A Funny Thing Happened at the (Faculty) Forum April
5, 2013
By
Leonard Zwelling
In
two words: No Surprises. Everyone played his or her part perfectly. Civility
was maintained. The room was only about two-thirds full, but the crowd was
attentive and polite. The only small moment of drama was when the issue of
compromised patient safety was brought up as a possible consequence of the push
to increase clinical revenues. That drew a nice round of applause and
perfunctory agreement from the President that this was of paramount importance
and then we moved on.
So
what are the takeaways from this faculty forum? Here are mine:
is a clear recognition on the part of the leadership that there are substantive
financial deficits in the operations of the hospital and clinics.
are more than offset by non-operating revenues.
is a generalized lack of understanding by the faculty present (84% to 16%) as
to why the push for clinical productivity has been so aggressive.
various places where revenues are spent within the organization (e.g., IACS,
Global, Moon Shots) were listed but the actual amounts devoted to each were
never revealed and the percentage of each area of expense that came from the
clinical revenue was never identified.
President’s emphasis is on revenue generation as the means to repair the operational
shortfall. Cost-containment was barely discussed in an objective and specific
sense.
projected 8% revenue increase used to construct the operational budget was
never explained although some particularly germane questions about the wisdom
of such optimistic projections at a time when clinical capacity is maxed out
was never fully addressed either.
President readily admitted that our current financial and business models are
not sustainable but did not clarify the new strategic model that would supplant
those he deemed inadequate.
I
am still concerned that there is a significant gap between the faculty’s
perceptions of the current state of affairs at Anderson and the one promulgated
by the leadership. This in turn leads to a gap in trust. This then leads to the
poor morale. Somehow we all have to get on the same page and this was evidently
not the case to my perceptions today at the forum—at its beginning or its end.
What
I found really lacking were two things:
was it not possible to provide the attendees with a complete financial picture
of the organization prior to the meeting and frankly, even during the meeting
(see #4 above)?
do we go from here?
In
summary, while every one was on his or her best behavior, I walked away no more
confident in the path the institution would take than I was when the forum
began. There still seems to be an excessive amount of department by department
bean counting in an organization that runs on just one pot of money, most of
which is generated by the activities of the clinical faculty. Is it so much to
ask to have a complete Balance Sheet, Income Statement and Statement of Cash
Flows for a $3.3B “non-profit” corporation? I don’t think so, yet we are still
without that accounting or accountability.
If
the leadership really wants to lead not just aim and pray for hope and change,
the leaders might consider a more revealing statement of the financial position
of the institution and the elucidation of a series of possible strategic
scenarios that represent the various choices the leadership could make based on
what will happen in the health care environment of Houston, Texas and the
United States.
I
had hoped that was what I would hear. Hoped it, but I did not expect it. Here’s
to not being disappointed through lowered expectations.
If
you came to the forum hoping to slake your thirst for insight, leadership,
planning and empathy. I am afraid you walked away both thirsty and confused.
What’s next? I cannot say that I have any idea from what I saw and heard last
night and that is, indeed, troubling.
The
requisite questions were asked to the credit of both the Senate and the faculty
present at the forum. This was no spring shower as I had alluded to in an
earlier blog. Unfortunately, it was not the hoped for confessional and contrite
performance from the leadership that could have empowered a new era of
faculty-administration cooperation.
It’s
still true about what men can’t say: “I’m wrong; I’m lost; I’m sorry”. As all
of us men who have made substantive errors know, that’s where the healing
begins. That’s also why Hillary Clinton’s stance with the Pakistini press was
successful. She could say all of that and do so with the blessings of her boss.
This
leadership stuff is like golf. It’s an easy game, but it’s real hard to play.
We all need to try harder, but only leadership can lead.
