Jay Perman preaches the gospel of nice.
Employees follow the incoming president of the University of Maryland, Baltimore from job to job because they so enjoy working with him.
Medical students at the University of Kentucky remember their pleasant shock at hearing the dean say they couldn't be good doctors if they weren't good people first.
"I wear it as a badge of honor," says Perman, who began his new job Thursday. "There's not enough nice in health care. Nice is what the public demands."
Some might question whether a guy who's known for his collegial demeanor is the right choice to lead a university that endured a turbulent spring because of lax controls over a former law dean's salary. But Perman, a pediatrician by trade, rejects the notion that nice is antithetical to firm.
At Kentucky, if he heard that a star doctor had a reputation for nastiness among colleagues, he'd call the offender in for coffee. He'd lay out his expectations for decent behavior and if, after a few months, he heard that his words had no effect, he'd fire the cantankerous doctor.
"If there's a concern that one of his people has done something inappropriate, he will look into it," says Elsie Stines, a Silver Spring nurse practitioner who commuted from Maryland to Kentucky every week so she could work with Perman. "He always addresses it and says, 'This is what I've done. These are the steps we've taken to fix it.' He's always direct. He does not like for things to fester."
"I'm the president of a university," Perman says. "I have the bully pulpit. Who says nice doesn't get you further than not nice?"
Nice had a lot to do with Perman becoming a pediatrician. As a medical student at Northwestern University, he thought he'd be a gynecologist. But every time he entered the operating room, he realized that his real interest lay with the baby being born.
Nice led him to administration. He felt deeply satisfied when one of his hires was published in the New England Journal of Medicine or won a big grant from the National Institutes of Health, so he sought that feeling on a grander and grander scale.
Even Perman's grand ideas tend to have nice at their core. He wants his university to take on big problems, like childhood obesity, but he figures that can't happen if the scientists at the medical school don't fully appreciate and collaborate with the law students who shape public policy.
Back to Baltimore
Perman's hiring at UMB is a homecoming. He made his reputation as a top pediatric researcher at the Johns Hopkins University and then chaired the pediatrics department at the University of Maryland School of Medicine. He raised his four children in Baltimore, coached youth sports and served on the board at Har Sinai Congregation in Owings Mills.
He says his new job might be the only one that would have lured him from Kentucky, where he established school-based programs to combat obesity and pushed initiatives to steer doctors back to their medically underserved rural hometowns.
"I think the setting is perfect for him," says Stines, who will continue to work as Perman's nurse and hopes to set up programs to help Baltimore students reach medical school and to train nurses from Haiti.
Perman, 63, is a first-generation American, born and raised in Chicago. His parents are Ukrainian. He attended undergraduate and medical school at Northwestern and harbored no greater ambition than to practice pediatrics in his home city for the rest of his life. But he ran into a question he could not shake: Why did so many infants have gastrointestinal problems that defied treatment?
"I was frustrated that we didn't have any way to get them better and fascinated that we did not know how to address this problem," Perman says. "Those were the seeds of my academic interest."
Unable to find the answers he sought in the Midwest, Perman moved east to Harvard University, where he learned to do heavy-duty research. From there, he went to the University of California, San Francisco and, in 1984, to Hopkins, where he established a full-blown program in pediatric gastroenterology. He could have spent the rest of his career as a well-respected, well-known pediatrician at one of the best hospitals in the world.
But again, something in his nature caused him to reach for more. He saw that the University of Maryland had no equivalent pediatric program and that far more patients would be served if he could forge a collaboration between the chief academic competitors in Baltimore's medical landscape. So he led the creation of a joint research program between two schools that rarely worked together at the time.
"He has always been the kind to reach out and partner with people," says Michael M.E. Johns, who worked with Perman as dean of the Hopkins medical school and is now chancellor of Emory University. "He obviously has a very high IQ and is a first-rate researcher, but he also has that ability to read the people around him. He sees the opportunities to bring them together."
With his taste for administration whetted, Perman moved to Richmond, Va., for three years to become chief of pediatrics at the Medical College of Virginia. He returned to Baltimore in 1999 to take the same job at the University of Maryland.
He realized during his time at Maryland that he might like to run an entire medical school. In 2002, he shadowed Richard Krugman, the veteran dean of the medical school at University of Colorado Denver.
"The thing he was really able to latch onto was the need to go into every conversation and be able to listen," Krugman says. "To not formulate a view until you have all the facts."
Soon after his time with Krugman, Perman learned that he had been recommended as a candidate to lead Kentucky's medical school. "I had never set foot in Kentucky," he says. "I had never even driven through Kentucky. It was a total abstraction for me."
