What Did The Clinical Leadership Say? A Translation

What Did The Clinical
Leadership Say? A Translation


Leonard Zwelling

the email that was sent from the Division Heads and assorted others on June 10:

Dear Faculty Members,

MD Anderson Cancer Center provides a unique environment
for our faculty members due to our multidisciplinary approach to eliminating
cancer; our academic mission has been the cornerstone of our history and
success. As the healthcare landscape evolves, we must rebalance and revisit how
best to preserve what makes us uniquely MD Anderson, while also ensuring our
organization remains successful within this new landscape.

Recently, the Division Heads and the Executive Committee
of the Faculty Senate discussed the feedback received regarding concerns for
the preservation of non-clinical time that advances the mission of MD Anderson.
For clinical faculty members our first priority is, and should continue to be,
providing exceptional care for our patients. We also recognize that productive
non-clinical time is a significant driver of innovative research, education,
and service. However, clinical faculty members often feel that this time is
increasingly difficult to maintain. This is not only an issue at MD Anderson,
but a national challenge currently impacting other academic healthcare centers.

As Division Heads, we support the preservation of time for
non-clinical activities and understand these activities contribute to faculty
career development and the overall success of the organization. We also believe
there are significant opportunities to work more effectively in today’s
environment, including the optimization of OneConnect, utilization of other
technological resources, and improvements in our operational practices. Time is
one of our most valuable resources, and the ability to be efficient and
innovative in the way we operate is one way of preserving this precious

We support efforts at both the local and institutional
levels to find balance amongst the many responsibilities and obligations faced
by all faculty members, including education, scholarship, and institutional
service. We welcome the opportunity to continue working with faculty members
and institutional leadership on this important topic.

me this ought to be read at the United Nations where simultaneous translation
is available. Since it will not be read on the east side of Manhattan, let me
try to reduce the email to English.


particularly clinical faculty who actually generate spendable revenue, need to
spend more time in the clinic billing.


with shrinking grant funds from NIH, reimbursement is dropping meaning we
cannot have as great a luxury as we used to, to have the faculty do research and
teach when the faculty could be billing. This is a problem everywhere in the
US. Doesn’t that make you feel better about it?


everything we know about the fact that EMRs slow patient care, we will use more
technology to increase efficiency. If that makes no sense, ask Watson.


word “amongst” is among those rarely seen in colloquial English. Isn’t this
cool that we used it in our condescending email to you?

the whole world knows that life is tough and that money in health care is
harder to make than ever. Of course, an honest presentation of what MD Anderson
is actually making and spending and from what and on what might go a long way
to assuaging the animus (see I can use cool words, too) of the faculty toward
its leadership.

Division Heads have got to be kidding. How can an institution that claims to
give quality care at all its locations “surrounding Houston” actually claim
that academic pursuits distinguish one of the locations at 1515. Delivering
quality care? Excuse me. Prove it! Not if you are running more people through
the clinics at the same time as you are demanding greater adherence to a novel
method of data record keeping.

only thing I cannot quite figure out is why the Division Heads felt compelled
to write this nonsense. Perhaps they didn’t really write it? If not, who did
and why?

2 thoughts on “What Did The Clinical Leadership Say? A Translation”

  1. Perhaps they're planning to an adopt some efficiency measures to increase profits. Here at NYU they use lean six sigma and have even trained key personnel to be black belts. NYU also brought in consultants to teach surgeons how to operate faster. And, of course, there is EPIC, which is designed to maximize billing. Who cares if the "service providers" hate it because it minimizes their time actually talking to the "client."

    1. There are some legitimate questions about what six sigma even means in health care. Its original meaning had to do with designing products with great tolerance for mistakes so they worked even if not put together perfectly (case study is Motorola beeper). Not sure what this means in health care where one sigma would be amazing. The sigma has to do with standard deviation and I think six sigma is 3 to 4 mistakes in a million operations. Not sure health care is ready for that. To do this requires defining efficiency and quality in health care. That needs to be done first and it is likely to vary fro place to place. Quality at McDonalds ain't quality at Peter Lugar's.

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