The Virus As The Excuse

By

Leonard Zwelling

https://www.wsj.com/articles/coronavirus-gives-cover-to-hard-calls-11595008586?mod=opinion_lead_pos8

         Matthew Hennessey makes some really good points in his Wall Street Journal op-ed on Saturday, July 18.

         The coronavirus and our response to it will change everything.

         Here are some of the things he says will be forever altered.

         China’s plague on the world has allowed China to distract attention away from what it is doing in the South China Sea and Hong Kong. Xi never lets a good crisis go to waste. China has now risen as the major rival to the United States on the world stage and its intentions are clearer than ever. It will seek to dominate the U.S. if at all possible by any means necessary. The balance of power in the world has shifted.

         Sports have used the virus as an excuse to change its rules (a man on second base to start extra innings in baseball and a three-batter minimum for every relief pitcher). That will speed things up. It’s what baseball has needed for a while but might have been resisted by the fans if there were any. Whether the fans ever return to the stadiums may rest solely on whether or not we get a safe vaccine in the near future. Golf may become the new football.

         The Ivy League has done away with the need to submit SAT or ACT scores when applying as well as getting rid of coffer draining small sports in many colleges. Colleges will have to go on diets now that the world has realized that the over-priced on campus experience may not be necessary. The University of Phoenix could have told you that.

         The Catholic Archdiocese of New York closed 17 schools. That will save money, too. The entire concept of what school is may change as well, but not for the better. How kids will be socialized until we get a vaccine is quite a mystery, but on-line learning is here to stay.

         And what about all those lay-offs that many supervisors have been inching towards for years. Many employers have realized that they may be able to get by with fewer people working from home without the need for large amounts of rental space and cubicles. Is this the death knell of commercial real estate?

         Will any of this touch academic medicine? It might.

         First, many academic medical institutions have woefully bloated bureaucracies that have arisen for a number of reasons, but mostly because they could. Now they can’t. My guess is that even MD Anderson will do a little trimming in the near future and I suspect the same will be true throughout the Texas Medical Center. It may finally become clear to the leaders of these institutions that the extra money they have used to over hire derived from elective surgery revenue. With that curtailed, even for a brief period, they can learn to do with fewer administrators. When I was a VP, I had three layers on the org chart—my associate VP and me was one, our five or six managers was two, and everyone else the third. Now there are layers of bureaucracy. That can stop. Every Division administrator doesn’t need fifteen assistants.

         Second, research will be affected in a number of ways. My guess is that faculty investigators will have to cover even more of their costs to the institutions through grants. That means their own salaries and those of their support staff. There is going to be less clinical revenue to shift over to the research side for a while. I also think that the quality of research will have to rise. There simply is not enough money to carry mediocre investigations published in third-rate journals. I suspect the granting agencies may become the ultimate arbiters of what gets done and who gets tenure. Some labs will not survive.

         Third, teaching is upended and most will be done remotely. Entire buildings of space for bureaucrats and instructors will become superfluous. The very nature of the academic organization may change as more work shifts to dens and living rooms when it does not involve patients or mice.

         The coronavirus has exposed the fallacy of the need for a huge academic center replete with space and support personnel when the actual mission of patient care, research and teaching should have been the focus all along. I think the academic CEOs are going to have to make some “hard calls” as Hennessey puts it.

         The modern academic medical center is overbuilt and overstuffed with people, space and air conditioning that the virus has made us aware we may not need. It’s expensive and money is not filling some bottomless pit.

         Academia may have to tighten its belt significantly after the virus. Many believe this is long overdue.

Leonard Zwelling