
someone who you want to bringinto the practice, they're
coming from an academic place.Right. And so understanding what
that even means, I will be fair.You know, when I was coming up,
I didn't even know how long ittook to become a doctor.
(09:47):
Right. And then, you know, Ikind of fell into this and I was
like, holy moly, look at all thetraining that they have to go
through and all the all the, youknow, components that you have
to meet in order to even, youknow, put an MD after your name
and get your and get yourlicense and so I really think
it's for everybody and and Iwould encourage everyone to, you
know, drop into a session butbut to be a little bit more
(10:11):
concrete about, you know, whyshould they make it a priority?
I think that academic medicineis is under attack, Daniel. I
think from not only a and thisis an a apolitical statement,
only from a funding perspective,which is not only at the federal
government level, but at manyother different levels. Right.
(10:33):
Funding is is tight. I thinkthat we have to do a lot with a
little because as part of auniversity system, you know, we
are trying to spread, you know,an amount of money against those
three missions that we strivefor every single day. So how do
(10:54):
we do that? And in addition,we're trying to recruit the best
of the best of the best, everysingle day. And so, you know,
one of my sessions, which we maytouch on is, you know, how do
you get that leader in academicmedicine?
What are they looking for?Because funny enough, it's not
(11:14):
just about pay all the time. Andso, you know, I I I think it
really is a a good session. Andthen I'll I'll end with this,
Daniel. Over the last fifteenyears, and in fact, I was given
some collateral to yourmarketing folks.
Over the last fifteen years,there has been more and more
expansion of academicaffiliated. I'll put that in air
(11:37):
quotes for anyone's anyone notwatching us online. You know,
practices that have grownoutside the metro area and into
what we like to call bedroomcommunities. And that's because
way back in the day, if you hadthat sub, sub, sub, sub, sub
specialist, you know, they werein Downtown Baltimore or
(11:58):
Downtown Boston or, you know,wherever, and you had to fly to
them or come to them. That's notthe case anymore.
Right? Patients are a lot more,picky when it comes to health
care, which is great. Right?Choices is fantastic. But we
have noticed that we've got toget out into the community
rather than saying, you know, ifwe build it, they will come.
(12:21):
That's not really a thinganymore. And so, you know, as an
example, north of me inPennsylvania, Penn Med or the
University of PennsylvaniaMedical Practice has bought
additional community hospitalsthat are outside just the
Philadelphia area becausethey're expanding their
(12:43):
footprint and also theirclinical practices. In addition,
we have seen retiring privatepractice folks who, you know,
want to, you know, go live onthe beach or wherever they want
to live and have said, well, Iwant to sell my practice, but I
don't want to sell it to privateequity. I don't want to sell it
(13:05):
to, you know, whatever. And andmaybe they don't have a junior
partner that they've brought on.
And so a lot of academicpractices have been buying up.
Additional private practices ofUT Southwestern where I was
prior to Johns Hopkins, they hada fantastic push And they are in
the giant DFW Metroplex. You canfind a UT Southwestern branded
(13:28):
physician all over the metroarea, not just at one place in
in Downtown Dallas.
Daniel Williams (13:34):
Okay. Thank you for giving us the 30 foot view.
So, let's do a.
Jonathan Leer (13:38):
I I may have dived it down a little We
Daniel Williams (13:41):
kind of dipped in a little bit and that's okay.
So, let's do this now. You aregoing to be part of four
different sessions. Let's justdo kits on these four sessions.
Give a little taste of whatsomeone could expect, little
elevator pitches for them.
Let's start at the one that youdid mention. This is on academic
(14:04):
leader recruitment andretention. So wherever you want
to go, I'll just I'll throwsomething out there for you and
you can take it in the directionyou want. But I'm looking at it
from what's the core challengethat perhaps you'll be
addressing in that session.
Jonathan Leer (14:20):
Yeah. So I've got two fantastic co presenters with
me. I've got Tom Rossi andRebecca Napier. Rebecca is a
senior vice president financeand administration at the
University of New Mexico Schoolof Medicine. And Tom works for
Jackson Physician Search and hasbeen part of executive
recruitment for many, many yearswhen he was at HCA.
(14:45):
And then prior to that, he hadother experiences. And what
we're looking at there is, youknow, with an aging workforce
with with people that are intheir sixties, seventies, and in
fact, I even have an 80 year oldon my faculty. You know, they're
they're starting to retire.They're starting to to to take a
step back. They're they'restarting to say, you know, hey,
(15:08):
I need to take it out of fourthgear and put it into second.
And so how do you recruit thatleader? And, you know, it's just
as we've been saying the wholetime, it's a certain phenotype
of an academic leader. They haveto do all three. They need to
know all three, just likeadministrators need to know all
They need to know the educate,heal, and discover. And so
(15:30):
that's a very specificphenotype.
And so how do you find thosepeople? Where do you look for
them? And when you are in therecruitment process, you know,
it's not just about throwing abucket of money their way. You
know, what are their researchpassions? You know, do they need
to set up an entire lab?
