Sanford's challenge: Lure top talent to S.D.

Sell scientists on doing `something revolutionary,' expert advises

First of a two-part series

© Copyright 2007 Argus Leader

PHILADELPHIA - When Sanford Health executives embarked on a grand plan to help sick children, they came to Philadelphia for guidance.

The doctors and scientists at the highly regarded Children's Hospital of Philadelphia and at Johns Hopkins Hospital in Baltimore offered similar advice: Recruit the best people. Build a strong research foundation.

Then came a warning: It won't be easy.

Dr. Tom Curran, the deputy scientific director at the Children's Hospital of Philadelphia, recalled his experience at a previous job at St. Jude Children's Research Hospital in Memphis, Tenn.

"Getting people to even visit Memphis was a challenge," he said.

Recruiting top-notch scientists is the No. 1 task for Sanford in its quest to become a global player in children's medicine, chief executive officer Kelby Krabbenhoft acknowledges. Without a track record of high-powered research or a famous medical school, experts say Sanford must sell scientists on the idea of relocating to South Dakota to explore new research frontiers.

Curran's office in Philadelphia now overlooks buildings at the nearby University of Pennsylvania, which provides faculty positions for doctors at the children's hospital and helps drive its research projects. Any kind of expertise exists somewhere on the campus, Curran said.

"Here, there's sort of a perfect storm environment where all of that comes together," he said.

Today, Philadelphia is one of the few places in the world where surgeons operate on the tiniest of babies while still inside their mother's wombs. In the labs, there's a sense that researchers could discover, at any moment, the latest in a long series of breakthroughs since it opened as the nation's first children's hospital in 1855.

Johns Hopkins has its own impressive accomplishments. Open-heart surgery was widely viewed as an impossibility in 1944, so a Johns Hopkins doctor and his assistant practiced on dogs until they learned techniques that saved the lives of babies. That opened the door to modern-day heart surgery.

`All about the talent'

After his employees visited Philadelphia and other children's hospitals, Krabbenhoft said his organization's ability to recruit people is the biggest risk factor in transforming the Sioux Falls health system into a world-class institution on par with the Children's Hospital of Philadelphia and Johns Hopkins.

"It's all about the talent," he said.

But Sanford officials say they are undaunted by the seemingly monumental task of founding and nurturing a world-renowned research center in South Dakota.

"I know the reputation of Children's Hospital in Philadelphia is one of the foremost in the world," South Dakota businessman T. Denny Sanford said.

"And that's where we're heading, but it's going to take us some time to get there."

He is giving $400 million to Sanford Health, headquartered in Sioux Falls. The money will be used to foster groundbreaking research at its new children's hospital and its planned network of clinics around the world.

Lifesaving work will be done for children treated in Sioux Falls and at the clinics.

But if Sanford Health can attract researchers who uncover new treatments and cures, then it holds the potential for a far greater reach.

"If you are building a research hospital to come up with cures for children, then you are helping the entire world," Curran said.

"That's because discoveries you make in your local hospital can make an impact on a worldwide basis."

World-class wanted

To do research with a global reach, Sanford must find ways to recruit the kind of world-renown talent assembled in places such as Philadelphia and Baltimore.

The world-class doctors and researchers sought by Sanford Health need space and money to support their work, said Dr. George Dover, director of the Johns Hopkins Children's Center.

"But probably as important to world-class researchers is an environment of intellectuals, a concentration of brains around them so they can collaborate with each other," he said. "They want a community of scientists, a community of scholars around them."

Researchers on the highest levels, Dover said, "need to be around people equally as smart as they are."

Johns Hopkins has this type of environment, with globally recognized doctors and researchers in its old, red-brick buildings and modern high-rises that cover several city blocks in east Baltimore. It helped develop a new model for medical education - an academic medical center, where learning and caring for patients took place simultaneously.

"There were a lot of medical schools and a lot of famous hospitals, but they were not built as one," Dover said.

That allowed the sort of collaboration that Dover sees as key to building a world-class research program.

In Sioux Falls, it is the opportunity to start groundbreaking research that could attract scientists to the Northern Plains. Sanford's plans include a dome to protect researchers from the harsh winters and a research park in southwest Sioux Falls that could feature an 18-story tower.

"What I sell them on is the opportunity to build a program," said Dr. Ben Perryman, vice president for research at Sanford.

That's how the health system recruited Perryman to Sioux Falls five years ago from the University of Colorado. "I was a tenured full professor of medicine when I was recruited here, so obviously, I thought there were opportunities," he said.

In late February, Sanford announced a significant milestone. An elite pediatric geneticist, Dr. H. Eugene Hoyme at Stanford University in California, would be the new chief pediatric medical officer for Sanford Children's Hospital and chairman of pediatrics at the University of South Dakota's Sanford School of Medicine.

Though Hoyme's hiring was regarded as a major step toward Sanford's goals, Hoyme wasn't even recruited as part of its new initiatives. He had applied for the position long before the $400 million donation was announced, partly because the Dell Rapids native wanted to return to South Dakota.

Perryman said Sanford hopes to announce other big-name hires in coming weeks.

"Clearly, there will be people who will not be interested in locating here," he said.

But key people will be, partly because of "a quality of life here that is under-appreciated," Perryman said.

