publication date: Sep. 4, 2015

UT Chancellor Mandates Unprecedented Shared Governance Structure at MD Anderson 

After years of turmoil and plunging morale at MD Anderson Cancer Center, the UT System took what observers describe as an unprecedented step—forming a Shared Governance Committee.

The new structure, instituted Sept. 1, disbands the once powerful Executive Committee, thereby changing the cancer center’s top-down power structure.

The new governance committee is designed to incorporate input from the faculty, and serve as the top advisory body to the institution’s president, Ronald DePinho.

The group will include all MD Anderson division heads, the chair of the Faculty Senate, as well as the chair-elect, the immediate past chair, and MD Anderson senior executives. The decision was announced Aug. 14, in a faculty-wide email from DePinho and Gary Whitman, chair of the Faculty Senate.

“In recent months, we have focused intensely on bringing together voices and talents from across our 21,000-employee institution to ensure adequate leadership representation and to enable awareness of issues and ideas that can lead to, or detract from, MD Anderson’s greatness,” the email said.

The email included two letters sent by UT System Chancellor Bill McRaven, addressed to DePinho and the Faculty Senate Executive Committee, respectively.

“The single most important issue, in my opinion, is assuring that bidirectional trust flourishes within the MD Anderson family,” McRaven wrote to DePinho in a letter that was dated July 22, but released Aug. 14. “Toward that end, I believe that a new shared governance structure will be transformative.”

McRaven’s approach is highly unusual, observers say.

“There have been occasions, hardly common, but not exceedingly rare, in which members of the governing board have suggested/advised/urged/insisted that an autocratic administration provide/allow the faculty a stronger role in academic governance,” Jordan Kurland, associate general secretary at the American Association of University Professors, said in an email to The Cancer Letter. “If the object of the board’s or system’s concern is expected to remain in office, however, this pressure is applied privately.

“I’m not aware of any case like that currently at MD Anderson, where the system chancellor has approached it as a matter of public concern,” said Kurland, who has been with AAUP for about 50 years.

McRaven’s letter describes how the new Shared Governance Committee should operate—including which issues it should cover and how frequently the members should meet.

McRaven also instructed MD Anderson’s leadership to develop an internal communication plan that would make the committee’s decision-making into a transparent process, “especially in terms of how clinical revenues are directed.”

“The shared governance team will serve in an advisory capacity to the President, who will continue to operate as the final decision authority for the institution,” McRaven wrote. “At the same time, the shared governance team includes broad representation of the institution, and if governance is functioning effectively, with thorough discussion, deliberation and opportunity for dissent, the decisions of the President will be closely aligned with the recommendations of the shared governance committee.

“Once the decision is made by the President, it will be considered final.”

In the letter, McRaven expressed his “full, unqualified, and unwavering support” for DePinho and his leadership, also saying that his “many conversations with faculty and staff reveal that there is a continuing sense that more can be done.”

“It is my goal, therefore, to communicate a set of institutional priorities that I hope will be embraced not only by your executive and faculty leadership team, but also by the faculty and the administrators,” he wrote.

The new shared governance structure is an MD Anderson effort, DePinho’s administration officials said.

“The Shared Governance Committee is the result of extensive work by faculty leaders and administrators, all of whom are committed to fostering a collaborative spirit, building on our strong institutional momentum, seizing extraordinary scientific opportunities and wisely addressing critical challenges facing health care,” MD Anderson said in a statement to The Cancer Letter.

“It’s clear our strides toward shared governance and responsibility in recent years have proved successful based on the exceptional success of the institution on all fronts—academic, clinical, scientific, fiscal, philanthropic and recruitment.

“Our recently closed fiscal year 2015 was one of our best ever in all of these areas. Together, we are moving toward our shared mission to reduce the pain and suffering of cancer globally.

“MD Anderson is committed to providing fair and competitive compensation for all positions based on market data. In addition to market data, the institution will continue to consider the specific responsibilities and expectations for each position. This is not only sound management, but also is consistent with the policies of the University of Texas System.”

MD Anderson recently proposed pay raises to members of the Executive Committee (The Cancer Letter, April 17). It is not publicly known whether MD Anderson will freeze or roll back compensation for executive leaders, as the faculty proposed in a white paper presented to McRaven June 14 (The Cancer Letter, July 13).

 

“I am Not Aware of Anything Quite so Thoughtful and Engaged”

A directive placing faculty officers on an institution-wide executive committee is unheard of, said Matthew Finkin, director of the Program in Comparative Labor and Employment Law & Policy, and the Albert J. Harno and Edward W. Cleary Chair in Law at the University of Illinois.

“On its face the chancellor’s initiative is most impressive: it takes shared governance seriously; it sets out key areas for improvement; it calls for transparency and accountability in achieving its goals,” said Finkin, who has participated in four AAUP investigations and chaired two. “I am not aware of anything quite so thoughtful and engaged.”

