Faculty Senate’s Faculty Meeting

Faculty Senate’s Faculty Meeting The Voice of the Faculty September 26, 2013 Joseph Romagnuolo MD MSc FRCPC FASGE FACG AGAF FACP President, Faculty Senate Professor, COM (Div of GI and Hepatology)

Outline • Year in review in the Senate; • Ongoing issues involving the Senate; • Outgoing FS President's Vision for the Faculty Senate; • Introduction of New Faculty Senate Officers; • Incoming FS President's address; • Open Discussion/Feedback

Purposes • Summarize what the Faculty Senate does and has done • Gather input on how we have handled issues, and how to handle ongoing/future issues • Ask for your support in these ongoing issues, either as a Senator or as a policy-maker outside the Senate • Introduce the incoming Senate officers

Overview of the Senate • “Voice of the faculty” – 66 senators, 21 alternates • Electoral Units having 50 or fewer “qualified” (F/T) faculty represented by four Senators • Electoral Units having between 51 and 100 qualified members represented by six Senators • Electoral Units with more than 100 qualified faculty members shall have six Senators and elect one additional Senator for every 33 additional qualified faculty members in excess of 100 • Common myth debunked – “FS is all non-clinical/non-COM faculty”: Not true! • COM-CS: 34 senators, 14 alternates • COM-BS: 6 senators, 2 alternates • 3 officers (president, VP, secretary) • 6 electoral unit leaders (COM-CS, COM-BS, CON, COP, CHP, COD, DLSI) • 3 standing committee chairs (FIR, IA, CE) • 4 ad hoc committees (peer-review, clinical affairs, modified faculty, space) • Officer elections in July, Senator elections in Sept

The Senate Constitution This Constitution defines the composition of the Faculty Senate, its role in the academic affairs of the University, and the basic principles of self-governance of the faculty of the Medical University of South Carolina as authorized by the Bylaws of the Board of Trustees of the Medical University of South Carolina, Section 6, Article b, August 1976. Article II Purpose The purpose of the Faculty Senate shall be to act as the sole representative body of the faculty, to receive, organize and, if deemed appropriate, execute business of the faculty that is submitted to it by members of the faculty, the administration, or the Faculty Senate itself, and to represent the views of the faculty to the administration. The Faculty Senate serves as the voice of the faculty. In accordance with its vision and as permitted by state law, the Faculty Senate serves as an advisor to the administration in ensuring the success of the University's mission in teaching, research, and service.

Year in Review from the Senate A full year, indeed…

Challenges? • No protected time for Senate activities • Busy schedules, volunteered time • No administrative support • No financial infrastructural support • Variable recognition of Senate’s role by some committees and some MUSC “entities” • Restrictions on use of legal fund

Highlights – the “non-compete”: • Victory for the Senate and faculty - MUSC-P was successfully persuaded to rescind their revised/expanded restrictive covenant (“non-compete”) agreement, albeit after threat of injunction by F.Senate legal counsel • Started under Paul Jacques as President – Survey, use of Legal fund • Handled badly • Faculty threatened with termination of MUSC-P pay if they did not sign, within days of receiving the contract – faculty resignations occurred • Non-compete was misrepresented as part of the university contract • Chairs misrepresented the contract as “better” because of smaller radius, smaller penalty, without disclosing/realizing the expanded restrictions (referral base, liquidated damages, “any” termination, expansion of types of employment disallowed, center of the radius including p/t satellite clinics, etc) • MUSC-P refused to work with the Senate to revise language (before injunction) claiming they do not deal with “faculty” but rather “members” • Senate represents MUSC faculty; and some of our faculty are your members; nearly all of your members are our faculty • University admin did not seem to take joint responsibility or claim jurisdiction to correct the errors, even though our handbook, and our malpractice situation, clearly states the President/MUSC has ultimate power over the MUSC-P entity

Non-compete cont’d • FS still locked out of negotiations and official place on MUSC-board • Faculty made a pitch at TH - just as much effort should be paid to retention as is put into devising a non-compete • It is not clear that this pitch was heard and acted upon

