Your article on the Northwestern University Medical School anesthesiologists’ suit against the faculty practice plan (“NU doctors’ age-bias suit a symptom of larger woes,” Metro, Feb. 15) touches on an important issue in the re-engineering of medical schools and teaching hospitals.
In the five medical schools and eight teaching hospitals with which I am personally familiar, there are unquestionably a number of senior faculty members who are unwilling to share in the efforts to provide a higher-quality product at a lower price or to rethink whether a university is “bricks and mortar” or “a community of scholars.”
For many senior individuals, their years of greatest creativity and effort preceded the review of their credentials for tenure.
Thus they are very angry about the changes that have since occurred–the loss of status of medicine as a profession, the societal expectation of increased accountability and the pressure to demonstrate their own productivity in terms of clinical earnings, research grants or administrative efforts.
Their response to requests to participate in problem-solving or reinvention is outright refusal. (At the same time, some of the individuals most willing to “think outside the box” are in their 60s and 70s.) Exactly how a department leader is to deal with this behavior is unclear.
The burden of the academic physician remains the same despite the changes in practice circumstance: to care for the sick regardless of the complexity of their illness or ability to pay, to disseminate existing knowledge and to participate in the creation of new knowledge.
For the chief, chair or dean, there is an additional responsibility–to preserve the mission of the institution in the face of external forces and the demand for change.
The question of how to deal with senior individuals who refuse to participate meaningfully and positively in the need for change and then claim they are being discriminated against because of “ageism” is one of the major challenges facing current medical and educational leadership.
