Chapter 10: Becoming the First Woman Chair of a Clinical Department

Chapter 10: Becoming the First Woman Chair of a Clinical Department

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Description

Here Dr. Bruner talks about the process that ended in her becoming the first woman chair of a clinical department (Pathology and Laboratory Medicine) at MD Anderson. She began to build her administrative skills by attending courses in leadership. She applied for the position of Division Head when the Divisions of Laboratory Medicine and the Division of Pathology were combined. (Dr. Bruner talks about the administrative reasoning behind this move.) Given her qualifications she feels she was passed over because the selection committee "couldn't quite envision a woman division head." She notes that the Department of Pathology was in limbo while the search for the new division head and chair was in progress. She lists the qualities of MD Anderson that convinced her to stay at the institution: term tenure, the all-funds budget, the interdisciplinary integration of specialties, and the physicians who love what they are doing. When the new Division head came in, he chose her for the Chair of Pathology in 1998.

Identifier

BrunerJM_01_20120604_C10

Publication Date

6-4-2012

Publisher

The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center

City

Houston, Texas

Topics Covered

The Interview Subject's Story - The Administrator; The Administrator; Professional Path; Experiences re: Gender, Race, Ethnicity; Obstacles, Challenges; Gender, Race, Ethnicity, Religion; Building/Transforming the Institution; Multi-disciplinary Approaches; Growth and/or Change; Obstacles, Challenges; Institutional Politics; Controversy

Transcript

Tacey Ann Rosolowski, PhD:

Would you like to start talking now about becoming chair?

Janet M. Bruner, MD:

(laughing) I can.

Tacey Ann Rosolowski, PhD:

Well, I just—I think I was—what was it? Dr. Batsakis suggested that you might want to think about becoming chair, and you immediately thought, “No, I don’t want to do that.”

Janet M. Bruner, MD:

I know.

Tacey Ann Rosolowski, PhD:

And then something changed your mind.

Janet M. Bruner, MD:

Well, it was like the minute he said that and I said, “Why would I want to be a chair?” That’d never entered my mind. All of a sudden it was like, “Oh. I hadn’t thought about that before!”

Tacey Ann Rosolowski, PhD:

Why do you think you’d never thought about it?

Janet M. Bruner, MD:

I guess it’s just that I had no thirst for power or glory, and I guess I had just never thought that that would be something I wanted to do. I just wanted to be a pathologist, make diagnoses, do some research, and just do the same thing I had been doing, but I think also that I have a certain amount of attention deficit disorder so that I do something for a few years or several years, and then it’s like, “Okay, now I need something else—something more.” So I think that was probably—I don’t—that was probably in the early ‘90s and it was around the time—I was the only neuropathologist here up until 1992. In 1989 or so, I realized that I was just [phone begins ringing]—I was way too busy.

Tacey Ann Rosolowski, PhD:

Oh, should I pause it while you—? Do you need to take that call?

Janet M. Bruner, MD:

I guess I’d better, yeah.

Tacey Ann Rosolowski, PhD:

Okay. Let me just pause it. [The recorder is paused.] Okay. We’re recording again.

Janet M. Bruner, MD:

Okay. Sometime in the late ‘80s, I was doing a lot of research, and the brain tumor program here was growing a lot. It was growing rapidly. We were adding neurosurgeons. We had hired a new Chairman of Neuro-Oncology, Victor Levin. So there was a lot of demand on my time, and the surgeons were doing more cases, so I had more cases to sign out, more research to do. Victor was hiring more research neuro-oncologists. I realized that I was just too busy, and finally I decided at some point that I was going to have to either get some help or get out of here, because I just couldn’t survive. I interviewed a few places to try to think about moving, and I wasn’t really anxious about doing that. I did ask—finally approached Dr. Batsakis, and he said, “Yeah, I think you’re right. You probably do need some help.” He said, “How many people do you think you need?” I said, “I think probably need two people”—which—crazy! Going from one to three? So he said—and I was shocked—and he said, “Okay. Hire a couple of people.” I think what was burdening me more than the patient care work was the research, because there was so much demand for collaboration, and I had trouble getting time to do anything of my own because everybody else wanted a piece of me to collaborate in their research. I interviewed several neuropathologists, and I did find two people who joined me in 1992, both right about the same time—Dr. Lauren Langford and Dr. Greg Fuller, who are still here—and they were lifesavers. What can I say? So that gave me a chance to feel what it would be like to work with other people and sort of supervise, if you will, although they didn’t need much supervision. They knew what to do. I also had my lab people that I had supervised. About the time that Dr. Batsakis said I needed to take some steps if I wanted to become a chair, I actually did go and take some courses with the American College of Physician Executives, which has some really good leadership courses—things like conflict management, managing change, managing the difficult physician—things like that. I think that was really good for me. Then I did interview in some other places for chair, but that was more in conjunction with interviewing for the job here. Dr. Batsakis retired in 1996—or did he retire in ‘94? No. He retired in ‘96. At the time, MD Anderson was going through a lot of changes. Dr. Mendelsohn had just come on, and it was decided at some higher level of the administration that they were going to combine the Division of Laboratory Medicine—which was a division at the time—with the Division of Pathology. Both of those were higher-level entities than they are now. The administration thought this made a lot of sense because we were all pathologists, and we should be working together, and we didn’t think it made any sense at all because—yeah, we were all pathologists, but we did totally different things. We said things like, “Wait a minute. Why don’t you combine Diagnostic Imaging with Radiation Oncology because they’re all radiologists? Shouldn’t they be working together?” “Oh no, no. That’s totally different!” Well, we didn’t think it was totally different, but no one was listening to us, because we were very small at the time and not powerful enough, I guess.

Tacey Ann Rosolowski, PhD:

I was curious about that combining.

Janet M. Bruner, MD:

To me, it was a way to decrease our power, because before we were two fairly powerful divisions, and afterwards we were one.

Tacey Ann Rosolowski, PhD:

What was—? Why would that have been a desirable outcome? Why would anybody want to decrease the power of those two divisions?

Janet M. Bruner, MD:

Because you have less representation at the table you have to deal with—one voice instead of two, one vote instead of two if it comes to it—both in hospital issues and also I think at the practice plan level. I don’t know. I was a peon at the time. It didn’t make any—yeah. It didn’t make any sense. So now are we working much more closely together? No. Are we perfectly happy being essentially as separate as we ever were? Yeah. I mean, it’s not that we don’t get along. We always got along, but we never worked together because we do totally different things, and we’re okay with that. We didn’t care—we’re not antagonistic toward the lab people, and they’re not antagonistic by the same token. Yeah. They’re okay, but we’re as close to them as we are to Radiology. They just do a different thing.

Tacey Ann Rosolowski, PhD:

Have there been some difficulties that have arisen from that combining?

Janet M. Bruner, MD:

I don’t think so, really. I almost feel like we’re the same as we were before.

Tacey Ann Rosolowski, PhD:

Interesting.

Janet M. Bruner, MD:

We’re just as separate. We’re just as close. I’m not sure that there have been advantages for us. I’m not sure what advantages—the hospital talks about things like economies of scale, blah-blah-blah. I don’t know how they’ve found any of those because it’s a completely different practice.

Tacey Ann Rosolowski, PhD:

Yeah. Interesting.

Janet M. Bruner, MD:

I feel like we’re the same as we were in 1994, but we just have a different name. Now what they did save was they saved a division head position, obviously, because they only have one division head now instead of two.

Tacey Ann Rosolowski, PhD:

Right.

Janet M. Bruner, MD:

So they saved a division head position and the support surrounding that, which is a few support people—not a huge number.

Tacey Ann Rosolowski, PhD:

So you were telling this story in conjunction with the story about you becoming chair.

Janet M. Bruner, MD:

Right. Right.

Tacey Ann Rosolowski, PhD:

I just wasn’t—I need to get that dot connected. I’m not sure how that happened.