And just a fun fact, Daniel, labequipment, not cheap. And so,
(15:53):
you know, what do we need tobuy, you know, three negative 80
degree freezers? And for anyonelistening out there, when I say
negative 80, I do mean Celsius.It they're cold and they're very
expensive and they come withlittle Bluetooth monitors in
case they start to warm up ifyou have a power outage because
you could lose your entiresamples, if that happened. And
(16:16):
so, you know, do they need a labsetup?
Are they coming with, you know,personnel members that they've
been working with for the pastten years? Right from and I'm
gonna pick a random state.Right? If they're coming from in
Nevada to Maryland, and, youknow, they've had a lab manager
that is followed them over thelast three moves. We need to
(16:40):
know that.
Right? So it's not just aboutthe the actual base pay. That's
a component, of course. It'sabout a lot of different things.
And so we're gonna talk aboutthat and kinda how we address
it.
And then on the side of that,how do you retain them? What's
in how do you, how do you retaingood quality people?
Daniel Williams (16:59):
Okay. Let's jump to our next one then. Just
get a quick hit on this one.Academic Medical Center
Roundtable. Just tell us what'sthe goal of this conversation?
What do you expect to get out ofthis?
Jonathan Leer (17:11):
Yeah. I mean, I think the goal of this
conversation, Daniel, is to isto trauma bond together with all
of my academic medicinecolleagues and cohorts. And just
to say, hey, you know, we're allfeeling it. And I think
sometimes we can feel verysiloed. We can feel very, like
(17:35):
we're the only ones that areexperiencing this challenge.
And and and and that's not true.And so I it's it's really what
the goal of this would be isit's a moderated session, but
it's gonna be a fairly openedforum with some prompts and
round table discussions withpeople to say, you know, what
are you experiencing? You know,yes, the NIH is is is a big
(17:59):
topic of conversation right nowand what's coming down the
pipeline for, you know, what wecall the F and A rate which we
don't have time to delve intothat but come to the session. We
can talk about it. You know, andand what does that mean?
And how do we shift and change?You know, what's going on with,
you know, recruitment ofindividuals who are
(18:22):
international? There's a lot of,you know, visa issues right now
and with travel bans and thingsof that nature. I mean, these
are things that that otherpeople have to think about too.
But but just trying to get in aroom together and talk about it
and just know that noteveryone's alone.
(18:43):
And my hope would be for me andmy my co moderator, is that, you
know, people walk out of therewith an idea, with a spark, with
a something and take it back totheir organization and say,
well, why don't we try this? Oh,well, I just went to the MGMA
Leaders Conference and, youknow, Jonathan at at University
(19:03):
of Maryland said, right? Maybewe can, you know, talk about
that and so, you know, I thinkthat that's what's great about
these conferences is that we canall get together and just, you
know, say, I hear you. Iunderstand you and you know,
let's talk about it together.So, that that's kind of what
we're trying to get out theround table.
Daniel Williams (19:21):
Okay. This next topic, you have touched on a
little bit already, but it'smaximizing impact, resource
management amid shrinkingprofessional fees. The the title
kinda says it all right there.You've already touched on this.
Is there anything withincontext, maybe your co
presenters, anything else youmight wanna share about this
(19:44):
particular session?
Jonathan Leer (19:45):
Yeah. Amazing co presenters, my colleagues from
when I was at Hopkins. We've gotChristian Hartman, the brand new
chief administrative officer forthe Department of Medicine.
We've got Jameson Kays and AnuRaman. All wonderful
professionals that I had thehonor and privilege of working
next to shoulder to shoulderwhen I was at Hopkins.
(20:08):
And, you know, what we wanted totalk about was and I did touch
on it a little bit, but, youknow, I think if you just kind
of think about it from anoverall perspective, you know,
we we are working with peoplethat are sub, sub, sub, sub, sub
specialized and so often timeswhen we encounter those
(20:29):
individuals, you know, they theyare the experts in their field.
They are the go to when it comesto, you know, certain things.
And oftentimes as theadministrator, you know, we kind
of get put in the middle of whatthey need and and and what we
can provide. And, you know,those two things, unfortunately,
(20:51):
are are somewhat, you know, onon a scale here. And so, you
know, I would love Daniel everysingle day to every time a
faculty member were to come tome and they need four negative
freezers to be able to wave amagic wand and say, here you go.
Unfortunately, that's not thecase, right? We have to think
(21:12):
about capital request becausethose are very expensive pieces
of machinery. They have to becapitalized. So what does that
mean? Right?
We also have to think aboutlabor, right? I would love to
put a, an MA or an LPN or evengosh, a full RN paired with a
physician one to one everysingle day. That's just not
(21:36):
possible. You know, I would loveto do a lot of different things
and sometimes, unfortunately, Isit in the hot seat when it
comes to, you know, well, whatcan we do and how can we do? And
so, you know, we are having athreat of shrinking professional
fees.
We are having an issue when itcomes to our FNA rate on NIH. We
(22:01):
are having a lot of differentchallenges. And so how do we
prioritize those resources? Canwe think outside the box? Right.