Non-compete cont’d • Many of us oppose the concept, other than perhaps of an amortized penalty/payback of recruitment investment • Non-competes can allow administration to invest less in other retention efforts • Rather there be effort to strive to be the “preferred place of employment” rather than “the only place you can work without leaving town” • Even when non-enforceable, the threat of “our pockets are deeper than yours…” is powerful • “Caged” people obsess on leaving, finding a loophole, etc • People who want/need to leave do not make good faculty members and co-workers • Medical providers are people, with families, kids in school, spouses working in town, and cannot easily leave town when MUSC does not work out as an employer • Something becoming “widespread” does not mean it’s right

Other Highlights… • Legal fund was replenished – thank you • Space ad hoc committee (I. Koutolas) was formed because of concerns over PI responsibilities in lab space moves, and clinical space reallocations • Governance committee (M. Mueller) changed our by-laws to allow officers to be elected a few months earlier than the Senate elections, to allow a transition period – passed by BOT • Officers-elect are on executive as non-voting members • Better continuity of business

Highlights cont’d – F. Evaluation • FIR committee (A. Rheingold) proposed changes to the handbook re Faculty evaluation language RATIONALE: Faculty Handbook section 9.02 Faculty Evaluation needed revision as current version was not accurate and was vague in its description of evaluation procedures. 9.02 Faculty Evaluation CURRENT WORDING: The State of South Carolina requires that all state universities and colleges evaluate faculty performance. In order to comply with this requirement, MUSC has developed a faculty evaluation procedure, which has been approved by the Division of Human Resources of the State Budget and Control Board. Each college of the University has an approved Performance Appraisal form (faculty evaluation). See Appendix 6.05 for copies of these forms. The form is completed annually for each faculty member, and is kept in a permanent file under the purview of the dean or director. The faculty member has a right to full disclosure of the Performance Appraisal. The faculty member is required to sign the appraisal, indicating s/he has read the evaluation form, but has the right to make written comments concerning agreement or disagreement with the evaluation. 9.02 Faculty Evaluation PROPOSED REVISION: The Medical University requires regular evaluation of each faculty member’s performance. Each Medical University College has an approved faculty performance evaluation form (Appendix 6.05a). Evaluation is based upon the core faculty responsibilities of teaching, research/scholarly activity, clinical activity, institutional activity, professional growth, and other activity, as appropriate. Any change to performance evaluation form requires concurrence from faculty representatives within each College. Department Chairs or Division Directors must meet at least annually with each of their faculty members to review attainment of goals proposed in the previous year's evaluation, appraise the quality of his/her work, and to establish specific, mutual agreement for the coming year’s goals. Written justification is required on the evaluation form for unacceptable or marginal ratings. The faculty member has the right to make written comments regarding the evaluation, and to have them included in the evaluation. The faculty member signs the performance evaluation form, confirming that she/he has read the comments of the supervisor. The record of this meeting becomes part of the faculty member’s permanent record, retained by his/her Chair or Division Director, under the purview of the College Dean. Faculty has the right to full disclosure of the performance evaluation and the right to appeal the findings reported in the evaluation (Section 8.01, Faculty Grievance and Appeal Procedure).

Highlights cont’d • FIR (A. Rheingold) reviewed revised COI policy and committee charge documents with minor suggestions • IA committee (A. Begle/T. Brown) new process of tracking approved documents through university hierarchy • CE committee (S. Drayton) organized a Promotions and Tenure Workshop (Fall’12) and a New Faculty Orientation (NFO) (Summer’13) • Both well-received • Unclear whether NFO to be continued by FS