Janet M. Bruner, MD:

What happened was that Dr. Batsakis retired, and I’m not sure if Dr. Glassman retired around the same time. Anyway, that seemed to be the time to make this connection. They just let us float in Pathology. It may be that the other division head didn’t retire at the same time. I can’t remember. We had an interim chair or division head—I can’t remember when it was done—for a while—and for at least a year nothing was done. We just kind of floated out there, and we lost some pathologists. A few had retired. Some people left because they just didn’t—it was not comfortable being in a—sort of a temporary situation. At the same time, they were building the new hospital, so we were having to make decisions like how it was going to be laid out, how the labs were going to be—and we really had nobody—didn’t have a permanent person in charge. That was—I guess it turned out okay, but it probably could’ve been better. Then I guess in 1997 or so, they started recruiting for a division head for Pathology and Lab Medicine. I by that time had taken—had done these leadership courses, really thought about it a lot, and I did compete for that position of division head because I’m boarded in anatomic as well as clinical pathology, so it was okay for me to do that. Even though I hadn’t practiced clinical lab since I was a resident, I at least knew about them—knew what they did—which most of the pathologists here I think were not double boarded. They were mostly anatomic pathologists. I really think I made a pretty strong run at that job. They interviewed a few other people, but there were some fairly high-level people at MD Anderson who I don’t think wanted an internal candidate and that is the point. I also don’t think they wanted a woman. There were no women division heads, and I think they just couldn’t quite envision that. It was several more years before Dr. [Eugenie] Kleinerman became a division head, and she also had a very tough time getting her job.

Tacey Ann Rosolowski, PhD:

Really?

Janet M. Bruner, MD:

So I think it just—it wasn’t—it just wasn’t the time. I think I could’ve done the job, and I think I was a strong candidate. It just didn’t happen. It was during that period of time when I interviewed for other chair jobs outside, and I realized some very unique things about MD Anderson that made me reluctant to jump to another place. We’ve got some really good things here that help the chairmen and keep people working. One is our term tenure rather than lifetime tenure, and another is just the way that the funds are handled and distributed. It’s the all-funds budget we have between the hospital and the practice plan, and we really are very collaborative, very integrated. We’re one hospital and practice so the hospital—in a lot of other places, the hospital hires the technicians, and the doctors function separately. If you have a technician who’s not doing their jobs, you can’t get rid of them, because they work for the hospital, not you. Now here it’s also hard to get rid of them, but at least if you document it, you can. No one’s telling you, “No, you can’t fire them, because they don’t work for you.” So it was—I saw other departments of pathology where very senior pathologists had lost all their grant funding, weren’t doing much clinical work, still had a lab, and had lifetime tenure and were still pulling a big salary in that the chairman had to pay for with very little resources and had no recourse because the person was tenured. I thought, “Man, I don’t want to get into that situation!” Term tenure is very good here, and it keeps people working. Also, like I said before, the people here—the physicians here love what they’re doing, and they work hard. They’re productive for the most part—productive at either research or patient care or both. So there were a lot of advantages at MD Anderson, and I was very disinclined to actually take one of these other jobs out there. When I found out that I wasn’t going to become the division head I had to decide—and my husband and I talked about this. “You have to decide. Are you going to stay there and do what you do, or are you going to stomp out of there and take a job you really don’t want anyway?” So I just decided. “Okay, no problem. I can stay here, and we’ll be okay.” Because I had these other two neuropathologists, we had a good practice, we had good research going on. Dr. Hamilton joined. Of course, he didn’t know me, and I didn’t know him. I couldn’t interview him since I was also a candidate for the position, but I think he realized once he got here that I was a pretty good resource. I don’t know to this day if I was his choice or not, but somebody somewhere told him when he was looking for a permanent—he obviously had to get a permanent chair, because we had an acting chair. So he had to get a permanent Chair of Pathology, permanent Chair of Lab Medicine. I don’t know whether it was his choice or somebody upstairs told him, “You’d better pick her,” but I felt like it was okay, because I had competed for the division head position, so it wasn’t like I was just selected out of nowhere. I felt like I was a good candidate, and I felt like if I thought I could do the division head job, obviously I felt like I could do this job, too.

Tacey Ann Rosolowski, PhD:

Sure.

Janet M. Bruner, MD:

I had a lot of ideas about how we needed to go forward. That was right around the time that we were moving into this hospital, so things were happening very quickly, and I think we had a chance to really be a lot better and a lot bigger at the same time. I found Dr. Hamilton to be a very nice person to work with.

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Chapter 10: Becoming the First Woman Chair of a Clinical Department

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