Finkin is the author of two definitive books on tenure in the U.S.: The Case for Tenure, and For the Common Good: Principles of American Academic Freedom. He is also an author of Labor Law, a leading casebook in American legal education.

“This is really an amazing turn around. I am really curious to learn of the faculty’s input in getting to this point and its reaction to what has, in effect, been ordered to be put in place,” Finkin said.

 

McRaven Calls for Team Effort

McRaven thanked the Faculty Senate Executive Committee for its work—specifically the white paper the committee prepared in July, which addressed what it called “pervasive” low morale at the institution, and called for the UT System to freeze the salaries of DePinho and his executive team until they reach parity with faculty compensation (The Cancer Letter, July 13).

“As we look to the future, it is clear that a team effort will be required to improve the climate at MD Anderson,” McRaven wrote in his letter to the Executive Committee. “The executive leadership team must embrace the principles of shared governance, transparency, and support of faculty academic effort. At the same time, the faculty must be an engaged and willing partner in these efforts.”

McRaven also said MD Anderson must “overcome a historical misperception that the purpose of the Faculty Senate is to serve as the loyal opposition to the administration.”

“The white paper has begun to change that dynamic—I have witnessed a genuine alignment of interests across the various stakeholder groups,” McRaven wrote. “In the proposed new shared governance model, it will be key for all of those involved in decision-making roles to act first and foremost in the interests of the greater good of the institution.”

Again calling for greater communication between all parties, McRaven wrote: “In my discussions with various stakeholders, it is clear that all constituents believe that internal communications can be improved at MD Anderson Cancer Center.

“Clearly, the executive leadership team understands that they have to do a better job in that regard, but I would also charge the Faculty Senate representatives to meet regularly with their constituents in order to make sure that they fully appreciate the range of opinions that are held. The white paper process illustrated that faculty opinion is diverse, and to be effective, the Faculty Senate cannot be seen as representing only one segment of the broad range of opinion.

“When meeting with faculty colleagues, it would be helpful if the message from the Faculty Senate representatives was as balanced as possible.”

 

Tenure and Evaluations

In his letter to DePinho, McRaven noted concerns over the institution’s policies on tenure and faculty evaluations.

In June, the American Association of University Professors censured MD Anderson after a yearlong feud over the decision to deny tenure to Kapil Mehta and Zhengxin Wang, two professors who had been unanimously recommended for tenure renewal by the MD Anderson Promotion and Tenure Committee (The Cancer Letter, June 13).

“The process of building trust will be advanced if faculty members feel that they have input into the process of evaluating the performance of all faculty administrators,” McRaven wrote, discussing the upward evaluation process.

“The faculty administrator upward evaluation process was not implemented since 2010, in part because it was perceived that it was not functioning in a way that provided constructive feedback to faculty upper administrators. That may well have been a justified decision at the time, but the passage of five years without faculty input into faculty administrator evaluations is adding to the sense that faculty do not have an adequate voice in the organization.”

McRaven called for a summary report of the faculty reviews for promotions and tenure as well as actions taken over the previous appointment cycle:

“During the past year, one of the issues that was addressed was a perception that there is an inadequate appeals process for rejections of promotion and tenure requests. A proposal was implemented to create an advisory review to the President when he or she disagrees with a unanimous favorable vote of the promotion and tenure committee.

“Thus far, there has not been a need to invoke this new process, so it is premature to judge whether or not it is working. Therefore, I look forward to a summary report from the 2014-15 annual appointment cycle concerning the number of faculty reviewed in the promotion and tenure process, the distribution of votes by the promotion and tenure committee, and the need, if any, to invoke the appeals process. I trust that the review of these data over time will reveal whether the new grievance process is working or if it requires further modification.

“Faculty grievances also arise outside of the promotion and tenure process and it is appropriate for the shared governance committee to charge a group of faculty and administrators to conduct a review of the current faculty grievance appeals mechanisms and make recommendations about improvements in the policies and procedures. Recommendations for changes in grievance policies and procedures should be submitted to the shared governance committee and those that are endorsed should be transmitted to the President to render a final decision. Once implemented, these policies and procedures should be monitored over time to assure that they are working effectively.”

 

Justifiable Salaries?

Top administrators at MD Anderson earn seven-figure salaries, and their compensation has been increasing dramatically while faculty raises have been slow (The Cancer Letter, April 17).

In 2014, basic science faculty members received an incentive payment of $2,000. Incentive pay for clinical staff was calculated as a percentage of base pay linked to the amount of their work in clinical operations and other factors, officials said. There was no merit raise in 2014, because MD Anderson didn’t meet the institutional financial goal required to trigger that merit pay, officials said.

