We live in a small state. Dr. Lowry Barnes, chancellor of the University of Arkansas for Medical Sciences, and I have known each other since we were in high school in the 1970s. He was at Pine Bluff High School and was the state lieutenant governor for high school Key Clubs, which were sponsored by Kiwanis Clubs. I was chapter president at Arkadelphia High School.

Today is Barnes' 66th birthday.

I lost track of Barnes for a number of years after high school. While I pursued a career in journalism, Barnes earned a medical degree with honors from UAMS College of Medicine. He later completed his internship and residency there, then pursued advanced fellowship training at Brigham & Women's Hospital/Harvard Medical School, followed by the prestigious John N. Insall Traveling Fellowship and an orthopedic fellowship in Bern, Switzerland.

I came back to Arkansas in 1989 after almost four years as a Washington correspondent for the Arkansas Democrat. With a growing reputation as a surgeon, Barnes could have practiced anywhere in the world. But he also returned to Arkansas.

Barnes was born in Meridian, Miss.; his family moved to Pine Bluff when he was 11. He's the first person raised in Arkansas to be chosen as UAMS chancellor. He's also the first chancellor who's still practicing medicine.

"I gave up hip surgeries, but I'm still doing knees," Barnes said.

In spring 2023, I toured the new UAMS Orthopaedic and Spine Hospital (known as TOSH) with Barnes. The $85 million facility covers 158,000 square feet and has 10 operating rooms, 24 private rooms for overnight observations, and a separate section for pain management. The hospital was Barnes' idea.

"It has exceeded all expectations," he said of TOSH. "The culture is just incredible here. Our goal is to make it the best day it can possibly be for someone who really doesn't want to be here having surgery. Our patient numbers continue to grow. We have people coming from all over the country."

Barnes practiced for a number of years at Arkansas Specialty Orthopaedics, where he served for more than a decade as president and managing partner. He became one of the world's leading knee and hip surgeons. Barnes served as president of the American Association of Hip and Knee Surgeons, and remains active in orthopedic societies worldwide.

Barnes left Arkansas Specialty Orthopaedics to join UAMS in 2014 as professor and chair of the Department of Orthopaedic Surgery and Rehabilitation. He has published more than 350 peer-reviewed articles and holds seven patents for orthopedic surgery devices and implants. His celebrity patients include the likes of former Pittsburgh Steelers quarterback Terry Bradshaw. You might remember UAMS television ads that featured Bradshaw.

During our 2023 TOSH tour, Barnes handed me his business card and told me to call if I ever needed anything. I stuck the card in my pocket and didn't think about it again until a few weeks later. I was in Atlanta for my son's law school graduation from Emory University when a pickup made a left turn into a crosswalk where I was walking and sent me flying. As soon as I got back to Little Rock, I was in Barnes' office as a patient.

Last June, Dr. Cam Patterson announced he would leave his job as UAMS chancellor after seven years. Barnes was named interim chancellor the following month.

"In most cases, the interim is there to simply keep the ship afloat until a permanent chancellor is named," said Leslie Taylor, UAMS vice chancellor for communications and marketing. "Not Lowry Barnes. From the minute he stepped into the chancellor's office as interim, Dr. Barnes has pushed to improve medical education, care and research in our state. He was making a difference from the start."

Shortly after Barnes was named interim chancellor, I was back at TOSH early one morning to have a cup of coffee and visit with him. Knowing how much he enjoyed his role as surgeon, I asked him why he would want to lead a massive, complex institution with about 12,500 employees.

"When I made the move to UAMS in 2014, I wanted to see what I could do to impact health care for this whole state," he said. "I wanted to see if my leadership style would work here. Health care is a challenge in our part of the country. Our rural hospitals are very much at risk of closing. Rural doctors often have nowhere to send patients. That puts pressure on UAMS. We have some serious challenges."

As interim chancellor, Barnes met each Monday through Friday with what he describes as the executive leadership team. He knew that UAMS would need to grow in order to survive.

"Health care is a low-margin business," Barnes told me that morning at TOSH. "We have to get bigger. We're looking at every part of this institution to see where we can grow."

When selected as one of four finalists for the chancellor's job, Barnes conveyed the same message. During a town hall meeting on the UAMS campus in early December, he described himself as an "unabashed Arkansas homer."

"We have to grow," he said during the meeting. "We know we need more beds so we can treat more patients. We can't have anyone paddling in the wrong direction. We need a goal in front of us."

If hired by the University of Arkansas Board of Trustees as chancellor, Barnes said he would work to increase indirect research funding from $32 million to $50 million a year, raise an average of $5 million per month in philanthropic funds (UAMS usually raises less than $3 million a month) and double the annual budget.

"There are plenty of headwinds against us," Barnes told UAMS employees, noting that 61 of the state's 75 counties have poverty rates between 17 percent and 29 percent. He also noted that 60 counties have just one or no hospitals. Two-thirds of Arkansas hospitals are at risk of closure, he said.

Ryan Anderson wrote for the Arkansas Democrat-Gazette: "UAMS can fly through those headwinds by expanding digital health for rural reach and utilizing mobile health units--like a soon-to-launch unit for lung cancer screening and an existing one for breast cancer screening--as well as transforming obstetrical care in rural areas, expanding rural hearing care and improving nutrition in underserved regions, Barnes said. UAMS has been dedicated to rural outreach for decades, so 'we just need to expand it. We're going to address rural health care.'"

