Chapter 11: The Decision to Retire and Reflections on Working Under Two Physicians in Chief

Chapter 11: The Decision to Retire and Reflections on Working Under Two Physicians in Chief

Loading...

Media is loading
 

Description

In this chapter, Dr. Ecung explains the factors that led her to retire at the end of 2016, setting her decision in the context of her work with two physicians in chief, Thomas A. Burke, MD [oral history interview] and Robert Brigham.

She begins by noting that she was serving as Associate Vice President of Clinical Operations when Dr. Burke came in as physician in chief, and he made the conscious decision to keep her in that role. This gave her to opportunity to observe the process by which he was removed from that position and notes that she felt it was “not done with integrity.” She talks about Dr. Burke’s accomplishments in his role and explains that he had the habit of “speaking truth to power” while also being a “citizen of power.” She explains the process of removing him (2013) and why integrity is so important in executive levels of an institution.



Next, she talks about her expanded role as Vice President of Clinical Operations under Dr. Thomas Buchholz because another key individual had left the institution and Robert Brigham had come in as new Senior Vice President for Hospital and Clinics, working closely with Dr. Buchholz. She describes the new perspective that Mr. Brigham brought from his years at Mayo Clinic and the changes that he and Dr. Buchholz instituted.

Dr. Ecung explains how her role changed and was ultimately diminished in this new administrative context. She talks about her decision to retire and cut off from all contact with MD Anderson for one year, explaining her reasoning. She also talks about how people who remained in the office of the Executive Vice President felt they had lost an advocate when she left.

Identifier

EcungWB_C11

Publication Date

2-27-2017

City

Houston, Texas

Topics Covered

The University of Texas MD Anderson Cancer Center - Institutional Change; Professional Path; Obstacles, Challenges; Institutional Processes; Working Environment; Growth and/or Change; Obstacles, Challenges; Institutional Politics; MD Anderson Culture; Professional Values, Ethics, Purpose; Faith, Values, Beliefs; Evolution of Career; Professional Practice; The Professional at Work; Leadership; On Leadership; Critical Perspectives on MD Anderson; Critical Perspectives; Women and Minorities at Work; Understanding the Institution

Transcript

Tacey Ann Rosolowski, PhD :

And okay, so we were strategizing just a bit before, and you were kind of elaborating on how you had made certain decisions on retiring from MD Anderson. So I was hoping you'd speak a little more about that.

Wenonah Ecung, PhD:

So I guess what I wanted to share was how important it is, or has been for mewe talked about doing one of the interviews at your house, or at MD Anderson. And I declined. One, I wasn't going to be on that side of town to go to your house, but I declined actually going to MD Anderson, because I've made a commitment to myself to stay away from MD Anderson for a year. And during that period of time, it's helped me to reflect uponI know how I was feeling when I left. And I know what I shared as I left. But it'sthe distance has given me some time to reflect on, were those accurate descriptors of why I left? The bottom line I've come to: it was the right thing to do. It was my decision, and I'm still comfortable in the decision. But again, I've gained a little bit more clarity on what was happening for me at the time, after being there for almost 40 years, I was four months shy of 40 years. And I still had the energy for the job, but I no longer had the desire to do the job. So it's been, again, real important to me to be able to reflect on why, after all those years, that I no longer have the desire, that I no longer experience the joy in getting up and making the drive that I had made for 39 years. Why had it dissipated?

Tacey Ann Rosolowski, PhD :

And what were the conclusions that you came to from that reflection?

Wenonah Ecung, PhD:

Well, we'd hadI think it was building up to that point. So as you know, we had turnover with Dr. Burke, Tom Burke, where he was the Physician In Chief. I'd been hired by David Callender, who had left shortly after he hired me as his Associate Vice President. When I say "shortly," I do mean shortly. It was within six months. And I had left a good role, a solid role. And then when Tom Burke took over, the [Associate Vice President] role was actually affirmed. He made a conscious decision to keep me on, for which I was grateful. And we had a great working relationship for the 11 years that I was his Associate Vice President. And when I saw how things were handled with him prior to leaving the Physician In Chief, he transitioned to another role. But when I saw how it was handled, and him actually leaving, or being removed from being Physician In Chief, I think without me knowing at that time, something began to stir inside of me, because it didn't feel like it had been done with integrity.