Fun little teaser story. Right?We've got a cardiology practice
at Hopkins that wanted to expandtheir clinical footprint up to a
(22:21):
northern location in NorthBaltimore County where GI was
already sitting. We discoveredand Christian really deserves a
credit on this one. But wediscovered that, you know, GI
was seen most of their clinicpatients in the morning because
the GI physicians would then goto the Endoscopy Suite and do,
(22:42):
you know, EGDs and colonoscopiesand whatever.
And cardiology could use thatsame space and we could co
locate, right? Where thetraditional model is you get a
clinic. It's like Oprah, you geta clinic, you get a clinic, you
get a clinic, right? Can wethink outside the box? Can we
Right.
Can we look at different ways ofdoing things? And so that's what
we'll talk about.
Daniel Williams (23:02):
Okay. Your last session, this culminates with
everything you've been talkingabout. So if you're shrinking
resources, not you, but if thatis the environment you're
experiencing, then there is abattle for, well, if it's we had
10 of whatever denomination wewanna say, and now it's five or
(23:25):
three, then you have theremaining lab folks and everyone
else competing for those subzero refrigerators or whatever
it might be. So then it getsinto this last session, grant
management. What does it allmean there?
So, I mean, that is gonna beeven more important. What what's
(23:47):
going on in grant management,balancing those resources,
making people have, making surethey have what they need, but
then also prioritizing becausesome unfortunately are not gonna
get the funding they need there.Talk about that, Jonathan, and
what's going on in that side ofthe business.
Jonathan Leer (24:05):
Yeah. I mean, gosh, Daniel, I could I could do
forty five minutes on that.Yeah. I won't. But, you know, I
I think for people that don'tdeal with grants every single
day, it can it's it can seemvery daunting.
And I'm not gonna say that it'snot. Right? Like, there's a lot
of terminology that, you know,unless you're in the in the know
or in the biz, know, you don'treally talk about every single
(24:29):
day. And so, you know, let's saythat you are a administrator and
you're coming to the conferenceand you've just gotten the job
at, I'll pick another state, theUniversity of Indiana. And all
of a sudden you show up andyou're really good at clinical
operations because they hiredyou from a private practice and
a little bit about education.
But research in grant managementis completely foreign to you.
(24:51):
Hopefully, this session willgive you some of those tips and
tricks and what we're talkingabout when we say grants. And
the fun part is, Daniel, and youkind of teed me up super well
here is that grants don't justhave to be at academic medical
centers. There are grants thatare, you know, supported by Eli
(25:13):
Lilly and and, you know, averitable cornucopia of
foundations, American CancerSociety, American, you know,
Lung Association, and on and onAmerican Heart Association that
give grant money to people thatapply for it. And so if you're
even listening to me right nowand you're like, I have nothing
to do with academics.
I don't even know why I got, youknow, you know, into this, you
(25:36):
know, podcast. I just want youto know that that you can if you
work at a cardiology practicein, you know, Davis, California,
I keep picking different states.You know, you can apply for a
grant through the and you canget new heart monitors. You can
(25:58):
get new, you know, you know,pulse oxes. You can apply for,
I'm going to say free money.
Obviously, there's a lot ofstrings attached to that. But
that's not money coming out ofyour operating account and
coming out of your physician'sprofessional fees. And so what
(26:18):
does it mean when I say grants?And then, you know, for people
that maybe are in the biz andare doing this every single day,
what are the challenges thatwe're facing right now? And how
can we shift and change?
Do we need to open it up beyondjust federal grants? Right. NIH,
DOD, HRSA, which is HRSA, whichis a more of an education based
(26:43):
federal organization to morefoundational organizations,
right? Like the American HeartAssociation, the American Cancer
Society or what I have done, youknow, and maybe spill a little
bit of of the of the tea here.You know, I really have
(27:03):
partnered very collaborativelywith industry partners, right?
Pharmaceutical companies. Sure.GSK, Eli Lilly. Gosh, II can't
think of another one off the topof my head but like there's a
cornucopia of them out there andso, you know, we in academic
(27:24):
medicine for a long time havebeen very laser focused on
federal because that's how youget, you know, certain ratings
and that's how you get papersproduced in the New England
Journal of Medicine. But, youknow, now that we're facing some
turmoil, you know, maybe we needto take those horse blinders off
(27:45):
and we need to look outside.
And so we're gonna talk aboutthat.
Daniel Williams (27:49):
That is wonderful. Thank you for sharing
so much information about thisacademic track at our show. If
someone's, looking to pick yourbrain or just connect with you
at the conference, any ideawhat's the best way to where do
they find you in Orlando? Willyou be at Disney or where will
you be?
Jonathan Leer (28:07):
What's No. I unfortunately, my daughters will
not be coming with me much totheir chagrin. They've got
school. So, you know, you saidit at the very top of the
podcast. I mean, with foursessions, hopefully people don't
get sick of me.
