“He is able to convey very, very complex ideas in a simple way so that people can understand the real issues that we’re facing,” McCall said.
“He has regularly been identified as one of the most influential people in healthcare in America, and he gets that recognition because he’s been working with the most important issues in healthcare his entire career.”
Life in the West Wing
As a medical school student at the University of Alabama at Birmingham, Roper said he quickly realized that a life of laboratory research was not what he wanted.
But his interest in politics and public policy led him to other aspects of medical science — and eventually to the White House, where he served under Reagan as well as George H.W. Bush.
“I discovered that there’s a public policy and political side to medicine,” Roper said. “In some respects that’s what public health is about.”
During the 1980s Roper served mainly as a senior White House staff member, but for a period he directed the Health Care Financing Administration — now known as the Centers for Medicare and Medicaid Services. Roper then served as director of the Centers for Disease Control from 1990 to 1993 under George H.W. Bush, who he said had valuable things to say about the nobility of working in public service.
“Nowadays it’s gotten to be fashionable for people to disparage people who work in the government and call them bureaucrats, and say the work they do is unimportant,” Roper said. “My experience, whether in the White House or in the Centers for Medicare and Medicaid Services or in working at the Center for Disease Control — these are very smart, very hardworking, very dedicated people who really do want to serve the great American public.”
After years in both the public and private sector, Roper got a call from Michael Hooker, then-chancellor of UNC, about an open position at UNC as dean of the School of Public Heath.
“We ended up visiting and liking it a lot,” Roper said of UNC. “It seemed like a great opportunity to take what I had learned and been reasonably successful with in the world of government…(and) put that into practice in the university setting.”
Roper and his family came to Chapel Hill in the summer of 1997, and they have been in town ever since. Seven years after his arrival, Roper took over as dean of the medical school, as well as chief executive officer of the UNC Health Care System.
“We are the largest medical school by quite a lot in the state of North Carolina, so we do important work training the next generation of physicians and health professionals,” he said, adding that UNC’s medical school is ranked sixth in funding from the National Institutes of Health among public schools.
A changing system
As chief executive officer of one of the top performing health care systems in the country, Roper said teaching, research and patient care are the system’s main focuses.
“We provide heath care to hundreds of thousands of people, and happily we do very high quality work in a way that is very satisfying to our patients and our families,” he said.
Roper said although the prestige of UNC’s system is exciting, there is still much uncertainty surrounding America’s health care system.
“You can either be scared of that or you can thrive on it, and on a good day we are doing quite well, but we have some challenges to be sure,” he said.
As a way to adapt to this changing health care world after the passage of the Patient Protection and Affordable Care Act in 2010, the UNC School of Medicine will offer a new curriculum in August 2014 for its medical students: Translational Education at Carolina.
Kenya McNeal-Trice, an assistant pediatrics professor involved in developing Translational Education at Carolina, said it is a curriculum emphasizing the importance of integrating a strong science foundation with clinical care and patient contact. The new curriculum will allow medical school students to explore clinical interests sooner, as they can complete the foundation phase within 18 months as opposed to two years, she said.
Vice Dean of Education at the School of Medicine Julie Byerley, who is leading the change, said this particular change was not a response to the Affordable Care Act, but students would be more exposed to issues in the law.
“We are definitely taking into account how health care is changing,” she said. “We will be teaching about the Affordable Care Act as we talk about population management.”
McCall said Roper was also instrumental in getting UNC Health Care employees trained as certified application counselors so they can assist people signing up for health care.
She said in 2010, he was a source of support to decision-makers in Washington during the process of determining the health care policy.
Roper said because the health policy community is relatively small, he is close friends with the policy makers in Obama’s administration.
He added that he would have done things somewhat differently with the new health care policy, but if the answer to America’s health care problems was simple it would have happened a long time ago.
“I think we’re going to be fighting about health care for a long time to come,” Roper said.
Keeping UNC at the top hasn’t been without its challenges. As the head of a school boasting around 1,650 staff members — nearly half of UNC’s entire faculty — Roper faces the challenge of making sure his faculty has the support and resources they need.
“We have faculty that are world-renowned leaders from lots of areas,” he said.
“Our faculty are so renowned, so prominent that they are constantly being recruited to go other places.”
Roper said budget cuts from 2009 to 2014 have proved a threat to the school’s faculty retention. However, they’re doing OK so far, he said — as he smiled and knocked on the wood of his desk.
The $75 million loss to UNC’s medical school has sent Roper to Raleigh several times — especially in the past semester — to speak with legislators.
“Over those five years we have had a 40 percent cut. Four-zero,” he emphasized.
“That has caused us to have to make very difficult decisions about, ‘What are we going to focus on? What are we going to do more of, but also what are we going to do less of?’”
Despite budget cuts, the current uncertainty of health care policy and his seeming nostalgia for the days he had an office on the West Wing’s second floor, Roper expressed his content with where he is now.
“I consider it a great honor to be here, engaged in the work that I am,” he said. “I’m fulfilled by what I do and I plan to keep doing it.”