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Spirit is published three times per year by the Texas A&M Foundation, which manages major gifts and endowments for the benefit of academic programs, scholarships and student activities at Texas A&M University.

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Trailblazers

21st Century Doctor

Dr. Carrie Byington ’85 has one goal: to transform health care as we know it. 

“The current system is unsustainable,” said Byington. High costs and inefficiencies mean that the people in most need of care are often the least likely to have access to it. Innovation is often limited by administrative constraints, legal issues and other challenges. A leaky pipeline of talent means there aren’t enough doctors available to provide care or conduct research, and then there’s the issue of a serious lack of diversity in the medical community.

Tackling these problems is no small task, but Byington, dean of the Texas A&M College of Medicine, senior vice president of the Texas A&M Health Science Center and vice chancellor for health services at The Texas A&M University System, is up for the challenge. In her first year on the job, Byington is already making great strides toward transforming health care in Texas and beyond.

 

The Texas A&M College of Medicine is refocusing on its founding mission of serving Texas' rural poor.

Scholar, Doctor, Leader

Byington has been an Aggie since her first breath. Born in Bryan while her father attended Texas A&M, she grew up all over the state; he worked for Mobil Oil (now ExxonMobil) and job-related moves were a regular occurrence. “I’m very proud to be a Texan,” she said. 

After her undergrad years as an Aggie, Byington attended medical school at Baylor College of Medicine and completed her residency in pediatrics at Texas Children’s Hospital in Houston. It was at Baylor that she became aware of the magnitude of health disparities in her home state. “One of our primary training hospitals treated individuals without resources,” she said. “Every day, I encountered patients who were unable to afford medication, unable to read the instructions given to them for follow-up care, or unable to communicate in English with the medical staff to describe their problem. I saw the toll this took on them, their families and our community.”

Byington brought these lessons with her when she moved to Utah to practice medicine and teach. For the next 21 years, she dedicated her career to increasing access to care, especially for women and children living in poverty. She co-founded a clinic at the University of Utah to serve the most at-risk populations in Salt Lake City, including recent immigrants, refugees, pregnant teens and children in foster care. The clinic, which has won national awards, focuses on strengthening families by helping to address the social determinants of health, including screening for violence, ensuring food and housing security, assisting with transportation, and offering dental and legal services. To address literacy needs, Byington opened a free library within the clinic in 1998. The children’s library bearing her name became a county-supported public library 10 years later and is still going strong.

Though she had a leadership position and a successful career with a thriving practice at the University of Utah, when Byington saw the chance to return to Aggieland, the choice was easy. “I want to transform health care in this country,” she said, “and there is so much capacity at Texas A&M. I believe we can achieve health care transformation here and I believe we can do it better than any other place in the United States.”

 

Merging Engineering and Medicine: The Case of FilmArray 

Byington knows about medical innovation and translational science firsthand and is a fellow of the National Academy of Inventors. She is one of the collaborators responsible for FilmArray, a diagnostic tool used in 70 countries and in hospitals across the U.S. that has transformed our ability to diagnose infections since it was introduced in 2011. When the first version of the technology was being developed, it tested for just one type of virus: SARS (severe acute respiratory syndrome).

“It was beautiful technology and chemistry and there was no doubt that it worked,” said Byington, “but there was just one problem, as I discussed with the engineers: No physician would ever use it. The range was too narrow. What we really needed was something that would test for the majority of pathogens that cause the syndromes like respiratory distress or fever that we see all the time. We needed to test for viruses and bacteria at the same time. That had never been done before.”

Byington worked with engineers and basic scientists to perfect the technology, eventually creating a tool that tests for 21 of the most common viral and bacterial pathogens that cause respiratory infections from influenza to pneumonia. If a patient comes in with severe respiratory symptoms, a single, relatively inexpensive test can now determine the likely cause in about an hour, leading to faster, more accurate care.

They have since created additional FilmArray tools to test for gastrointestinal illnesses, sepsis and fever. Another benefit of the FilmArray technology is that accurate diagnoses can reduce the inappropriate use of antibiotics for viral infections, leading to fewer antibiotic-resistant “superbugs.” If a doctor can determine quickly that a patient is fighting a virus and not a bacterial illness, they won’t prescribe unnecessary antibiotics.
 
The respiratory FilmArray product was used in the rapid detection of the pandemic H1N1 flu in 2011 and the enterovirus D68 that caused polio-like symptoms in hundreds of children in 2014.

Engineering the Future

A key differentiator at Texas A&M is that the College of Medicine exists as part of the Health Science Center, where collaboration occurs between researchers and practitioners in all the health disciplines, from dentistry and nursing to pharmacy and public health. “Team-based medicine and working with interprofessional health teams will be incredibly important in addressing health disparities,” said Byington, stressing that health care cannot be the sole responsibility of physicians. “There are not enough physicians to deliver the one-on-one care that we need to really address chronic issues in the communities we serve. We need to engage the whole team of providers and address needs in a holistic, integrated way.” 

A new degree program called EnMed (Engineering Medicine) will promote innovative technical solutions to health problems.

This is especially true in rural Texas, where rates of chronic illness and cancer are higher, access to health care is limited, life expectancy is lower and doctor burnout is pervasive. “The College of Medicine was created through the Teague-Cranston Act to serve the rural poor and assist the veteran population of Texas,” said Byington. “In this, our 40th anniversary year, we have recommitted to that mission in a big way. Our history, combined with the Aggie core values of respect, excellence, leadership, loyalty, integrity and selfless service, make Texas A&M the ideal place to transform care for rural and military populations.”