Part of a revolution

Then there's the allure of a growing research enterprise that represents a new frontier.

"The first few biggest-name scientists who join the effort may have the chance to do something revolutionary," Renee Reijo Pera, director of Stanford University's Center for Human Embryonic Stem Cell Research and Education, said shortly after the Sanford gift was announced.

Pera, originally from Duluth, Minn., said Friday there are many top scientists from the Midwest who might be interested in returning, as Hoyme did. But recruiting them might be difficult, she said, because "there are things that are mainstream science that cannot be done in South Dakota."

South Dakota is one of six states with bans on embryonic stem cell research, and anyone who violates the law could face jail time.

Without the ability to do such research, Pera said, "I believe you can be very good or excellent, but I don't believe you can be outstanding."

The research component of Sanford Health's future plans is paramount, according to the doctors and researchers in Philadelphia and Baltimore. Their advice:

§ Build research into their plans at every stage.

§ Allow their researchers to be creative.

§ Foster a strong academic and intellectual environment.

At the Children's Hospital of Philadelphia, "every patient who comes in the door is considered a research subject," Curran said.

In Sioux Falls, "our goal is to incorporate research and research opportunities into everything Sanford Health has," Perryman said. "I want to push research activities - that excitement of discovering - and infuse that into all of our activities."

`A tall challenge'

Sanford also intends to identify and resolve "one of the most pressing health issues of our day."

During their visit to Philadelphia, the South Dakotans shared some of their plans with the doctors there.

They mentioned zeroing in on one disease during a conversation with Dr. Philip Johnson, chief scientific officer at the Children's Hospital of Philadelphia.

"I think that's going to be a tall challenge," Johnson said.

Many people want to do research that's not already being done. But Sanford Health could decide to launch a research project on a specific disease, and chances are high that someone at a medical research institution, university, hospital or pharmaceutical company somewhere else in the world already is doing it.

For example: Obesity is considered a great threat to children.

"The question is, are you going to be able to set up a research program around the genetics of obesity, and are you going to be able to do something in that area that's not already being done? I doubt it," Johnson said.

Regardless of where Sanford decides to focus its resources, Curran said, it should allow its researchers to be creative and follow their leads wherever it takes them.

"Sometimes," he said, "far-flung research on fruit flies can impact children with brain tumors."

Curran's own research involving fruit flies holds the promise of developing new therapies for brain tumors in children.

Perryman said it is essential that researchers are given the freedom to make discoveries.

"You don't manage the process of discovery," Perryman said. "You manage providing the resources and assembling the people. The process itself cannot be managed because of the unpredictability of the course of discovery. ... It's totally unpredictable."

Jeff Martin can be reached at 605-331-2373.

COMING MONDAY

THE WORLD STAGE: Can Sanford Health compete overseas with Mayo, Harvard and other famous U.S. institutions now doing business there?

@ARGUSLEADER.COM: Drs. Tom Curran and Peter Adamson talk about combining medical research and healing.

BLUEPRINTS TO A DREAM

Sanford Health hopes to emulate the world-class care and research at the Children's Hospital of Philadelphia and Johns Hopkins in Baltimore. As Sanford seeks to make its global imprint on pediatric medicine, it will use these renowned institutions as benchmarks to measure its success.

­ CHILDREN'S HOSPITAL OF PHILADELPHIA

Æ Its past: Founded in 1855 as the nation's first pediatric hospital.

Æ Its future: New $400 million, 558,000-square-foot research building is under construction.

­ JOHNS HOPKINS

Æ Its past: Hospital founded in 1889. Part of academic medical center that changes the way doctors are trained.

Æ Its future: $1.2 billion plan features construction of two 12-story towers totaling 1,473,000 square feet.

­ SANFORD HEALTH

Æ Its past: Traces roots to 1894, when first hospital in Sioux Falls opens.

Æ Its future: $52 million Sanford Children's Hospital is under construction. Future plans include new heart center and 18-story research tower.

The Sanford Initiatives

Æ Investment in Children: Pediatric clinics will be established across the country and perhaps internationally. Each will be tied to the Sanford Children's Hospital, set to open in Sioux Falls in 2009.

Æ Sanford Research: Growth in current research and creation of the Sanford Pediatric Institute, which will focus on children's health research.

Æ The Sanford Project: Aims to identify and then resolve "one of the most pressing health issues of our day."

Æ Sanford Healthcare Campus of the Future: Integration of components and facilities on Sanford's Sioux Falls campus.

About this series

Soon after South Dakota businessman T. Denny Sanford announced his $400 million donation and Sioux Valley Hospital renamed itself Sanford Health, the health system singled out the Mayo Clinic and two other institutions: Children's Hospital of Philadelphia and Johns Hopkins Medicine.

The gift "will drive our ability to become a medical research organization on par with Johns Hopkins; to obtain the caliber of

excellence in medical education programs such as the Mayo Clinic; and to be recognized for world-class pediatric patient care and research on the level of Children's Hospital of Philadelphia," Sanford Health said.

Argus Leader projects editor Jeff Martin and photojournalist Elisha Page visited the Children's Hospital of Philadelphia and Johns Hopkins to interview the world-class scientists there and see first-hand why Sanford views these places as benchmarks.