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Penn medical school dean leaves big legacy

At a University of Pennsylvania cocktail party recently, business magnate Ray Perelman expounded on why he had bestowed $225 million on Penn's medical school - a gift that means the place now bears his name.

David L. Cohen, the Comcast executive and chair of Penn's board of trustees, recalled listening intently as Perelman talked about the university's role in health care, civic life, and so on. Suddenly, Perelman paused.

"If it wasn't for that man, I would never have made this gift," Perelman said, pointing over Cohen's shoulder at a slender fellow who had walked nearby.

The man was Arthur Rubenstein, and he would just as soon have had that finger pointed somewhere else.

Rubenstein, 73, will step down Thursday after a decade as dean of the medical school and the university's executive vice president for its health system, which includes three hospitals as well as outpatient services. And by all accounts, he has had a dramatic impact - his role in Perelman's gift only the latest of many accomplishments.

Rubenstein presided over a turnaround in the health system's once-dire financial status, maintained the medical school's top-tier status in research, erected buildings, and boosted the school's ranking among the best places to learn to be a doctor.

To have achieved all this, to have maneuvered adroitly in a realm of big egos and multimillion-dollar deals, Rubenstein must be a forceful, hard-charging type, right?

On the contrary, the first word out of colleagues' mouths is that the dean is just so . . . nice.

"All he talks about is everybody else," said Glen Gaulton, executive vice dean at the nation's oldest medical school.

When Rubenstein spoke at the ceremonial opening of Penn's $370 million translational research building last month, for example, he credited Gaulton with making the project happen. It was not just a typical pat on the back from manager to subordinate, but a full-force deflection of the spotlight, the vice dean said.

"I did some of it, I suppose, but he's the one who really got it done," Gaulton said.

And when prominent Johns Hopkins University researcher Chi Dang agreed to move to Penn, a worried Rubenstein pressed him to make sure his family was OK with the move. In two conversations.

"He meant it in a real way," recalled Dang, who is leaving a vice deanship at Hopkins to head Penn's cancer center.

Rubenstein, who has said he left his native South Africa in the 1960s because he found apartheid "intolerable," will remain at Penn in a teaching role.

He started getting things done with his gentlemanly demeanor even before he arrived at the school in 2001.

It was a rocky time for the health-care industry, and for Penn in particular. In fiscal 1999, the health system had posted a net operating loss of $200 million, and its debt at one point approached $800 million. The situation was so bleak that the university considered selling the highly respected health system.

Rubenstein, who had held top posts at the University of Chicago and the Mount Sinai School of Medicine, cautioned against such a sale when he interviewed at Penn, recalled Cohen, the trustee.

Instead, Rubenstein preached the value of having an equal balance among research, clinical care, and education. Politely but firmly, he said he would not be interested in coming to Penn if he were not able to strike this balance, Cohen said.

"He's such a nice man, you would be tempted to say to yourself that he's not strong," Cohen said. "But he's the strongest person you've ever seen. He would smile and say, 'I can see how you would say that, but have you considered this, that, and this?' Because he's so nice, because of his use of humor, he gradually wears you down."

Rubenstein helped streamline the leadership structure of the med school and health system so that they had one board of trustees under the aegis of a new entity, Penn Medicine. The financial picture slowly improved, with the help of health system chief executive officer Ralph Muller, whom Rubenstein hired in 2003.

Penn Medicine, which had revenue of $4.07 billion in fiscal 2010, sold underperforming physician practices in the suburbs and redoubled its efforts to improve clinical care for complex diseases. That included the addition, in 2008, of the outpatient building called the Perelman Center for Advanced Medicine (also named for Ray Perelman and his wife, Ruth).

And Penn's health system developed regional networks, sending its physicians to provide care at partner community hospitals and then, for complex cases, receiving referrals at its own hospitals in Philadelphia.

"We wanted to make Penn a patient destination," Rubenstein said in an interview in his office, formerly an old-style operating theater. The health system has enjoyed a string of years in the black, even during the recession.

Meanwhile, a stream of research stars has come to campus under Rubenstein's watch, most recently Dang and the husband-and-wife team of George Shaw and Beatrice Hahn, prominent HIV researchers at the University of Alabama.

Hahn said Rubenstein had sold her on the deal with the same point he emphasized before arriving himself: Penn's balance of research, education, and clinical care.

"I've never seen a place where I think pretty well every department is headed up by an M.D.-Ph.D., meaning that both sides are covered," Hahn said.

Rubenstein, who will be succeeded by J. Larry Jameson of Northwestern University, said he was flattered by all the praise. But true to form, he tried to deflect it.

"It's a team-based approach," he said. "We're all in this together."

Early in his career, Rubenstein made a name for himself as a diabetes researcher. Among his successes was his help in discovering a connective peptide that is now commonly monitored to gauge endocrine function. Due to this expertise, defense lawyers enlisted him to testify in the 1985 murder trial of Claus von Bulow, who was famously acquitted.

Now that Rubenstein is going back to teaching full time, it is not hard to predict one of the lessons that he will impart to the next generation of physicians.

In his commencement address last month to medical school graduates, the dean listed numerous qualities that are thought to be important for doctors in dealing with their patients. But one, he said, stands above all:

"I am convinced that humility is the essential characteristic."

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Kristen Fitch

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