Barnes closed his talk by promising a "forward-facing, transparent and no-holds-barred approach to success."

On Feb. 5, UA trustees voted unanimously to remove "interim" from Barnes' title. Barnes called it "a humbling opportunity. Arkansas is at my core. It's an incredible state. I love giving back to the state, and I moved from private practice to UAMS to make a difference."

Barnes said UAMS had been in the black for four consecutive months as of December, the first time since the pandemic began in 2020.

"There's a different feel on campus with everyone dedicated to moving the needle forward for the state," Barnes said. "They [UAMS employees] have gone above and beyond, which has made all the difference in the world. They're all so important to what we do. They deserve to know where we're going and why. I've been such an active interim that nothing is really going to change. We're going to do the same things we've been doing."

"As the state's only academic medical center, UAMS isn't like other hospitals or health systems whose focus is solely on patient care," Taylor said. "We train the next generation of health care professionals. ... Research and education are costly, and UAMS only receives about 6 percent of our funding from our state appropriation. Tuition doesn't cover the cost of educating students. We try to keep tuition as low as possible.

"Clinical revenue subsidizes our education and research missions. For many years, UAMS had a deficit. Dr. Barnes has us back in the black. Health care is expensive, but Dr. Barnes doesn't believe that cutting jobs and programs is the way to go for our university to flourish. Instead, he's committed to growth so we can improve the care we provide the state. Our annual revenue is about $1.5 billion, and his goal is to grow to $3 billion. He signs his emails to employees and students 'let's go!'"

Barnes recently announced that UAMS had increased its minimum wage from $15 to $16 per hour. He's also committed to making UAMS the nation's friendliest health-care provider. Barnes and a team of employees are working with the Louis Hotel in Wilson to create a UAMS hospitality program called UAMS Cares.

Barnes used chancellor's foundation funds to start what's known as the Chancellor's Scholars program. In the first year, the program funded 40 full-tuition scholarships.

"In return for receiving these scholarships, the students have to work in Arkansas equal to the number of years for which they received support," Taylor said. "So if medical students get a four-year scholarship, after their residency or fellowship they're required to practice in the state for four years. Fundraising is taking place to keep this program going."

A decade ago, UAMS was the only medical school in Arkansas. It graduated about 160 physicians a year. Since then, three medical schools have been added, the most recent being the Alice Walton School of Medicine in Bentonville. The first class entered it last summer. Meanwhile, the Arkansas Colleges of Health Education in Fort Smith and the New York Institute of Technology's College of Osteopathic Medicine in Jonesboro train osteopathic physicians.

"With three medical schools graduating students and another that will be graduating them in three years, it's more important than ever that we increase the number of residency positions in the state and then keep physicians here," Taylor said. "Studies have shown that physicians are more likely to practice close to where they complete their residencies. Part of the problem is residency training is expensive, and funding for residencies is capped. Dr. Barnes is working hard to increase the number of residency positions in the state. Medical students have to do a residency after graduation. There just aren't enough positions to accommodate the number of students who graduate."

In February, UAMS and the University of Arkansas at Fayetteville announced an accelerated six-year bachelor of science to doctor of medicine program. The goal is to create a more direct pathway for students to move from high school to a medical degree, thus reducing student debt. The inaugural cohort will enter the program in fall 2027. It will be the third program of its type in the country.

"The collaboration between UAMS and the University of Arkansas reflects what is possible when two great institutions align around a shared purpose," Barnes said. "We understand that the path to becoming a physician can be long and costly. That creates real barriers for talented students and for the communities that need doctors most. This six-year program changes that equation, giving exceptional Arkansas students a faster, more affordable route to a medical degree and ultimately to the patients who need their care."

Dr. Steven Webber, dean of the UAMS College of Medicine, was born in London. He went from high school into a five-year combined preclinical and clinical education for a medical degree. Five-year and six-year programs are common in Europe. Webber led discussions with UA officials. The inaugural cohort will be limited to 20 students. For the first year, admission will be by invitation.

Students will spend their first two years in Fayetteville, earning credit for a bachelor's degree in medical science through the Fulbright College of Arts and Sciences. They will then transition into the standard four-year curriculum at UAMS. The medical school curriculum will remain unchanged.

"At the end of the day, it's all about having the right people in the right jobs," Barnes said. "There's not a county in Arkansas that doesn't have UAMS graduates working there. It's important to the future of Arkansas that UAMS be as strong as it can possibly be. We owe that to the people of Arkansas."

rnelson@adgnewsroom.com

Rex Nelson has been senior editor and columnist at the Arkansas Democrat-Gazette since 2017, and he has a biweekly podcast called "Southern Fried."

After graduating from Ouachita Baptist University in 1981, he was a sportswriter for the Arkansas Democrat for a year before becoming editor of Arkadelphia's Daily Siftings Herald. He was the youngest editor of a daily in Arkansas at age 23. Rex was then news and sports director at KVRC-KDEL from 1983-1985.

He returned to the Democrat as assistant sports editor in 1985. From 1986-1989, he was its Washington correspondent. He left to be Jackson T. Stephens' consultant.

Rex became the Democrat-Gazette's first political editor in 1992, but left in 1996 to join then-Gov. Mike Huckabee's office. He also served from 2005-09 in the administration of President George W. Bush.

From 2009-2018, he worked stints at the Communications Group, Arkansas’ Independent Colleges and Universities, and Simmons First National Corp.

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