So I will be around. But I amalways happy to connect with
(28:29):
anyone. You know, when you're onthe app for for leaders
conference, which MGMA does formost of its event, there is a
directory L E E R. It's prettyeasy. You can type that in.
I should have all of my contactinformation there. But, you
know, let's say that someone'slistening right now and they're
like, hey, I'm on the fenceabout whether I should come or
(28:50):
not, which spoiler, you shouldcome. But you can email me at
jleer@som.umaryland, which isyou maryland dot edu. So it's
it's a bit of a long one, butpeople are welcome to email me.
(29:14):
I'm on LinkedIn, l e e r.
I'm the only one out there. I'vegot alphabet soup after my name.
You should see this ugly mug.Happy to connect with anybody.
Daniel Williams (29:25):
All right, Jonathan, you're so gracious
with your time both here and youwill be in Orlando. So thank you
so much for that. Great catchingup with you today.
Jonathan Leer (29:34):
Wonderful catching up with you, Daniel.
Thanks so much.
Daniel Williams (29:37):
All right, everyone. I will drop in those,
direct links to Jonathan'semail, LinkedIn, and perhaps
some other resources where we'veconnected with Jonathan
previously. Thank you so muchfor being MGMA podcast
listeners.
Hi. This is Daniel Williams, senior editor
at MGMA and host of the MGMAPodcast Network. The following
is an interview that wasrecorded before the MGMA Leaders
Conference in Orlando, but webelieve this conversation about
academic practices containsvaluable insights for practice
(00:25):
leaders. So in this interview,you'll hear from myself and our
guest, Jonathan Leer. Jonathanis senior director of clinical
business operations at theUniversity of Maryland School of
Medicine.
Let's go to that conversationnow. So bring us up to speed.
(00:46):
You were telling me offline. Youmade a move, back in January. So
just bring us up to speed foranybody who hadn't listened to
our previous episodes or hadn'theard you live before.
Who is Jonathan Leer? What areyou doing these days?
Jonathan Leer (01:02):
Oh gosh. Who is Jonathan Leer? What what a what
a interesting question. I don'tthink we have the two hours. So
I'll keep a 30,000 foot view.
So, yeah, last time I was on thepodcast and and last time I was
in in front of individuals at aconference, I was at Johns
Hopkins, working in a, you know,administrator capacity over
(01:24):
there. Really just a fantasticorganization. Very much
appreciate all my time there,but was able to be provided with
an opportunity to move over kindof across the street really.
We're only about two miles awayto the University of Maryland
School of Medicine here inbeautiful Downtown Baltimore and
(01:45):
so from there, I'm a seniordirector in the Department of
Medicine and right now, I'moverseeing about three different
divisions. I oversee pulmonarycritical care and sleep medicine
working collaboratively with myclinical chief and my division
chief and all the other kind of,you know, associate
(02:05):
administrative individuals inthe Department of Medicine, the
largest department in the entireschool of medicine.
So big job, big shoes to fill,I've been enjoying it since
January.
Daniel Williams (02:17):
That is wonderful. So you, I was joking
with you offline. You're goingto be speaking a lot. People are
going to see a lot of you inOrlando if they're anywhere near
that academic track. But let'stalk, let's take that wider lens
view on academic medicine forjust a minute.
(02:38):
So, what are some of the thingsgoing on there? I know you were
telling me offline that you hadbeen pitching this track at
Leaders Conference for a while,2025. We're going to have it But
let's just talk about academicmedical centers. What are some
of those trends going on? Whatis what's happening there right
now in that space?
Jonathan Leer (02:58):
Yeah, it's a great question, Daniel, and I
appreciate tee up there. Youknow, I I think, you know, I
kind of fell backwards intoacademic medicine. You know III
went off and got my MHA andthought I was going to be kind
of you know acute care in thehospital or be on the physician
side of the coin and really didnot have a great understanding
(03:21):
of what academic medicine was.Through a series of events after
a consulting career, I startedat University of Texas
Southwestern Medical Center inDallas, Texas where where my
family used to live. And itreally just kinda opened up my
eyes, to what academic medicinewas.
It is, you know, and I say thisa lot and people will probably
(03:44):
get tired of hearing me say itat the at the conference too.
You know, it it really is muchmore of a broad lens than just
clinical operative, you know,needs and actions and things
that we do on a very, you know,daily basis. It's it's a
tripartite mission. You'll hearthat a lot. You'll hear a lot of
(04:05):
academic medicine people saythat a lot.
And what that tripartite missionis just to kind of boil it down.
It's to educate, heal, anddiscover. That's really the the
three things that we do everysingle day, right? We have
individuals that are eithergoing through medical school,
residency, or fellowship or orsome type of post doctoral
(04:25):
program in the educate partheal. You know, that's that's
your, you know, general come tothe hospital.
People, you know, get admitted,go to the Ed, you know, so on
and so forth. That that we needto take care of on a on a daily
basis and and really, you know,focus on the patients And then
the discover part, which is thething that really hits the
(04:47):
headlines and makes academicmedical centers, I think, shine
is the research aspect, whetherthat's bench research or whether
that's, you know, more academicresearch from a, you know, a
data analytic perspective. Itreally is looking at cutting
edge technologies, newtherapeutics, you know, how we
(05:07):
combat the diseases that thatnone of us want. Right? Like
nobody, you know, wants to getsick every single day.
