Special Report – Faculty Urges UT System to Help Fix MD Anderson’s Woes

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Faculty Urges UT System to Help Fix MD Anderson’s Woes

By Paul Goldberg

The Faculty Senate of MD Anderson Cancer Center asked the UT System officials and the Board of Regents to “provide guidance” to the administration of the Houston-based center “in establishing milestones and timelines to implement measures to improve the morale of the faculty and the general health of the Institution.”

The resolution, which was distributed to the faculty on Feb. 16, reveals that the faculty’s dissatisfaction with MD Anderson President Ronald DePinho continues even after top UT System officials put him on notice to improve the faculty’s morale (The Cancer Letter, Nov. 7, 2014).

The document asks the UT System to step in, but stops short of expressing a lack of confidence and doesn’t seek removal of DePinho, who took the top job at the cancer center on Sept. 1, 2011.

The resolution was passed unanimously by the 154 members of the MD Anderson Faculty Senate present at the Nov. 20, 2014, meeting. It was sent to the regents on Feb. 6, in advance of their meeting Feb. 11-12. The institution’s full faculty received the communication.

The text of the resolution that was distributed to the faculty members follows:

Whereas, numerous surveys have indicated pervasive dissatisfaction with the Executive Leadership of the Institution,

Whereas, there is broad dissatisfaction with the long term institutional priorities established by the Executive Leadership,

Whereas, there is consensus among faculty of a disenfranchisement in institutional governance,

Whereas, there is the lack of integration of existing faculty with new initiatives,

Whereas, there is an unbalanced financial support for long term initiatives at the expense of immediate clinical and research faculty needs,

Whereas, there is concern about a climate of fear and the likelihood of retaliation against faculty expressing alternate opinions vis-à-vis the Executive Leadership,

Whereas, there is an immediate concern that our highly esteemed faculty will continue to separate from the institution under the current circumstances,

The faculty of MDACC request that the Chancellor and Executive Vice Chancellor for Health Affairs, in close collaboration with the University of Texas Board of Regents, provide guidance to the Executive Leadership in establishing milestones and timelines to implement measures to improve the morale of the faculty and the general health of the Institution.

The Issue Was Brewing Since November

A letter that accompanies the resolution states:

On Thursday, Nov. 20, 2014, in a closed meeting the Faculty Senate unanimously passed the attached resolution of concern to be sent to the Board of Regents. On Friday, Feb. 6, 2015, the attached resolution and accompanying explanatory cover letter were sent via overnight mail to the Board of Regents through Chancellor [William] McRaven and Executive Vice Chancellor [Raymond] Greenberg.

These documents were subsequently delivered to President DePinho. The ECFS requests that this be considered a confidential communication.

Thank you,

Karen A. Fukawa, project manager, Faculty Senate

Fukawa’s letter was distributed to faculty members at 5:24 p.m. Feb. 16.

An hour later, heads of MD Anderson divisions and the institution’s vice provost responded with a non-confrontational email that suggested that the administration is addressing the faculty’s concerns. The letter wasn’t signed by DePinho, his wife Lynda Chin, chair of Genomic Medicine and as scientific director of the Institute for Applied Cancer Science, and Ethan Dmitrovsky, the provost or Tom Buchholz, physician in chief.

The text of the response follows:

As faculty leaders whose key responsibilities include enhancing the mission of MD Anderson by upholding our core values and achieving our goal to eliminate cancer, we read with interest and take seriously the most recent message from the Executive Committee of the Faculty Senate (ECFS) to UT System Chancellor McRaven and Executive Vice Chancellor for Health Affairs Greenberg.

The Feb. 6 ECFS memo and its accompanying Nov. 20, 2014, Faculty Senate resolution again emphasize the need for us to listen to all of our colleagues and to consider all viewpoints. We must work together to address issues of concern in a collegial manner, ensuring that we maintain and increase the institution’s positive trajectory.

With that in mind, we appreciate and thank the faculty for being partners with us in making steady progress, including the recent approval of new resources dedicated to improving clinical faculty efficiency. We have had extensive engagement of faculty members throughout all of our clinical divisions and science departments in establishing our long-term strategic plan and improving our near-term responsiveness to challenges. For example, several important actions in response to faculty member feedback were detailed in a presidential memo on Dec. 8 — subsequent to the Nov. 20 resolution referenced by the ECFS. Many initiatives already have achieved results; others will take months to years, and we look forward to working with all of you moving forward.

We remain committed to understanding the needs of our faculty and maintaining an environment for both personal and professional fulfillment in support of our mission. As part of that effort, we will continue to engage and collaborate directly with our faculty colleagues as well as representatives of the Faculty Senate and its executive committee.

Especially during this time of unique and unprecedented pressures for academic healthcare institutions, we stand together with the faculty and our administrative leaders to surface problems for attention and to smartly and aggressively implement the solutions necessary to remain the premier cancer center for patient care, research, prevention and education. With your help, involvement, and partnership, we will ensure a culture of sustained excellence.

Thank you,

Marshall E. Hicks, division head, Diagnostic Imaging

Stephen G. Swisher, division head, Surgery

Richard E. Champlin, division head, Cancer Medicine, ad interim

Stephen Hahn, division head, Radiation Oncology

Stanley R. Hamilton, division head, Pathology and Laboratory Medicine

Ernest Hawk, division head, Cancer Prevention and Population Sciences

Helen Piwnica-Worms, Vice Provost of Science

Thomas F. Rahlfs, division head, Anesthesiology and Critical Care, ad interim

Cindy L. Schwartz, division head, Pediatrics, ad interim

Barbara L. Summers, division head, Nursing

David J. Tweardy, division head, Internal Medicine

A day later, on Feb. 17, top MD Anderson administrators joined the division heads in making a stronger statement, this time to The Cancer Letter, arguing that goals have been established and milestones reached in response to faculty concerns.