He got the job and, again, nice proved to be one of his biggest assets as he crisscrossed the state, making friends and creating programs with people of sharply different backgrounds, creeds and political beliefs.
"You wanted to go to work for him," says Julane Hamon, who served as Perman's chief of staff at Kentucky. "You knew that if you had a good idea that made sense, he would help make it happen."
Hamon, for example, noticed a lack of private places for women to breastfeed on campus. She mentioned her frustration to Perman and together they lobbied the university to require every manager to make a clean, private space available for breastfeeding employees.
'Like a little kid'
Many top university administrators give up practicing their original craft. Not Perman. At Kentucky, he held a dean's clinic every other week, so each medical student could spend half a day watching him work with patients and bandy diagnostic opinions with Stines and other doctors.
Promoting diversity in the field is another of his passions, so he invited minority undergraduates to watch him work. At UMB, Perman plans to hold a "President's Clinic" and to invite not only future doctors but students of social work, pharmacy and even law.
"If I want to be a model, I have to continue to practice myself," he says.
Hamon remembers how Perman would light up on clinic day, bobbing around the office with a stethoscope around his neck. "He was like a little kid," she says, "doing what he loved."
Rachel Saunders, a third-year medical student at Kentucky, recalls the surprising first impression Perman made on her.
"He talked about not letting medical school make you bitter," she says. "Sometimes, you work so hard that you forget why you're here. But then you see him and he's still so passionate about what he does. You know, it's the first day, and he's telling you what it takes to be a good doctor. Not many places teach you that."
His clinic will be but one example of Perman's push to educate students from different disciplines in the same settings. "How can we teach everybody separately and then expect them to go out and work together?" he says. "We have to give them the opportunity to learn what the person next to them knows."
He uses the example of a child in Baltimore suffering from lead poisoning. What good would it do for the hospital to detoxify the patient, he says, without a lawyer to make sure the child's home is cleared of lead paint and a social worker to monitor the child's progress?
In addition to sculpting his leadership style, Perman discovered a new research passion in Kentucky. Early in his six-year tenure, he asked the state health commissioner how the medical school could best help surrounding communities. Kentucky ranked in the top five in the country in the rate of obesity, she told him, and the problem disproportionately troubled minorities and those from lower economic classes.
So Perman conceived the Jumping Jaguars program, sending medical students to teach exercise and nutrition at an elementary school in a poor section of Lexington. Like any good researcher, he was fascinated to find that the results of the effort were not what he expected. The children's body mass indexes did not decrease in a statistically significant way, but their attitudes, habits and attendance rates improved greatly. Perman hopes those changes pay off long term and plans to continue researching the subject by establishing similar programs with Baltimore schools.
Perman believes that if left unchecked, childhood obesity will pull down the nation's health care system because it leads to so many health problems later in life. Beyond the physical consequences, obese children are more likely to battle depression and less likely to attend school regularly because of social stigmas.
He envisions a multifront battle in which scientists explore the causes of obesity at the molecular level while lawyers push to have more sidewalks installed so children are more apt to exercise.
UMB is a complex institution with seven graduate schools and $500 million in outside research grants flowing through annually. In that breadth, Perman sees nothing but promise.
"I see a great opportunity for us to declare war on childhood obesity," he says. "It would really take advantage of all our resources."
To achieve his grand ambitions, Perman will have to steer UMB past the scandal that erupted earlier this year, when a state audit revealed that former law dean Karen Rothenberg had received $410,000 in "questionable" compensation beyond her contracted salary.
Asked about the audit, which hastened former UMB President David Ramsay's retirement and remains under review by the attorney general's office, Perman says, "I don't know chapter and verse on every point but I don't think what is presented there is a culture of irresponsibility. What I've been told is that every aspect has been dealt with and that policies and procedures are in place to prevent a repeat."
It's no accident, however, that one of his first hires was a new vice president of accountability, Pete Gilbert, who served as Perman's dean of finance at Kentucky.
"We will have a culture of understanding that we need to follow rules and that we are accountable to the taxpayer," Perman says.
Job: New president of the University of Maryland, Baltimore
Career highlights: Dean of University of Kentucky College of Medicine since 2004; chief of pediatrics at University of Maryland Medical System, 1999-2004; professor of pediatrics at Johns Hopkins University School of Medicine, 1984-1996
Academic interests: Pediatric gastroenterology, childhood obesity, greater minority representation among doctors
Family: Married with two grown sons and two grown daughters