Highlights cont’d- Peer Review • Peer-review ad hoc committee’s (C. Davies) recommendations History • Following a number of complaints from clinical faculty, the Faculty Senate first examined the MUSC Hospital peer-review system in spring and summer of 2011 • This included meetings between representatives of the Senate and Dr. Pat Cawley (Medical Executive Director), culminating in some modifications to the published peer-review policy • Further revision was deemed necessary, however, and in November 2011, the Faculty Senate charged an ad hoc committee to investigate the MUSC hospital peer-review process system and to make specific recommendations. • The committee considered the AMA document which explains the rights afforded to physicians in the peer-review process by the Health Care Quality Improvement Act of 1986 (HCQIA). • Faculty/Senate Victory - Over a year of negotiations, almost all Senate-approved recommendations have been accepted by Legal Counsel and Danielle Scheurer, and the most recent package is now ready to go back to the Senate for approval • Timeline: • October 2012 – Recommendations document developed by Senate ad hoc Peer-review committee • November 2012 – Recommendations document passed by Senate • December 2012 – Recommendations document presented to Medical Executive by Jack Crumbley • January 2013 - Joe Romagnuolo, Jack Crumbley and Chris Davies met with Annette Drachmann and Danielle Scheurer to go over document • February 2013 – Written response to recommendations received, but some legal questions still outstanding. • March 2013 –JC and CD met with DS to go over their initial response. • June 2013 – Legal opinion issued by AD • August 2013 – JR, JC and CD met with AD and DS to resolve remaining differences • September 2013 – Outcome of negotiations approved by Senate ad hoc Peer-review committee

Peer Review Recommendations • Bottom Lines: • Form letter with no information saying you were being reviewed, is now a detailed half-page summary of the specific incident • Detailed data will be given in 90% of cases within 45d (reportable quality metric) to the accused • Departmental Peer Review committee, not just the Chair • Published guidelines re Process • Ability to represent oneself • “No concern” prior events N/A to review panel • Removal of COI, permanent voting members (memory), non-overlap between MEC and PRC voting membership • Chair does not have submit a letter on your behalf for you to appeal • Appeal process is now independent from PRC: • 3-member independent committee consisting of (1) Hospital Chief Medical Officer (2) Highest ranking medical staff physician in the faculty senate (3) a 3rd member dually appointed by the first 2 members • Complaint Entry Recommendations • Departmental PR Recommendations • Medical Staff PR Recommendations • Findings of PR Recommendations • Appeals Mechanism Recommendations • Membership of MS-PRC Recommendation • Faculty Education Recommendation • Revised Workflow

Highlights cont’d • Parking Rate Increases • Inadequate disclosure of 5-year plan • Inadequate justification of how parking structure “investments” (to increase clinical, research and tuition revenue) that are not returning enough to make up for the investment are being born by employees • CofC parking cheaper, Roper/VA parking free • Lack of consensus on whether salary-stratified, rather than value-stratified payment structure is acceptable • We pleaded for further discussion but denied

Highlights cont’d – Legal Fund Home • FS Legal fund: • Used to be housed outside of MUSC • Brought into MUSC system for ease of accounting • Obstructions of its use: • Need for approval from State Attorney General • Capping of hourly legal reimbursement at $150/hr • Approval for release of payment by MUSC/MUSC-Legal Counsel • “Action” (as opposed to advice) may be difficult • MUSC vs MUSC • Gathered information on the legal and accounting costs of having a separate, off-campus legal fund • Feasible for new donations; difficult to move donations already in the MUSC account to an outside account • Executive committee passed a motion to pursue a legal fund outside of MUSC walls

Highlights cont’d – MDM, 2FA • Mobile Device Management, 2-Factor Authentication • Sought FS input early one (~1 y ago) • Concerns expressed, but importance understood • Communication/roll-out not ideal • Posters/Sign-up desks before dissemination of information • Remain concerns re privacy: • Phone tracking • Apps tracking • Phone content “wiping” • Remain concerns re practicality: • In off-site meeting, out of country, etc getting phone call to access email • Remember, you can opt out…

