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1st
appeared 9 April 1999
Faculty Concerned About UCSF Stanford's Impact
on Academic Mission
Although the layoffs at UCSF Stanford Health Care do not directly affect UCSF employees,
some members of the faculty have concerns that the job reductions will infringe upon
UCSF's academic mission. Faculty from UCSF's Schools of Medicine, Dentistry, Nursing and
Pharmacy recently aired their concerns to UCSF Stanford officials at an Academic Senate
Town Hall meeting.
Faculty said they fear that because employees will be forced to "do more with
less," the teaching and training of the next generation of health care providers --
and possibly the treatment of patients -- could be compromised.
Many of the schools' faculty members who spoke at the meeting said that even before the
layoffs were announced, the merger of UCSF and Stanford Medical Centers created some
challenges for them. They also said that UCSF Stanford does not adequately seek their
input when making decisions that may affect UCSF's academic mission.
UCSF Stanford officials reiterated that the problems that make the layoffs necessary were
not caused by the merger but by external economic factors, such as shortfalls in
government reimbursements for the care of Medi-Cal and Medicare recipients, skyrocketing
increases in the costs of drugs and medical supplies, and the competitive patient care
market. Although they acknowledge that they need to solicit more faculty input, UCSF
Stanford officials emphasize that the merger has actually strengthened the market position
of the medical centers, which helps to protect their academic missions.
About 800 UCSF Stanford Health Care employees will be laid off over the next few months in
an attempt to cut $170 million from the organization's $1.5 billion annual
operating budget. The layoffs will come as part of an initial reduction of 1,275 full-time
equivalent (FTE) positions and another 725 positions will be identified for reduction
during the next few months, according to UCSF Stanford.
Although central administrative services will be hardest hit, with an estimated 40 percent
reduction in its workforce, hospital support staff will be cut by about 28 percent; direct
patient care staff by about 9 percent; and diagnostic services staff in areas such as
X-ray and lab services by about 8 percent, according to UCSF Stanford.
Diana Taylor, chairperson of the Faculty Council Executive Committee and associate
professor in the School of Nursing, said that the merger created several opportunities for
the School of Nursing, such as student scholarships and the newly established research
enterprise called the Center for Patient Care Innovations, but that the
"long-standing problem" of lack of access to clinical education, research
training and practice sites has grown worse.
"With increasing patient acuity and fewer nurses caring for more patients, clinical
training of students or participation in research activities becomes a burden for the
clinical nursing staff," said Taylor. "They [the clinical faculty] are telling
us that they don't have the time or the institutional support to continue to participate
in these educational activities."
Bill Kerr, Chief Operating Officer of UCSF Stanford, said that although the merger may
have exacerbated these problems, it did not cause them. "It's a reality of the
efficiency required in this highly competitive market," he said.
Taylor said she is worried that the School of Nursing, which is consistently rated as #1
or #2 of all schools nationally and is this year rated #1 for the most NIH funding, will
not be able to sustain this reputation "due to the lack of stable funding for our
clinical education programs." She recommended that UCSF Stanford clearly articulate
their commitment to the School of Nursing's academic mission and that they appoint nursing
faculty to their leadership committees.
Joe Guglielmo, a professor in the School of Pharmacy, said that although the merger has
resulted in some positive outcomes, such as opportunities in service, teaching and
scholarship, he is concerned that reducing the number of FTE positions may become a
limitation. UCSF Stanford has proposed cutting jobs in the departments of pharmaceutical
services at both the San Francisco and Stanford campuses.
"The combined excellence in teaching, research, and service has resulted in the
School's continued ranking as #1 in the country and probably the world," Guglielmo
said. "The academic mission of the School of Pharmacy links directly with the FTE
support from the department of pharmaceutical services at each campus. With the first wave
of cuts, little input was requested from the School of Pharmacy regarding potential
cost-cutting measures or the potential impact of the cuts upon the School's academic
mission."
Kerr says that clinical pharmacy faculty are actively engaged in deciding what jobs will
be cut at UCSF and that final decisions "would not be made without their
participation." In general, an array of UCSF clinical faculty are involved in UCSF
Stanford's decisionmaking, as members of the leadership group and of the physicians'
organization board, and as members of their related subcommittees, said Kerr.
Some clinical faculty in the School of Medicine said they were unsure that UCSF's
reputation for high-quality patient care could be maintained amidst these tough economic
times. Although UCSF Stanford is mainly reducing jobs in areas removed from patient care,
some clinical faculty say that the cuts will nevertheless affect patient care and will
make lower an already sinking morale among health care providers.
"My feeling is that the faculty is depressed -- there is a morale problem," said
Svein Oie, chair of the Academic Senate and professor of biopharmaceutical sciences.
Oie put forth a proposal to establish a new standing committee of the Academic Senate
called the Committee on Clinical Affairs. This cross-campus committee would consist of
seven regular members and deal with clinical-related issues with the intention of
identifying trends and decisions that may affect teaching, service and research.
"There's a very real need for a place for faculty," said Bruce Wintroub, Chief
Medical Officer (CMO) of UCSF Stanford, who added that faculty input has "not been a
strong element of the merger so far." In fact, Wintroub this week announced that he
will be stepping down as systemwide CMO so that faculty at both campuses can serve as CMOs
for their respective medical centers. Ted Schrock will be CMO at UCSF and Peter Gregory
will be CMO at Stanford.
"We continue to explore how to most effectively communicate with faculty and engage
them in our planning, as well as in our overall operations," says Kerr, who added
that this is one of the issues being tackled by the new site-based CMOs.
Links:
UCSF Academic Senate
UCSF Stanford Health Care
Related Daybreak stories:
UCSF Stanford to Lay Off 800
Employees
Merger Compounded -- but
Did Not Cause - Current Campus Stresses, Says Debas
UCSF Stanford Health Care
Faces Fiscal Challenges
Source: Paula Murphy, Daybreak
editor |
