2012 APM New Chairs and Emerging Leaders Program Survey

1. 2012 APM New Chairs and Emerging Leaders Program Survey February 29, 2012 Westin La Paloma Tucson, AZ

2. Rating Scale • Average score based on a scale of one to five, with a score of one indicating the participant strongly disagrees and five indicating the participant strongly agrees. • Average scores based on responses from 19 participants.

3. Question 1 Now that I’ve negotiated a start-up, I’ll likely get very little else from the institution. • 2.58 from 19 responses. • 1.50 from panel of experienced chairs

4. Question 2 I have one or more chiefs who want to undermine my authority as the new chair. • 2.47 from 19 responses • 1.83 from panel of experienced chairs

5. Question 3 I don’t need a strategic planning retreat; rather, I need to take bold action as a new leader. • 2.26 from 19 responses • 1.50 from panel of experienced chairs

6. Question 4 I have inherited a sub-optimal financial arrangement with which to run my department. • 3.32 from 19 responses • 2.67 from panel of experienced chairs

7. Question 5 Our faculty members find mentors on their own and experience adequate career development. • 2.16 from 19 responses • 1.67 from panel of experienced chairs

8. Question 6 Women and minorities are doing well at all levels in our department. • 2.32 from 19 responses • 1.67 from panel of experienced chairs

9. Question 7 Safety and quality are more of hospital issues than departmental issues. • 1.95 from 19 responses • 1.17 from panel of experienced chairs

10. Question 8 My relationship with the hospital is that I try to prevent them from screwing my department. • 1.89 from 19 responses • 1.33 from panel of experienced chairs

11. Question 9 All my chiefs perform well on all their missions. • 2.21 from 19 responses • 2.33 from panel of experienced chairs

12. Question 10 I have some high-profile, yet whiny and needy, faculty members with a strong sense of entitlement. • 3.42 from 19 responses • 4.00 from panel of experienced chairs

13. Question 11 Regular meetings are a waste of time; my chiefs and faculty know how to contact me when needed. • 1.63 from 19 responses • 1.17 from panel of experienced chairs

14. Question 12 I have adequate financial resources for teaching our house staff. • 2.53 from 19 responses • 2.17 from panel of experienced chairs

15. Question 13 I have adequate financial resources for teaching our medical students. • 2.42 from 19 responses • 1.67 from panel of experienced chairs

16. Question 14 Mastery of the department’s finances is the single best characteristic of an effective chair. • 2.68 from 19 responses • 2.00 from panel of experienced chairs

17. Question 15 My faculty can’t meet external productivity benchmarks because our patients are sicker than elsewhere. • 2.26 from 19 responses • 2.17 from panel of experienced chairs

18. Question 16 If I am not extremely “hands-on,” I cannot be an effective chair. • 2.32 from 19 responses • 2.67 from panel of experienced chairs

19. Question ** The most important role I have as a chair is to have a high national and international scientific profile. • 2.11 from 19 responses • 2.00 from panel of experienced chairs

20. Question 18 Our full-time faculty compete extremely well for patients against our hospital and community voluntaries. • 2.89 from 19 responses • 2.83 from panel of experienced chairs

21. Why did you become a Chair of Medicine? • Knew I could do as well or better than most others; and I wanted to be a bigger part of the solution • Loved the people/faculty/fellows/housestaff and students; Committees to taking care of all "the department of medicine people"; Opportunity for personal development and growth; Lead and develop/recruit faculty; Engage and enhance research, education, and clinical programs in the department • To impact quality of care delivered to large population and participate in generation of effective healthcare providers

22. Why did you become a Chair of Medicine? • I spent 20 years doing virtually the same thing and was bored. This is a new set of challenges. • To remember why I became a physician; Ability to make a difference (e.g., changes in healthcare, next generation, do good) • To be in a position to make positive, progressive, changes to move the department forward • It’s a natural progression in my career; The opportunities in growing a department; The dean who recruited me is a great role model • Wish to build a better department; given career development opportunity/exciting challenge/rewarding opportunity