And so, you know, we we'retrying to figure out what's
going on on a daily basis. Infact, I'll I'll share a a small
story with you. Actually, thestory just came out this
morning. My division chief,Doctor. Jason Rose, has been
(05:28):
working with the dean of theSchool of Medicine, who's also a
pulmonary critical care doctor,Doctor.
Dean Gladwin. And they mighthave found a protein and a
therapeutic that will combatcarbon monoxide poisoning, which
affects over fifty thousandpeople every single day. And so,
(05:51):
you know, that therapeutic thatthat protein that is, you know,
well beyond my comprehension asa as a business, you know,
professional, was developed hereon-site at the University of
Maryland School of Medicine. Andand, you know, it's taking it
from bench to bedside. Right.
(06:11):
And, you know, how can we dothat? And so that's a
fascinating, you know, kind ofannouncement that they had that
that we are now potentiallygoing into into clinical trial
phases on using this newtherapeutic for people that are
suffering from carbon monoxidepoisoning, which, you know, is a
silent killer, right? Carbonmonoxide is odorless, tasteless.
(06:33):
It, you know, it it reallyaffects a lot of people in a lot
of urban areas as well. So shoutout to Doctor.
Rose and someone that I get towork with on a daily basis, and
I'm just proud to do so.
Daniel Williams (06:45):
That is remarkable. Thank you for
sharing that. And we had acarbon monoxide alert recently
in our house. We had thedetector there in our home and
we thought something major hadhappened but actually it was
just I think the battery hadfinally, run down. We'd had it
(07:09):
for many, many, many years inour home and it freaked us out a
little bit, but we everythingwas okay, but that is something
not to take lightly.
So that is incredible that y'allare doing that work there.
Jonathan Leer (07:22):
So It is, Daniel. It is. Yeah. PSA for whoever's
listening to the podcast. Get aget a carbon monoxide detector
in your house.
A lot of them are paired withsmoke detectors. Right. Yeah.
So, PSA out there, be safe inyour home and with your loved
ones.
Daniel Williams (07:39):
Okay. So, as we mentioned that we have added
this academic track at Leadersthis year, If someone is, an
academic medicine leader, whyshould they make this event with
this track in mind, a priorityfor themselves and their
organization?
Jonathan Leer (07:57):
Yeah. It's a great question, Daniel. And and
again, I I I wanna I wanna stay30,000 foot view and talk about
these things. And and, you know,a lot of people hear academic
medicine and they don't really,you know, think, well, maybe
that's me, maybe that's not me.It's becoming more and more
prevalent.
And so I think this trackhonestly is for people that
(08:20):
aren't just at universitymedical centers, that aren't
just affiliated with academicmedicine. I think it's honestly
for people that are in metroareas that are in in close
proximity to an academic medicalcenter. Right. There's a lot of
private practices that we workwith on a daily basis, you know,
(08:43):
that that really feed the beast,so to speak. Right.
Because we are known forquaternary care. And so just to
define that a little bit, right.There's there's primary,
secondary, tertiary and thenquaternary care. And quaternary
basically means we have the sub,sub, sub, sub specialist in in
these, you know, things that aresuper rare or or, you know,
(09:04):
there's like three people in theworld that know how to cure
these diseases. And so, youknow, if I'm talking to someone
or if anyone's listening rightnow and and you're like, well, I
work at a primary care officein, you know, Lincoln, Nebraska,
then fine.
Great. That's awesome. But, youknow, we also have the
University of Nebraska and theyhave an academic medicine, you
(09:25):
know, presence there. And I'msure that there is a
relationship. In addition.
Right. If you've got someone whoyou're recruiting, if you've got
someone who you want to bringinto the practice, they're
coming from an academic place.Right. And so understanding what
that even means, I will be fair.You know, when I was coming up,
I didn't even know how long ittook to become a doctor.
(09:47):
Right. And then, you know, Ikind of fell into this and I was
like, holy moly, look at all thetraining that they have to go
through and all the all the, youknow, components that you have
to meet in order to even, youknow, put an MD after your name
and get your and get yourlicense and so I really think
it's for everybody and and Iwould encourage everyone to, you
know, drop into a session butbut to be a little bit more
(10:11):
concrete about, you know, whyshould they make it a priority?
I think that academic medicineis is under attack, Daniel. I
think from not only a and thisis an a apolitical statement,
only from a funding perspective,which is not only at the federal
government level, but at manyother different levels. Right.
(10:33):
Funding is is tight. I thinkthat we have to do a lot with a
little because as part of auniversity system, you know, we
are trying to spread, you know,an amount of money against those
three missions that we strivefor every single day. So how do
(10:54):
we do that? And in addition,we're trying to recruit the best
of the best of the best, everysingle day. And so, you know,
one of my sessions, which we maytouch on is, you know, how do
you get that leader in academicmedicine?
