New York Times Profiles UCSF Chancellor: An Innovator Shapes an Empire

October 11, 2011

Editor's Note: This article is from The New York Times, Oct. 11, 2011, © The New York TimesAll rights reserved. Used by permission and protected by Copyright Laws of the United States. The printing, copying, redistribution, or retransmission of the Material without express written permission is prohibited. 

By Denise Grady

The phone call, at home one night last week, came from a student seeking donations for the University of California, San Francisco. “Well,” Dr. Susan Desmond-Hellmann told the caller, “I’m actually the chancellor at U.C.S.F.”

Susan Desmond-Hellmann, MD, MPH

Susan Desmond-Hellmann, MD, MPH

The student, seemingly unaware that chancellor meant head of the university, kept up her pitch: The doctor and her husband had given $5,000 in the past, so how about another donation?

Dr. Desmond-Hellmann said they had already made another donation. The student kept trying.

Describing the call to an auditorium full of professors, administrators and students at the university, Dr. Desmond-Hellmann laughed impishly — but took delight in the student’s determination.

“Good job!” she said. “And I’m hoping she actually Googles ‘chancellor’ to find out what that is after the call.”

The audience laughed, too. The unspoken part of the joke, most knew, was that other donation. The chancellor and her husband, Dr. Nicholas Hellmann, had recently given $1 million to the university.

Dr. Desmond-Hellmann, 54, has been chancellor for a little more than two years. She came to U.C.S.F. after a stunningly successful career in the pharmaceutical industry. University officials invited her to apply for the job. She is the first woman to lead the university, and the first chancellor from outside the ivory towers of academia.

The university is widely regarded among scientists as one of the nation’s crown jewels of biomedical research, and a birthplace of biotechnology and innovation. But the public knows it less well, and Dr. Desmond-Hellmann wants to make U.C.S.F. as famous as the Mayo Clinic. The school is undergoing an enormous expansion in a difficult economy, and as a physician and scientist, she hopes to raise it to an even higher plane. As a businesswoman, she is determined to make sure it has enough money to get there.

Dr. Desmond-Hellmann’s years in pharmaceuticals left her, by her own account, “very, very wealthy,” with a fortune that she and her husband expect to give away. She could easily have retired. Instead, as the economy crumbled and public universities nationwide struggled with shrinking funds, she took on the daunting job of running a medical center and research university with 23,000 employees, two hospital complexes, dozens of clinics, 5,590 students, residents and postdoctoral fellows and a $3 billion budget.

She studied medicine at U.C.S.F. (she is a cancer specialist), met her husband there and took the job, she said, because she loves the place: “With the potential impact you have as an educator and as somebody who could lead an institution like this, maybe I could help make a difference.” Her vision for the university is to make it “the world’s pre-eminent health sciences innovator.” That means “unparalleled” care for patients, brilliant faculty and staff paid enough to stay and fast translation of scientific discoveries into treatments.

U.C.S.F. has already received one of the federal government’s largest grants to any university ($112 million over five years) for translational research, which turns basic-science discoveries into treatments for patients. Dr. Desmond-Hellmann wants an even stronger focus on those efforts, many of which are happening at the school’s gleaming new building for stem-cell research and its enormous new waterfront campus, Mission Bay, which is becoming a medical and biotech empire.

Dr. Desmond-Hellmann hopes to supplement the usual sources of income like patient fees, grants and tuition by increasing collaborations between the university and the biotech companies that have sprung up in the Bay Area — many of them spinoffs from research that began at the university.

To those who say this is the wrong time to set her sights so high, she points out that two phenomenally successful companies, Apple and Genentech, the biotech giant she helped run, were both started in 1976, when the economy was in the dumps.

A Proven Track Record

Coming from someone else, her ambitions might seem overblown. But not many people have her track record.

Before returning to the university, she spent 14 years at Genentech, where she last served as president of product development. The company produced an extraordinary lineup of drugs during her time, including the cancer drugs Avastin and Herceptin — both of which represented new approaches to fighting the disease —and became America’s leading maker of cancer treatments.

Her name has appeared on every manner of “most” list: most powerful innovators, most powerful women, most highly paid women.

She left the company in 2009 after Roche acquired Genentech, though she said Roche had wanted her to stay. By that point her compensation (base pay, stock and other payments) was more than $8 million a year. She also owned hundreds of thousands of shares of Genentech stock, worth $95 a share.

At U.C.S.F., her starting salary was $450,000 a year.

Trim and energetic, she works hard, and plays hard to clear her head. She is a skier and gung-ho mountain biker whose goal for this past summer was “no stitches” (she made it). On weekdays, she gets up at 4:45 a.m. to run.

