One Reason the Faculty Are
Ignored : Leadership Acts Like It Is Acceptable To Do So 


Leonard Zwelling

         In this short op-ed in Sunday’s (Dec 7) NY Times, Adam
Grant, a professor at the Wharton School at Penn and Sheryl Sandberg, the COO
of Facebook, write about real research into the nature of bias against women.
They convincingly argue that the more the environment admits to bias and
reinforces gender stereotyping, the worse things get for women.

article could not come at a more relevant time. The nation is going through a
wrenching debate about racial bias, the unequal application of police power to
citizens based on race and the on-going struggle for women to gain equality in
a difficult economy where the two-person wage-earning household is more common
and necessary than ever.

         According to Grant and Sandberg the song from Avenue Q
called “Everyone’s a Little Bit Racist” is not only true but its sentiment
gives license to the acceptability of prejudice as well as its tolerance in the
work place. This is the exact opposite of what an exercise in mindfulness is
supposed to do and suggests that it is more groupthink and the acceptance of
innate bias than mindfulness that dominates attitudes in modern society. What
to do?

         The key, according to the authors, is changing the message
from the admission that bias exists to reinforcing that it is not tolerable.
Leaders must demand equal treatment of all and demonstrate it themselves.
Essentially, we who truly believe that bias is unacceptable, but omnipresent in
modern American life, must find it offensive, say so, and act to combat it

         Without being too immodest, when I was a vice president and
was recommending chairs for positions leading key federally-mandated committees
for presidential appointment, I called on every single available female on the
faculty to serve in these positions. Several turned me down, but most did not
and did terrific jobs when being called upon for their first administrative
leadership roles.

many might say that I couldn’t have come home if I hadn’t nominated all of
those women. They would be correct. If marriage is anything it is
consciousness-raising of one partner to the plight of the other’s group and
life experience, so I do not apologize for learning what my wife had to put up
with to get where she is and for me to try to improve things for women when I
could. Virtually all of the managers in the Office of Research Administration
over my 12 years were women with but a few exceptions.

         All this being said, there is one more place that bias needs
a look, and it is a place where no one would ever have imagined it would be

         I believe that those who run academic medicine, medicine in
general, and the health care-industrial complex are biased against—doctors!

         I know, I know, I am nuts, but not so fast.

         If the faculty of Anderson has one totally legitimate
complaint, and it is one they share with physicians from private practice to
the Ivy League to Capitol Hill, it is the lack of doctor input into how
patients are cared for. I don’t mean how orders are given and done. I mean how
process, procedure, policy and management affect how that care gets to patients
and how the patients are moved through the system from the front door, through
the labs and clinics and even how it is determined what is permitted and what
is not on clinical protocols. The first line of defense against a patient suffering
from a medical error is minimizing a doctor’s chance of making the error in the
first place. That’s best done through the design of care systems by doctors not
by lawyers or politicians who are convinced that EMRs will actually save patients and/or money. My reading and conversations suggest neither may be the case.

         So in the spirit of the Grant and Sandberg article, it’s not
enough for the leadership of MD Anderson or the Chancellor or the Executive Vice
Chancellor or the Board of Regents to express concern about the turmoil at
Anderson, the unhappiness of the faculty and the general state of morale (low)
at what was once the foremost place for cancer care in America. We hear you say
you get it. Hell, how could you not? You did the most recent survey!

show us you get it. Do something for goodness sake. Some of you are doctors. Don’t dismiss
what faculty members think just because it is faculty members thinking it (and
expressing it in surveys). Mouthing the message of shared governance is nice.
Making sure it lives is even nicer.

         Please do so for the women and men of the MD Anderson
faculty, the most important doctors in their patients’ lives.

Leonard Zwelling