Dr. Robert Fiser stepped down as chair in 1994 and the Department of Pediatrics underwent its first change in leadership since 1975. Dr. Terry Yamauchi was named interim chair. After a national search, Dr. Debra Fiser was named chair of the DOP in 1995. Dr. Fiser was a medical student at UAMS and completed her residency in Pediatrics at the University of Kentucky and fellowship training in Critical Care Medicine at the University of Florida. She returned to UAMS and ACH as an Assistant Professor in 1981. She established and grew the Critical Care Section within the DOP, and she served as Chief of Critical Care at ACH until she was appointed Chair of the DOP.
During those years, she also oversaw the Critical Care Transport Service and the ACH Sleep Disorders Center. After serving as chair of the DOP for 11 years, she assumed the role of Dean of the School of Medicine in 2006. Dr. Stacie Jones, who served for many years as Chief of the Allergy/Immunology section, said this of Dr. D. Fiser: “I think one of the things that influenced me early on is Dr. Fiser had this incredible work ethic, was very smart, worked hard, had a very high bar for all of us, for her own performance as well as those of us that were around her… As a chairman, she was tough. She maintained that high bar. She took over our department at a time when health care was dramatically changing and when fiscal responsibility and financial worries were hitting academic medicine. And she had to make a lot of tough, savvy choices and she did it well. But again, in the middle of having a very high bar and expecting performance from us all, she would also mentor and would help us through hard decisions.”
Dr. Mary Aitken, who served as Chief of the Center for Applied Research and Evaluation as well as Vice Chair for Research of the DOP said, “Dr. Fiser was an outstanding mentor, good role model as a woman leader, as well as a researcher, kind of doing it all. She was one of the founders of pediatric intensive care at the national level. She was a one-woman show for the ICU here.”
Dr. Stephen Schexnayder, who served as the DOP’s Chief of Critical Care and Vice-Chair for Education for many years, said this about Dr. D. Fiser, ”She had the job of figuring out as we began to encounter some more challenging economic times in medicine, figuring out how to right-size groups and right-size staff and what we could pay for and what we could not pay for while really continuing to grow the educational and research missions of the Department. She was obviously a very gifted administrator and really was an organizational maven in terms of figuring out structures and processes.”
During the decade 1995-2006, the DOP achieved consolidation and growth of many programs already established, but the DOP continued with considerable growth in clinical and research programs, along with educational programs for medical students, pediatric residents and fellows in pediatric subspecialty areas.
Dr. Harry Ward, who served as Chancellor of UAMS since 1979, retired in 2000. Dr. I. Dodd Wilson served for 14 years as Dean of the UAMS School of Medicine from 1986 until he assumed the role of Chancellor in 2000; he continued in that position until his retirement in 2009. Dr. Al Reece was appointed Dean of the School of Medicine in 2002 and served in that role until 2006.
Dr. Jonathan Bates served as CEO of ACH, and Dr. Betty Lowe served as Medical Director during most of the years that Debra Fiser served as chair of the DOP. ( add picture #18 from Fiser 4/18/18 I will send) After Dr. Lowe’s retirement, Dr. Bonnie Taylor assumed the role of Medical Director in 2001. The number of inpatient beds at ACH grew steadily during the decade of Dr. Fiser’s leadership. In 1979 there were 125 inpatient beds available at ACH; by 1991 there were 268 beds, and there were 292 beds by 2005. This increase was partially due to the increasing reputation of ACH, but it was also driven by the ever-increasing number of pediatric subspecialist faculty in the DOP and their need for beds to care for their patients.
Clinical programs directed by the faculty of the DOP continued to grow and thrive during these years, while several new clinical programs were initiated. The Comprehensive Neurology and Epilepsy Center opened in February 1995. A multidisciplinary group of providers addressed all health issues of children with seizures and other neurologic problems. The new Neurosciences Center opened in the west wing of the hospital in 1998.
The new Cardiology center opened in 1998 and provided several focused clinics, such as the arrhythmia clinic, the Electrophysiology clinic and the Transplant clinic. The adjoining Heart Station provided more non-invasive cardiac testing for both outpatients and inpatients. The Pediatric Heart transplant program continued to grow and was considered one of the top ten pediatric heart transplant programs in the country by 2000. The ACH Heart Transplant program received official certification as a Medicare-approved heart transplant center by the U.S. Dept. of Health and Human Services in 2001.
Under the leadership of Dr. Robert Arrington, the new NICU opened in 1997. This new expansion increased the bed capacity from 30 to 53. At the time of the 20th anniversary of the ACH NICU in 2000, Dr. Arrington noted, “The first few years we were open, our patients experienced a 25 percent mortality rate. Today that rate is below 5 percent.”
Dr. Ross, who later became the chief of the Section of Neonatology, recalled Dr. Arrington: “Dr. Arrington WAS Neonatology in Arkansas. He received an incredible amount of respect from everybody, both at Arkansas Children’s Hospital and the community; everybody knew him. He was also known for his excellence in teaching, especially at the bedside, and his deep understanding of the physiology of newborns. That wasn’t all there was to him as well. He was a very devoted leader in the Section. He cared for everybody very deeply. He celebrated their successes.”