The administration’s statement reads:

We were surprised to learn of the Faculty Senate’s resolution of November 20, 2014, since goals have been established and milestones reached in response to faculty concerns. Just yesterday, in a communication to all faculty, our division head leaders outlined several outstanding efforts that have taken place since November. Additionally on December 8, several other important actions were detailed in a presidential memo to our faculty.

During the past several months, leadership and faculty members have worked together to address faculty frustrations and opportunities for improvement. Based on their complexity, issues were addressed rapidly or identified for a process of repair over time. We’ve also succeeded in engaging hundreds of faculty at every level in charting MD Anderson’s future through our strategic planning process, and we’ve directed executive actions to improve communication of financial processes, reduce bureaucracy, direct seed and bridge funding, and onboard additional staff to reduce workload — all in response to faculty feedback. In addition, our leadership team continuously has opened new lines of communication with our physicians and scientists. While many of MD Anderson’s 1,700 faculty members do not share the senators’ concerns, we believe our unwavering commitment to listen, communicate and act will continue to have a positive impact on our world-class faculty over the coming months and years.

We welcome the input and participation of our faculty, our Board of Visitors, The University of Texas System, and importantly, our patients and families in ensuring the success of MD Anderson and achievement of our mission. Our focus remains clear and our commitment to the institution’s continued clinical and research excellence remains strong for the countless people who entrust their lives to us.

Ronald A. DePinho, President

Thomas Buchholz, Physician-in-Chief and Executive Vice President

Ethan Dmitrovsky, Provost and Executive Vice President

Leon Leach, Executive Vice President and Chief Business Officer

Dan Fontaine, Executive Chief of Staff

Marshall E. Hicks, Division Head, Diagnostic Imaging

Stephen G. Swisher, Division Head, Surgery

Richard E. Champlin, Division Head, Cancer Medicine, ad interim

Stephen Hahn, Division Head, Radiation Oncology

Stanley R. Hamilton, Division Head, Pathology and Laboratory Medicine

Ernest Hawk, Division Head, Cancer Prevention and Population Sciences

Helen Piwnica-Worms, Vice Provost of Science

Thomas F. Rahlfs, Division Head, Anesthesiology and Critical Care, ad interim

Cindy L. Schwartz, Division Head, Pediatrics, ad interim

Barbara L. Summers, Division Head, Nursing

David J. Tweardy, Division Head, Internal Medicine

Previous Surveys

Members of MD Anderson’s faculty are an intensely watched cohort.

Over a bit more than two years, four separate surveys attempted to gauge the level of faculty morale and satisfaction at MD Anderson Cancer Center.

All produced similar results: faculty morale is low, and a large proportion of the faculty says the administration is tone-deaf to their needs.

The most recent survey—conducted by the UT System and reported on Nov. 3, 2014—allows comparison with the earlier efforts.

The MD Anderson Faculty Senate administered two recent surveys of the faculty (The Cancer Letter, Jan. 18, 2013, March 29, 2013, Sept. 20, 2013). MD Anderson’s administration attempted to accomplish the same task in its biennial BIG Survey of the faculty and staff (The Cancer Letter, May 23, 2014).

The MD Anderson administration has acknowledged that there is room for improvement, albeit with the caveat that academic medicine is an unhappy place these days (The Cancer Letter, Dec. 12, 2014).

The upcoming vote in the works now represents the Faculty Senate’s rejection of the administration’s assurances that the problem is (1) overstated and (2) being managed.

“Our latest data shows there’s work to be done in establishing improved relationships and communications between leadership and faculty,” MD Anderson officials said in response to questions from The Cancer Letter last December. “Our faculty retention success is exceptional,” officials said. “The institution has one of the highest faculty retention rates among all UT System institutions. When it comes to employees, MD Anderson’s success is due in great part to our efforts to hire and retain people who share our passion for our mission.

“The dedication to them is reflected in many ways, including our regular attempts to obtain their input and reactions so that we can continue to ensure the best for our patients and those who serve them.”

The administration provided the following examples of its efforts to improve faculty morale:

We’ve launched extensive efforts to get our leaders out of the office and into our clinics, labs and other work settings to talk with faculty. They attend staff meetings and feedback sessions to listen to concerns and take those thoughts and ideas back to the rest of the administrative team.

Engagement efforts were extensive throughout our recent strategic planning process. Communications took place face-to-face, through email and online.

We have expanded the extent of our communications, especially in areas where faculty and staff have requested more information.

In response to the most recent faculty survey data, we’ve asked department heads to gather additional information to help us react and respond.

We’re addressing some of the logistical frustrations voiced by faculty related to computer technology used as part of our business.

In response to our faculty’s request to receive more information about MD Anderson’s finances, we’re increasing the regularity and depth of detail of these communications.

We’re investigating what we can do to help staff manage the expanding regulatory requirements we face. We want to ensure we’re operating efficiently, safely and effectively, while reducing as much time burden for staff as possible.

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President Joe Biden’s proposed Advanced Research Projects Agency-Health would be a welcome partner to NCI—particularly in conducting large, collaborative clinical investigations, NCI Director Ned Sharpless said.“I think having ARPA-H as part of the NIH is good for the NCI,” Sharpless said April 11 in his remarks at the annual meeting of the American Association for Cancer Research. “How this would fit with the ongoing efforts in cancer at the NCI is still something to work out.”
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