For the past eight months, James “Jimmy” Keeton, MD, had been dutifully filing away a set of issues to be tackled by whoever would be named the next vice chancellor for health affairs at the University of Mississippi Medical Center.

 

Now, he gets to open that file up and put each task back on his to-do list.

 

“I take this on as an awesome responsibility, but also an incredible privilege,” Keeton said days after being confirmed to that post by the Mississippi Institutions of Higher Learning Board of Trustees. He had been serving in an interim capacity since Dan Jones, MD, left the vice chancellor postition to lead the entire University of Mississippi system as its chancellor.

 

 “I never expected to be here,” Keeton said of his new role. “I’m just fortunate to be able to play this part and to have some effect on healthcare in Mississippi.”

 

Keeton’s appointment as vice chancellor and dean of the School of Medicine comes at a challenging time. The medical center has already sustained $20 million in cuts since the State of Mississippi began shrinking its support during the recession. Meanwhile, at the federal level, the future of the American healthcare system was being volleyed in political play.

 

Fortunately for Keeton, whose career experience ranges from domestic private practice to working with the National Health Service in England, whatever model emerges won’t be entirely unfamiliar.

 

“I’ve seen just about every venue of how healthcare is delivered in the western world, and that experience has been of great aid,” he said. “We don’t have any idea what’s going to happen in Washington, but whichever way it goes, I’ve seen it.”

 

A native of Columbus, Keeton received his medical degree in 1965 from UMMC, where he also completed a rotating internship and residencies in general surgery and urology. He went abroad for training in pediatric urology at the Hospital for Sick Children in London, then served as a lieutenant commander in the U.S. Naval Hospital in Great Lakes, Ill.

 

Keeton returned to Jackson in 1973 and spent two years on the surgical faculty before transitioning to a 27-year career in private practice. He rejoined full-time faculty in 2000 and was named Jones’s chief of staff in 2007. He had served as interim vice chancellor since early fall 2009.

 

The top post at UMMC was not one he pursued. But the two finalists for the position — Scott Stringer, MD, chairman of the Department of Otolaryngology and Communicative Sciences, and Robert Robbins, MD, chief of cardiovascular surgery at Stanford University — both withdrew their names during the final stages of the search process. Keeton offered to continue.

 

“That offer was a backup plan,” he said. “I told Dr. Jones that if we ended up in a crisis here, I would be willing to stay on as vice chancellor or in whatever role he felt was appropriate.”

 

Jones chose to take Keeton up on his offer, rather than start the search process over and keep the medical center’s leadership in limbo.

 

For Keeton, stepping into the vice chancellorship in an official role has actually been smoother than transitioning into the interim post. Chiefly, he’s had the chance to gather a strong leadership team around him.

 

“What I didn’t have in place was a Jimmy Keeton,” he said, referring to the role in which he served Jones. “I didn’t have a chief of staff, and I didn’t want to appoint a lot of positions directly related to that office during the interim situation.”

 

Since agreeing to the vice chancellor assignment in early February, Keeton was able to bring to his side LouAnn Woodward, MD, in a shift from interim dean of the medical school to associate vice chancellor for health affairs and vice dean of the school.

 

“Now I truly do have a second-in-command,” Keeton said. “If I’m not here, she’s the go-to person, and we’ve agreed that one of us will always be here if the other is not available.”

 

In addition, Stringer has taken leadership of UMMC’s clinical enterprise, including of University of Mississippi Healthcare and the University Physicians, as associate vice chancellor.

 

As for his own tenure as UMMC vice chancellor, Keeton says he has no set timeframe. He’s already a decade past the age he once expected to retire; he celebrated his 70^th birthday the same week the IHL approved his new appointment.

 

As he brings the medical center through the fiscal challenges it faces today, he’s comforted that at least the value of UMMC is not an argument he needs to make to Mississippi’s governor, Legislature and IHL board.

 

“They all understand: They don’t want anything to happen to this engine,” Keeton said. “The medical center provides a tremendous bang for the buck for the state of Mississippi.”

 

Of its $1.2 billion budget, UMMC relies on the state for some 12 percent — all of which is directed to the medical center’s primary mission of educating and training physicians.

 

“The misconception people have is that we get money from the state for patient care, but actually, we have to make the money ourselves,” he said. “That’s where it gets challenging.”

 

As the current economic environment wears on, Keeton’s primary focus is to protect the financial security of the medical center. With a staff and faculty of 8,500, it’s the second-largest employer in the state of Mississippi.

 

“These are difficult times, but we also have great opportunities,” he said. “Fostering health and education in our state is critical to job creation, and we pursue our mission in partnership with all the other healthcare providers and hospital systems in the state.”