What are they looking for?Because funny enough, it's not
(11:14):
just about pay all the time. Andso, you know, I I I think it
really is a a good session. Andthen I'll I'll end with this,
Daniel. Over the last fifteenyears, and in fact, I was given
some collateral to yourmarketing folks.
Over the last fifteen years,there has been more and more
expansion of academicaffiliated. I'll put that in air
(11:37):
quotes for anyone's anyone notwatching us online. You know,
practices that have grownoutside the metro area and into
what we like to call bedroomcommunities. And that's because
way back in the day, if you hadthat sub, sub, sub, sub, sub
specialist, you know, they werein Downtown Baltimore or
(11:58):
Downtown Boston or, you know,wherever, and you had to fly to
them or come to them. That's notthe case anymore.
Right? Patients are a lot more,picky when it comes to health
care, which is great. Right?Choices is fantastic. But we
have noticed that we've got toget out into the community
rather than saying, you know, ifwe build it, they will come.
(12:21):
That's not really a thinganymore. And so, you know, as an
example, north of me inPennsylvania, Penn Med or the
University of PennsylvaniaMedical Practice has bought
additional community hospitalsthat are outside just the
Philadelphia area becausethey're expanding their
(12:43):
footprint and also theirclinical practices. In addition,
we have seen retiring privatepractice folks who, you know,
want to, you know, go live onthe beach or wherever they want
to live and have said, well, Iwant to sell my practice, but I
don't want to sell it to privateequity. I don't want to sell it
(13:05):
to, you know, whatever. And andmaybe they don't have a junior
partner that they've brought on.
And so a lot of academicpractices have been buying up.
Additional private practices ofUT Southwestern where I was
prior to Johns Hopkins, they hada fantastic push And they are in
the giant DFW Metroplex. You canfind a UT Southwestern branded
(13:28):
physician all over the metroarea, not just at one place in
in Downtown Dallas.
Daniel Williams (13:34):
Okay. Thank you for giving us the 30 foot view.
So, let's do a.
Jonathan Leer (13:38):
I I may have dived it down a little We
Daniel Williams (13:41):
kind of dipped in a little bit and that's okay.
So, let's do this now. You aregoing to be part of four
different sessions. Let's justdo kits on these four sessions.
Give a little taste of whatsomeone could expect, little
elevator pitches for them.
Let's start at the one that youdid mention. This is on academic
(14:04):
leader recruitment andretention. So wherever you want
to go, I'll just I'll throwsomething out there for you and
you can take it in the directionyou want. But I'm looking at it
from what's the core challengethat perhaps you'll be
addressing in that session.
Jonathan Leer (14:20):
Yeah. So I've got two fantastic co presenters with
me. I've got Tom Rossi andRebecca Napier. Rebecca is a
senior vice president financeand administration at the
University of New Mexico Schoolof Medicine. And Tom works for
Jackson Physician Search and hasbeen part of executive
recruitment for many, many yearswhen he was at HCA.
(14:45):
And then prior to that, he hadother experiences. And what
we're looking at there is, youknow, with an aging workforce
with with people that are intheir sixties, seventies, and in
fact, I even have an 80 year oldon my faculty. You know, they're
they're starting to retire.They're starting to to to take a
step back. They're they'restarting to say, you know, hey,
(15:08):
I need to take it out of fourthgear and put it into second.
And so how do you recruit thatleader? And, you know, it's just
as we've been saying the wholetime, it's a certain phenotype
of an academic leader. They haveto do all three. They need to
know all three, just likeadministrators need to know all
They need to know the educate,heal, and discover. And so
(15:30):
that's a very specificphenotype.
And so how do you find thosepeople? Where do you look for
them? And when you are in therecruitment process, you know,
it's not just about throwing abucket of money their way. You
know, what are their researchpassions? You know, do they need
to set up an entire lab?
And just a fun fact, Daniel, labequipment, not cheap. And so,
(15:53):
you know, what do we need tobuy, you know, three negative 80
degree freezers? And for anyonelistening out there, when I say
negative 80, I do mean Celsius.It they're cold and they're very
expensive and they come withlittle Bluetooth monitors in
case they start to warm up ifyou have a power outage because
you could lose your entiresamples, if that happened. And
(16:16):
so, you know, do they need a labsetup?
Are they coming with, you know,personnel members that they've
been working with for the pastten years? Right from and I'm
gonna pick a random state.Right? If they're coming from in
Nevada to Maryland, and, youknow, they've had a lab manager
that is followed them over thelast three moves. We need to
(16:40):
know that.
Right? So it's not just aboutthe the actual base pay. That's
a component, of course. It'sabout a lot of different things.
And so we're gonna talk aboutthat and kinda how we address
it.
And then on the side of that,how do you retain them? What's
in how do you, how do you retaingood quality people?
Daniel Williams (16:59):
Okay. Let's jump to our next one then. Just
get a quick hit on this one.Academic Medical Center
Roundtable. Just tell us what'sthe goal of this conversation?