23. Why did you become a Chair of Medicine? • Intensifying activity and to help department of medical school at difficult times; I have been at that institution since a long time • I was asked to do it and felt it was my "calling" and responsibility to take my turn at the helm • To build a patient focused, academic, multidisciplinary center of excellence where there is a strong commitment to core values • Right thing at the right time particularly for the institution. I say the latter because this role was not aspiration nor expectation. Now I am privileged to do so and also am committed to the role

24. Why did you become a Chair of Medicine? • Vice Chair of Clinical Affairs-To have an opportunity to be an agent of change and better the wellbeing of patients in a way that best takes advantage of my skillset • I was excited about becoming a leader in an environment in which medicine is changing rapidly and academic internal medicine is changing even more rapidly. We have big issues to track!

25. Why did you become a Chair of Medicine? Responses from experienced chairs panel: • I thought that I could do a good job. And, I thought that someone else could do a worse job and that would be would be working under them. • The opportunity to facilitate the careers of trainees and faculty; to leverage discovery; to improve clinical care in an academic safety net institution; and to challenge myself professionally and personally. • To mentor and guide my faculty, who will advance the care of patients, educate all around them, and expand knowledge in their chosen fields

26. Why did you become a Chair of Medicine? Responses from experienced chairs panel: • Wanted a challenge and thought I could make a contribution.

27. What are the two biggest challenges you believe you face in the coming year as chair? • 1) Developing acceptable, fair, transparent faculty compensation plan 2) Integrating advance practice providers and hospitalists into the academic matrix • NIH budgets; Economy; Health care reform • Financial and functional impact of change in healthcare delivery systems. • 1. Working to put fellowships in subspecialties in place 2. Recruiting quality faculty with research interests

28. What are the two biggest challenges you believe you face in the coming year as chair? • 1) Lots of open positions-how to fill them, create culture of change as well as loyalty 2) Finances-balancing financed AND mission • 1) Financial environment (i.e., decrease in reimbursements 2) Increased clinical demands on department • The ability to manage time well and to have time for strategic thinking and planning; To filter through data from multiple entities and to prioritize areas of importance

29. What are the two biggest challenges you believe you face in the coming year as chair? • Building academic stability/productivity in era of increased demands; Inspiring and fostering younger faculty to take leadership roles/responsibilities • Difficult NIH funding climate/faculty; Need to do more with lower dollar return/core clinical activities • Better alignment of department, hospital, and faculty practice; to be in a better position to address changes in healthcare reform/payment changes • Financial solvency; Maintaining esprit de corp; Diversifying faculty and staff

30. What are the two biggest challenges you believe you face in the coming year as chair? • These are excellence in recruitment and ensuring smooth start-up of a new hospital • Health systems/college of medicine's ability to come through with the needed fiscal resources; Need for dean, CEO of health system, and CEO of physician group all being on board "aligned" with all three missions • Develop stronger/clearer relationship with our faculty practice organization in order to better execute initiatives (e.g. billing mechanisims, clinic process, structure

31. What are the two biggest challenges you believe you face in the coming year as chair? • 1) Recruiting a leadership team of division chiefs 2) Rebalancing our missions (i.e., growing our research base) while maintaining/enhancing clinical quality and faculty compensation

32. What are the two biggest challenges you believe you face in the coming year as chair? Responses from experienced chairs panel: • Adequate funding (especially from the medical centers) of clinically active faculty. NIH funding levels, including recent cut in salary cap. • 1. Decline in financial support from affiliated hospital-how to make ends meet without disenfranchising faculty;2. Recruitment of two section chiefs and a residency program director. • 1 Fully instituting the EMR; 2 Making quality and safety an integral part of all departmental activities

33. What are the two biggest challenges you believe you face in the coming year as chair? Responses from experienced chairs panel: • Recruiting top faculty members and chiefs in a competitive environment. Changing our compensation plan to be more fair (which will hurt some existing people).