In fiscal year 2015, faculty members received 4 percent merit raises, based on performance in the FY2014 fiscal year. The budget for fiscal 2016 includes a 3 percent merit increase for faculty as well as an incentive program, which is in the midst of being updated, according to slides presented to the center’s Budget Advisory Committee April 6. The document is posted here.

Two top administrators at MD Anderson Cancer Center, whose job responsibilities include maintaining harmony with the faculty, received substantial pay increases for having “excelled beyond expectation” and “effectively” directing the center’s clinical activities.

According to documents obtained by The Cancer Letter under the Texas Public Information Act, MD Anderson Provost Ethan Dmitrovsky and Physician-in-Chief Thomas Buchholz received $200,000 each in deferred compensation in 2015.

With incentive pay, supplemental annuity and deferred compensation included, the 2015 raise could boost Dmitrovsky’s total paycheck by as much as 22.9 percent compared to fiscal 2014. Buchholz’s compensation could increase by 31.4 percent.

In 2014, with bonuses and incentive pay, Dmitrovsky’s W-2 form reported that he earned $1,095,174 from MD Anderson. Buchholz’s W-2 reported his earnings at $1,027,233 last year.

However, compensation for the two executives was “not at equity with other members of our executive leadership team, particularly with regard to deferred compensation offerings,” MD Anderson President Ronald DePinho wrote to the Board of Regents.

Leonard Zwelling, a medical oncologist and former vice president for research administration at MD Anderson, argues that the cancer center is paying its executives too much.

“The question is, are these salaries really justified?” Zwelling wrote on his blog. “The new President of UT Austin turned down $1M for what he thought was a more appropriate $750,000 and he’s running a huge campus that dwarfs MD Anderson’s in size (but probably not clinical revenue).

“Then we heard that the reason that Buchholz and Dmitrovsky needed to make more is because they were assuming some of the work the President had been doing. Well, The Ronald’s salary was not reduced in sync with his right and left hand men’s increases and what is that work the two picked up anyway?

“Now, with the new shared governance, some of the pressure ought to be off the Physician-in-Chief and Provost as the faculty are there to prop them up (I wonder if the new faculty members of Leadership team will get raises, too).

“Perhaps it is time to bring in the auditors from the state to assess the value of the Leadership Team folks to the institution, compare their pay with that of the faculty both at Anderson and throughout the UT System, and then compare their pay with that of similarly-titled colleagues at other cancer centers adjusted for geographical inflation. (It costs about 40% more to live in New York City than in Houston, so a dollar for dollar comparison with personnel at Memorial Sloan Kettering is ridiculous).”

MD Anderson officials didn’t respond to The Cancer Letter’s questions about compensation for members of the former Executive Committee.

 

DePinho, Faculty Senate Announce Change

In an email sent to MD Anderson faculty and staff Aug. 14, DePinho and Faculty Senate Chair Gary Whitman pledged to work cooperatively.

The text of the email follows:

 

Date: August 14, 2015

To: All MD Anderson Faculty

From: Ronald A. DePinho, M.D., President and Gary J. Whitman, M.D., Faculty Senate Chair

 

In recent months, we have focused intensely on bringing together voices and talents from across our 21,000-employee institution to ensure adequate leadership representation and to enable awareness of issues and ideas that can lead to, or detract from, MD Anderson’s greatness. In addition, Chancellor Bill McRaven has provided sage advice in recent weeks and offered his perspectives and guidance in the form of two letters, addressed to both of us. We both wish to share these letters with you (see attached).

We are unified in our interest to advance the institution and are pleased to announce a new era of collaborative leadership at MD Anderson — marked by a genuine interest to create shared understanding and shared responsibility. To accelerate the realization of collaborative leadership, we are taking definitive steps to establish the institution’s first Shared Governance Committee. Effective September 1, 2015, this committee will become MD Anderson’s foremost advisory body to the president, assuming the responsibilities of the Executive Committee, which will be disbanded in its current form on August 31. Membership of the Shared Governance Committee will comprise all division heads; the Faculty Senate’s immediate past chair, current chair and chair-elect; and senior executives.

A renewed spirit of cooperation, rooted in our mutual desire to make this the best institution it can be, is palpable. It has been a key element over the past several months in advancing our institutional strategic plan well into its current implementation phase; ensuring progress across key focus areas; developing solutions for emergent operational issues; and supporting and advancing our world-leading faculty and staff to enable their continued scientific and clinical achievements for the benefit of countless people across the globe. We want to foster this collaborative spirit, build on our strong institutional momentum, seize extraordinary scientific opportunities and address critical challenges facing healthcare.

In summary, our new Shared Governance Committee has one fundamental objective: to collaboratively facilitate the advancement of MD Anderson toward achievement of our mission.

We are excited about working closely with each of you in Making Cancer History, together.

 

Ronald A. DePinho, M.D.

President

Gary J. Whitman, M.D.

Chair, Executive Committee of the Faculty Senate

 

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