What do you expect to get out ofthis?
Jonathan Leer (17:11):
Yeah. I mean, I think the goal of this
conversation, Daniel, is to isto trauma bond together with all
of my academic medicinecolleagues and cohorts. And just
to say, hey, you know, we're allfeeling it. And I think
sometimes we can feel verysiloed. We can feel very, like
(17:35):
we're the only ones that areexperiencing this challenge.
And and and and that's not true.And so I it's it's really what
the goal of this would be isit's a moderated session, but
it's gonna be a fairly openedforum with some prompts and
round table discussions withpeople to say, you know, what
are you experiencing? You know,yes, the NIH is is is a big
(17:59):
topic of conversation right nowand what's coming down the
pipeline for, you know, what wecall the F and A rate which we
don't have time to delve intothat but come to the session. We
can talk about it. You know, andand what does that mean?
And how do we shift and change?You know, what's going on with,
you know, recruitment ofindividuals who are
(18:22):
international? There's a lot of,you know, visa issues right now
and with travel bans and thingsof that nature. I mean, these
are things that that otherpeople have to think about too.
But but just trying to get in aroom together and talk about it
and just know that noteveryone's alone.
(18:43):
And my hope would be for me andmy my co moderator, is that, you
know, people walk out of therewith an idea, with a spark, with
a something and take it back totheir organization and say,
well, why don't we try this? Oh,well, I just went to the MGMA
Leaders Conference and, youknow, Jonathan at at University
(19:03):
of Maryland said, right? Maybewe can, you know, talk about
that and so, you know, I thinkthat that's what's great about
these conferences is that we canall get together and just, you
know, say, I hear you. Iunderstand you and you know,
let's talk about it together.So, that that's kind of what
we're trying to get out theround table.
Daniel Williams (19:21):
Okay. This next topic, you have touched on a
little bit already, but it'smaximizing impact, resource
management amid shrinkingprofessional fees. The the title
kinda says it all right there.You've already touched on this.
Is there anything withincontext, maybe your co
presenters, anything else youmight wanna share about this
(19:44):
particular session?
Jonathan Leer (19:45):
Yeah. Amazing co presenters, my colleagues from
when I was at Hopkins. We've gotChristian Hartman, the brand new
chief administrative officer forthe Department of Medicine.
We've got Jameson Kays and AnuRaman. All wonderful
professionals that I had thehonor and privilege of working
next to shoulder to shoulderwhen I was at Hopkins.
(20:08):
And, you know, what we wanted totalk about was and I did touch
on it a little bit, but, youknow, I think if you just kind
of think about it from anoverall perspective, you know,
we we are working with peoplethat are sub, sub, sub, sub, sub
specialized and so often timeswhen we encounter those
(20:29):
individuals, you know, they theyare the experts in their field.
They are the go to when it comesto, you know, certain things.
And oftentimes as theadministrator, you know, we kind
of get put in the middle of whatthey need and and and what we
can provide. And, you know,those two things, unfortunately,
(20:51):
are are somewhat, you know, onon a scale here. And so, you
know, I would love Daniel everysingle day to every time a
faculty member were to come tome and they need four negative
freezers to be able to wave amagic wand and say, here you go.
Unfortunately, that's not thecase, right? We have to think
(21:12):
about capital request becausethose are very expensive pieces
of machinery. They have to becapitalized. So what does that
mean? Right?
We also have to think aboutlabor, right? I would love to
put a, an MA or an LPN or evengosh, a full RN paired with a
physician one to one everysingle day. That's just not
(21:36):
possible. You know, I would loveto do a lot of different things
and sometimes, unfortunately, Isit in the hot seat when it
comes to, you know, well, whatcan we do and how can we do? And
so, you know, we are having athreat of shrinking professional
fees.
We are having an issue when itcomes to our FNA rate on NIH. We
(22:01):
are having a lot of differentchallenges. And so how do we
prioritize those resources? Canwe think outside the box? Right.
Fun little teaser story. Right?We've got a cardiology practice
at Hopkins that wanted to expandtheir clinical footprint up to a
(22:21):
northern location in NorthBaltimore County where GI was
already sitting. We discoveredand Christian really deserves a
credit on this one. But wediscovered that, you know, GI
was seen most of their clinicpatients in the morning because
the GI physicians would then goto the Endoscopy Suite and do,
(22:42):
you know, EGDs and colonoscopiesand whatever.
And cardiology could use thatsame space and we could co
locate, right? Where thetraditional model is you get a
clinic. It's like Oprah, you geta clinic, you get a clinic, you
get a clinic, right? Can wethink outside the box? Can we
Right.
Can we look at different ways ofdoing things? And so that's what
we'll talk about.
Daniel Williams (23:02):
Okay. Your last session, this culminates with
everything you've been talkingabout. So if you're shrinking
resources, not you, but if thatis the environment you're
experiencing, then there is abattle for, well, if it's we had
10 of whatever denomination wewanna say, and now it's five or
(23:25):
three, then you have theremaining lab folks and everyone
else competing for those subzero refrigerators or whatever
it might be. So then it getsinto this last session, grant
management. What does it allmean there?
