Who Writes The Policy? Who Does The Policing?


Who Writes The Policy? Who Does The Policing?


Leonard Zwelling

This is what Rabbi Google has to say about the origins of the words “policy” and “police”:

Policy “comes from the Middle English term policie, meaning “government” or “civil administration.” That word was derived from the Latin polītīa, meaning “polity,” a politically united group of any kind. The Latin polītīa is the basis of many related words, including politics and police.”

“To police is to maintain law and order, but the word derives from polis—the Greek for “city,” or “polity”—by way of politia, the Latin for “citizenship,” and it entered English from the Middle French police, which meant not constables but government.”

To put it all together, the policy is the manner in which an organization or civil entity will be governed and the police are the ones that see that the policy is actually followed by maintaining law and order.

It is evident that the successful application of policy to any given organization or government depends, in part, on a police function. The only question then is the one that gives this blog its title. Who writes the policy? Who does the policing?

For as long as I can remember, these questions have been critical to the function of an academic medical center. Clearly the leadership of an institution or its governing board write the policy and the same people may well be responsible for the police function. The only question is does the board or the leaders write the policy and assure police compliance by themselves or with the consent of the governed, i.e., the faculty and staff.

For my whole career at MD Anderson the policies came from several sources.

There were certainly and are still Regents’ Rules that emanate from Austin and have a lot of weight. There are clearly laws written by the Texas State Legislature and signed by the Governor that affect life at MD Anderson. The current debates about tenure and DEI programs are two good examples and proposed laws could change life at Anderson.

The leadership of MD Anderson writes tons of policies. Those governing the faculty are compiled in a Handbook, but, and this is key, every one of those policies and all new ones are supposed to be reviewed and approved by the body that represents the faculty—the Faculty Senate. There is some debate at the present time as to whether or not that is happening with the current administration and whether or not the “shared governance” dictated by the Regents’ Rules is being dutifully obeyed by the current leadership at Anderson.

Another source of governing policy at Anderson is the federal government. Rules governing Medicare, Medicaid, federal grants, clinical research, laboratory animal welfare, biosafety, and research misconduct all emanate from Washington, DC (or close by in Bethesda). But how these are policed has changed greatly since I was in a leadership position at Anderson. I should know. Most of the oversight of federal research regulations fell to me. Why? Because it was felt by the previous administrations, that a faculty member who presumably had the sensibilities of someone doing research should be the point person looking out for the faculty and for the institution in matters involving federal research regulation. As far as I can tell, this is still true for clinical research at Anderson, but not so much for the rest of research regulatory oversight.

I would urge the Faculty Senate to investigate who is writing policy for research regulation at Anderson and who is policing that policy. If it isn’t a faculty member, perhaps the old model ought to be dusted off and reanimated.

Lawyers and non-faculty administrators have no business overseeing the governance of research at a major academic cancer center. And faculty ought to have a hand in policy writing and certainly on policy policing.

It appears to me that MD Anderson has become more autocratic, less collegial, and certainly not inclusive when it comes to the oversight of the rules governing research. This can be fixed. There’s a new Vice President for Research. He ought to be the faculty’s voice in matters of research regulation like I was many years ago. It’s best for everyone, especially the faculty performing research if a colleague plays that role and is the “designated inmate” when things go wrong. The lawyers have no stake in the quality of the research. They just want strict compliance, but, then again, what do lawyers know about research?

Dr. Zwelling’s new novel, Conflict of Interest: Money Drives Medicine and People Die is available at:


on amazon if you search using the title and subtitle,


directly from the publisher Dorrance at: https://bookstore.dorrancepublishing.com/conflict-of-interest-money-drives-medicine-and-people-die-pb/m

2 thoughts on “Who Writes The Policy? Who Does The Policing?”

  1. As I progressed through my career as a leader in creating Vascular Centers at Mayo Clinic, Eastern Maine Healthcare, and Roper St Francis Heathcare-MUSC in Charleston, SC, I was concerned about the MANY rules and measurements that intervened. They seemed rather rigid and designed to maximize institutional net operating income and diminish physician power and income. They also placed nonresearchers in positions of controlling research, an area where they had no real understanding, experience, or contribution. We must understand that there is a breed of healthcare professionals who are no different in intent than Southern plantation owners who knew how to exploit they’re enslaved. We need an Emancipation Proclamation to end overuse of medical administrative entrepreneurship.

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