Highlights cont’d – COM compensation proposal • COM electoral unit Leader (A. Smolka) and the Executive summarized the faculty concerns at a Town Hall, and Constructed a survey: 337 faculty responded (~50% of clinical COM) • Plus 150+ written comments for each of 2 questions re the advantages of the model, and suggestions for improving the model – these were forwarded to the Dean. Survey results: • Revision of COM salary structure is necessary and beneficial for the institution • Agree (96, 28.4%), Disagree (152, 45%), Don't Know (90, 26.6%) Missing 1 (0.3%) • How do you expect your salary to change under the new plan? • Increase (8, 2.4%), Decrease (209, 62.4%), No Change (118, 35.2%) Missing 4 (1.2%) • The new compensation plan will likely be more standardized and transparent than the existing models • Agree (86, 25.5%), Disagree (159, 47.2%), Don't Know (92, 27.3%) Missing 2 (0.6%) • I believe that faculty was adequately consulted during the development of the new compensation plan • Agree (15, 4.5%), Neutral (48, 14.2%), Disagree (274, 81.3%) Missing 2 (0.6%) • My Chair and/or Division Director has detailed, or will detail soon, the metrics he/she will apply in determining my 2014-15 compensation • Agree (152, 45.2%), Disagree (98, 29.2%), Don't Know (86, 25.6%) Missing 3 (0.9%) • I am confident that metrics devised for my job description will be relevant and achievable for me • Agree (77, 22.9%), Disagree (146, 43.5%), Neutral (113, 33.6%) Missing 3 (0.9%)

Highlights cont’d – COM compensation proposal Survey results cont’d: • In your opinion, how long before implementation of the new compensation plan should all performance metrics be announced by COM or Department Chairs? • 1 month (11, 3.3%), 2 months (9, 2.7%), 3 months (26, 7.8%), 6 months (287, 86.2%) Missing: 6 (1.8%) • In your opinion, what effect will the new compensation plan have on the ability of MUSC to recruit qualified faculty? • Easier (7, 2.1%), More Difficult (289, 86.5%), No Effect on Recruitment (38, 11.4%) Missing: 5 (1.5%) • What impact will the proposed compensation plan have on your continued employment at MUSC? • Increase the likelihood of remaining (8, 2.4%), Decrease the likelihood of remaining (226, 69.1%), Has no impact on my decision to remain at MUSC (93, 28.4%) Missing: 12 (3.5%) Individual component concerns: • >80% rated “20-40% at risk” and “at risk subject to institutional funds avail” and “performance impacted by things out of faculty control” as “high concern” • >2/3 rated “lack of specific rules re timing and metrics” and “institutional metrics used” as “high concern” Concessions: • 64-83% ok with each of the alternate components proposed by Senate • Only 13% felt incentive-based compensation was COMPLETELY unacceptable

Faculty feedback…. • Quotes (re FS response to COM Compensation Plan TH): • “Just wanted to send a quick note to thank you and the faculty executive committee for an excellent and measured response to the clinical faculty compensation plan. As you have outlined the plan is a disaster and I believe will potentially cause a mass exodus of the clinical faculty.” • “I would like personally to thank you folks for this email, which is exemplary in being candid, informative, clear, and balanced. Thank you for all of the hard work you are doing on behalf of the MUSC faculty. I really appreciate all of your efforts.” • “Many thanks for your email detailing the Faculty Senate executive response to the COM 2014 clinical faculty compensation plan. As was the case with the non-compete 'agreement' of 2012, the administration's hubris in proposing the compensation plan is shocking. I agree with each of your itemized responses and thank you for addressing the larger spectrum of interrelated problems rather than only the most vulgar aspects…” • “This is fantastic. Thank you for your hard work!” • “I really, really liked the statements here. They are well written, cogent arguments, and speak for a real set of truths.” • “Although the administration shenanigans do not affect me anymore, I want to congratulate you for your efforts on behalf of the clinical faculty. “ • “I just wanted to thank you for representing the faculty. The communication you have instituted this year is unparalleled in my 10 year experience here. You have been very transparent, and for those of us who are not always able to attend these meetings or catch up on the videos, I wanted to say thank you for your efforts and your service to us. It is greatly appreciated.”