So, I mean, that is gonna beeven more important. What what's
(23:47):
going on in grant management,balancing those resources,
making people have, making surethey have what they need, but
then also prioritizing becausesome unfortunately are not gonna
get the funding they need there.Talk about that, Jonathan, and
what's going on in that side ofthe business.
Jonathan Leer (24:05):
Yeah. I mean, gosh, Daniel, I could I could do
forty five minutes on that.Yeah. I won't. But, you know, I
I think for people that don'tdeal with grants every single
day, it can it's it can seemvery daunting.
And I'm not gonna say that it'snot. Right? Like, there's a lot
of terminology that, you know,unless you're in the in the know
or in the biz, know, you don'treally talk about every single
(24:29):
day. And so, you know, let's saythat you are a administrator and
you're coming to the conferenceand you've just gotten the job
at, I'll pick another state, theUniversity of Indiana. And all
of a sudden you show up andyou're really good at clinical
operations because they hiredyou from a private practice and
a little bit about education.
But research in grant managementis completely foreign to you.
(24:51):
Hopefully, this session willgive you some of those tips and
tricks and what we're talkingabout when we say grants. And
the fun part is, Daniel, and youkind of teed me up super well
here is that grants don't justhave to be at academic medical
centers. There are grants thatare, you know, supported by Eli
(25:13):
Lilly and and, you know, averitable cornucopia of
foundations, American CancerSociety, American, you know,
Lung Association, and on and onAmerican Heart Association that
give grant money to people thatapply for it. And so if you're
even listening to me right nowand you're like, I have nothing
to do with academics.
I don't even know why I got, youknow, you know, into this, you
(25:36):
know, podcast. I just want youto know that that you can if you
work at a cardiology practicein, you know, Davis, California,
I keep picking different states.You know, you can apply for a
grant through the and you canget new heart monitors. You can
(25:58):
get new, you know, you know,pulse oxes. You can apply for,
I'm going to say free money.
Obviously, there's a lot ofstrings attached to that. But
that's not money coming out ofyour operating account and
coming out of your physician'sprofessional fees. And so what
(26:18):
does it mean when I say grants?And then, you know, for people
that maybe are in the biz andare doing this every single day,
what are the challenges thatwe're facing right now? And how
can we shift and change?
Do we need to open it up beyondjust federal grants? Right. NIH,
DOD, HRSA, which is HRSA, whichis a more of an education based
(26:43):
federal organization to morefoundational organizations,
right? Like the American HeartAssociation, the American Cancer
Society or what I have done, youknow, and maybe spill a little
bit of of the of the tea here.You know, I really have
(27:03):
partnered very collaborativelywith industry partners, right?
Pharmaceutical companies. Sure.GSK, Eli Lilly. Gosh, II can't
think of another one off the topof my head but like there's a
cornucopia of them out there andso, you know, we in academic
(27:24):
medicine for a long time havebeen very laser focused on
federal because that's how youget, you know, certain ratings
and that's how you get papersproduced in the New England
Journal of Medicine. But, youknow, now that we're facing some
turmoil, you know, maybe we needto take those horse blinders off
(27:45):
and we need to look outside.
And so we're gonna talk aboutthat.
Daniel Williams (27:49):
That is wonderful. Thank you for sharing
so much information about thisacademic track at our show. If
someone's, looking to pick yourbrain or just connect with you
at the conference, any ideawhat's the best way to where do
they find you in Orlando? Willyou be at Disney or where will
you be?
Jonathan Leer (28:07):
What's No. I unfortunately, my daughters will
not be coming with me much totheir chagrin. They've got
school. So, you know, you saidit at the very top of the
podcast. I mean, with foursessions, hopefully people don't
get sick of me.
So I will be around. But I amalways happy to connect with
(28:29):
anyone. You know, when you're onthe app for for leaders
conference, which MGMA does formost of its event, there is a
directory L E E R. It's prettyeasy. You can type that in.
I should have all of my contactinformation there. But, you
know, let's say that someone'slistening right now and they're
like, hey, I'm on the fenceabout whether I should come or
(28:50):
not, which spoiler, you shouldcome. But you can email me at
jleer@som.umaryland, which isyou maryland dot edu. So it's
it's a bit of a long one, butpeople are welcome to email me.
(29:14):
I'm on LinkedIn, l e e r.
I'm the only one out there. I'vegot alphabet soup after my name.
You should see this ugly mug.Happy to connect with anybody.
Daniel Williams (29:25):
All right, Jonathan, you're so gracious
with your time both here and youwill be in Orlando. So thank you
so much for that. Great catchingup with you today.
Jonathan Leer (29:34):
Wonderful catching up with you, Daniel.
Thanks so much.
Daniel Williams (29:37):
All right, everyone. I will drop in those,
direct links to Jonathan'semail, LinkedIn, and perhaps
some other resources where we'veconnected with Jonathan
previously. Thank you so muchfor being MGMA podcast
listeners.
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