Topics, May 15, 2007
Thank You, Dr. Tisher, Welcome, Dr. Kone
Leadership Transition, Children's Services and Great Organizations
Thank You, Dr. Tisher, Welcome, Dr. Kone
I want to begin this column by giving a big salute to College of Medicine Dean Craig Tisher, who turns over the reins today to Dr. Bruce Kone. Craig has accomplished so much in his five years as dean. Most importantly, he improved the financial position of the college, earning the respect and trust of his department chairs in what was a difficult time. In addition to many other achievements, he championed the development of the proton therapy institute in Jacksonville, personally overseeing virtually every detail of its successful completion. I heard one of Craig’s colleagues describe him as the college’s “indispensable man,” and it’s true that the strong position in which the college finds itself today is hard to imagine in the absence of Craig’s leadership. It has been a wonderful opportunity for me to work side-by-side with a person of such character and integrity, and we’re fortunate that Bruce Kone is cut from similar cloth. By the way, Craig isn’t going anywhere. The university will continue to enjoy the benefits of his experience and leadership as he contributes to the development of our application for an NIH Clinical and Translational Science Award, among other duties. Thank you, Craig, and welcome, Bruce.
back to topLeadership Transition, Children’s Services and Great Organizations
Recently I was a reluctant speaker at a party for a friend and colleague. I say reluctant because the guest of honor was Dr. Terry Flotte, the chairman of pediatrics and, as of today, the new dean of the University of Massachusetts Medical School. Terry’s departure, after 11 years of continuous achievement for the University of Florida, leaves a gaping hole not only in our team but in many of our hearts.
The occasion got me thinking about the larger question of leadership transition. Whether you happen to work for a Fortune 500 company or a state’s flagship university, really good organizations are frequently faced with the fact that their top performers will be recruited by others. Those who excel sometimes choose to move on to a bigger job at another institution, leaving a void to fill.
Voids like that can make someone seriously depressed. But I choose to think about it differently. Leaders like Terry Flotte don’t so much leave a hole to fill as they leave a platform. They leave a level of achievement that exceeded what they found here when they arrived and that serves as an even higher launchpoint to attract the next exceptional leader to be chair of pediatrics. This approach to leadership transition is, I believe, one of the many ways that organizations go from “good to great” and then sustain their greatness and build on it.
A couple of thoughts stick in my mind about Terry Flotte. About halfway through my time as chairman of pediatrics, Nick Muzyczka, who then headed UF’s fledgling genetics program, came to me with the idea of co-recruiting Terry. Nick described him as a young pediatric pulmonologist at Johns Hopkins who, despite his youth, was a key player nationally in gene therapy. My first thought was, what do I need another pulmonologist for? But when I took a look at this guy and saw what he was doing as a physician scientist it was clear that we couldn’t not recruit him.
The other thing that struck me about Terry over the years is the way he seamlessly integrates patient care and research. After he arrived he took on the leadership role of the whole genetics initiative and led its transformation from a College of Medicine-based center to a university-wide institute. That was pretty heady stuff. But at the same time, I recall seeing him at the hospital in the middle of the night caring for one of his cystic fibrosis patients. So I began to get a real visceral sense that Terry’s work in the lab was driven by the problems that he faced with his patients. There’s not a better example of one’s mission and passion and skill all coming together to make a big difference.
Terry’s departure comes at a time when the Department of Pediatrics and the other College of Medicine children’s physicians are seriously challenged with the move of roughly half of children’s patient services to Shands at AGH. I’m sure nobody feels worse about the timing than Terry himself. Going into it, we knew the move would be daunting, and it’s proving to be every bit of that and more. The good news is the plan to address these challenges was in place even before Terry announced his resignation. Incoming College of Medicine dean Bruce Kone, interim pediatrics chairman Rick Bucciarelli, the hospital leadership under Tim Goldfarb and I have been actively working the plan since then.
In the near term, I believe three things need to happen. The first is the appointment of a clinical physician leader – the equivalent of a chief of staff position for children’s services encompassing both locations. This would be a person who deals with operational issues involving patients and physicians – deciding, for example, what procedures would best be done in which facility, or assuring that the anesthesiologists at AGH work with pediatric surgeons in the same way the anesthesiologists do at Shands at UF. The key ingredient is that this person is empowered to work effectively across the boundaries of academic departments, across clinical disciplines and across the venues of care.
The second piece is the formal linkage of this physician leader with hospital administration. Together with a lead administrator, the team would coordinate all aspects of children’s services whether at SAGH, SUF or the clinics. To fulfill this responsibility, the team must represent key elements of children’s care. They also must have accurate and complete information on the children’s clinical services. The team will need to examine children’s hospital services using a distinct set of operating, financial, and quality reports so that we can better understand the relationship of quality outcomes, inpatient volumes, throughput, ancillaries, reimbursements, overheads and the bottom line as we continue to evolve as a children’s hospital.
The third piece is to begin to lay the groundwork for a major fundraising campaign for constructing the hospital facility that allows reintegration of all children’s services back in a single site. And that means developing the case feasibility, assembling the team for fundraising and mustering the will to make it happen. Right now, the cancer hospital is the centerpiece for UF&Shands fundraising and we don’t want to disturb that. But important preparatory steps for the Children’s Hospital can take place now that won’t detract from that effort.
We should get more definition on these and other issues next month when the Shands HealthCare Board of Directors meets to further refine its strategic plan. The College of Medicine has made matters related to pediatric care at the two sites and reintegration of pediatric services in a single facility among its highest priorities and presented that clinical strategic plan to the Shands Board last month.
While I know that these challenges with children’s services are real and they are creating real hardship for faculty and staff, I am confident they will be resolved. The main reason I am confident is because I know the University of Florida is a great organization that can handle big challenges, turn them into opportunities, and move forward. We can absorb a body blow like losing a Terry Flotte and appreciate that, because he was so good and he accomplished what he did, he’s raised the platform for the next rising star to take us even further, faster.