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June 27, 2013

Changes proposed in medical school’s shared governance

A proposal by faculty leaders to improve shared governance in the School of Medicine is in the hands of Dean Arthur S. Levine, senior vice chancellor for the Health Sciences.

Amid calls for increased faculty participation in decision making, Senate President Thomas C. Smitherman and past president Michael Pinsky met with Levine earlier this month to propose changes that would include more elected faculty on the medical school’s executive committee, additional faculty meetings and more opportunity for committee reports and dialogue at those meetings.

They also have called for the establishment of faculty advisory panels similar to those in place in the Dietrich School of Arts and Sciences and the formation of a group to rewrite the medical school’s governance document, known as the plan of organization.

Smitherman said that because the 2011 plan was not approved by faculty, a revised version is warranted.

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Faculty concerns over a medical school salary policy that could cut pay for some tenured faculty members by 20 percent a year have sparked questions in the Senate over the amount of input faculty have in setting medical school policy as well as a lack of faculty awareness of some of those salary policies. (See May 16 University Times.)

In his June 12 report to Senate Council, Smitherman said, “The proposal states some general principles and provides some possible rough ideas and frameworks to put more tangible evidence of governance into place.”

The proposals resulted from discussions in and beyond the University Senate and were vetted with the help of Senate past president Nicholas G. Bircher and vice president James T. Becker, Smitherman said.

“We envisioned a plan in which the faculty and the dean’s office together, in a cooperative and collegial way, could begin this effort. We presented this proposal to Dr. Levine and he accepted it. We are very grateful to him for that. He and Vice Dean Steven Kanter have begun some work on the details on how to implement it.”

Levine stated through a spokesperson that he and his advisers are considering Smitherman’s proposal, as well as other strategies to further promote shared governance in the medical school.

Smitherman said demand for more faculty participation has been on the rise in the medical school. In his Senate Council report, Smitherman said he and Pinsky formulated the proposal after concluding that the salary policy issue had pushed their fellow medical school faculty members to a “tipping point” beyond which most “would insist on more tangible means of shared governance being present.”

Smitherman told the University Times that the tipping point came when faculty discussions of the planned salary cuts grew heated. He said that although he felt the school administration had acted in accord with University policy, faculty members’ inability to easily locate the relevant documents exacerbated concerns.

Medical school administrators already have taken steps to address some of those issues. At the Senate’s request, the relevant salary policy documents that faculty had been seeking have been posted on the medical school’s faculty pages online.

“I think we’re making some headway,” Smitherman said.

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Neither the faculty members nor medical school administrators would release a written copy of Smitherman and Pinsky’s proposal to Levine, but Kanter, who as vice dean oversees faculty issues, told the University Times that the medical school administration is taking action in response.

Increasing the number of faculty on the school’s executive committee is “an excellent suggestion,” said Kanter. The executive committee, which sets school policy, currently is made up of the chairs of the medical school’s 31 departments, plus three elected faculty members — two from clinical departments and one from a basic science department — who serve three-year terms.

Taking into account the school’s growth, both in the number of faculty and the number of departments, “it makes sense to have more slots for elected faculty representatives,” Kanter said.

“By bringing more faculty into the executive committee, there can be richer and broader discussions,” and additional faculty members would not only bring more diverse perspectives to the table, but would add to the number of faculty members sharing committee information in their departments.

Exactly how many faculty members would be added remains to be seen. “Ultimately the faculty would decide,” Kanter said. Smitherman said he and Pinsky had not suggested a specific number.

Another “excellent suggestion,” Kanter said, is to increase the number of faculty meetings to three per year and to ensure those meetings include committee reports as well as time for open discussion. “I think that’s a good format.”

While three faculty meetings per year had been mandated by the school’s governance document, poor attendance led to the decision to cut the number of required meetings.

The medical school’s plan of organization requires only one faculty meeting per year, “at which the Dean shall give a State of the School address and at which other matters, as necessary, may be discussed.”

However, it also allows for special meetings to be called by the dean or by written request of five or more faculty members.

Plans are in the works to hold a faculty meeting this fall to vote on expanding faculty representation on the executive committee, Kanter said.

As for an advisory committee, Kanter said that the executive committee historically has been the principal advisory committee to the dean. “With additional faculty representatives, I believe the executive committee will be an even more effective advisory panel.”

Kanter said that the 2011 revisions to the medical school’s plan of organization were voted on and approved by the executive committee.

“Further revisions to the plan of organization will be an important agenda item for the newly constituted executive committee and will be presented to the faculty for discussion and a vote,” Kanter said.

He noted that scheduling a meeting that substantial numbers of faculty can attend is no easy task. Some faculty members have early-morning hospital obligations, while others are required to keep late clinic hours. Still others work in outlying areas. “One of the challenges is getting 2,200 people together in the same room. And, if you can do that, having meaningful faculty meetings,” Kanter said.

“It presents a real challenge in terms of just simply scheduling the meeting. At the same time, it’s critically important to have open channels of communication with the faculty.”

Smitherman agreed, acknowledging that attendance at faculty meetings had been “terrible.”

“We can make that better and we really should,” he said.

Most faculty members want to know there’s a faculty body behind them when the going gets tough, but often they don’t want to participate themselves, Smitherman said. “But people want to know meetings were held and substantive issues were discussed.”

Smitherman said the medical school could take a page from the Dietrich school’s bylaws to ensure large numbers of faculty have a voice in important issues. There, if lack of a quorum at a faculty meeting prevents a formal vote on an issue, a majority of members present can call for a proposal to be presented to faculty via an emailed ballot.

Smitherman said he had emphasized in his communications with the dean that shared governance provides a forum for faculty to discuss important issues and to make suggestions and recommendations “while remaining mindful that it’s the senior administration that makes the decisions.”

Smitherman said: “The dean has pretty much accepted our proposal; now, it’s just the details.” Smitherman said his intent was to foster a collegial, cooperative and cordial effort.

“So far, it has been,” he said.

—Kimberly K. Barlow


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