Improvements in both areas require innovation, and Byington need not look further than a few miles for a promising partnership. “Texas A&M has one of the finest engineering schools in the nation,” she said, “and the ability to partner health sciences with engineering gives us an opportunity to dramatically advance health through innovation.”

Enter a new degree program called EnMed (Engineering Medicine), the brainchild of Byington and M. Katherine Banks, vice chancellor and dean of engineering. This interdisciplinary partnership, to launch in 2019 in collaboration with the Houston Methodist Hospital, will create a new kind of health care provider: a “physicianeer,” or a scientist with the ability to see health problems in a radically different way and find technological solutions that have never been considered before.

Fifty students will comprise each class of EnMed scholars and in four years, these talented students will earn both a medical degree and a master’s degree in engineering. The hope is that by combining medical knowledge with engineering technical prowess, new technologies will arise—technologies, for example, that can connect physicians and patients remotely without losing the same quality of care as in-person treatment; technologies to help those in the military to be safer, to have fewer injuries, to recover from injuries more completely, and to give them better quality of life; and most importantly, innovative new tools for diagnosis and treatment.

A handful of students piloting the EnMed curriculum are already advancing the medical field. One fourth-year medical student, Nga Tang ’18, is developing a tool to detect dehydration in infants with a smart pacifier, an invention that won a South by Southwest competition last year. Two other students, first-years Cannon Woodbury ’21 and Kenneth Livingston ’21, are working on a device that will help ophthalmologists examine premature babies, who are at high risk of visual impairment and have special challenges in examination.

These students are training to be translational scientists, capable of taking discoveries from one area and translating them into results in another. “This multidimensional approach will push the envelope for health care transformation,” said Byington. “This is the kind of training we need to create 21st century doctors.”

 

Fixing the Leaky Pipeline

Equipping 21st century doctors in new ways is half the battle, but to truly transform health care, something more fundamental needs to change—students of any gender, race or socioeconomic background must be able to afford and attend medical school while being supported along the way.
 

According to Dr. Byington, "Texas A&M is the ideal place to transform care for rural and military populations."

In the U.S., individuals from the top 20 percent income level of households make up most of the medical school student population. Additionally, student debt is higher now than ever before. “These demographics combined with financial pressures influence how and where physicians will practice after they complete their training,” said Byington. “My goal is for all the health professions to represent the diverse demographics of the U.S., and Texas A&M is a system with remarkable, diverse undergraduates that could support the inclusive health professions workforce we’re trying to create.”

Byington has recently signed agreements with six schools in the Texas A&M System to bring students into the medical school faster. If they reach certain milestones, they can shave one year off their undergraduate training. “It can take 15 years or more of college, medical school, residency and fellowship to become a fully-trained physician. For physician scientists, it is even longer. For many students, it is just too long,” said Byington. “It’s a competitive world, and talented students have many career options. We need to make the health professions more attractive to the best students.”

Persisting through that period of training is difficult, especially for non-white, non-male students, due to a lack of mentorship. “What we have across the nation is a leaky talent pipeline. Mentorship is essential to retaining the best minds in medical research,” said Byington. Particularly for women and minorities in this field, it can be hard to find a mentor because of a lack of diversity in leadership roles in medicine.

As the first Mexican-American woman to hold this level of leadership for an academic medical center in the U.S. and as a newly elected member of the National Academy of Medicine, Byington uniquely understands the need to make the health professions more inclusive and representative. In this spirit, she has mentored more than 100 medical students, fellows and junior faculty members herself.

“For me, it's all about helping people reach their potential,” she said. “Mentorship is the single most important factor in helping people to persist in the profession. It is an investment that pays off over time. We need this investment if we are to have the workforce to develop the new treatments, technologies and innovations necessary to have the best health care in the world and to eliminate health disparities.”

It’s just one more way that Byington is addressing the many health challenges facing Texas and the nation; one more way that she’s striving to transform health care, one student at a time.

You can support the Health Science Center by contacting Kirk Joseph '84, senior director of development (below). 

Opportunities for Visionary Investors 

Byington has big dreams for the future of the Health Science Center, but health care transformation can’t happen without the strategic investment of visionary partners. Funding priorities include:

  • Naming the Texas A&M College of Medicine: A naming gift of $75 million will address Byington’s priorities: improved health in rural populations, elimination of health disparities, development of new technologies, and partnerships with the military in care and service.
  • Supporting physician engineers through the EnMed program: The colleges of engineering and medicine hope to raise $50 million to support students and faculty in the EnMed program. Endowed opportunities begin at $100,000.
  • Providing scholarships for veteran medical students and medical students seeking to serve rural populations: Endowed gifts of $125,000 support Dean’s Excellence Scholarships.
  • Retaining and recruiting world-class faculty: Endowed chairs ($1.5 million), professorships ($1 million) and career development professorships ($500,000) reward career achievement and retain exceptional scholars.

If you'd like to learn more about these funding opportunities, please contact Kirk Joseph '84, senior director of development for the Texas A&M Health Science Center, at (979) 436-9107 or kjoseph@txamfoundation.com.

Contact:

Kirk Joseph '84

Assistant Vice President for Development
Health Science Center