Ongoing Issues Unfinished business…

Ongoing Issues– Industry Relations Policy • FIR and IR subcommittee (N. Sutkowski) reviewed a draft of Industry Relations Policy, which was rejected. Why? – Examples: • Restriction on earning money on “personal time” to only things of “academic purposes”; activities could not be “just for financial gain” • Vague definition of “industry” which included professional associations, non-profit organizations, etc • Vague wording – “may be prohibited”, “may be allowed” • Restrictions on faculty being used by industry to get feedback for marketing, product promotion, etc or demonstrating a product • Restrictions on CME, slides, etc • Restrictions on activities “outside academic setting” • Restrictions on consulting for financial institutions, legal, etc • Working group organized by the Provost, with FS representation (N.S.) • Newer version still had issues: • Department approval of off-hours consulting activity • Several iterations • Pre-final version now submitted to Exec and Senate for review

Ongoing Issues- Post-tenure review • FIR committee (A. Rheingold) proposed changes to the handbook re Tenured Faculty Post-tenure review (Section 6.05) Rationale: 1. FIR would like to strengthen Faculty’s involvement in the development of faculty goals that will subsequently be the topic of evaluation, therefore wording to include mutual agreement between faculty member and supervisor was added. This will allow faculty a stronger voice in negotiating behaviorally specific goals and related duties for the upcoming year that will be evaluated. Given the recent financial strain and pressure for faculty to assist with funding salaries, by adding mutual agreement would allow faculty to help determine goals evaluated for post-tenure review that would be within their direct control. 2. There is no single way of protecting ALL faculty members within a standard evaluation procedure. However, FIR believes that faculty evaluation would be strengthened by faculty assisting in determining weights of applicable categories to be evaluated. Further, benefit/costs were weighed for keeping current wording related to evaluation based upon majority of categories versus changing evaluation based upon weighting of categories. a. Majority of categories: Benefits: Allows for evaluation across categories to be even, therefore if there is a deficit in only one category, post-tenure review would not be threatened. Costs: Does not distinguish between primary and secondary responsibilities (for example, if a faculty member’s main responsibilities are clinical and excels in clinical evaluation, but is evaluated poorly in teaching which only encompasses a minimal amount of time, the faculty member would still be placed up for post-tenure review). May be difficult to address if faculty has even number of applicable categories. b. Weighting of categories: Benefits: Allows for faculty to be evaluated based upon main responsibilities, therefore if there is a deficit in secondary responsibilities, post-tenure review would not be threatened. Allows for choice of equal weighting (i.e., majority of categories). Costs: Folks may view weighting equivalent to funding, which is not the intention. Opportunity exists for faculty to become “bad citizens” for the university in that s/he may devote themselves to only one aspect of their work.

Ongoing Issues- Post-tenure review • Proposed Changes: 6.05 Post Tenure Review ORIGINAL WORDING Each tenured faculty member undergoes annual reviews. The faculty member’s annual review is integral in determining performance. The Department Chair/Division Head will use the five-point scale for annual reviews (unsatisfactory, marginal, satisfactory, very good or outstanding), but for the purposes of reporting to the Provost’s Office, overall performance will be summarized on a three-point scale (superior, adequate, inadequate). If a faculty member is rated as below satisfactory in a majority of applicable performance categories on the five-point scale, they will receive an “inadequate” overall evaluation on the three-point scale. Each year, the faculty member must be made aware of specific requirements to attain an adequate annual review so that he or she is given the chance to meet these specific requirements. 6.05 Post Tenure Review RECOMMENDED WORD CHANGES Each tenured faculty member undergoes annual reviews. The faculty member’s annual review is integral in determining performance. The Department Chair/Division Head will use the five-point scale for annual reviews (unsatisfactory, marginal, satisfactory, very good or outstanding), but for the purposes of reporting to the Provost’s Office, overall performance will be summarized on a three-point scale (inadequate, adequate, superior). At least once per year, the weights of the applicable categories will be decided by mutual agreement between the faculty member and the Department Chair/Division Head. If a faculty member is rated as below satisfactory in the weighted overall majority of applicable performance categories on the five-point scale, they may receive an “inadequate” overall evaluation on the three-point scale. Each year, the faculty member and Department Chairman/Division Chief must agree on the specific requirements needed to attain an adequate annual review so that he or she is given the chance to meet these specific requirements.

