Leonard Zwelling

As I understand it, the Physicians’ Referral Service (PRS) was the brainchild of R. Lee Clark. It served as a repository for the clinical revenues generated by the clinical faculty and paid for many of the benefits for BOTH clinical and basic science faculty.

The benefits package when I arrived at MD Anderson in 1984 was the best in all of academic medicine. Even as the salaries here were more than competitive, the benefits package was superlative and abetted the recruitment and retention of many stellar faculty members over the years. PRS benefits were the golden handcuffs that kept our best faculty in Houston.

Even though the PRS was overseen directly by the President and a faculty board and one President absconded with some $50 million to fulfill a matching pledge of a large donor to get a building up, for the most part, the faculty and especially the clinical leadership have played an integral and significant role in the manner in which the PRS was run and had great input into critical decisions made that affected faculty salaries and benefits. The PRS is a gem of MD Anderson and a major contributor to the history of excellence of the MD Anderson faculty.

Imagine my surprise when I learned that the current President has decided to put the PRS under Human Resources in the organizational chart. That means faculty no longer control the PRS. The head of HR does and that means the President alone does. This along with the notion of “one MD Anderson” and the refusal on the part of the President to acquiesce to a major faculty desire, a faculty dining space, indicate that the President is trying as hard as he can to level the playing field among all MD Anderson employees by lowering the status of the faculty. This is a major error.

MD Anderson has two major assets—its name and its faculty. What distinguishes MD Anderson from all other cancer centers is its singular mission and the dedicated faculty that make that mission a reality every day. I am sorry Dr. Pisters, there is an intrinsic difference between the faculty and the rest of the employees at MD Anderson. For one, who do you think produces the revenue, the cafeteria workers? I appreciate the need to respect all employees and pay them a good salary, but my guess is that the multiplication factor difference between the President’s salary and that of his lowest paid employee is greater now than at any time in the institution’s history. There is no more coddled group of non-revenue producers than the faculty administrators of MD Anderson. I should know. I was one and was never confused about my role. My only purpose was to serve the needs of the faculty and the faculty’s research. I wonder how many faculty administrators retain that value system today given the marked escalation in their salaries since my time at Anderson ended eight years ago.

I hope Dr. Pisters reconsiders his latest move to lessen the importance of the faculty in small ways from dining rooms to who supervises the fruits of their labors. Faculty Affairs, PRS and all things pertaining to the faculty do not belong in Human Resources. They ought to have a direct reporting line to the President as has historically been the case or at least to the Chief Academic Officer.

This is an awful turn of events that may portend the leveling of faculty benefits with those of the rest of the employees which could evaporate a major recruiting tool for new young talent. That would be too bad. I can see the SAP (the annual benefits bonus payment) running now.

2 thoughts on “PRS In HR Is Not OK”

  1. What an insightful commentary. Administration everywhere is working to control physicians while maintaining their salaries and bonuses. It’s so insidious and so destructive of recruiting excellent physicians.
    When our hospital tried to close down the Physicians’ Dining Room, one of our surgeons gave $1 million dollars to sustain the dining room and then more when he died. We need to think innovatively in how we sustain physician leadership and bargaining power.

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