Regarding the advances in neonatology in the DOP and ACH and UAMS, Dr. Whitt Hall, long-time Director of the NICU at UAMS, recalled,” Neonatology has come a long way. Our training program, with maybe a couple of exceptions, has more beds than any other training program in the country. The clinical work of neonatology has really blossomed. When I was a resident, a baby born under 1000 grams, which is 2 lbs. 3oz., we pretty much wrote off. And now it’s a walk in the park. Now, we hold off treatment for babies born under 400 grams, which is about 1 lb. So babies that are born at 25-26 weeks virtually always survive and always do well.”
Several new clinical programs were initiated during the years of Dr. D. Fiser’s chairmanship. The inpatient hospitalist program started in 2003. The Department of Pediatrics assumed administrative responsibility for the Pulaski County Head Start Program in 1999 under the leadership of Dr. Charles Field. This included 30 classrooms serving approximately 1000 pre-school-aged children.
Dr. Field recalled:” The Head Start program parent organization in Pulaski County got into trouble, and they were looking for a safe harbor place to put the program. We thought it was a darn good fit for the Department of Pediatrics, as did the people at the level that were actually operating Head Start day to day. Dr. Yamauchi was acting Pediatric Chair; he said I’m okay with it but go talk to the Dean. The Dean at the time, Dr. Dodd Wilson, said I’m fine with it but take it to the chancellor. After some financial questions were answered, Dr. Harry Ward said sure, let’s go ahead and apply. Well, we applied, and the people in Dallas had never heard of a medical school or Department of Pediatrics wanting to be involved in a Head Start program. The grant ended up coming here, and it’s been here now for, I think, 23 years, and we just got renewed. “
The outreach clinics continued to grow in the state. The new Northwest Arkansas Center for Children opened in 2005. This brand-new building housed multiple outreach clinics in a large clinic area, along with a Kids First site and the Schmeiding Developmental Center. The Schmeiding Developmental Center, which opened as a new program in Springdale in 1991, was recognized as its own section in 2001, with Dr Mary Ann Scott as Section Chief. The first full team was assembled in 1995. Clinical services provided included developmental pediatric visits as well team evaluations for children and adolescents, neuropsychological evaluations and therapy services. A Reading Clinic was established in 2009 for children with dyslexia. The Dennis Developmental Center in Little Rock moved into a much larger facility in the renovated Westside Junior High School in 2005.
Under the leadership of Drs. Rob Lyle and Patrick Casey, the Medical Home clinic began in 2006. This program attempted to provide coordinated and comprehensive care to very complicated children with multiple medical conditions. Dr. Casey recalled,” In the Growth and Development clinic, I was seeing more and more very complicated children; some would go home with feeding tubes, some would go home with ventilators, and in a place like ours, they may see six different doctors: see the lung doctor, heart doctor, kidney doctor. So, with Dr. Lyle, who was seeing the same situation in the High-Risk Newborn Follow-up clinic, we decided to start the Medical Home Program.”
During the years 1995-2006, the DOP clinical activities grew considerably. Total inpatient admissions at ACH were 76110 in 2004-2005. Clinical revenue exceeded $61 million.
Dr. Fiser initiated the Center for Health Promotion under the Co-Directors Dr. Mary Aitken and Dr. Gary Wheeler. This center assisted in developing programs and research funding for injury prevention, tobacco cessation, and childhood obesity. Dr. Aitken said, “Injury prevention was my area, and Dr. Wheeler was particularly interested in tobacco cessation, and we both worked in the obesity area that was emerging. So essentially, we developed funding streams and there were faculty participants and recruits in all three areas.”
Under Dr. Fiser’s auspices, Dr. Joan Cranmer developed the unique process of faculty mentoring and promotion within the DOP. This began as a process to mentor clinical scientists but ultimately evolved to provide mentoring for all junior faculty, whether clinical educators, clinical scientists, or basic scientists. Dr. Cranmer also chaired the DOP promotion and tenure committee, which reviewed the status of faculty members scheduled to be reviewed by the promotion committee of the College of Medicine. This review was rigorous and typically resulted in 100% success in the promotion of DOP faculty by the College of Medicine. This mentoring process developed a local and national reputation and was emulated by many departments with the UAMS College of Medicine as well as Pediatric departments at other universities; a description of this process was published in the journal Pediatrics.
Dr. Eduardo Ochoa, chief of the Section of Community Pediatrics, recalled:” We had this internal process where you would have a warm-up for the Promotion and Tenure process at the university level. You were assigned reviewers for your packet. Actually, you were assigned a mentoring committee first, then when it came time to put a packet together, you had a first and second reviewer. So, there was all this work that you did on your packet before it even went to the University. So that by the time you put the final packet together, it was a slam dunk; everything, all the I’s were dotted, and all your stuff was in the right folder. All of that, I think, as a department, we owed to Debby.”
Dr. Stephen Schexnayder commented:” It became the standard that all junior faculty have a mentoring committee to help them find their way academically through the promotion and tenure process. That ultimately culminates in preparing them to go up for promotion. Part of this is kind of helping faculty that are not ready to understand that they’re not ready and figuring out what they need to do to get them ready.”