Tacey Ann Rosolowski, PhD :

I didn't realize he'd been removed from that position, rather than electing to transition from it.

Wenonah Ecung, PhD:

Well, I'm sure we could probably say it was a mutual decision to leave the role. And initially, he transitioned to the network, and then eventually he transitioned back to being a faculty member, administering patient care. [ ] But even as a mutual decision, I guess I was on the end of maybe having too much knowledge of what was going on; and as I mentioned, the integrity and the way it was done. And I guess I began to question whether or not it was truly the right thing to do, just as many others. He had pulled us back from the brinks of financial disaster on a couple of occasions. Was not only a faculty champion, but also was able to speak forthright to them in terms of the direction we needed to go, or why we couldn't go the direction they wanted to go. So as I said, things began to stir in me, in terms of

Tacey Ann Rosolowski, PhD :

I'm sorry, can I interrupt you just for a moment?

Wenonah Ecung, PhD:

Mm-hmm.

Tacey Ann Rosolowski, PhD :

And I understand the sensitivity of these issues. But I'm wondering if you could give me some kind of indication of what you were uncomfortable with. You said you felt it wasn't done with integrity.

Wenonah Ecung, PhD:

Mm-hmm.

Tacey Ann Rosolowski, PhD :

However that feels best to you. Maybeif you don't want to speak to it, that's fine, but I'm wondering even if you could tell me what could have been done, that would have been a more successful process in your eyes.

Wenonah Ecung, PhD:

Well, I think initially, when he transitioned to the network, my version of the reason, we'll say, had to do with, we had a new president coming in, and Burke's voice was one of truth to power. Although I have to say, heI learned from him, even though he spoke truth to power. When he left the room of power, he was always an excellent citizen [ ]. So whatever the marching orders were, he would bring them down to his staff, of which I was included, and we would carry them forth. We didn't know that perhaps there had been disagreement around the boardtable in the board room. But he was going to actually carry out the orders. What became reality for me was that he would speak truth to power, even though he'd march out and support [the president]. And as a leader, what became apparent for me was that the individual in power didn't want to hear the truth. And so many of the soldiers sat around the table, and it became one of self-censure, if you will. But because he didn't participate in that, he was transitioned out. Now, every leader has a right to surround themself with who they want. So, fine. But when I said I was able to reflect backso that was just, if you will, one of the balls or pieces of the puzzle that was put in place. After he left, then Tom Buchholz came on, and I supported him as his AVP [ ]. Later, Tom Burke was going to be completely removed from the administrative structure and returned back to faculty. And again, "completely removed" are my words. We can say it was a mutual agreed-upon decision between the players at hand. But at that point, I knew I had information in terms of who was aware that this was going to take place. And I recall vividly there was a meeting where we set in, and he shared with us what he'd be doing, which was stepping back. He alluded to the turmoil that existed. And I watched other players in the room indicate they had absolutely no knowledge. And I knew they had knowledge. And that's where, I guess, the integrity in what was taking place just began to really unfold, and I started puttingthat was another piece of the puzzle, if you will. So I beganone of the things I had always prided myself on MD Anderson being there was, moving forward through a sea of integrity. That's important to me. So I began to question where do I fit in this new environment, if you will. The environment of patient care hadn't changed, but administratively, a new environment was being created. And I began to question where did I fit. So the first two years of being with Tom Buchholz as his AVP, we had additional turnover, so Gerard Colman, who was our Senior Vice President [ ] for Clinical Operations, all of a sudden left. And that really left Tom Buchholz and I to run Clinical Operations, or to come up with some structure to run Clinical Operations. And Buchholz relied upon me heavily. So for a two-year period, I had people truly coming to me. And I was making decisions, of course I was running them by Buchholz. But I was very much in the center of what was going on. In the interim, he was looking for a replacement for Gerard Colman. And after interviewing multiple candidates, settled upon Bob Brigham, or Robert Brigham. Bob came in as our Senior Vice President for Clinical Operations. And this is part of my reflection after being away for a while. While I was there and Bob was on board, what I began to see was his language, Bob's language, was reshaping MD Anderson, and somewhat in the spirit of Mayo Clinic, which was where he had come from. And I began to hear kind of, if you will, "out on the streets," which really means the hallways, of MD Anderson the same concern. We are not Mayo. We don't do things like Mayo. But he proceeded forward. I began to see Bob and Buchholz put in an administrative structure of individuals, some individuals who were very adept at Clinical Operations and others who knew absolutely nothing about Operations. And again, my role as Associate VP with Tom Burke had been, when things were happening out on the street, I let him know what was going on so that he could course correct, continue the course but know what was coming forththat was part of my role as the AVP. What I found with Bob and Tom was, the role became diminished in Bob's mind. And you have towhat I should share is, right now what I'm sharing with you isn't anything that I didn't share with Tom Buchholz. And I did also share it with Bob Brigham. So I'm fine with this being in the record. But what became very clear to me was, the structure Bob had at Mayo was very different. There was no individual like myself in between he and his boss, or even at the side of his boss. Not in between, but at the side. And as I shared with Bob, in my leaving, I made the decision because it had become very clear to me. He didn't want any daylight between he and Tom Buchholz. And I represented daylight, is what I had figured out. Of course, he denied that. But that is what had become clear for me. So in being able to reflect for these probably nine months now, almost a year, what I've come to realize is the role, even though I had been in it with David Callender, with Tom Burke, with Tom Buchholz, I was used to being agile enough to change roles and shift what the role needed to be. But what became clear for me was Bob's idea of the role did not match at all any of what I had done over the past 11 years. Actually what he envisioned was a lesser role. And why I say that is because, one, I've always had an assistant for the past 20 years, and if they were in meetings, my assistant took the minutes. Well, his idea of this AVP role was the AVP would take the minutes. As I shared with him, that is not a skill of mine. It is not something I went to school to do, and it is not something that I enjoy doing. I have folks in place that are highly confidential that know the art of taking minutes, and are very adept at it, and could they? And his answer was, "No." So for me it became very clear, he was shifting the role, moving it towards places that I believe he knew would become dissatisfiers for me. And there was a point where I decided, as I shared with him, representing daylight, it was time for me to move on. Now, I was fortunate enough to be in a position to be able to retire 10 years prior to that. But because I loved what I was doing, and as our saying, "I am MD Anderson," I truly felt that way. I had stayed. But I no longer had a reason to stay. And I felt very much that if you want to reshape the role, the best way to do it is for that individual to get out of the way so that you guys can move forward with whatever direction you want to go. And so for me, there became role conflict, there became ambiguity in the role. When I would share these things with Tom, he would indicate he hadn't noticed, or he didn't see it. So for me, making a decision that it's time to go was the right thing to do. Although when I made the decision, I walked in on November 4th, and it's very clear to me, with my resignation letter in hand, indicating I was going to retire that August 31st, so that was at least an eight to nine months' notice. And he declined it, and felt that it was an emotional decision. He really wanted me to go and think about it, and we could talk about it in December. And I recall giving him back the letter saying, "It may be grounded in emotion, but I've had some time to really think about it, and it is truly what I want. So I'll think about it, but I'm going to ask you to hold on to the letter." And in December, when he didn't mention anything, I mentioned it, and we got back together. And he said, "Why don't you just keep thinking about it a while?" So I said, "Fine, but you do still have the letter." And as time passed and it got to be March, and he hadn't talked to me any more about it, I mentioned it to him because I knew clearly, I intended to leave. And it was at that point in time that I think he realized, this is a steadfast decision. There's no changing course. And things went into action.

Tacey Ann Rosolowski, PhD :

Did you findI mean, as I'm listening to the story, I'm thinking, what a peculiar position to be in. I mean, on the one hand, here are these individuals who are sending you messages that they don't want you doing what you're best at doing. And yet you're being told that they don't want you to resign. I mean, did that seem kind of paradoxical to you? Or

Wenonah Ecung, PhD:

No, because it was only one individual sending me that message. Tom Buchholz was actually sending me a different message. When I would mention to him things like, "Bob shared with me that I'd be reporting to him, I'm a little surprised that you hadn't had that conversation with me first," and he said, "Where are you getting that from?" I said, "As I said, from Bob himself." And he said, "No, there's been no discussion of that." I said, "Well, as I shared with Bob when he told me I'd be reporting to him," I said, "Tom, I need to let you know that I shared with him, that would be a problem." So when I asked Bob had he talked to Tom about it, Bob told me emphatically, "Yes." And I shared that with Buchholz. [ ] He said, "No, we have not talked about this." He said, "I don't see any reason for your reporting structure to change." So that was clarified. But again

Tacey Ann Rosolowski, PhD :

It's a weird triangulated situation.

