Let us hope that UTHSC San Antonio administrators treat the new doctorate nursing faculty better than they treated Bob Klebe. Let's also hope that the UT "accordion compensation plan" does not adversely affect the program. UT System administration has already admitted to recruiting problems as outlined in the Zemanta box at the end of this post. Of course, administrators blame the state of Texas rather than their own actions.
The University of Texas Health Science Center at San Antonio will soon begin offering a doctorate in nursing practice, pending approval from the Texas Higher Education Coordinating Board.
I was surprised to learn that the University of Texas Medical Branch is second only to M.D. Anderson, albeit a distant second, in terms of total revenue. This is the university constantly complaining to the Legislature about how poor it is. Of course, the university would come back with the idea that it has expenses to match its relatively large revenue, but let us not forget that during the 2008 reduction in force, UTMB staff was lining up for $3 million in bonuses.
Curious about how your medical school stacks up against other schools in Texas? Then go to this website and look at the interactive data available there. I've already gone there and looked at a small part of the information available, operating expenses per full-time faculty and full-time staff, the results of which appear below the link.The results, particularly those for UTMB, are rather surprising to me. UTMB appears to be an expense leader, ahead of the pack in expenses per staff, and in competition to lead the pack in expenses per full-time faculty members. And this from an institution that seems to try to solve its budget problems through reductions in force. Another RIF or two, and it will be the leader in both categories, I suspect.
Dr. Lois Bready of UTHSC is part of a task force for the Accreditation Council for Graduate Medical Education (ACGME) which sets rules for advanced training. Proposed changes would increase supervision of rookie doctors and limit first year interns to 16 hour shifts instead of 24.
“The sleep literature really shows that an increase in errors is made after interns, particularly, have been working for 16 hours straight,” Bready said.
The negotiation process has been “a lot more difficult than I ever thought it would be,” Wolff told guests at the luncheon. “I would hope you put pressure on these systems to come together and deal with what's right for San Antonio, rather than just what's right for their particular systems.”
Recruiting top-notch scientists to Texas has been difficult, Shine
said, because of a perception in the outside world that Texas is
unreceptive toward such science-related issues as evolution and climate
change.
Of course, this absolves UT and its component institutions of any blame whatsoever, doesn't it? Why, it's the fault of the citizens of Texas, according to this theory, not anything that UT's administrators have done. What a self-serving little theory.
An inconvenient truth concerning the global warming and evolution excuses, however, is that there is a little more to the story. UT has taken action against faculty that has gotten national attention. Perhaps the most visible of these actions involved the reduction in force the UT system sanctioned and the UTMB administration carried out against faculty in 2008, recently resulting in a censure from the AAUP. Utterly failing to involve faculty governance in the process except as window dressing toward the end, UTMB administration employed a stacked RIF selection committee and a stacked RIF appeals committee to carry out its agenda. On average, the selection committee, which included the Provost's neighbor and a disproportionate number of people from the Provost's former department before his promotion, had about eight minutes to consider the careers of faculty being considered for a cut. It is impossible to digest a substantial curriculum vita in only eight minutes, much less the volumes of other information that these faculty generated throughout their careers. Of course faculty names had been presented to the committee by chairs, who had largely already made the decisions.
As for the RIF appeals committee, it was uniformly staffed with management personnel who also held faculty appointments. (UTMB President David Callender holds a faculty appointment.) This committee only upheld about three appeals, and one successful appellant's contract was not renewed a month later, making the whole process meaningless for him.
Then there are the well-publicized cases in which UT has crushed dissent, such as Dr. Larry Gentilello's concerns that UT Southwestern was not in conformance with Medicare rules. He was the chair of a department until he made his concerns known to UT Southwestern management (not a third party), and suddenly found himself demoted and his pay cut. (More about UT Southwestern and its Medicare problems can be found on the blog UT Southwestern and Parkland Hospital Stories. (See additional stories concerning this in the Zemanta box below.) Dr. Gentilello's case is still under way and on appeal right now.
Click on the highlighted text to read about similar cases involving Dr. Robert Klebe of UTHSC San Antonio, and Dr. Naiel Nassar, yet another unfortunate instance occurring at UT Southwestern. Dr. Klebe's case is still ongoing with UT appealing to the Fifth Circuit in May after having lost two separate jury awards in favor of Doctor Klebe of $900,000 and $400,000, and UT has vowed to appeal Doctor Nasser's case after a jury awarded him $3.6 million dollars.
No, there's more than evolution and global warming going on here. UT needs to stop looking at Charles Darwin and Al Gore and start looking in the mirror for the root of its problems. Of course, all that hot air accompanying its excuses may well be contributing to global warming.
Perhaps more than just money was involved in this merger proposal going belly up. Please read the letter to the editor linked below and then take a look at the related articles in the Zemanta box.
To attract quality students, one needs quality faculty, who come to institutions with quality leadership at the administrative, dean and department levels. An objective examining committee knew full well that few, if any, of these things are in place at either institution.
Along with consolidation and layoffs, the health science center introduced a new pay structure that holds faculty doctors to certain productivity standards, and rewards researchers based on the amount of grant money they bring in.
The practice is common at medical schools across the country, but is relatively new to San Antonio, Henrich said. The UT System mandated the pay plan for all six UT health science centers in 2007, and it took effect in 2009.
“It is meant to be more of a carrot than a stick,” Henrich said. “If your practice grows, you can expect to keep part of that for your own income. If you are in research work and you bring in extra grants, it will result in some incentive.”
I linked to the article above back on 5 June, but my emphasis was different from what it is today. Intrigued by the comments concerning the compensation plan and how faculty pay would expand or contract like an accordion depending on the number of patients seen or the number of grants received, I decided to get a copy of UTHSC San Antonio's compensation plan, which is linked below. Allow me to once again repeat my little syllogism:
Access to resources control productivity. Administrators control access to resources. Administrators control productivity.
I view these accordion compensation plans as one of the greatest threats to tenure and academic freedom that exists. If faculty members say or do something that makes them fall out of favor with the powers that be, many will find their compensation shrinking. I have seen it happen more than once. Meanwhile, here is UTHSC San Antonio's compensation plan in all its accordion-like glory. I understand all UT health components are going to something similar if they haven't already:
Faculty need to be on the lookout to make sure whatever policies are in place for a reduction in force are actually followed and that this financial bind is not used as a means to attack tenure.
UTHSC President William Henrich didn't say how many of the center's 5,572 faculty and staff will be laid off, but said he doesn't anticipate “big numbers.” Layoffs will be done on a rolling basis as various units begin streamlining and consolidating, he said.
Like all state agencies, the health science center was forced to cut 5 percent of its budget in 2010-11, and is facing a 10 percent cut in 2012-13.
“All of these things hurt. No question,” Henrich said. But “we would be remiss if we did not work on every aspect of our business. Our productivity is under scrutiny in all quarters.”
As UT Southwestern's leadership wiggles deeper and deeper into this quicksand, I have one question: where is the UT System in all of this? In the not-too-distant past the University of Texas Medical Branch at Galveston, the University of Texas Health Science Center at San Antonio, and now UT Southwestern have all gotten the attention of the Feds. This is not rocket science. Even I understand that a faculty physician must supervise a resident. It seems to me that ensuring compliance with that simple fact wouldn't be hard to do, and it also seems to me that the System Office ought to be interested, assuming that doing the right thing is interesting to the System Office.
Late this afternoon, UT Southwestern Medical Center posted online a written statement from President Daniel Podolsky, calling our story Sunday "misleading and incomplete."
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