Let’s talk about the work being done by the department’s leadership team: the central office, Vice and Associate Chairs, Division Directors and Division Administrators. In reflecting on this, I landed on the metaphor of a house. We want to consider what efforts are visible and easily noted (the exterior of the house) and what work is less visible (the foundation). When you buy a house, the style and structure is what draws you in. However, once you move in, you get to know the creaks and groans of the hardwood floor, the leaky faucet, and the inevitable hidden problems requiring urgent attention. You think you’re just going to remodel a bathroom but then the basement sump pump fails during a heavy thunderstorm. As easy as it might be to just swap out that draining tool for another that will also fail in a few years, it may make more sense to dig out around the foundation, seal the cracks, and grade the landscaping so water runs away from the house.
Whether it is a California earthquake or an Iowa tornado, our house will fare badly if the foundation is not solid. Thus, many of our priorities and much of the work in the last six months done by the department’s leadership has focused on identifying structural concerns and launching repairs: fixing the foundation. These priorities, not visible when one looks at the exterior of the house, are needed to ensure that the department is structurally sound and will survive shocks and stresses. These efforts include financial elements: how we define and compensate clinical effort and how we ensure that the entire department is getting the resources it needs to support the tripartite mission. We have been taking a deep dive into the compensation plan (a concern identified by many faculty) and negotiating funds-flow with the health system to ensure fiscal (and structural) stability. Another foundational effort has been to ensure we have the leadership team in the department and divisions to serve our faculty and staff. The foundation needed attention. We will continue these and other efforts to bolster the fundamentals including department morale, the research and education missions. and faculty recruitment and retention.
In parallel, there have been above-ground, visible kinds of changes as well. Perhaps the most visible is the coming establishment of the Division of Hospital Medicine, to be led by Dr. Jeydith Gutierrrez. Other leadership changes (recruiting a new department administrator, and adjustments in division leadership) have worked toward identifying the right team to take our department forward. We committed to two cluster hires for research efforts, established two new vice chair roles, and asked for broad department feedback (and will soon share those results).
Upi’s “Oh, WOW” moment
Of course I cannot do this work alone and so building the right team aligned with a common vision and style is important. Sometimes that is getting the right people in existing roles, but sometimes that is getting the right responsibilities into the right roles. This was the rationale behind creating the two new vice chair roles, one to tackle the mentoring gap for junior and mid-career faculty and the other to ensure we are providing the best care possible to our patients. I was excited to see how many of our faculty members rose to the call for applications. Because these were new positions, the search committees were not just evaluating candidates but methods and metrics for what these vice chairs could accomplish. These were invigorating and hopeful conversations and I am excited to see what Drs. Josalyn Cho and Martha Carvour will achieve in their respective domains.
Photo for Reflection
Up above you can see what I mean when I say I want to build a structure that lasts. My family and I were lucky to see the Coliseum in Rome on a trip to Italy in March 2020. In fact, we were on one of the last flights out of the country before everything shut down. It is hard to look at that photo and not think of how quickly things can change and how quickly fragility can be revealed in times of crisis. For nearly 2,000 years these stones have endured more plagues and pandemics than just COVID-19, more than dozens of wars, more than anything humans or nature can throw at it. Did those Roman designers, masons, and builders know it would last this long? Perhaps not, but they knew how to work together to build it right.
One more photo from that trip. That is my son standing framed in the entrance to the Coliseum’s arena. This photo makes me think about the people who once walked through that arched doorway two thousand years ago. Each of those Romans had different roles inside and outside those walls, just as each of us have different responsibilities here. My goal is that each of you feels supported and able to meet your goals, no matter the mission, no matter what storms come our way.
We are ensuring that the department structure is built on a solid foundation. The walls that rest on the foundation and make up the house will hold the stories of your successes and accomplishments. I’m excited to see progress in both arenas (see what I did there 😀).