“You read her C.V. and you don’t expect what you see, which is that she is disarming,” said Dr. Robert M. Wachter, the university’s chief of hospital medicine. “She is so nice that people may wonder whether she is tough enough. She is. When she came back to U.C.S.F., she quickly looked at the landscape and said, ‘We have to make some tough changes about money.’ ”

Declines in state money and Medicare payments will cost the university $38 million this year, and huge numbers of new Medicaid patients will be another drain.

Dr. Desmond-Hellmann’s initial strategy was to cut administrative jobs, though she says the university cannot cut its way to excellence. Last year, the changes saved $29.3 million — but did cost 270 jobs, via layoffs and by job openings left unfilled.

“The general consensus is that it’s the right thing to do,” Dr. Wachter said of these decisions, but added, “They’re not wildly popular.”

Among traditionalists, her ideas about medical education may raise some eyebrows.

“I predict that 10 years from now, the entire curriculum will be different in medical school,” Dr. Desmond-Hellmann said. For one thing, she suggested, the time spent in school could be shortened. Now, someone who wants to specialize in surgery and research must spend about 15 years in training.

“Is that sustainable?” she asked. “I’m not an expert on medical education, but I think a question that needs to be asked is, ‘What does college look like?’ ” Some schools already offer shorter programs, in which students earn college and medical degrees in six or seven years, instead of eight.

“What I see increasingly is customization,” Dr. Desmond-Hellmann said.

For instance, for students who want to work in rural areas with poor and underserved patients, a university program helps them prepare early in their training. She said such programs let students “customize so their learning is appropriate, and follow their passion.”

She recalled describing her ideal doctor to someone she was interviewing to become vice dean for education. “I said, ‘If I just do a thought experiment, I want my doctor to be really smart, punctual, thoughtful, funny, have a good bedside manner, have a sense of the community and the population, because of health care reform and the costs of care, and I’d really like them to walk on water. Could you produce those at large volume and low cost?’ ”

Learning to Lead at Home

Dr. Desmond-Hellmann grew up in Reno, Nev., one of seven children. Her father was a pharmacist and her mother an English teacher. She and her siblings went to college in Reno because it was affordable, and she needed student loans for medical school at U.C.S.F.

“I felt kind of like an underdog when I first showed up here,” she said. “I often laugh that Nick and I gravitated to each other and became friends, because around the table as we were interns, there was a lot of Harvard and Yale and U.C.S.F. and Stanford, and there were two notable state-school kids — Nevada and Kentucky.”

She and Nicholas Hellmann married in 1987. In 1989, they moved to Uganda for two years to study and treat patients with H.I.V. or cancer. They went because of the values they had both formed from growing up in large Catholic families and attending Catholic schools. “I think that what we got from our family life and our education is this sort of really strong sense of purpose and wish to make a contribution,” Dr. Desmond-Hellmann said.

She took her management style from her upbringing, too. Her parents were always looking for their children’s strengths, she said: “Great managers figure out what people are really good at and what gets in their way, and they pull out the best in people.”

After Uganda, she and her husband moved to Kentucky, where Dr. Desmond-Hellmann treated cancer patients.

They chose not to have children.

“I was surrounded by young kids as I was growing up, so I didn’t really feel like I needed to have the experience of babies,” Dr. Desmond-Hellmann said.

In Kentucky, she found herself having to tell too many patients that chemotherapy had stopped working and there were no more drugs to try. When her husband was offered a job at Bristol-Myers, in Connecticut, she went to work there, too, hoping that she could help develop new cancer drugs. She worked on the cancer drug Taxol, and discovered that she loved drug development.

“It was like I had been training my whole life for that job,” she said. Her next move was to Genentech, in 1995. At the time, the company had no cancer drugs, but had begun developing them. She soon became part of that work.

Arthur D. Levinson, then head of Genentech, said the company prided itself on a culture that stressed basic research, innovation, breakthrough drugs and, above all, the well-being of patients. Dr. Desmond-Hellmann fit right in, he said.

Dr. Desmond-Hellmann was “just wired” to put patients first, he said — and also had rigorous training in statistics, as well as medicine and oncology, that enabled her to look at data on new drugs and pick winners and losers.

She was also able to tell researchers when their projects were being given low priority or dropped.

“She’s a very nice person, so this did not come naturally to her,” Dr. Levinson said, adding that if he had any criticism of her in her early days there, it was that she was a bit too soft. “But she got it quickly. She became a tough leader, tough in a positive sense. She was willing to make tough calls without much difficulty.”

He promoted her quickly and repeatedly. “I knew she was the kind of leader who could go very far,” Dr. Levinson said.

Photo by Elisabeth Fall/fallfoto.com