Ongoing issues- Relationship with MUHA/MUSC-P • FS involvement in MUHA and MUSC-P inadequate • A “Faculty and Clinical Leadership Relations Committee” is being considered by Governance Committee • Representing faculty interests at the Medical Executive Committee (MEC) of the Hospital/MUHA, reporting relevant upcoming changes to the Senate Executive, through an appointed active Medical Staff clinical faculty representative from FCLR, who will attend MEC meetings. • Representing faculty interests at MUSC-Physicians Board meetings, reporting relevant upcoming changes to the Senate Executive, through an appointed MUSC-P member clinical faculty representative from FLCR, who will attend MUSC-P meetings. • Reviewing changes in MUHA/MUSC-P Policies that affect faculty rights, freedoms and ability to carry on their University duties; policies would ideally be sent for Senate review by MUHA/MUSC-P, or alternatively by interested Medical Staff or MUSC-P clinical faculty who become aware of such a change. • Determining faculty impact by policies implemented by MUHA/MUSC-P through survey, faculty assembly, or other means • Lobbying for change in policies implemented by MUHA/MUSC-P that are not in faculty’s best interests

Ongoing issues • Governance committee – definition of % for “full-time” status • Choosing a %, confirming a list of faculty meeting eligibility • Emerging Performance-Based compensation • COM X-Y-Z Model, SuccessFactors, etc • Moving FS Legal Fund outside MUSC – passed by FS exec • Policing and assessing success of “Funds Flow” • Faculty privacy vs patient privacy - MDM • Policy Development and University/ “Clinical Leadership” structural changes outside the Senate • Defining “faculty input” in handbook and in university culture • Space allocation, reallocation • CofC collaboration/merger • MUSC University President Search (FS rep)

Outgoing President’s Vision Opinions on Direction and Emphasis…

Where should we go? • Funding for the Senate • All 3 entities MUSC, MUSC-P, MUHA NEED to have Senate involvement • Reprimands, from the highest level, of university/faculty policy development outside the Senate, with supervision of this by the “MUSC” entity • MUSC President/Admin has to clarify their oversight and power of these clinical entities • Caution re occult “taxes” - MUSC/MUHA/MUSC-P make “investments,” but is it appropriate to tax faculty with a new fee if investments do not pan out? • MUHA/MUSC-P are beginning to make decisions re efficiency and expansion that may potentially hurt educational and research goals of MUSC • Policy decisions that threaten other MUSC missions (e.g. “efficiency” threatening student/resident education) need to be reported promptly to the Senate • Ear to the ground re new Compensation/Evaluation models • Beware the new non-compete • Careful not to allow post-tenure review to become over-used and diminish the meaning of tenure • Report and oppose any intimidation that Senators face in doing their job • Continue to have a strong, united voice – regardless of whether the issue is in YOUR college, or affects YOU • We are weakest when divided

Emphasis on recruitment/retention of faculty needs to be pushed • Worries me that current “strategic plan” may not be congruent with this

Thank you • Faculty • Faculty Senators • Executive Committee • Dr. Sothmann and other administrators that have worked with us over the year • My fellow officers – Jack Crumbley (VP), Laura Carpenter (Secr) • I apologize for explicitly indicating I was not available to run for the customary “second term” • Appreciate the kind words, encouragement to continue, etc

Introduction of New FS Officers New blood, New energy…

New FS Officers (effect. 0ct8, 2013) • President: • Tom Smith PhD, Professor, DLSI • Vice President: • Angela Mund CRNA DNP, Assistant Professor, CHP • Secretary: • Amy Thompson PharmD, Assistant Professor, COP

Incoming President’s Address Dr. Tom Smith…

Open Discussion and Feedback Open Mike…

Faculty Senate’s Faculty Meeting