The U.Va. Health System continues to rank among the top teaching hospitals in the nation. Indeed, ten medical specialties attained a top fifty ranking in the 1999 edition of U.S. News & World Report's tenth annual guide to "America's Best Hospitals." Endocrinology and cancer departments placed in the top fifteen of more than six thousand hospitals reviewed. Another survey, conducted by Modern Healthcare, recognized the Medical Center as one of the top one hundred acute-care hospitals and one of the top fifteen major teaching hospitals in the country. Hospitals in this study were judged by their clinical practices, operations, and financial management.

In practical terms, these high rankings mean that patients at the Medical Center benefit from the latest medical techniques. For instance, the U.Va. Health System was the first hospital in the United States to adapt vertebroplasty, a new technique of repairing spinal vertebrae compression fractures often associated with osteoporosis. This minimally invasive treatment relieves pain and enables patients to resume normal activities in a fraction of the time of traditional methods. Thanks to the leadership of Dr. William Spotnitz, professor of surgery, the U.Va. Health System has been a leading proponent in the United States of fibrin sealant, a blood-based, biodegradable tissue adhesive that can be used during an operation instead of stitches. One of the advantages of fibrin sealant is that it markedly reduces healing time.

Medical Research for Patient Care Transplantation represents the ultimate expression of medical technology and surgical skill. The surgeons at the University's Charles O. Strickler Transplant Center are among the most skilled in the world. In August 1999, a team led by Dr. Timothy Pruett, professor of surgery and chief of the transplant center, inserted an additional liver in a boy whose liver had failed. By providing a backup liver, Dr. Pruett hopes to give the original liver time to heal, sparing the young patient a lifetime of dependency on immunosuppressant drugs. Dr. Irving Kron, professor and chief of thoracic and cardiovascular surgery, and his colleagues have pioneered a new technique to address the shortage of lungs available for children. With funding from the National Institutes of Health, Dr. Kron discovered that when a small section of adult lung is transplanted into a young laboratory animal, growth factors cause the lung to fill out and develop. Dr. Kron subsequently performed this operation successfully on two children who were dying of lung failure. This discovery opens up intriguing possibilities. If Dr. Kron can identify these growth factors, he may be able to regenerate damaged lungs without transplantation.

These achievements are particularly remarkable in an environment of severe financial pressures. U.Va., as with medical centers nationally, is caught between the rising cost of providing health care and drugs and declining federal reimbursements. With the margin of revenues over expenditures at just 1 percent, the U.Va. Health System has taken a number of cost-cutting measures including freezing spending and hiring, eliminating up to 80 positions, and embarking on a strategic planning process designed to produce administrative efficiencies.

Lifesaving Research

The quality and effectiveness at the University Health System is driven by the proximity of talented researchers.

The National Institutes of Health awarded the Health System $5.7 million for research into the causes of Parkinson's Disease. By understanding its origins, researchers lay the groundwork for more effective therapies.

Clinical trials conducted at the University by Dr. Frederick G. Hayden have paved the way for a new drug that can both prevent and treat influenza.

Support for the Community

In the past, cost-shifting from clinical care has been a major source of support for University medical schools. In today's competitive health-care environment, this is no longer an option, and the medical school is undergoing a major transformation as it develops other sources of revenue. In the meantime, the school's ability to provide financial aid for deserving students is constrained, and research space remains at a premium. This situation hinders efforts to attract some of the nation's best researchers and makes grant proposals to federal agencies and private foundations less competitive. To overcome this challenge, the School of Medicine has broken ground for a new  biomedical research building with lead funding from the Whitaker Foundation. This building will house the University's rapidly growing biomedical engineering program. Planning is currently under way for a second research building.

Private donors have generously contributed to health initiatives, making the capital campaign for the Health System extraordinarily successful. The School of Medicine reached its original $125 million goal two years ahead of schedule and achieved its augmented goal of $160 million in the summer of 1999. The School of Nursing also met its initial goal and has raised its sights to $10.2 million. In the months ahead, the Health System Campaign will focus on funding research programs and new laboratories.