Wenonah Ecung, PhD:

Exactly. Exactly. I would sit in meetings with Buchholz and Ethan Dmitrovsky, as Maureen [Cagley] and I did all the time. And depending upon the topic, either Maureen or myself would have marching orders on how to move forward with it. When I would move forward on the clinical side, what I had been doing for the past 11 years, I would get an email from Bob saying, "You need to come to me, don't go to my direct reports." And anytime I had gone to direct reports it had always been in the name of Ethan and Tom. I had always made a point not to use the power of their position to assert myself. And so that was kind of like the final straw. And I had a discussion with Bob about it, too. But that was kind of like the final straw. That's where role conflict comes into play. I've got my boss telling me to do one thing, his partner saying, no, don't do it. So navigating that conflict and the ambiguity that was developing in the role, I'm pretty sure now is what moved me in the direction of saying, this isn't what I want to do anymore.

Tacey Ann Rosolowski, PhD :

Yeah. Yeah, I can well understand. Yeah. Now, you mentioned not having any contact with MD Anderson for a year. Now, how do you feel that helpsthat process helps you, and how do you feel it helps the people that you left behind?

Wenonah Ecung, PhD:

Well, I knew I was comfortable in my decision to leave. I knew we were financially comfortable in me leaving. But I hadn't admitted to myself that there was an underlying current of some anger there in leaving. And so for me, being gone for a year, I needed that time, as I mentioned, to self-reflect on what happened, what was really going on. So that was the "me" part of it. Being the VP, and I think being a reasonably decent VP, I had peopleI know I had people that sought me out. I was counselor. I was chief of staff, that trusted me, that could come to me and share things, and knew I'd be able to help whoever was the Physician In Chief understand what was going on, even though the outcome may not be what they wanted. But I was able to act as an advocate on their behalf. So I knew I was leaving people behind that truly valued me. And as people learned about me leaving, they literally came to my office and said, "What am I going to do? What happens when I have this concern? What will I do?" So I felt it would only be fair to them if, again, I needed to step completely back so that they could learn to form relationships with whoever else was to be in that role. My assistant, Martha Hinojosa, had worked for me for 20 years. And I felt some guilt in actually leaving her. I think she was more emotionally mature in that regard, in saying to me, "You've earned this." Not understanding what was behind it, but in saying, "You've earned this," she would be okay. So it was people like her and those in the office, and throughout the institution that I felt somewhat guilty about, leaving them behind.

Tacey Ann Rosolowski, PhD :

That seems like I can imagine a number of leaders would experienceI mean, depending on the situation, that that seems like it comes with part of the territory of being a leader in an institution that you really believe in, in working with people who you really care for and respect.

Wenonah Ecung, PhD:

I hope so. I hope so. I think those are the operative words; that you care for and that you also respect.

Tacey Ann Rosolowski, PhD :

Well, and clearly it was returned as well. It's sort of a nice compliment to have. Yeah. What do you visualize happening after that year is up? I mean, would you re-establish? How do you see that taking shape?

Wenonah Ecung, PhD:

Well, I've had a couple of people that have reached out anyway, and they want to have lunch. So when that year is up, I will set up some lunches that we can get together and share stories.

Tacey Ann Rosolowski, PhD :

Yeah. Yeah. And kind of see what happens from there.

Wenonah Ecung, PhD:

Yeah.

Tacey Ann Rosolowski, PhD :

Well, thank you for talking about that. You're the first person who's kind of talked about that kind of stepping away process, and what that period of time's all about. I think that's a really interesting and important perspective to have. It speaks to a dimension of leadership that's kind of in a blind spot so far in the project.

Wenonah Ecung, PhD:

Glad I could share it.

Tacey Ann Rosolowski, PhD :

Yeah. Yeah, me too. Would you like to step back in time now?

Wenonah Ecung, PhD:

Sure. We can.

Conditions Governing Access

Open

Chapter 11: The Decision to Retire and Reflections on Working Under Two Physicians in Chief

Share

COinS